Why no doppler?

[Nicole730]

Another thread got me thinking, how come some of you choose not to use a doppler to hear the heartbeat? Is it because we don't know what it might do to the child? Or you just don't see a reason to? Or something else? I believe my homebirth midwife has one she uses, so I will most likely have a listen at my appointments, unless anyone gives me a good reason not to

What other testing do you decide not to have and why? Including anything for you or baby after baby is born.

For my first I was only going to have one ultrasound because I was curious to see what my baby looked like and find out the sex, but I didn't want to have too many because I don't know what they might do to the baby. I ended up having 2 in the same day at 39 weeks because the doctor's were freaking me out telling me there was something wrong (there wasn't).

[OlyR]

from what I understand a doppler is based on ultrasound technology (the sound you are hearing is the mimic of the movement it's picking up).

I read about it quite a bit and realized I kind of fall in the middle. I feel it's probably better to not use it, but I really needed the piece of mind and wanted my husband to start feeling a little more attached so I did ask the midwife to use it at my last appointment. That said, I can't imagine renting one for daily home use, but that is just me. My good friend has had multiple losses and is now due a few weeks before me (yippee! out of her first tri for the first time ever). I know she either rented or bought one and uses it pretty frequently (says she will stop when she can feel regular movement). I'm not in her position and would never judge her since the piece of mind she is getting from it is probably putting her in a healthier state of mind. (got a little of topic, sorry!).

[Rikki Jean]

Yep, it's ultrasound waves, and they are actually stronger than the waves in a sonogram, from what I understand. After a certain point in the pg, you can hear the HB with a fetoscope (a stethoscope that's made for hearing fetal heartbeats), so a doppler really isn't necessary...just easier.

We do minimal testing because so much of it is not necessary for every.single.woman. I am 110% sure that I have no STDs (my husband and I were virgins on our wedding night, and there is no question about our faithfulness to each other), so STD testing is unneccessary for me (and if I were having a hospital birth, that would make the eye goop for the baby unneccessary as well).

I don't fall into any of the risk categories for GD, and I think that the way they do the test is rather ridiculous, so we opt out of that one.

AFP has a incredibly high false-positive rate, and a true positive would not change our feelings about the pregnancy, so we don't even bother worrying ourselves over that one.

We are skipping a u/s, but if our mw had any concerns that warranted one, we would defintiely do one. As long as everything stays normal and healthy, we don't feel that it's really necessary. I will miss seeing that sweet baby, but we've decided that the trade-off makes it worth it, since we really don't know the long-term effects of u/s waves.

We will probably do the GBS (we have before), even though I don't fall into any of the risk categories. It's pretty non-invasive (my mw let's me swab myself in the bathroom), so I'm okay with it. My mw is neutral on it for me, but she does feel that if I don't have it, and we have to transfer in an emergency, the hospital will give the baby abx anyway, since we won't know if I have it or not.

Did I miss any tests? I can't remember...

Oh, after the baby is born, we won't do eye goop. We don't plan to do vit k, but in the case that the birth becomes traumatic and we feel that it's needed, we'll do the oral doses (mw carries it). We'll do the PKU test (I know it has a different name now, but I don't remember what it is), even though I hate watching my baby cry during it. We didn't do the hearing test with either of the boys, but I'm leaning toward doing it this time, as DS2 may have some hearing loss.

[aramat]

I, too, read that the doppler is actually stronger than ultrasound. Didn't know that last time around...and my midwife checked at every appointment! I felt weird about it at the time but trusted my midwife and didn't know about the strength of it until recently.

I'm cool with one ultrasound -- which we're not yet sure we'll do or not -- so now I only want to use doppler if I have to. (Which I did, last week, after a bit of bleeding and cramping!)

[Rikki Jean]

Originally Posted by aramat

I, too, read that the doppler is actually stronger than ultrasound. Didn't know that last time around...and my midwife checked at every appointment! I felt weird about it at the time but trusted my midwife and didn't know about the strength of it until recently.

I'm cool with one ultrasound -- which we're not yet sure we'll do or not -- so now I only want to use doppler if I have to. (Which I did, last week, after a bit of bleeding and cramping!)

I think that it's just one of those things that you have to take step by step. You can say, "NO doppler, EVER!" but then what happens when you have a situation like yours? The real problem is that it's used liberally in the medical community, but I personally don't feel that it means I have to rule it out completely. We used it briefly at my 10w appointment, because DS1 really wanted to hear "the heart go beep", and I needed some reassurance, since I had a m/c in May. Sometimes, the trade-off is worth it.

This is actually the first mw that I've had that doesn't use a doppler regularly, so my guess is that it's normal for a lot of them to use it at every appointment. I'd also venture to guess that one of the reasons that the doppler is favored is that it picks up the hb considerably earlier in pg than a fetoschope does.

[lulu_n2]

Originally Posted by Rikki Jean

We'll do the PKU test (I know it has a different name now, but I don't remember what it is), even though I hate watching my baby cry during it.

