Ultrasound/Doppler safety (clarification in post 65)

[no5no5]

Let me preface this by saying that if you don't want to hear graphic depictions about ultrasound risks, you should not read on.

Okay, so when I was pregnant with DD, I was totally uninformed, and I did not know that there was any risk whatsoever associated with ultrasound. I had the early ultrasound, the second-trimester ultrasound, and doppler heartbeat checking every visit. Then Bliss posted that article, and the more research I do the more freaked out I get. When I first started considering that maybe early ultrasounds aren't all that great, it hadn't even occurred to me that second-trimester ultrasounds might also be dangerous. NOW, it has finally registered that those Doppler heartbeat thingies are totally also ultrasound. And probably just as dangerous.

And now I'm reading about the actual effects of ultrasound, and if you're not careful it can significantly increase the temperature of the fetal brain. THAT doesn't sound so good. And in the first trimester, there is a risk of "cavitation-type non-thermal effects," which seems like a totally meaningless but nonetheless frightening phrase.

So now I am thinking that I am going to have to give up not only the early ultrasound, but also the second-trimester ultrasound AND the doppler heartbeats. Meaning I won't even know if there's really a baby in there at all until, gee, quickening or something. Meaning, how the heck will I find out if the baby has serious birth defects? Can I really be expected to go 9 months without any idea what the heck is in there???

Okay, I know I am way overreacting. But I am an all-or-nothing kinda gal, and I just don't see myself saying, "Yes, it may cook the baby, but I'll do it anyway just for a minute..." :

[BlissfullyLoving]

nono, if you did not get an ultrasound or use the doppler do you think you would go 9 months without knowing what is going on? You can use a fetascope to listen to the heartbeat. You also would feel the baby's movement. I think that you would have an idea. Even a good midwife, or ob, can feel the baby for position and size. My midwife knew ds's weight to the ounce.

Ultrasounds are not guaranteed to find every problem either. Most times they show the possibility of a problem and you need further testing to get a conslusive answer. If you wanted answers you could just go straight to the testing, but even that is not always conclusive. You have to get rather invasive to get definitive answers. Would you do that anyway?

Lastly, there are degrees of risk. 3-d ultrasounds are much riskier then the older weaker ultrasounds. Transvaginal is riskier then abdominal, and the doppler is the least risky.

Good luck with your decision. I know the information is scary. You have to decide what is best for you. Perhaps the reassurances of the heartbeat at 12 weeks with the doppler is worth the risk to you...I know it is to me.

[maxwill129]

Originally Posted by BlissfullyLoving

Perhaps the reassurances of the heartbeat at 12 weeks with the doppler is worth the risk to you...I know it is to me.

That's how I feel. As far as a u/s, I don't know. I REALLY want to find out the sex of this baby. Dumb, I know, but we gave away EVERYTHING and I really want to buy girly diapers, clothes, etc if it's a girl. Plus, I really want the kids to feel more attatched to the baby and I think that would help, but I don't want to worry about the risks. Too much thinking and decision making!

[kriket]

I'm still up in the air on this, does anyone have a good link?

[tulipmama]

I looked at the research (there are a ton of links in prior posts on this board) and for this pg decided to have as 12 week u/s to see all was well, a 20week anatomy u/s (plus to find out gender) and that is all. No doppler-- which is fine b/c I can feel baby move. I will permit doppler during labor. Dopplers actually emit more sound waves than ultrasounds b/c dopplers emit constant sound waves whole ultrasounds emit intermittent sound waves. So I decided to fore-go the doppler and have 2 ultrasounds. My midwife uses a fetascope during appts., but that is more for his practice-- I can feel the baby move and that reassures me. If I ever have reason to worry, then I will change my plans accordingly.

[kangaroomum25]

http://www.midwiferytoday.com/articl...oundwagner.asp

http://gentlebirth.org/archives/SKonUS.html

http://www.plus-size-pregnancy.org/P...oundsafety.htm

http://www.fda.gov/FDAC/features/2004/104_images.html

http://www.midwiferytoday.com/articles/ultrasound.asp

http://www.unhinderedliving.com/pultra.html

[no5no5]

Originally Posted by BlissfullyLoving

nono, if you did not get an ultrasound or use the doppler do you think you would go 9 months without knowing what is going on?

