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I hate going to the doctor  

post #1 of 19
6/26/07 at 2:29pm
Thread Starter 
As far as OBs go, mine is wonderful and amazingly crunchy. For example, when she saw I was reading Spiritual Midwifery while I was waiting for her, she said, "Oh, great book!!!"

Today, however, I measured a little low (34 cm - I'm 36 weeks) and after she measured, she asked when I had my last u/s. (28 weeks) Then she says casually, "Let's get another one to check his size."

I measured dead on last week, so I was blindsided by this. I was noncommittal, but the more I think about it, the more I'm intending to NOT make the appointment - at least not until after my appt next week where we can discuss this more in depth.

I don't even know WHY she's ordering the u/s. Upon brief palpation she said she doesn't think he's going to be as big as my earlier babies (8-9 lbers) - the exact opposite of what my midwife said LOL - so the test here isn't to feel sure I can VBAC a "big baby." Is she worried about him not thriving? IUGR? Is she not worried at all and just routinely orders a sizing u/s at this stage of pregnancy?

Everything is going fabulously right now <knock wood> - blood pressure is low, not a speck of swelling, babe is super active, strong heartbeat. I'm pretty sure I don't want an u/s.

Needless to say, I want to know more about her motivation here before I consent to this.

I just had to vent. I'm frustrated.
post #2 of 19
6/26/07 at 2:35pm
Bee- I think you need to go with your gut here. It's not unusual to start measuring lower, especially if the baby has dropped into the pelvis or changed direction. My MW last night was expecting me to measure much lower, as the baby's head has all but disappeared behind my pubic bone. Nope! It was a cm and a half more than last week. The reason? Last week, the babe's bottom was pushed out on my left side, with little feet and legs curled up on my right side (and head down). This week, the wee little butt was straight up in the air, facing out as high as it could point in my uterus, with legs and feet towards my backbone (head still down).

It sounds like your OB is very friendly towards a less interventionist approach if she likes Gaskin. Call her office and ask a nurse if she can contact you later regarding this. Ask her about her reasoning. Discuss with her your hesitations about repeated US exposure, especially since you're pretty close to the end.

Clara
post #3 of 19
6/26/07 at 2:44pm
Exactly what Clara said!!!

And don't forget that a u/s means absolutely nothing this close to the end. It can not give anyone an educated guess as to the weight of the baby. They might say it is 6lbs and it turn out to be 9lbs or vice versa.

hth
post #4 of 19
6/26/07 at 2:50pm
I agree with everyone else... an u/s this late in the game isn't going to say much. Everything looks great, there's no reason to consent to this or stress yourself over it. The nurse midwife at my doctor's office and my doctor consistently disagree about the baby's size. I've never said to either of them that they differ in their views but I find it somewhat comical. Although I will say they seem to bounce around with their opinions. Yesterday doc was guessing Sage would be around the same size as her brothers, roughly around 8, 8 and a half pounds. I'm taking the wait and see standpoint... I don't think anyone can know until the baby makes it's way here.
post #5 of 19
6/26/07 at 3:00pm
I agree with everyone else--I think you've just dropped.
post #6 of 19
6/26/07 at 3:23pm
As above....I actually dropped a cm off since the baby dropped.....

The u/s won't tell you much that's important with everything else being healthy....

Good thinking on your part...don't do it...
post #7 of 19
6/26/07 at 3:28pm
I went 2 cm smaller this time than 2 weeks ago, presumably b/c baby is better positioned for labor now. And u/s aren't terribly accurate at this stage anyway. Go with your instincts!
post #8 of 19
6/26/07 at 3:33pm
Thread Starter 
Anyone know if there is there a difference between "dropped" and "engaged"? I always kind of assumed they were the same thing...

Anyway when she checked my cervix, she said the boy isn't engaged at all.

But, even so, he's all over the place still. He's in a completely different position everytime I'm measured (twice a week right now between midwives and shadow care OB). I feel very confident that his position likely accounts for the measuring difference.

