To ultrasound or not ultrasound? - Page 3

[changingseasons]

Originally Posted by geekgolightly

I would certainly hope that no one assumes to know better than a woman's OBGYN what is best for her pregnancy.

And most of us know a person/are a person wherein an US dx an issue with the fetus wherein interventions could be put into place to improve the chance of a positive outcome, be it as simple as bedrest or delivering at a hospital with a level III NICU.

Are you serious? You think that a doctor trained in surgery (NOT natural pregnancy and childbirth) knows what's best for your body? Not YOU?

And I bet if you looked around a little more, you would find that everyone also knows someone (whether they realize this or not) who had unnecessary interventions because of an u/s.

[IdentityCrisisMama]

I'm most interested in the studies that show that ultrasound does not improve fetal outcomes. The Radius Trial is a good read for that info. There is another trial that I can't find called the Helsinki trial that shows that ultrasound does improve fetal outcomes but it seems only if termination is an option.

From that I get that if termination is an option (no judgement) an ultrasound can reduce your chances of infant morbidity or mortality. If not, your chances are not improved. And, actually the Radius Trial seems to imply that the outcomes are diminished.

I'm sorry! I just realized this was the May DDC. I must have clicked the wrong one. Happy pregnancies, ya'll.

[MamaChef]

Originally Posted by littleteapot

Thanks Mamachef, that was very informative! I stand corrected.

NP.. I think sometimes people latch on to these things that are only partially correct to prove their point so it gets repeated and repeated and mantra-cised. The problem comes with Doppler Ultrasound vs. Doppler auscillation devices. People lump them both together.

I think the other thing to note is that since this was written in 2000, U/S can be up to 8x stronger now in the cases of some of the 3 or 4 d ultrasounds. Alot of mainstreap folks roll their eyes at that because we tell them crap about how dopplers are 30x stronger then U/S.. so why would they think 3 or 4 d were really as bad as some say.

So, moderation is always best for any type of U/S, but it's time we started accurately portraying the risks that we know instead of the scare tactics. Or else we are no better then the docs that do the same on the other side.

Education is key.

Originally Posted by geekgolightly

I would certainly hope that no one assumes to know better than a woman's OBGYN what is best for her pregnancy.

This is a hard one. I do expect the woman, in most cases, to know what is best for her and her baby. Especially if she is educated and takes all sides of the equation into account. OBGYNs sometimes make bad calls.. so do midwives and cardiologists.. ad infinium.

I think the reality is that alot of women have lost touch with their body, fertility and birth and we are willing to take the knowledge of others without question sometimes instead of giving ourselves the credit we deserve as life bearers, nurturers, healers.. So, my caveat is that while OB/GYNs are informational "experts", they dont know me like I know me. They dont know my baby like I do. We should be partners in deciding what is "best" for any given individual pregnancy.

[littleteapot]

Oddly related link that was passed onto me today: http://www.consumeraffairs.com/news0...al_videos.html
"FDA warns against fetal 'keepsake' images, heartbeat monitors"

[MamaChef]

Originally Posted by littleteapot

Oddly related link that was passed onto me today: http://www.consumeraffairs.com/news0...al_videos.html
"FDA warns against fetal 'keepsake' images, heartbeat monitors"

In the case of doppler, you can try this for yourself. It was one of my midwife's labs.. stick a waterproof doppler probe in a beaker of water. Turn it on .. keep turning it on when it goes off or the batteries run out.. do it for an hour or longer. Check the temp of the water. Stick a piece of meat in there if you want to simulate tissue. There wont be the slightest temp change over a control beaker of water/ meat sitting in the same room. Guaranteed.

I was going to type this earlier but didnt have the research and didnt want to look it up.. LOL. Yes, the 3d/4d and doppler us can heat tissues. But just to help give the flip side of this. No study that Im aware of has showed a rise in temp over 1 degree and this was over a long period of exposure. This same type of temp rise can happen when a mother takes a hot bath. So, grain of salt... and more studies needed. I know, I know, temp change from a bath, and due to a ultrasound wave are possibly different on a cellular level. But the studies arent conclusive and until the are, caution should be used.

