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Discussion Starter · #1 ·
My intention is to ask for a "line-item-veto" rather than rejecting the ultrasound flat out because I think I might have more luck if I know what they're looking for and how the information isn't necessary or can be gotten by other means. I'm going through all the things they typically look for in the 20 week routine ultrasound, and there are a few things I still have questions on. BTW, the ultimate objective would be to veto every line so I don't have the ultrasound at all.<br><br>
Size of pelvis - mine is already proven so I assume that is good enough<br><br>
Dating the age of the baby - I have my NFP chart, which my OB understands and values, so dating is not an issue. When it came down to the end of the pregnancy, I would definitely go by my temp spike rather than the size of the baby at 20 weeks. However, what if the baby is smaller than it should be, as though perhaps it wasn't getting enough nutrients from the placenta? Is there anything that could be done about it?<br><br>
Placenta previa - I'd like to wait until 35 weeks and do a "placenta hunt" then to make sure we know where it is. Obviously, if I do have a 20-week ultrasound, we may find that it is fine there. I just don't want to hear that I have placenta previa at 20 week so I can worry about it for four months until it is resolved (which it most likely will be) or have repeated ultrasounds to see if it has moved in the mean time. This unnecessary worry would be another great reason to avoid the 20-week ultrasound.<br><br>
Twins - we'll find out soon enough. I don't need to know I'm having twins at 20 weeks.<br><br>
Sex of the baby - this is what I definitely do NOT want to know. And I don't want to know that they know either. I know it will not matter to me when I have the baby in my arms, but if I find out ahead of time, either way I will agonize over the ramifications (I want a girl, but we would need a house with more bedrooms, basically), and I don't want to be stressed for the entire second half of the pregnancy because I supposedly know the sex of the baby. This would be my biggest reason for NOT wanting the ultrasound.<br><br>
Deformities - what can they find and what can they actually fix? In my mind, if a baby is not normal, it at least deserves to have a normal pregnancy and birth. The last thing a compromised baby needs is a mother who is stressed over having a baby with special needs - that can only make things worse. I know that the information isn't always really accurate - they don't catch everything and they often cause false alarms. That aside, I still would really like to know what they can actually do something about. Otherwise, there really is no point. Most things they can diagnose fairly quickly after birth, and it really doesn't matter if it's diagnosed firmly 4 hours or 12 hours after birth - the facts are the facts and the treatment will be about the same.<br><br>
I tried to get out of having the ultrasound with ds, but my OB's response was that the wives of OB's have more ultrasounds than anyone else, implying that they were perfectly safe. However, this time, I think that the reason why those women have more ultrasounds is because OBs are the most nervous fathers (so glad my DH isn't one!). So that's not going to work with me this time. I do have the record of a normal pregnancy, so it isn't like I'm expecting to have a premie or anything. I just would really like to skip the ultrasound completely, but I'd like to find answers to the questions I posed above if at all possible.<br><br>
Thanks for helping!
 

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Honestly? Unless you want to spend your WHOLE pregnancy fighting, I wouldn't go line item. Just say no ultrasound.<br><br>
-Angela
 

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I have no choice but to have u/s because I`m rh sensitized. I had 2 pregnancies with no u/s at all & it is really nice. I recently had my first u/s with this baby at 13 weeks and they discovered a placenta previa which had me totally freaked out for a week. Then I just wished I had never known that, considering it will probably move. In your case, with your attitude towards deformities and the fact that a true previa would be noticed in the 3rd trimester (by painless slow bleeding) than you could easily reject the u/s. For dating the baby and twins, they are both things I think you would be aware of without an u/s. Good luck!
 

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<div>Originally Posted by <strong>pageta</strong></div>
<div style="font-style:italic;">I tried to get out of having the ultrasound with ds, but my OB's response was that the wives of OB's have more ultrasounds than anyone else, implying that they were perfectly safe. However, this time, I think that the reason why those women have more ultrasounds is because OBs are the most nervous fathers (so glad my DH isn't one!). So that's not going to work with me this time. I do have the record of a normal pregnancy, so it isn't like I'm expecting to have a premie or anything. I just would really like to skip the ultrasound completely, but I'd like to find answers to the questions I posed above if at all possible.</div>
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As a medical spouse, I can tell you that a LOT of doctors get a kick out of sneaking their wives into the hospital to catch a quick peek of the babe, every chance they get. It's like Tom Cruise wanting his own machine to look at his unborn whenever he wants. They do it because they can, not because they've evaluated the risks and benefits!<br><br>
As for your OB, I would think an easier approach than anticipating every possible excuse would be to respond to the ultrasound suggestion with, "What do you hope to find?" then "How will that affect my care? What alternatives are there to find that information?" and "Let me think about it and get back to you." THEN you can research and rebutt just the things you're not sure of!
 

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I'd think "no" should be good enough. If they didn't respect that, it might be time to find a new practice. If they have liability concerns, you could offer to sign a waiver. The line item thing seems to invite debate rather than express a final preference to decline. Or are you concerned that there is in fact a valid reason for doing the screening that you might be missing?<br><br>
I did get the 20 week screening, and no one mentioned pelvis size (that one seems like even more BS than dates). They did measure my cervix length, and the size of my ovaries as well. Found a cyst on one ovary, so now I know why kicks over there hurt! The rest was just shots of the heart and brain and other vital organs. They measured the femur and nuchal fold. We're planning a home birth, and we wanted to know if there were any conditions present that might require a change in birth plans or quick transport to the hospital. I do think there are some problems that do require immediate surgery or stabilization (certain heart or lung problems, gastroschisis, spinal issues), but if you are birthing in a hospital anyway (you didn't say), then the standard newborn evaluations should by all means catch those. That's just my personal reasoning. And they should respect yours without making you jump through hoops. When a provider offers a screening, I think the burden of proof is on the provider.
 

