I am a midwife, childbirth educator, lecturer, doula, and natural mother of eight children. This is not a medical reference; I do not proclaim to give medical advice. Anything stated here is from personal experience, research, study, and opinion. Each woman has the responsibility to do her own research, consult with her own medical team, and make her own decisions about pregnancy and birth.

Wednesday, October 13, 2010

To Have or Not to Have an Ultrasound...(and a link to an amazing twin home birth)

Bismillah al-Rahman al-Rahim

Having an ultrasound has become common place during pregnancy.  In the States I found it routine to be given a vaginal ultrasound at the first obstetric visit and an abdominal ultrasound around 20 weeks, when the gender can be determined.  In Egypt I found it routine to be given an ultrasound at EVERY obstetric visit.  I didn't have much prenatal care in Saudi, but from what I can gather, it's more like Egypt.

I've read a lot of literature that suggests that ultrasound has some mutating effect on cells.  Most conservatives feel that more research has to be done to determine if routine ultrasound exposure is having unknown adverse effects on our babies.  In fact, a visit to the U.S. Food and Drug Administration website reveals that, "...the long-term effects of tissue...by high-intensity sound waves [ultrasound]...are not known."

I hope that you enjoy this article.  Let me know if you have a story you'd like to share.  Now on to the story...To Have or Not to Have an Ultrasound...(and a link to an amazing twin home birth)...

The U.S. FDA has even issued a warning against the use of ultrasound in pregnancy for non-medical purposes, such as "keepsake" videos and home heartbeat monitors.  You can view the full warning at their website:  Avoid Fetal "Keepsake Images, Heartbeat Monitors

Although I never had a "keepsake ultrasound" nor opted for the high-tech 3-D or 4-D ultrasounds, I still felt that my ultrasounds were a matter of routine and not actually medically indicated.  Even knowing this, I found it difficult to resist the chance to see my babies during my pregnancies.  In fact, I only managed to hold out during my second pregnancy.  Of course I was ridiculed by my doctor.  When I told him that I didn't want an ultrasound he said, "What if the baby doesn't have a brain?"

To this I replied, "Is there anything you can do about it?"  Of course the answer was no.  To which I stated, "Then I don't need to know."

But the thought of my baby not having a brain stayed with me right up to the birth.  In fact. I confused the on-call doctor who delivered her by asking, "Does she have a brain?" right after she was born.  You should have seen the look on his face!  I'm sure that was the strangest comment or question he's ever heard at a delivery. 

"Of course she has a brain," he stated in a rather condescending tone.

Not having had an ultrasound meant that the baby's gender was unknown until birth.  Waiting to know the gender was a real joy and excitement.  I honestly preferred not knowing and saving the "surprise" for the moment of birth.  But when the time came to get a glimpse of my babies in later pregnancies, I just found it so hard to say no!  Even harder to say no when the doctors asked if I wanted to know the genders.
When I teach expectant couples in my childbirth classes I always tell them that although there doesn't appear to be any short-term risks, the long-term potential risks are still unknown.  However, I have to be honest and also tell them that I go ahead and get the ultrasound, all the while feeling a little guilty that maybe I shouldn't.

I came across a beautiful story in Mothering Magazine Online about a twin home birth.  In the story, Blessings of Homebirth, the mother didn't have an ultrasound and was unaware that she was carrying twins.  I was really amazed when she stated, "In not noticing the signs that I was carrying twins, I was able to view my pregnancy as completely normal. And I was free of the interventions that are standard in multiple pregnancies and births today, such as bed rest, fetal testing, continuous monitoring, and obligatory c-sections."  The point really hit home that maybe sometimes it really is better not to know!  

I think of my own grandmother who had twins in her sixth pregnancy.  Back in her day there were no ultrasounds.  I always worry I may carry multiples since twins are more prevalent the more pregnancies you have and the older you get.  But maybe, if I am blessed with a ninth pregnancy, I'll be strong and pass on the ultrasounds.  I know I'll enjoy the surprise of finding out the gender at the birth, and who knows, maybe even the number of babies!

NOTE:  It's important to know that there are three types of ultrasound monitoring that are routinely administered during pregnancy.  The first is the Doppler which is a small hand-held device typically used at each doctor visit to listen to the baby's heartbeat.  The second is the ultrasound picture which is what I refer to in this article.  The third is the External Fetal Monitoring that is routinely used during labor and birth to generate a tape read-out of the baby's heartbeat and the intensity of the uterine contractions.

During my training as a childbirth teacher we were given a lot of references to research that concludes that the safety of ultrasound use during pregnancy is really unknown and more studies need to be conducted before they are ruled "completely safe."

However, it was noted that the level of invasiveness is obviously increased by the length of time the ultrasound waves are conducted.  The hand-held Doppler is used for a very minimal time and even the routine doctor's visit photo uses intermittent ultrasound waves and is only used for a short time during a doctor visit.  But it's important to know that the External Fetal Monitors used during labor and birth are far more invasive when you consider that the a hospital labor can last several hours with continuous fetal monitoring by ultrasound.

We must also consider that the monitor is only as good as the person monitoring it.  If it's left running unchecked for several hours then any potential problem is still left unnoticed.  On top of that there have been reports of faulty machines which render the readings inaccurate anyway.
I also want to mention that personally, I can't tolerate having the monitor strapped around my abdomen while it's contracting, it HURTS!  Also that my husband is totally against ultrasound but has always left it up to me.  If I do decide to avoid all ultrasounds, should I be blessed with another pregnancy, then I'm sure that I'll have his support and encouragement in doing so.

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