I wish I would have at least had the presence of mind to ask, "WHY?" at the appt lol. I was just dumbfounded by the suggestion and couldn't think of a thing to say. At least I'll be prepared when we next have a conversation about this.
post #9 of 19
6/26/07 at 3:35pm
I think the baby can "drop" down but not actually be engaged in the pelvic bones. I was told last week that Sage was still floating but was lower and this time I forgot to ask if she was "engaged". I know their position can change up until birth.
post #10 of 19
6/26/07 at 3:40pm
I measured 31 cm at my last appointment, and I was 34 weeks. My OB said that's to be expected as the baby drops lower into the abdomen/pelvis.

Definitely go with your instinct here, mama!
post #11 of 19
6/26/07 at 3:42pm
My baby has measured all over the place. It went from 37 weeks when I was at 35, down to 35 when I was at 36. Then back up again. Now I'm measuring 39 at 37 weeks. My OB has never been worried about it, in fact she was quite dismissive. She says it all has to do with baby's position, not its actual size.
post #12 of 19
6/26/07 at 3:58pm
Grrr... my pet peeve this pregnancy. I was measuring "big" and consented to an u/s to check baby's size, and now I'm on this intervention train I can't seem to get off. We just had our 3rd "extra" u/s today and were told that baby's abdominal circumference is still measuring big, which means not only that I can't use the birth center, but the words "c-section" keep being thrown around. I mean, how many women _don't_ get late term u/s and have no idea that their baby's ac might be a little bit "too big"-- and have a vaginal birth just fine?! I hate that drs believe that u/s will tell them everything. We were told our baby's weight estimate: 8lbs, 4 oz...... plus or minus 20 oz!! (I mean, how is that useful information?????)

Sorry for the rant about my own issues, lol... my point is that I think if your gut is telling you to skip it, then you should. Once that info is out there on official documents, then you may be stuck like me. :
post #13 of 19
6/26/07 at 4:19pm
Thread Starter 
Quote:
Originally Posted by tatermom View Post
Grrr... my pet peeve this pregnancy. I was measuring "big" and consented to an u/s to check baby's size, and now I'm on this intervention train I can't seem to get off.
Heather!

Yes, this is exactly what is stressing me out. I've been on the intervention train before - it's learning from that hard won experience that has me so embittered now. : Why, I'd love to see Jakey in utero again and see how he's grown. Fun!

But it's just not worth the risk. I really don't want to go in for an u/s for "size" (and personal pleasure) and have them identify some vague long-shot something that makes them (and potentially me) all scared and anxious. If there was actually some valid concern at this point, that would be different.

[Aside: I'm particularly sensitive to this right now, too, because my midwives recently shared a story with me where one of their clients got risked out of homebirth because the u/s clinic (same one where I'd go, BTW) found a possible heart problem. It was all very vague and possibility and maybe. The midwives were still willing to attend her homebirth, since there was no official dx, just "shadows," but ultimately she felt too pressured/nervous by the doctors and risked herself out to hospital birth. It went wonderfully, the midwives were present. Baby was perfectly healthy - no heart problem as it turned out.]

So, anyway, I just called the doc's office because I couldn't take it anymore. Turns out she's not worried about anything - the timing of the u/s suggestion right after the fundal measurement was merely coincidence. According to the person I talked to, doc says this suggestion was for a third trimester u/s she does routinely to check baby's growth. "It's a good thing!" the receptionist chirped.

Oh, honey. <sigh>

Anyway, that makes it easy to refuse. Yay!!!

GEEZ. I think my conventional OB from 11 years ago did less routine prenatal testing than I've had to consider this time.
post #14 of 19
6/26/07 at 4:24pm
Thread Starter 
Quote:
Originally Posted by tatermom View Post
We just had our 3rd "extra" u/s today and were told that baby's abdominal circumference is still measuring big, which means not only that I can't use the birth center, but the words "c-section" keep being thrown around.