Well, I would worry myself sick. I mean, what if there was spina bifida or placenta previa or something that would require a c-section? No amount of kicking and feeling is going to tell me that stuff.

Originally Posted by BlissfullyLoving

You have to get rather invasive to get definitive answers. Would you do that anyway?

I don't know. When I was pregnant with DD, all the tests came back perfect, so I didn't have to worry. I know that didn't happen with you, and I recognize that false alarms could happen, but I think personally I would rather be upset over nothing than not know something serious. Maybe I would change my mind if I had had a different experience.

Originally Posted by BlissfullyLoving

Lastly, there are degrees of risk. 3-d ultrasounds are much riskier then the older weaker ultrasounds. Transvaginal is riskier then abdominal, and the doppler is the least risky.

Do you have a source on that? I was not able to find anything that really differentiated.

Originally Posted by kriket

I'm still up in the air on this, does anyone have a good link?

It all started with http://www.midwiferytoday.com/articles/ultrasound.asp. But I've been searching on pubmed.com, and I've been finding a lot of statements of medical organizations warning practitioners that minimal use is required, and stating that most practitioners have no clue what they're doing.

Originally Posted by tulipmama

I looked at the research (there are a ton of links in prior posts on this board) and for this pg decided to have as 12 week u/s to see all was well, a 20week anatomy u/s (plus to find out gender) and that is all. No doppler-- which is fine b/c I can feel baby move. I will permit doppler during labor. Dopplers actually emit more sound waves than ultrasounds b/c dopplers emit constant sound waves whole ultrasounds emit intermittent sound waves. So I decided to fore-go the doppler and have 2 ultrasounds. My midwife uses a fetascope during appts., but that is more for his practice-- I can feel the baby move and that reassures me. If I ever have reason to worry, then I will change my plans accordingly.

Hmm. That's an interesting strategy. I'm not sure my midwife usually does an anatomy u/s. I know she usually does Doppler. My OB has scheduled me for an early ultrasound, but I am thinking of canceling. I guess what I need to do is to call her & see if she has any justification that can convince me.

I don't know. I am soooo paranoid, and of course I'd love to have a peak in there, which is why I am so torn. DH told me that if the ultrasound is not going to change the plan of treatment, and if I get it and something goes wrong I will blame myself, then I had better not get it. That way I can't blame myself if something does go wrong. But then, if something goes wrong that a later ultrasound could have fixed, e.g., by convincing me to get a c-section, I will still blame myself. Okay, I am done ranting for now. Thanks to everyone for the advice. And if anyone has more, keep it coming.

[kangaroomum25]

Really, I think if it's that important, just do a quick scan in the 3rd trimester. Doesnt have to take long at all.

[PassionateWriter]

Originally Posted by no5no5

Meaning, how the heck will I find out if the baby has serious birth defects? Can I really be expected to go 9 months without any idea what the heck is in there???

there are many women who have NO u/s's and NO dopplers used during pregnancy and do just fine.

[RachaelsMommy]

I think I've decided not to have any u/s. An early u/s won't reassure me, b/c I know several people who have m/c'd after seeing a heartbeat. If something is wrong with the baby, I don't want to know. I want to enjoy the pregnancy and bond with the baby. I also don't want to be treated like a ticking time bomb. From what I've read, babies not diagnosed prior to birth are more likely to survive some conditions. I think doctors are too quick to induce early or have a c/s when something is wrong. My friend's baby was diagnosed with Congenital Diaphragmatic Hernia at 20 weeks. She was induced 2 weeks early. Her little girl died 15 days later. Not saying that is what caused her death, but I would think 2-3 more weeks in the womb could have made her stronger.

[kangaroomum25]

I was thinking about how many women I've seen go in only not to see a heartbeat and have to wait a couple weeks sometimes (unless they go the d&c route) to miscarry and how hard that is. I think I'd rather not know ahead of time, but that's just me.

[tubulidentata2]

I have read several times that one minute of Doppler exposure is equivalent to 35 minutes of real time ultrasound exposure . I would prefer ultrasound, but we'll just have to see if anything comes up to know if we need either.

DH doesn't worry about it at all, but since ultrasounds aren't recommended for routine pregnancies, I don't see a good reason to get one normally. However, I have had a C-section, so perhaps my midwife will recommend one to verify placental placement.

