diagnosing miscarriage without ultrasound « Back to Group Discussions

[pastormama]

Hello all - here is my (imaginary at this point) dilemma.

I don't want to have any ultrasound at all in this pregnancy.  My midwives would REALLY like one at 20 weeks, but I still haven't made up my mind.  I'd rather have none.  Last time they caused a lot of fake problems (placenta previa, heart malformed, breech - none of which turned out to be true) that caused my stress to skyrocket and contributed to hypertension.  I want all of that out of my pregnancy this time!

I go for my second appointment next week, which should be just before 12 weeks gestation.  I have heard that a doppler may or may not pick up a heartbeat at this point (meaning - the pregnancy might be healthy, they just can't hear the heartbeat yet).  If there is no heartbeat, what do I do?  Just wait?  I don't want ultrasound to detect a miscarriage.

I have had no bleeding or cramping - nothing to suggest a miscarriage.  A little low back pain, but it has subsided.

We have also decided not to tell family or friends until we hear a heartbeat, to avoid the pain of having to go back and tell about a miscarriage if one were to happen.  So, if we get no heartbeat at the 12-week appointment, then I have to wait until 16 to tell, and I am already FAT with this one.

So, what would you do in my situation? 

[nstewart]

Maybe just wait and see if they hear the heartbeat before worrying?  If they don't detect the HB, ask if you can make an appointment at 13 or 14 weeks?  If you have no reason to think there is a problem, I would be inclined to assume that everything is fine even if they don't hear a HB.  Also, by 12 weeks I think they should be able to feel for cervical growth to additonally reassure you that you are on track.

[BaileyB]

They should be able to detect a hb at 12 weeks. I have never had trouble with them finding a hb at 7 weeks. Good for you for standing up for yourself and your baby!

[nstewart]

Originally Posted by BaileyB 

They should be able to detect a hb at 12 weeks. I have never had trouble with them finding a hb at 7 weeks. Good for you for standing up for yourself and your baby!

My doctor didn't find a HB with my DS at almost 11 weeks and told me it was totally normal, and not to worry.

[Lynann]

One thing to consider is that the Doppler uses sound waves, much like the ultrasound. The biggest difference is that the Doppler is continuous sound waves, and the ultrasound is pulsed sound waves. If you are not comfortable with the ultrasound for health reasons then you probably want to think more about using the Doppler too.

I'm actually planning on refusing the Doppler this time around, since I didn't know about how it worked last time. I'm going to ask my midwife to wait until she can hear the heartbeat with the fetoscope, which I think she started using at about 16 weeks last time (she would do both last time.) I do concede to the 1 ultrasound at about 20 weeks because DS1 was a c-section and she likes to confirm that the placenta is no where near the scar. Otherwise I wouldn't be doing any ultrasounds either (Didn't have any for DS1.)

I did have a missed/incomplete miscarriage before DS1 and didn't need an ultrasound to diagnose it. If it were to happen your body would eventually start to show signs of the loss. If you are not showing any signs, and your fundus is growing then I wouldn't be concerned about confirming the heartbeat. A growing fundus is a very strong sign of a healthy, growing baby.

[pastormama]

Thanks for the replies, ladies!

Lynann - I have been thinking more about the Doppler.  My midwives suggested that for the early heartbeat, a fetoscope was very difficult (for them) and they weren't experienced enough to find it before about 20 weeks.  I do plan to switch from Doppler to fetoscope as soon as possible.  They also want to monitor with Doppler (very occasionally) during labor, as making me lay still long enough for the fetoscope may be troublesome.  

When does the fundus start to really grow?  I'm showing a bit, but they didn't measure me at the first appointment, and so any comparisons would be from this point on.  I'm also not the skinniest, so it may take awhile before baby's growth is really evident.

My issues with ultrasound are less about the waves interrupting the uterine environment (although that does concern me).  It's more that it seems to open doors that don't need to be opened, KWIM?  Looking for every reason for a woman to lose faith in the ability of her body to birth normally, with a tool that sometimes doesn't have that much diagnostic value, especially in late pregnancy.

I will let you all know what happens Thursday, and then go from there!

[timesway]

Can i ask what isbad about ultrasound/doppler? This isnt an accusatory question.. I'm more intreagued.. never heard of someone refusing one and wondered why. Hope the pregnancy is a good healthy one x

[Lynann]

There is some research that may indicate that ultrasound/Doppler may cause changes on a cellular level in the developing baby. Its a technology that has never been properly assessed for actual safety, and sound wave frequencies are not accurately monitored either.

I personally just like to side on being more cautious with technology, especially in pregnancy.

[pastormama]

My issue with ultrasound is both what Lynann has described above, and for what it can do in the course of pregnancy.  It can, of course, be lifesaving technology - just like a c-section can be a life-saving procedure when it is truly needed.  But we have confused what is necessary in only very extreme cases with what is necessary for every normal pregnancy.  Just as 30% of women cannot possibly NEED a c-section (although some do, and I respect that), 100% of women do not need ultrasound to see their healthy babies being healthy. 

Some women have anecdotally reported their babies turning breech or turning away from the ultrasound.  They don't like it.  The womb is meant to be dark, watery, filled with rhythmic body noise, and calm.  Introducing random pulsed sound waves into that environment is not natural. 

For me, it caused a lot of stress (see my original post about all the things they thought were wrong during my first pregnancy).  Stress that was much more harmful than the predictive outcomes that the ultrasounds showed.  So when I weigh the risks vs. the benefits, I see more risks for me.  It's an individual decision, of course.  I'm sure the ultrasound techs and ultrasound producers are sad to lose my $$.

[BaileyB]

I totally agree, pastormom. I am avoiding a lot of over analysis this time around. I have had a stillborn from a cord accident at 38 weeks and and early m/c and one healthy daughter. My doctor wants to do (sorry if I already complained about this here) monthly u/s, NST every 2 weeks in the last tri, strip my membranes at 37 weeks (which will never work and only cause me pain), and induce me at 38 weeks. I already had an unneeded scare at 7 weeks when he thought I had antigens in my blood and it turned out to be nothing. We went from crisis mode to normal in 3 days. I don't need the drama. I just need a poke and prod free, calm pregnancy.

I have had 1 u/s already to confirm no twins when I had high HCG in the beginning and have had a listen with the doppler around 9 weeks before we left for out of town and were going to announce being pregnant to some friends. I am only planning on having 5 more appts between now and 40 weeks and am strategically placing them to avoid certain things or at least get in there as minimally as I can and still have an OB. Like, I am going to go at 35 weeks when it is too early to strip my membranes but then won't come in until 40 weeks.

[pastormama]

All is well!  Had appointment, heard heartbeat, told my boss and the folks.  But thanks for an interesting discussion!  We actually talked through ultrasound today at the appointment, and this midwife said she had been practicing so long (30 years) that ultrasound wasn't standard practice when she started, and she was totally comfortable without it.  So that's cool!

[timesway]

thankyou for your replys, i was just intreagued.. i think i have to have extra monitoring because of low weight and high risk factors.. and for this one at least i will feel more comfortable with that, but its interesting to hear your storys.. atm i still dont entirely believe theres a baby inside of me.. i think i need the image after so many miscarriages to feel like its ok to feel pregnant.. my first one is next week.. im very nervous though, and will keep an eye out for any unusual movements..is interesting to hear about the studys though i'd never heard about them before.
 

[jr'smom]

Very well said, Pastormama.