Fetal Monitoring Limits Raise Risks for Women in Periphery

In a move that raises the risk for pregnant women in the periphery, the Health Ministry restricts fetal monitoring to gynecologists only.

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Hana Levi Julian, MSW, LCSW-R,

Deputy Health Minister Yaakov Litzman
Deputy Health Minister Yaakov Litzman
Flash 90

Health Ministry Mandates Specialists for All Fetal Monitoring

In a move that may raise the risk factor especially for pregnant women living in the periphery, the Health Ministry has reportedly restricted the use of fetal monitors to gynecologists only.

Until several months ago, fetal monitors were standard equipment in most local kupat holim (HMO) clinic nursing stations, where a pregnant woman could easily be checked if there was a question about whether she had gone into labor. 

But not anymore. The equipment still exists, but it is no longer permissible to use it -- unless a specialist, a gynecologist, is present at the clinic at the time. The new regulation was confirmed by Leumit HMO spokesman Moshe Mosko.

"These were the orders we received from the Health Ministry, and Kupat Holim Leumit has no say in the matter,” said Mosko in an emailed response to a query by Arutz Sheva. The ministry is run by Deputy Health Ministry Yaakov Litzman (UTJ), whose party is a member of the Netanyahu coalition but who was unwilling to become a full-fledged minister in the Israeli government. The position of Minister of Health is technically held by Prime Minister Binyamin Netanyahu in order to fulfill legal requirements. It is not clear why the restriction was implemented.

However, the new limitation has serious repercussions for pregnant women living in the periphery. In some development towns and settlements, gynecologists visit clinics only once a week. Travel time from remote areas to a city hospital can take up to an hour or more, unless an ambulance is involved.

Patients are generally not eligible for ambulance services unless it is a question of urgent care. General assessment to determine whether a woman is in active labor does not fall into that category. “But because that same woman must be monitored due to other medical background, she ends up having to find her own transporation to get to the nearest gynecologist with a fetal monitor – usually in the closest city, an hour away,” noted one exasperated nurse, who asked not to be identified. 

She was not alone in her ire. “A pregnant women who may not feel fetal movement, or who may have doubts about contractions late in pregnancy no longer has the option of having her status accurately monitored by up-to-date equipment as a result of the new regulations,” pointed out an irate colleague, who also requested anonymity.

"I've spent weeks trying to battle this issue,” the doctor said, “but with little effect."

A pregnant woman present at the time who had just been told she could not be monitored due to the new rules was forced to travel to Soroka Medical Center in Be'er Sheva, nearly an hour away. Breathless and in pain, she told Arutz Sheva by phone, "This is dangerous, and makes no sense at all. That road has had its share of accidents, and this is not the time I want to drive myself, or take a bus."  As her husband dialed a taxi company to arrange for the ride to the hospital by a private cab -- a costly trip --her mother added that she was seriously reconsidering their options as a result. 

"What's the point of living in the periphery if an ambulance has more medical rights than a clinic with doctors and nurses?" her mother added.