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Importance of full ultrasound during pregnancy?

post #1 of 25
Thread Starter 

to make a long story short, I haven't yet had a full ultrasound and I am due in 3 weeks. 

My insurance has been so messed up that it kept getting rescheduled, and I have yet another appointment in 2 days that they are saying may not be covered. 

 

So my question: is this ultrasound completely necessary? I certainly cannot afford to pay out of pocket, and i'm wondering what the negative aspects of not having it are. thoughts?

post #2 of 25

I wouldn't worry if I were you! I had the whole round of tests and ultrasounds my first pregnancy, but I would reconsider most of them the next time around. Plenty of women give birth all the time without having ultrasounds, heck most of our mothers probably didn't even have an ultrasound option at all. I think the potential advantage of having the ultrasound would be so that you and your care providers can be more prepared if there are any visible health concerns. Having an ultrasound ultimately can't fix any problems, it can only make you aware of them. Which isn't always a good thing, as you may be worrying for no reason at all - as in, there is nothing you can do about it anyway and plenty of times when they pick up anomolies on the ultrasound it ends up being nothing. 

post #3 of 25

I never had one.  Not even with my 4th when I was 45.  In fact, the only tests I have done are the blood work and testing for iron.  None of the tests, including ultrasound, are 100% (or even 90%) accurate and since I was going to have the baby regardless of what the test results were and the results weren't going affect my delivery, I declined them.  And as for finding out the sex of the baby before hand, to me, that would be like knowing what my Christmas presents were before I opened them.  I preferred to be surprised.
 

post #4 of 25
I declined routine ultrasound during my pregnancy. I did have one during labor because there was some concern, but ACOG only recommends ultrasound when medically indicated. If you are concerned about the baby because of decreased fetal movements, bleeding, or some other reason, the an ultrasound is a good idea. If not, and everyone's healthy and things are normal, I wouldn't worry about having one.

I view their usage as similar to X-rays. We don't just X-ray things for no reason. We do so when there is a specific need because we need to see if something's wrong, and what specifically is wrong. If we don't suspect anything, we don't X-ray. (I'm not saying that ultrasounds and X-rays are the same, merely that they are diagnostic imaging tools and should be used in similar fashion.)
post #5 of 25

Ultrasounds are not necessary for a healthy pregnancy, IMO. Here are my thoughts on it. I had one with my first, but after a lot of research and reading we decided against it with our second. :)

post #6 of 25

I agree "routine" ultrasounds are unnecessary. I had my first baby via homebirth at age 40 and fully intended to forgo any ultrasounds- I especially think they're ridiculous just to find out the sex and believe the 3-D "keepsake" ones are unconscionable. I had some scary bleeding at 14 weeks though....

 

My midwives were all for the wait and see approach- and I agreed in theory but ended up getting an ultrasound to see if the baby was OK after all. Weighing the risks of ultrasound against the risks of my being highly stressed out waiting for weeks and weeks to either miscarry or feel a kick I decided the ultrasound in this case

was in my baby's best interests! I did ask the tech to keep it short and sweet- we just wanted to see how the placenta was and see movement- no fetal glamor shots! (everything was fine, btw)

 

I think, like many things, the technology is great and to be very grateful for when needed...but not to be over-used just because we can and it's there!!

post #7 of 25

IMO it's totally unnecessary.  Especially if you only have 3 weeks to go!  I wouldn't worry at all and just meet your baby in a few weeks... :D

post #8 of 25

My husband and I also made the choice not to do any routine ultrasounds during either of my pregnancies.  We decided if there was a medical reason to do so, we would, but otherwise not.  And we never had a medical reason to do it so ultimately we didn't have any ultrasounds with either baby.  My husband has a medical/bio/chem background, and from the beginning, he didn't like the idea that ultrasound heats fetal tissue.  He just felt like that couldn't be a good thing.  (And I agreed!)  And then as we did our research, we found that, as jesshrehor mentioned above, even the ACOG doesn't recommend routine ultrasounds.  

 

Here's an excerpt from ACOG Practice Pattern No. 5, August 1997:  In women with low-risk pregnancies, neither a reduction in perinatal morbidity and mortality nor a lower rate of unnecessary interventions can be expected from routine diagnostic ultrasound. Thus, ACOG believes that ultrasound should be performed for specific indications in low-risk pregnancy.