[littleteapot]

Once, when I was a little girl, I really wanted to find out how long it took a pill to break down in your stomach. So I took a glass of water and put it on my shelf, then grabbed one of my mother's gel-tab medications (with her permission) and put it in. Days went by and nothing seemed to happen to it. It looked a little shriveled, but it certainly wasn't dissolving. On the third or fourth day I asked my mother what I'd done wrong. She said that water in a glass is not a replacement for the structure of fluids in your body... and you can never run an experiment with one and expect the outcomes to be similar in another, there are far too many variables (like exposure to room air and becoming stale, being contained in skin, circulation, viscosity...).

And, Mamachef, your water analogy reminds me of the lesson I learned that day.

[MamaChef]

Well, I betcha if you had put an acid in there to dissolve the enteric coating you woulda had alot better luck. Our stomach uses acids to dissolve foods.

Water isnt amniotic fluid, but it's 99.999% of it

You are correct that you cant absolutely replicate body conditions without a body.. But even studies with bodies have never shown a temp rise with a doppler.

Originally Posted by littleteapot

Once, when I was a little girl, I really wanted to find out how long it took a pill to break down in your stomach. So I took a glass of water and put it on my shelf, then grabbed one of my mother's gel-tab medications (with her permission) and put it in. Days went by and nothing seemed to happen to it. It looked a little shriveled, but it certainly wasn't dissolving. On the third or fourth day I asked my mother what I'd done wrong. She said that water in a glass is not a replacement for the structure of fluids in your body... and you can never run an experiment with one and expect the outcomes to be similar in another, there are far too many variables (like exposure to room air and becoming stale, being contained in skin, circulation, viscosity...).

And, Mamachef, your water analogy reminds me of the lesson I learned that day.

[geekgolightly]

Originally Posted by littleteapot

Thanks Mamachef, that was very informative! I stand corrected.




That must be why we have a 32% cesarean rate (and rising) along with the absolute worst maternal and newborn outcomes (and care) of any industrialized country. It must be because OBGYNs are always right and know what's best for all women... right?

I would certainly hope that you, as a person over the internet, would never assume you know better about a woman than what an OBGYN knows, is what I mean.

It is very scary that you might assume you know what's best as someone who has never met another her, seen her, examined her and taken her history.

[geekgolightly]

Originally Posted by MamaChef

This is a hard one. I do expect the woman, in most cases, to know what is best for her and her baby. Especially if she is educated and takes all sides of the equation into account. OBGYNs sometimes make bad calls.. so do midwives and cardiologists.. ad infinium.

I think the reality is that alot of women have lost touch with their body, fertility and birth and we are willing to take the knowledge of others without question sometimes instead of giving ourselves the credit we deserve as life bearers, nurturers, healers.. So, my caveat is that while OB/GYNs are informational "experts", they dont know me like I know me. They dont know my baby like I do. We should be partners in deciding what is "best" for any given individual pregnancy.

I was speaking specifically to people who act as if they are experts over the internet and question the efficacy of multiple US when a woman has already explained that she has had multiple complications with previous pregnancies.

[MamaChef]

Originally Posted by geekgolightly

I was speaking specifically to people who act as if they are experts over the internet and question the efficacy of multiple US when a woman has already explained that she has had multiple complications with previous pregnancies.

Oh no,
I totally understand. I was more trying to bridge the gap between the people who were freaking out at the audacity to suggest an OB/GYN knows anything better after their umpteen years of school and hundreds of pregnant ladies and births then someone who has read alot of Ina May and has the power of google.

Ultimately, I wish women on these boards would look at the medical profession as partners and tools to use to help get the best possible outcomes for mother and baby instead of in such a combative way.

[changingseasons]

Originally Posted by MamaChef

Ultimately, I wish women on these boards would look at the medical profession as partners and tools to use to help get the best possible outcomes for mother and baby instead of in such a combative way.

