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Ultrasound drama, really upset. Advice please.

post #1 of 7
Thread Starter 

I'll try to keep this as short as possible, bear with me.


I didn't want any ultrasounds during this pregnancy, but since I'm going for a VBAC this time, I wanted to play it safe and rule out any placental problems, and make sure the brain/heart/spine, all looked okay in case the baby had any condition that would rule out a vaginal delivery.


Two weeks ago, when I was about 17 weeks, my midwife couldn't find the heartbeat.  She finally thought she found it under one of my hipbones (or something), but wanted me to have a quick ultrasound to make sure.  I thought it was going to be quick.  Apparently, it went through some OB that I had never heard of or talked to, and she ordered the tech to take as many measurements as possible.  I thought that maybe they were just going ahead and doing the fetal scan, but at the end of the u/s, the tech told me I'd need to come back in three weeks for the full scan since the baby was too young and she didn't get a good enough look.


Yesterday, I followed up with my midwife, at 19weeks, and told her my concerns about doing another full fetal scan (especially since the first one, which was supposed to be just a quick peak at the heart rate/movement, turned into a 45 minute, apparently pointless, scan in which the tech measured things like the thighs and arms and stomach.)  She said since the heart chambers were not visible then, but would be now, she'd just order a "complete the scan" ultrasound which would essentially only leave the heart to measure.  She handed me all of the other measurements from the first report and told me to make the appointment within the week.


I tried making that appointment this morning, but apparently radiology was interested in neither my midwife's orders or my concerns.  They told me, after a lot of transfers and being put on hold, that I either scheduled a full fetal scan, including all measurements, even the repeats, or nothing at all.  I called the midwife's office, and after they called radiology, they said unfortunately they weren't going to budge on the issue.  The nurse just recommended scheduling it and trying to convince the tech when I got there to listen to me.


I'm super annoyed, obviously.  How can they have my best interest in mind if they would rather I have no ultrasound at all than try to work with me to at least make sure the important things are ok?  I'm not scheduling an ultrasound with them at all now. 


I was wondering if anyone had any ideas for me.  I think they baby will probably be fine, but I'm wondering if I should try to get one somewhere else that will work with me.  Knowing the heart and brain looked good would give me peace of mind.  I called another hospital in my area so see what they thought.  The woman I spoke to said if my midwife faxed an order to them that just specified what was to be looked at, they would be happy to help me.



post #2 of 7
As a rather cynical person when it comes to the medical establishment my guess would be that they have a policy to do a full scan because they don't want to get sued in the event that they miss something from only doing a partial. But I'm an attorney so I think that way, and I don't for one second think that my best interests or that of my baby are at the top of their list.

If they didn't see anything at 17 weeks you're probably fine. With me they couldn't find the hb at 12 and I did a very quick (under 5 minute) u/s to confirm baby was ok, then just did the 22'week one as planned.

I think you're fine without another one and I totally understand why you'd be ticked, so patronizing.
post #3 of 7

I'm going to second that it's probably policy that they have to do a full scan. Though typically a doctor/midwife's order can override a policy like that. I'm very upset that they were so rude to you, people like that give healthcare professionals a bad name.


For whether you should get another ultrasound or not, that's completely up to you. I think you'd be fine to decline it, seeing as how the 17 week scan was good. But considering you said that you wanted the ultrasound in the first place to check on placenta and brain/heart/spine, and the heart wasn't visible enough at the other scan, it might give you peace of mind to go through the partial scan at the other hospital, since they are willing to follow your midwife's orders.

post #4 of 7
Thread Starter 

I had a feeling it was probably a policy/legal issue as well.  I just wish they had some sort of waiver or something; that seems like common sense.  I mean, it's not like I'm asking them to go above and beyond or anything.  I just want a limited ultrasound, especially since I already had one that I thought was excessive.  Thanks for letting me vent about this and for the encouragement.

post #5 of 7
If you feel the need and have the option I'd say try another care provider
post #6 of 7
That is such a shame they are requiring you to choose between excessive use and declining altogether. Maybe you could ask for another radiology center referral (since it sounds like the midwife is backing you) and see if they have a different policy. If not, the tech probably can't deviate from the order but it would be worth a try, and if she's willing to do the info you are concerned about first, you could always just get up once that part is complete.

You are not alone. I too found it hard to be conservative about ultrasounds once I had my first one too...my 'quick check' at 18weeks turned into a full anatomy, a lengthy vaginal one at that because the tech was inexperienced (her admission at the end), there were findings that led to several follow-up ultrasounds and testing that in hindsight, were all so, so uneeded.

The attitude was very much one of CYA and ultrasounds being considered so benign there is no need to limit or do a risk/benefit analysis even in my CNM practice. I decline them completely now, but there really needs to be a more moderate option.
Edited by neycie - 11/2/13 at 7:34am
post #7 of 7
Yk, I really can sympathize AND I really hate using Techs for my U/S needs.

With my first & second the ONLY person using an U/S on me was my OB. And the scans were never more than 10-15 minutes.

Like you, I wanted to play it 'safe' because of a safety factor (AMA) & I got the anatomy scan. I said yes to a student, she couldn't visualize some things in an *hour* so off to MFM I went. Then they had *their hour* & determined I needed an Echo. So cue another hour. Still, NBD: I read somewhere that some in fetal cardiology think every baby should get an Echo & I was mostly worried about the brain being exposed.

So *then* I agreed to a 32 week, just to check fluid level & growth. When I got there, oh snap! They have to measure *everything* again! I told them 1/2 hour this time only. The student got sorta put out but her boss (who I thought initially was a radiologist but turns out was only a bonefish tech) stepped up & guaranteed me 1/2 hour.

Anyway, I am not that upset about it really but I definitely remember why I skipped this plan the other times!
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