 

Good luck!  Seems like you're asking good questions!

post #9 of 25
If I never had an ultrasound, I never would have known that I had placenta previa (low lying placenta). I had a completely healthy pregnancy, and wouldn't have known if not for ultrasound information. If my condition was not known and I was to have a natural birth (like I planned) then I could have lost too much blood and put my baby at risk because the placenta would have detached from my uterus as my cervix dilated, leaving my baby with not enough oxygen and blood passing through her umbilical cord to her. This would have resulted in an emergency c-section. Instead, because we knew ahead of time, I was able to have a planned c-section and know what to expect and not be unconscious during the birth.
post #10 of 25
From the Cochrane database of evidence in medicine: Ultrasound can be used in late pregnancy to assess the baby's condition when there are complications, but carrying out scans on all women is controversial. Scans can be used in late pregnancy to detect problems which may not otherwise be apparent, such as abnormalities in the placenta, in the fluid surrounding the baby, or in the baby's growth. If such problems are identified this may lead to changes in care and improved outcome for babies. At the same time, screening all women may mean that interventions are increased without benefit to mothers or babies. Scans are popular, but women may not fully understand the purpose of their scan and may be either falsely reassured or unprepared for adverse findings. Based on existing evidence, routine ultrasound, after 24 weeks gestation, in low-risk or unselected women does not provide any benefit for mother or baby. Eight studies that randomised 27,024 women to screening or a control group (no or selective ultrasound, or ultrasound with concealed results) contributed to the review. The quality of trials was satisfactory. There were no differences between groups in the rates of women having additional scans, antenatal admissions, preterm delivery, induction of labour, or instrumental deliveries although the rate of caesarean section increased slightly with screening. For babies, birthweight, condition at birth, interventions such as resuscitation, and admission to special care were similar between groups. Infant survival, with or without congenital abnormalities, was no different with and without routine screening, and childhood development at eight to nine years was similar in the three trials that measured it. None of the trials reported on psychological effects for mothers of routine ultrasound in late pregnancy.

I would not do it nor recommend it to one of my clients unless there was a specific clinical reason.
post #11 of 25

It is really however you choose. Ultrasounds are said to be good to help determine anything that might need to be treated right away (everything will be waiting for as soon as baby is born) or if they can treat it within the womb or if further testing is needed. It is also used to determine the location and health of the placenta. Some say it is necessary others are in between and others say it is not needed and can even be dangerous. If you have had an uncomplicated pregnancy and everything seems to be going fine then you are only 3 weeks away from your estimated date of delivery; why even stress about it? I would have declined the ultrasound during my 4th pregnancy if I hadn't found a place that would allow my children to view it with us. 

post #12 of 25

I was on the fence with our second whether or not to do an ultrasound. We skipped the 13 week and only did the 20 week to determine the sex so my husband and I would have time to make a decision on circumcision. Everything about my pregnancy was perfectly normal up to this point and we had no history of issues. It was at that 20 week scan we found out our son had no kidneys and would not live long after birth. Because we had the ultrasound we were able to make all of the arrangements and plan for the birth and short life of our son. Had we not he would have been whisked to the NICU and our time cut short with him. I know this is an extreme case but I will be having them with all my future children, even though it was determined not to be a genetic issue and unlikely to occur again.

post #13 of 25

We skipped the early one because we were sure of our dates and only did the 20 week one. I was on the fence about it, but in hindsight I'm glad. I've read about enough rare complications that can be caught by ultrasound that knowing that we didn't have placenta previa, some oddball cord insertion that makes labor really dangerous, gastroschisis, etc. is worth it to me. I don't think there is a huge risk to not getting it, but it is possible to have something rare that would be caught by ultrasound that could otherwise be a huge problem. I don't think there is a huge risk to getting it either; I think the risks of ultrasounds have been greatly exaggerated by the NCB community. There are plenty of kids out there who were scanned multiple times and are totally fine. I think you can legitimately decide based on individual preference; would you rather have all the information, or are you content to not know for sure, go with the flow, and accept the slight chance that things could go terribly off the rails in a way that would have been caught? Me, I would rather have the information. I've read some stuff that says that scans, tests, etc. undermine the mother's confidence in herself and make a culture in which we assess babies for their fitness, and maybe some people feel that way, but that was not my feeling at all personally. I tried to bypass the Doppler and "trust my body", but I felt a loooot better once I finally caved and got it and found out that the little monster was a-ok. 

post #14 of 25

I don't like the idea of having a lot of ultrasounds, however, becoming a first time mom in my early 40s, I wanted to have the information and be prepared for things as much as possible... So I had the 12 week combined nuchal screening for both my kids, as well as the 18 week anatomy one. The kids were fine, but my placenta was giving me some grief both times. I had low-lying for DS, which moved enough later in the pregnancy to allow me to have my home birth. However, with DD, I had complete placenta previa and while it did move it never went beyond 0cm from the os... so my home birth plans went through the window. I had to have a planned c/s. I wanted a trial of labor, but everyone, including my much-loved and trusted midwife, said it was too risky as they were very concerned over the location of two maternal vessels. I was totally symptom-less the whole pregnancy, in terms of not having any pre-term labor, bleeding episodes, etc. If I had not had u/s and known about the previa, I can't help but wonder what would have happened, as I would totally have been doing a home-birth. I'm really grateful that an adverse event did not occur. I will say, though, that knowing about the previa all those weeks did throw me into a bad funk, as I became very depressed and anxious about having a c/s and I worried about complications for myself and the baby from that. (I have a history of anxiety and depression, so not really suprising it triggered that in me.) If I am blessed to get pregnant one more time, my thoughts at the moment are that I will have the same u/s again. I think my risk of previa is increased now, with the c/s and previous previa.