Maybe some of those women have had REALLY bad decisions made for them by their care providers because they trusted their doctors knowledge/education/experience over their own. And many of those women ended up with traumatic births, even damage to themselves and their babies. So please don't just assume that all of the hippy moms here on MDC just read a book and checked google and assumed they know more than the medical profession as a whole.

And for the record, the above post specified trusting "OB/GYNs" as care providers, not the medical profession as a whole (which I would hope includes midwives.) OB/GYNs are trained in surgery, NOT natural, low-risk pregnancy and childbirth. They might be very knowledgeable about how to prevent/fix risks and problems and how to apply interventions, but most women do not need those things, and having them suggested or performed actually makes the process more dangerous (for a low-risk pregnancy.)

[xtara2003x]

Originally Posted by changingseasons

Maybe some of those women have had REALLY bad decisions made for them by their care providers because they trusted their doctors knowledge/education/experience over their own. And many of those women ended up with traumatic births, even damage to themselves and their babies. So please don't just assume that all of the hippy moms here on MDC just read a book and checked google and assumed they know more than the medical profession as a whole.

And for the record, the above post specified trusting "OB/GYNs" as care providers, not the medical profession as a whole (which I would hope includes midwives.) OB/GYNs are trained in surgery, NOT natural, low-risk pregnancy and childbirth. They might be very knowledgeable about how to prevent/fix risks and problems and how to apply interventions, but most women do not need those things, and having them suggested or performed actually makes the process more dangerous (for a low-risk pregnancy.)

I think it's irresponsible in general to blindly trust ANYONE....be it a chiropractor, acupuncturist, OBGYN, Midwife, Medical Doctor, etc.

Just because a professional with years and years of experience gives us often times their opinion (based on THEIR education, professors, school books, training, etc), does not mean that that single opinion is necessarily "correct" or medically valid. You should take their information into consideration when making decisions, especially about pregnancy and childbirth in this situation, however, you can get several different opinions from several different professionals.....and YOU as the MOTHER have to decide which is most correct/ the best fit to you in your situation. Not all professionals agree.

I, for one, decided to go with a CNM with my first birth 4 years ago. I had a birth plan, and while MOST of my decisions were followed respectively, many were also dismissed as though they were not important (i.e., the midwife told me the cord stopped pulsing so she cut it after like 2 minutes - there is NO way it was done pulsing and done giving my baby's blood to my baby!).

[xtara2003x]

Originally Posted by changingseasons

And for the record, the above post specified trusting "OB/GYNs" as care providers, not the medical profession as a whole (which I would hope includes midwives.) OB/GYNs are trained in surgery, NOT natural, low-risk pregnancy and childbirth. They might be very knowledgeable about how to prevent/fix risks and problems and how to apply interventions, but most women do not need those things, and having them suggested or performed actually makes the process more dangerous (for a low-risk pregnancy.)

Double

[Earthylady]

Originally Posted by changingseasons

Maybe some of those women have had REALLY bad decisions made for them by their care providers because they trusted their doctors knowledge/education/experience over their own. And many of those women ended up with traumatic births, even damage to themselves and their babies.

yes, I would be one of those. My first birth/section. And WHY I became an educated, homebirthing momma to my following two children and hopefully will only ever again have an OBGYN or birth in a hospital if there is true medical necessity to do so.

[MamaChef]

Originally Posted by changingseasons

Maybe some of those women have had REALLY bad decisions made for them by their care providers because they trusted their doctors knowledge/education/experience over their own.

And nowhere do I say that women should trust doctors over their own experience. I said that women had stopped giving themselves the credit we deserved in knowing what was best for us. I said that women should take back their power.

In that process, they should be mindful that those Doctors do know a bit more then we probably do about when pregnancy diverges from low risk/ normal. So, no.. we dont just act like little obedient good girls, letting the Docs have full say.. but it makes me want to bash my head into walls when I see women in later DDCs or Im Pregnant talking about how their doc is over reacting about pitting edema, or how there really wasnt "alot" of protein in their urine, or how a blood pressure of 140/90 is perfectly normal and fantastic because they read on Ronnie Falco's archive it was OK. Or scaring the crap out of women by telling them that a simple doppler exposes their baby to 30X more U/S then imaging U/S.. or asking a mom why she is having another ultrasound, or cant have a VBAC or why she is listening to what he Dr is saying about xyz.