PKU, that's where they stick the baby's heal, right? My midwife had me nurse DS during this, and DS hardly knew it happened! Titty is a wonderful cure-all

[Rikki Jean]

Originally Posted by lulu_n2

PKU, that's where they stick the baby's heal, right? My midwife had me nurse DS during this, and DS hardly knew it happened! Titty is a wonderful cure-all

Yep, that's the test. I tried to nurse both of my boys through it, but it still didn't go too well.

[aramat]

OMG, the PKU! I can handle a lot of medical things, but baby blood is NOT one of them! Still, did it for both girls and probably will with this next little one. Nursing through it (it's very quick!) did work for us, but it may depend on who's handling the needle!

[Ninetales]

Basically because dopplers are essentially the same as ultrasound, only stronger. And I don't trust ultrasound technology.

I am not doing any kind of tests unless I personally feel like they are medically warranted. I wouldn't turn something down if I thought I needed it. The problem is that they do all these tests for everyone and it's inefficient and unnecessary. Not to mention the high rates of false as well as missed positives. I just don't see how it will do anything for me.

The only things I may possibly consent to later are GBS to avoid abx if I transfer (and even then I might just refuse and walk out AMA), and GD if I am presenting symptoms.

The only test for the baby I will consent to is PKU.

[Nicole730]

Thanks for your responses! I will definitely take that into consideration when going to my appointments and ask my midwife what she knows about it too. I have my first appointment in a little over a week! I will want to hear the heartbeat for the first appointment for sure...just some reassurance I guess.

As for US, I wasn't going to have any this time around - but if my insurance doesn't end up covering my HB, I might just have one to use up some of the maternity insurance money that will be just sitting there.

I will probably get tested for GBS, but not have an IV or anything if I am positive. I wasn't last time...but my water broke 26 hours before DS was born. I read it really only becomes an issue if it takes more than 18 hours from water breaking to delivery. So, I might want antibiotics on hand just in case labor is long again.

Thanks again for you input.

[J-Bean]

I completely understand why people use dopplers, but on my second pregnancy also did some research (especially after the OB tried to force me to do an early ultrasound to determine that I was pregnant---do a bloodtest or urine test idiot, I kept asking, not in those words, mind you). Dopplers do use ultrasound technology that is understudied and inconclusive. With that in mind, and remembering full well what the monthly "horse trots" (that's what the little heartbeat sounded like to us) sounded like with #1, we decided to pass on #2. Also, my midwife was very hand's off and non-medical and she said she'd have to find an asst. to do it if I wanted it. She determined through her research that it was inconclusive, and therefore not worth possible harm to anyone's baby. I could only respect that decision.
But, I remember full well the first time i heard that little heartbeat. Just me the first time. I was my first 'connection' besides vomiting and ms nausea, wild and emotional hormones and all. And the second visit I was eager to have my husband hear the 'realness' of hearing our actual baby's heartbeat.
That said, throughout the pregnancy, every month, i don't think I needed to continue hearing the doppler. I was fine to just have my midwife use her fetoscope and sometimes just listen and tell her story of placement of the babe, or let me and my daughters listen for the 'heartbeat underwater in a room down the hall with the door semi-closed' (that was her great description of listening for it).
There are so many choices to be made, that I think I really just recommend moms, especially new moms, to take them as they come. Post questions here or follow your instinct. Just remember if your in a medical setting, you instinct likely will follow that environment regardless of your basic ideology. With pregnancy #1 I was adamant about having a midwife but going ahead and using our insurance for a hospital birth. I ended up making a lot of decisions, with the full support and encouragement of my nurse midwife, that I didn't choose again (rhogam shot, gbs testing, iron testing, early bloodwork, 20 wk ultrasound). There was no dialogue about whether or not those things were normal, because they are and were in that setting. If I'd understood the differences between LM (licensed midwife) and CMs (certified nurse midwives) at that time, I wouldn't have chosen that route. But alas, so life goes.
Much luck to everyone.

[KoalaMommy]

a lot of people are worried about Ultrasound technology since there haven't really been any studies done. I think it's a personal choice. There may be some risks, it's hard to tell since nearly everyone has it done these days.

I personally don't worry about it for a few reasons. You can drive yourself nuts worrying about everything. And I doubt my practitioners would have allowed me to go through pregnancy without any checks. And since a more natural course is not an option for me, or other women with pre-existing medical conditions that complicate birth, I'm just doing the best I can. Plus since I had a miscarriage last time, I'm going to need doppler to convince me there's a living baby in there.

I broke my leg in my 1st pregnancy, and DD2 had half a dozen ultra sounds if you include the 2 they did in the 2 ERs I was in. My aunt gave me a lecture about it (she was a professor of nursing) but the only thing she could point to was a possible increase in left-handedness. Since my husband is left-handed, we neither see that as bad, nor as a freak thing, since they have a genetic left-handed parent. Also my kids are not left-handed.

It's literally a few seconds each visit, that's not so much if you decide to do it. If you decide not to, I think you're pretty much choosing a home birth midwife or unassisted. Which is fine, if that's what you want to do. I don't think most medical providers will leave them out totally.