Doing a separate post to ask you questions about this. What does this mean? Why are they talking c/s? That seems so very extreme. Does a large circumference indicate a serious condition? Or macrosomia? I am so sorry you have to deal with this! : Are you totally risked out of the birth center based on this most recent u/s or is there anything else they can do to pinpoint/eliminate the concern?

More mama
post #15 of 19
6/26/07 at 4:34pm
It's the head to abdomen circumference ratio that is causing concern-- they are worried about the possibility of shoulder dystocia (as abdomen size is used as a proxy for shoulder width), and the birth center is not legally allowed to let someone birth there with a known head:abdomen ratio less than 94% (usually they are supposed to be roughly equal). The thing that is so very frustrating to me, is, first, that most hospitals don't use this ratio for anything official (unfortunately ours does (the birth center is housed inside the hospital and has to follow hospital policy on things like this)) and second, of course most women don't know this ratio ahead of time and do just fine (our baby looked fine at the 20 wk u/s-- it was only at 32 wks that I was measuring big by fundal height and they convinced me to have a follow up u/s). I'm not convinced that the measurement means anything and I will NOT let it be used as an excuse for a c-section, but I can't do anything about the birth center policy. Today was our last u/s (at 37 wks now) and nothing has changed. Oh well, I'm ok with using regular L&D as long as I don't continue to get the c-section pressure....

Bee, I'm sure your measurements are "small" only because of the baby's position. When all this started I was measuring 3.5 cm "big" but at my next appointment I was actually measuring a half cm smaller than 2 weeks earlier because baby had changed position. : I would really be hesitant to do the u/s if I were you, unless you felt like something was really wrong, or maybe if you continue to measure small over the next week or two.
post #16 of 19
6/26/07 at 4:54pm
That is so sad that the nurse said that.

I also wanted to throw out there the whole "low fluid" thing. Keep in mind that the baby is constently drinking then peeing then drinking. And your body is always making more of it (every 4 hours or so).
When you are being measured, you don't know where in the cycle things are. AND...you said that 2 different people are measuring you. That means a hell of a lot right there!

Yeah, I just wanted it out there for you guys that are seeing OB's or having shadow care with them that this is a major reason for elective inductions. That's what they are considered, even though they will tell you that you need it.
I didn't realize how much they covered their own asses until I saw on a client's chart that she was in for an elective repeat c/s.... um, her OB refused to go along with VBAC, but according to her records and health insurance, it was elective.
Sorry, I'm done.
post #17 of 19
6/27/07 at 9:30am
Thread Starter 
Heather, this might be worth printing off and showing to your HCP/s regarding shoulder dystocia, particularly if they bring up the c/s issue again:

Gaskin Maneuver - study results
post #18 of 19
6/27/07 at 12:05pm
Thanks, Bee, that's a great article (other than the scary scary complications from some of the less successful maneuvers! . I'm going to talk to my mw about it today and I'm going to staple a copy of the article to my birth plan. Thanks a lot!!
post #19 of 19
6/27/07 at 12:26pm
Not in this DDC, but just have to say that I have personally thrown myself off of the intervention train. After my last appt when I left the doctor's office sore from sitting in a hard chair for 6 hours, having an ultrasound just because I was measuring big, and finding out that the blood test they did on my hubby was the wrong one: ( they were suppose to test him for the Kell Antigen but instead tested him for the Kell antibody), I decided that I need to take matters into my own hands. I am trusting my body and trusting my baby to know that everything is ok. If I feel like something is wrong, I will go in, but I was being seen at a high risk clinic, simply because I had 2 prior miscarriages. THIS pregnancy has been completely normal and I've had 4 ultrasounds that have come back good and had 4 NST's so far. I felt like that is enough and it is just stressing me out to go there, so I have decided to give myself a break for a 3 or 4 weeks even though they insist on seeing me every week.
I've learned on here not to stress out and trust your own body, so I am, and you know what? It just feels right.
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