If I were unsure of my dates, and if I were seeing a care provider who would give me a hard time about going "overdue", I might consider an early ultrasound.

[no5no5]

Originally Posted by PassionateWriter

there are many women who have NO u/s's and NO dopplers used during pregnancy and do just fine.

Oh, I am well aware that the vast majority of births take place with nothing like Doppler or ultrasound. I am also well aware that I am totally spoiled and selfish. It's hard being spoiled and selfish and having to give something up.

Originally Posted by RachaelsMommy

I think I've decided not to have any u/s. An early u/s won't reassure me, b/c I know several people who have m/c'd after seeing a heartbeat. If something is wrong with the baby, I don't want to know. I want to enjoy the pregnancy and bond with the baby. I also don't want to be treated like a ticking time bomb. From what I've read, babies not diagnosed prior to birth are more likely to survive some conditions. I think doctors are too quick to induce early or have a c/s when something is wrong. My friend's baby was diagnosed with Congenital Diaphragmatic Hernia at 20 weeks. She was induced 2 weeks early. Her little girl died 15 days later. Not saying that is what caused her death, but I would think 2-3 more weeks in the womb could have made her stronger.

I also know someone (a close friend) who miscarried after a normal early ultrasound. So I agree I will not feel super reassured. But I do think I would want to know if there were something wrong. I don't think I would let anyone talk me into being induced, pretty much no matter what, but some conditions DO require c-section, and I would definitely like to know about those in advance.

But I also have read something that indicated that outcomes are not significantly improved in normal pregnancies as a result of ultrasound. And that is pretty convincing. Of course, then it went on to say that ultrasound is useful in determining which pregnancies are normal.

Originally Posted by kangaroomum25

I was thinking about how many women I've seen go in only not to see a heartbeat and have to wait a couple weeks sometimes (unless they go the d&c route) to miscarry and how hard that is. I think I'd rather not know ahead of time, but that's just me.

Personally, I would like some warning. I feel like it would make it easier. I could be wrong.

Originally Posted by tubulidentata2

I have read several times that one minute of Doppler exposure is equivalent to 35 minutes of real time ultrasound exposure . I would prefer ultrasound, but we'll just have to see if anything comes up to know if we need either.

Hm. Do you remember where you read about the relative exposure of Doppler and ultrasound?

[BlissfullyLoving]

Originally Posted by no5no5

I don't think I would let anyone talk me into being induced, pretty much no matter what, but some conditions DO require c-section, and I would definitely like to know about those in advance.

Hm. Do you remember where you read about the relative exposure of Doppler and ultrasound?

I know a woman that had placenta previa undiagnosed with ultrasounds. She had an emergency c-section when her placenta detached at home, unplanned. Mommy and baby were perfectly healthy. After her birth I did some research, and there are many situations that previa goes undiagnosed with ultrasound.

Do you think that your at increased risk for spina bifida? From what I have read and heard if you are taking folic acid the chances of your child having a problem is very, very small.

I am too tired to respond to everything right now. I do want to answer the question about my source for relative risk on ultrasounds. I heard from my midwife (that uses neither ultrasound or doppler) and on mdc. I did not do much more research.

I would love to see the info that said that doppler exposure was much stronger then ultrasound. I have never heard that 30 seconds of the doppler was the same as a 35 minute ultrasound.

[no5no5]

Originally Posted by BlissfullyLoving

I know a woman that had placenta previa undiagnosed with ultrasounds. She had an emergency c-section when her placenta detached at home, unplanned. Mommy and baby were perfectly healthy. After her birth I did some research, and there are many situations that previa goes undiagnosed with ultrasound.

Do you think that your at increased risk for spina bifida? From what I have read and heard if you are taking folic acid the chances of your child having a problem is very, very small.

I am too tired to respond to everything right now. I do want to answer the question about my source for relative risk on ultrasounds. I heard from my midwife (that uses neither ultrasound or doppler) and on mdc. I did not do much more research.

I would love to see the info that said that doppler exposure was much stronger then ultrasound. I have never heard that 30 seconds of the doppler was the same as a 35 minute ultrasound.