[Ninetales]

Perfectly valid feelings, but I have to point out that there is no "allowing" on the part of a care provider. They are not in a place where they "allow" you do to or not do anything. They work for you and you tell them what you will and will not be doing.

[KoalaMommy]

Originally Posted by Ninetales

Perfectly valid feelings, but I have to point out that there is no "allowing" on the part of a care provider. They are not in a place where they "allow" you do to or not do anything. They work for you and you tell them what you will and will not be doing.

I beg to differ. When you're in the position of being kicked out of a practice because you don't go along with them, they call some of the shots. For those of you who have completely uncomplicated pregnancies, your statement is true. Some of us have to pick our battles in order to be with the most normal birth friendly practice that will take us.

[J-Bean]

I think what KoalaMommy said is so true. I am a non-medical mom in so many respects, but it's because I can be. And I know that this is not the case for every woman. It's so important that every woman and every parent discover their own paths to what's right for them. And, that path changes depending on the circumstances. I'm enjoying seeing these conversations, since some people can make the choices easily, others must decide with a lot of more factors, and some simply don't have that luxary. But, seeing it spoken about, which is so unlike the mainstream boards I've seen, is really a treasure. Thanks everyone.

[Ninetales]

Originally Posted by KoalaMommy

I beg to differ. When you're in the position of being kicked out of a practice because you don't go along with them, they call some of the shots. For those of you who have completely uncomplicated pregnancies, your statement is true. Some of us have to pick our battles in order to be with the most normal birth friendly practice that will take us.

That does make a difference. I just wanted to state that because I have heard many many women with uncomplicated pregnancies make statements about "having to" do what their doctor says or that the doctor "won't allow" them to make their own choices. Some people really don't realize that they are in charge, in most cases.

[SheBear]

We chose to be very conservative with doppler and ultrasound use because it is still very much an unknown, and as long as things are progressing normally, it is not necessary to the continued good health of the baby. If something is wrong, usually doppler by itself is not going to give you enough information, so really (as far as I know) it's just for fun 98% of the time. I'm sure there are situations where frequent monitoring can be justified, I just can't think of any.

We did use Doppler once already with this pregnancy....I had some spotting and some date discrepency, and a quick check for a heartbeat gave us reassurance on both counts. Now, unless something were to happen to convince me it was beneficial, I don't intend to use doppler again until labor....I do allow the mw to use it in labor pretty much as she desires...I feel like in that context the benefits outweigh the potential risks.

I'm totally in favor of using a fetoscope--don't see any problems with that, and if you've never heard the baby's hb via fetoscope, you are missing out! It sounds like a REAL heartbeat, not the weird horsetrot sound the doppler makes! It's really cool. Most of the time, a fetoscope can easily find the heartbeat from 20 weeks or so. They make long tubes so that mom, dad, and siblings can also listen. Some docs don't really know how to use a fetoscope (because it's considered old-fashioned and outdated) but any midwife worth her salt ought to be able to use one!

Another issue with doppler and ultrasound is the potential, unknown risks....I've recently read plausible articles posing questions about a possible link between increased (excessive) ultrasound/doppler use and autism. Of course more research should be done, but it makes sense to me that it is not a technology that should be taken lightly, to be used at the drop of a hat, for entertainment purposes or for anything less than a specific, well-defined reason, in which the benefit outweighs any potential risk.

Just my :, YMMV, etc...

[SheBear]

Originally Posted by Nicole730

I will probably get tested for GBS, but not have an IV or anything if I am positive. I wasn't last time...but my water broke 26 hours before DS was born. I read it really only becomes an issue if it takes more than 18 hours from water breaking to delivery. So, I might want antibiotics on hand just in case labor is long again.

Thanks again for you input.

PS, Nicole, you might be interested in checking into the Hibiclens (chlorhexadine) protocol for GBS....it has been shown to be as effective as antibiotic treatment, without the side effects for you or the baby. All of my midwives have been comfortable with (and encouraging of) it's use as a reasonable, effective precaution for GBS+ moms...in fact, I no longer even do the test, just assume a positive and do the hibiclens protocol--it's very cheap and very easy/non-invasive.

Anyway, just thought I'd share that in case you hadn't heard of it; something you could bring up with your midwife. HTH!

[leila1213]

Does anyone know whether most MWs are comfortable using a fetoscope instead, if it's requested? One I interviewed mentioned doppler, but also included fetoscope in her literature.

SheBear, have you found the Hibiclens to be very irritating to your skin/vaginal wall, or do you just have to use the right concentration to be okay? Maybe it affects everyone differently, but someone I met said it was horrible for her and she'd never do it right before labor/birth.

[SheBear]

That's not been my experience, Leila.....it is a bit drying, and I wouldn't do it for 4 weeks (as some women do, starting daily--or more--right at 36 weeks!), but using it every 2-3 hours starting with the onset of labor has never bothered me.

However, since it's cheap and easy to find, I'd highly recommend you test it out well in advance so you'll know for sure whether you have a sensitivity to it! Labor and post-partum is NOT the time you wanna discover something like that!! :