So, what do we do with normal/ low risk pregnancies to stop birth trauma, to stop interventions and surgeries?

We stay at home to have our babies or we pick hospital or birth center care providers that are trained in low risk pregnancy.

If that isnt an option because of money or location...
You go into your OB with the best possible attitude of partnership and you help educate them in natural birth. But what you dont go in there looking for a fight, acting like a know it all and expect anything less then the same treatment in return. So, when "enlightened" birth folk needle women about why they are doing xyz, dont they know that it isnt safe/needed/yaddayadda they are doing no service to that mother. Now, when they present studies that a woman can print out and take to their doctor, or well thought out concerns or questions.. that is helpful. When we treat women like they have power, then they will use it. When we berate them on why they arent using their power, they feel even more helpless, alone and marginalized.

Ive watched so many doula clients get the full meal deal doing that in hospitals and it just isnt nessecary to have such a combative and negative idea regarding your care provider if it happens to be an OB.

Barbara Herrara wrote a good post kind of about this
http://navelgazingmidwife.squarespac...al-ticket.html


Anyway,
I dont label myself, but I *am* on MDC, so some would think I'm a hippy. Ive put a decade towards become a homebirth midwife. I believe in low risk birth. I just dont believe this attitude of OBs being bad that pervades alot of the NCB community does any favors to birthing mothers. It sets most women up for a double bind, and that is not a psychologically stable thing. That hurts women.

[changingseasons]

I'm not sure I remember reading anywhere on this thread where anyone was OB bashing.

Originally Posted by xtara2003x

I think it's irresponsible in general to blindly trust ANYONE....be it a chiropractor, acupuncturist, OBGYN, Midwife, Medical Doctor, etc.

Just because a professional with years and years of experience gives us often times their opinion (based on THEIR education, professors, school books, training, etc), does not mean that that single opinion is necessarily "correct" or medically valid. You should take their information into consideration when making decisions, especially about pregnancy and childbirth in this situation, however, you can get several different opinions from several different professionals.....and YOU as the MOTHER have to decide which is most correct/ the best fit to you in your situation. Not all professionals agree.

I, for one, decided to go with a CNM with my first birth 4 years ago. I had a birth plan, and while MOST of my decisions were followed respectively, many were also dismissed as though they were not important (i.e., the midwife told me the cord stopped pulsing so she cut it after like 2 minutes - there is NO way it was done pulsing and done giving my baby's blood to my baby!).

This was really my point, and I also had a bad MIDWIFE experience with my first birth. So again, I am not blindly judging OB's here. The problem is handing over complete decision making to your doctor.

Originally Posted by MamaChef

Ultimately, I wish women on these boards would look at the medical profession as partners and tools to use to help get the best possible outcomes for mother and baby instead of in such a combative way.

But to come back to this part... that really would be ideal. But I would say that a good percentage of the medical profession doesn't view their patients as partners either. Which makes it hard as a patient to assert yourself when you don't necessarily agree with something that they suggest.

Also, many care providers are working, and making decisions, under hospital policies and insurance regulations... not necessarily what even THEY think is best for you and your birth. I think that's where things need to change. Insurance companies shouldn't be allowed to decide what is necessary/unnecessary for a patient, and hospitals shouldn't have to put in every possible CYA policy they can just to avoid a lawsuit.

anyway.... going way OT here. Back to the OP- just because your highly educated medical professional says "it's perfectly safe to have an ultrasound" doesn't make it necessarily true. There are definitely times and situations where ultrasounds are necessary. But that is not the case in every pregnancy, so it falls back to the patient to decide what is right for her own body and peace of mind.

[littleteapot]

Originally Posted by changingseasons

anyway.... going way OT here. Back to the OP- just because your highly educated medical professional says "it's perfectly safe to have an ultrasound" doesn't make it necessarily true. There are definitely times and situations where ultrasounds are necessary. But that is not the case in every pregnancy, so it falls back to the patient to decide what is right for her own body and peace of mind.