No, I am not at increased risk of spina bifida, or any birth defects other than deafness (which obviously would not change the birth plan). I think the end result of this whole thread is that I am feeling much more confident. Maybe I don't need any of it. I mean, I _know_ I don't need any of it, but maybe I don't even _want_ any of it. We will see how DH feels about my new thoughts when he gets home (yes, he is at work again).

Again, thanks to everyone for your excellent and diverse opinions.

[BlissfullyLoving]

Originally Posted by no5no5

No, I am not at increased risk of spina bifida, or any birth defects other than deafness (which obviously would not change the birth plan). I think the end result of this whole thread is that I am feeling much more confident. Maybe I don't need any of it. I mean, I _know_ I don't need any of it, but maybe I don't even _want_ any of it. We will see how DH feels about my new thoughts when he gets home (yes, he is at work again).

Again, thanks to everyone for your excellent and diverse opinions.

That is great. I really do believe that you have to assess the risk to benefit ratio anytime you do anything. We all have our different reasons for prenatal monitoring, but I believe that we are doing the best we can.

[ann_of_loxley]

See...I didnt know with my DS either, but I will not be getting doppler or scans with this pregnancy (or any others I may have!) because I know the risks now and this is how I see it... If there was something wrong...nothing I could do about it anyhow! A doppler or U/S might inform me fo what I could not see or hear from where my own head is, so for me there really is no point. It was fun with my son because I found out the sex - and though I wasnt worried, could have been for another woman when they said they thought something was wrong with his kidneys (which there wasnt in the end!)...but I dont need to know the sex this time around. For me, I am sticking without.
You can however buy your own fetoscope and/or they have microphone type 'dopplers' (not real dopplers) that you can use after about 20 weeks of pregnancy so you can use it anytime anyday in your own home if you wish - I did with my DS and it was nice to have that reassurance - so I know how wanting that feels.

[BlissfullyLoving]

Ann,
I thought the take home things to listen to the heartbeat were dopplers. What are they?

I just looked around, and I could only find home use fetal dopplers and fetascopes. What did you have?

[no5no5]

Originally Posted by ann_of_loxley

See...I didnt know with my DS either, but I will not be getting doppler or scans with this pregnancy (or any others I may have!) because I know the risks now and this is how I see it... If there was something wrong...nothing I could do about it anyhow! A doppler or U/S might inform me fo what I could not see or hear from where my own head is, so for me there really is no point. It was fun with my son because I found out the sex - and though I wasnt worried, could have been for another woman when they said they thought something was wrong with his kidneys (which there wasnt in the end!)...but I dont need to know the sex this time around. For me, I am sticking without.
You can however buy your own fetoscope and/or they have microphone type 'dopplers' (not real dopplers) that you can use after about 20 weeks of pregnancy so you can use it anytime anyday in your own home if you wish - I did with my DS and it was nice to have that reassurance - so I know how wanting that feels.

DH is actually a doctor , so we will use his stethoscope when we get to 20 weeks or so. But by then I'll be able to feel baby move anyway. So, yeah. It's a good thing, because we totally can't afford to rent anything. Plus, I'd be sitting there listening oh, say, 20 hours a day.

But man, I had not even really considered what it would mean to not know baby's sex until birth...what is my MIL going to shop for??? Is she going to send an equal number of hideous boy & girl outfits? Will she be limited to unisex?? Will she actually wait until after the birth to start shopping??? Oh, wait, I know. She will intuitively "know" which sex the baby will have and will shop accordingly. Darn. For a minute there I thought I was going to get a baby-junk-gifts reprieve.

[BlissfullyLoving]

Originally Posted by no5no5

But man, I had not even really considered what it would mean to not know baby's sex until birth...what is my MIL going to shop for??? Is she going to send an equal number of hideous boy & girl outfits? Will she be limited to unisex?? Will she actually wait until after the birth to start shopping??? Oh, wait, I know. She will intuitively "know" which sex the baby will have and will shop accordingly. Darn. For a minute there I thought I was going to get a baby-junk-gifts reprieve.

I would suggest (if you know the sex or not) you tell people to wait until after the birth to bring gifts, and just get a few essentials before (or use what you already have). Kids grow through things different anyway. It is just a better investment to have an idea of what size your baby is and how fast they grow before splurging.