 

Hillhouse, my heart goes out to you. I can't imagine the pain of that experience. It sounds like you got to spend precious time with your son in those moments. Love and light to you and yours...

post #15 of 25

The ultrasound isn't necessary, and this far along, it might be hard to even tell if there's anything wrong with baby. They are so squished in there at this point that it makes ultrasounds hard to see and the accuracy go down. 

I -personally- like receiving the 20 week u/s just to be on the safe side, but I feel it's a personal choice completely. 

post #16 of 25

I had my first baby at 36, and was informed by my midwife that I was one of less than 100 women delivering in MN that year to not have an ultrasound.  Having never been proven 100% safe, I just felt it was unnecessary.  My OB recommended getting one at 20 weeks to determine the position of the placenta, but my midwife (I delivered at home with a midwife but saw my local OB to save on travel to my out-of-town midwife) was able to locate the placenta position by listening to the baby's heartbeat (the placenta muffles the sound somewhat and can usually be pinpointed).  I am sure there are times when that would not work, but it did for us, and I was thrilled to skip an unnecessary (IMO) medical intervention.  I am now pregnant again and unless something unexpected arises, I will once again gladly skip this money-making test of the medical world.  However, let me clarify I do believe there are times when they are medically necessary, and in those circumstances, I am grateful we have this technology.  Ultrasound itself is not evil, just its gross overuse is.  Good for you for exploring this question, as I think most women just blindly go forward with whatever their doctors recommend.  Good luck with your decision, and whatever you decide will be right for you.

post #17 of 25

The Cochrane review was on routine use of u/s after 20 weeks, AIUI. It excluded the 20 week anatomy scan. That ACOG bulletin is 15 years old, too. 

 

At this point, though, it won't do much--and I am pro screening ultrasound. 

post #18 of 25

There is increasing evidence that u/s are dangerous. I would skip it and save the money unless you are extremely high risk. 

post #19 of 25

What evidence is this?

post #20 of 25

This is a pretty hot topic! It's my understanding that there will be experiences on both sides. I have a friend that had a routine ultrasound at 9 weeks and is convinced that's what caused her spontaneous abortion. We shared the same midwife (a very experienced woman) and when she had early bleeding with her second pregnancy she was advised not to get an ultrasound because it could cause more problems. A lot of home birth midwives I have spoke with are not pro-ultrasound. Midwifery today had an article a while back regarding the risks. Ultrasounds were originally developed to find weak spots and imperfections in metal (in ship hulls if memory serves) and there hasn't been much testing that I am aware of on their safety on the growing baby. With 3 weeks until your EDD there is a chance it could pick up on some random complications, but would it give you enough time to make arrangements? Possibly. There is also the chance because of the size and density factors involved with an almost full term baby, they wouldn't pick up on anything.

I am not pro-scans as a general practice, but if there are indicators/high risk factors that need to be weighed in, then perhaps they have a place. As HillHouse stated, it gave her and her family an opportunity to prepare which sounds like a wonderful blessing in their case. If it was a hospital birth, then NICU would be a huge issue for a situation like hers. A home birth would pose different issues but NICU would unlikely be one of them depending on time frame, etc. Modern medicine (heroic medicine if you will) has it's place but they also make a LOT of money on interventions like ultrasounds. Ultrasounds have their benefits in cases like some listed above, but they also have drawbacks like in my friends case and to our wallets. Leaving the choice ultimately up to you, as in, what will make you the most comfortable? Having an ultrasound and being mostly sure that nothing is wrong (they aren't 100%) but also taking on any associated risks of an ultrasound heating amniotic fluid and tissue? Not having an ultrasound and saving the out of pocket expense but possibly having an unknown that the medical community will say they could have diagnosed with ultrasound (which is not always the case, they are not 100% accurate). What makes you most comfortable, makes you able to sleep at night and will leave you with the least amount of anxiety and perhaps guilt for not doing "everything you could?" Our culture is predisposed to think we need to do everything in our power to know what we are being handed, many other cultures are not wired that way.

 

Whatever you decide, I wish you all the peace and happiness with your decision. Whatever you decide will be best for you and your family.

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