Quoted for truth. I'd like to think we all understand this is the point of this thread, and all conversations within regardless of the little bits we're arguing over... a huge portion of the ladies at MDC have a good amount of self awareness not to be "Scared to death" by reading something without doing their own research and self-advocacy. Mothering has always been about that, and that's what they stand for: rather than blindly listening to what you're told - by anyone.
And to be honest, what I'm hearing most from this thread (and others like it) is not as much "listen to me! I have more education!" but more, "Make sure you do your own research".

[seafox]

I think my ob/gyn is awesome, and trained in both surgery and low-risk pregnancy. I am a scientist, so I appreciate her intense education, even if it might not completely apply to my case (if I end up w/ a low-risk pregnancy again) it doesn't mean she is going to try and turn me into a case I'm not. I found her extremely helpful when discussing all the different kind of options that I have if/when things go wrong, but always hoping that nothing goes wrong.

At my hospital they were great, and let me labor for three days (I went in tuesday night, and delivered thursday night) and always gave me options, didn't push anything on me. I opted for pitocin the last day, but it was my choice. I ended up birthing naturally w/ the help of some really great nurses and my ob/gyn (who happened to come on call at that time!) They are very proud of their low cesarean rate (2% I think?) and try to keep it that way. I trust her, and that's why when she tells me two u/s are no big deal, I believe her, and having done my own research, I choose to not have vaginal ones or 3d ones and keep it minimal. And the u/s to see if I had appendicitis did save me from a burst one, no way was I going to refuse that one.

Just to put in a bit of ob/gyn praise in there really, how could she not be awesome if she goes to Nepal every year to help women deliver/etc ? with probably hardly standard medical equipment. She rocks.

[littleteapot]

Originally Posted by seafox

They are very proud of their low cesarean rate (2% I think?) and try to keep it that way.

Not to break into your lovefest (she sounds like an awesome doctor!) but as an ICAN co-leader I'm very curious where the 2% comes from: is this her private practice, or a hospital? Either way, I've never heard of it (and I'm sure we'd hear something) and I'd really want to back that up. If it exists, it's important for other women to know (and the WHO, who recommends a 10% cesarean rate)! Even the homebirth midwives here do not have a 2% rate. Generally it sits around 10%, and when it slips lower people start getting quite upset!

[seafox]

Originally Posted by littleteapot

Not to break into your lovefest (she sounds like an awesome doctor!) but as an ICAN co-leader I'm very curious where the 2% comes from: is this her private practice, or a hospital? Either way, I've never heard of it (and I'm sure we'd hear something) and I'd really want to back that up. If it exists, it's important for other women to know (and the WHO, who recommends a 10% cesarean rate)! Even the homebirth midwives here do not have a 2% rate. Generally it sits around 10%, and when it slips lower people start getting quite upset!

ah you are right, its 24%, (lost a digit!) lower than the national average I guess, but still higher than the WHO recommends. And that's the whole hospital, I'm guessing that includes planned cesareans, so it seems pretty low to me still.

My point is, while birth can be a low-risk low-intervention thing, its best not to completely forget either that childbirth used to be a leading cause of death for women. So while this country (compared to other developed countries) might not have reached the right balance of prevention/intervention, I think its best to try and reach that balance w/ being educated and prepared, rather than vilifying the ob/gyn/hospital/etc community, I guess. As a previous poster said working with them, I suppose, not rejecting everything outright. Finding a professional you trust and can work with is key, however.

Perhaps because I am a scientist I appreciate the statistics and the risks. It reminds me of the recent issue regarding mammograms - they decided the cost didn't justify how many they found in routine ones for women 40-50. Statistically, it might make sense, but the few women who had breast cancer spotted w/ that mammogram definitely spoke out - they would have caught it later, and possibly died or had a harder battle. So the few folks where the routine u/s catches something important are going to think its a fine idea. So it makes sense to learn the risks, learn the pros/cons of these choices. Ill likely get a mammogram at 40 if I can, and get a routine u/s at 20 weeks.