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If you have no real medical abnormalities or indications necessitating an ultrasound, just tell him 'no.' If he starts to patronize/argue/override, you say "no". If he schedules one for you anyway, you just don't go to the appt.<br><br>
Just don't do it if you're not comfortable with it.<br><br>
You're in charge of your healthcare. The doctor is an ADVISOR, he is not your lord and master.
 

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Discussion Starter · #7 ·
I think the "line-item-veto" is also very much for my personal peace of mind. If one of the many things they look at (it took about an hour for the one we had with ds) actually gives us valuable information that we can act on immediately, I would like to have a limited ultrasound that just looks at that specific thing. Just browsing for an hour and getting information of which 95% is of no immediate use other than to cause undue worry and agony seems like a waste of time to me. But I would hate to omit some part that would actually be useful. That is my concern.
 

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Let us not forget that women gave birth to healthy babies for thousands of years before the ultrasound. My Mom never had one and we all thrived<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"><br>
With my first two I was under the care of an OB and was a good little sheeple<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shy.gif" style="border:0px solid;" title="innocent"> so I had my share of U/S.<br>
My last two births were with a MW who agrees the unless there is a medical NEED there is NO need for U/S. If the baby wasn't growing they would be able to tell with fundal measurements and a true previa at term is so rare I wouldn't even worry about it.<br>
It seems to me U/S today is more about causing more stress making the Mama worry about baby size and bullying women into getting induced. Babies have been growing in Mommies since the beginning of our human race and it seems to me the plan works pretty well uninterrupted <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
Keri
 

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I highly doubt that if they give you an u/s sound that they won't look at thinks like placenta placement and such. I think that would technically be negligent on their part since that is routine in an u/s. And if you don't want to know, well, not sure how they'd handle that, but again I think that once you consented to an u/s that they would be negligent in not telling you things that could affect some of your choices. For example, I had a complete previa diagnosed at 12 weeks and it was upsetting for a day (mainly b/c my MW was not very comforting about it), but I was glad to have the information so I could be responsible about my activity (no lifting, no intercourse) and not aggravate a problem and make everyone worry. If they'd kept that info from me and I did have a bleed, that would have been a bad situation for everyone.<br><br>
So, if you don't want to know, I think you should refuse the u/s. If you do want to know some things, just know what the risks and choices are for the things you're not as interested in knowing and feel confident in your decisions.<br><br>
Not an easy place to be in, I know. I've wondered if I should have refused the 12 week u/s, but in retrospect, I'm glad I had the information so I could make choices about how to deal with it, even though it was worrisome.<br><br>
ETA: The only reason you may want to know about twins is so you can plan your diet accordingly. I know you need more protein with twins. This 2nd pg I'm eating the recommended 80 grams a day, didn't do that consistently with dd's pg, and it's made a tremendous difference in how I feel. With twins I believe you need something like 120 grams, which would take effort and planning. Just my .02.
 

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I didn't have any U/S with either of my planned homebirths. That choice did not affect the outcome in either case. It sure did make for a peaceful, relaxing pregnancy though.<br><br>
This time I am seeing a hospital-based CNM practice. I was offered the 20 week u/s if I wanted it. DH and I asked what the benefits to having it were. The CNM told us there was ZERO improvement in OUTCOMES from having a 20 week routine U/S. The ONLY difference in outcomes is that women who have that have a higher rate of terminations, because they are told their baby has a "defect."<br><br>
No comment on that, except to say after losing one child, I don't care if my baby has three eyes and cleft palate and club feet and down's... I just want a LIVE baby. I'd have been ECSTATIC if my son had lived, even with brain damage. I'd take caring for him every day of his life over only being able to visit his grave ANY DAY.<br><br>
So obviously, that reason for having an U/S doesn't apply to me. I'm with the OP, I'd rather have a peaceful pregnancy, and deal with any health issues after the baby is born.<br><br>
It sounds like from your post, you don't have any medical reason for an U/S, and you'd prefer not to have one. You're perfectly within your rights to decline ANY prenatal test, including one the ACOG and the FDA both say is unnecessary and not advised (routine U/S with no medical indication).<br><br>
Kathryn
 

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Say no thanks and relax. You have given this alot of time and thought, and probably stress too. We can live our whole lives with "what ifs" ....and really all we can do its take the information we have on hand in this moment and make the best decision possible. There are no gurantees.<br><br>
If you go with it, take away the info you do want and lay to rest the rest of it.<br><br>
Like the PP, I too have lost a child shortly after birth, and all the planning, questions and education don't comfort you.<br><br>
GL!
 

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Ya know... I seem to recall reading that some major "authority" has, as their "official" position, that U/S are only to be used if "there is some reason" that "more information is needed." IMHO, that means that IF something seems off, than it can be a diagnostic tool. IMHO, that does not mean "let's do lots of them cause it's fun to "see" the baby and plan the nursery."<br><br>
So, um, yeah.... "no thanks!" should be just fine. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

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Just to answer a couple specific parts of your question...<br>
Re: deformities--for some conditions, such as spina bifida and hydrocephaly, in utero surgery is often preferable these days due to major complications that may occur at birth.<br>
Also, to second the PPs comments regarding twins--certainly, you would figure it out around 20-22 weeks anyway with a competent care provider, but, the comment regarding protein is dead-on: 120-150 grams of protein a day is highly recommended, as is putting weight on early--for example, an optimal weight gain for an average-sized mom is roughly 24 lbs by 20 weeks. So, if either of those things were to apply to you, the 20 wk u/s might be a consideration, but certainly not a necessity.
 

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I didn't have an ultrasound with DD 5 years ago. When the CNM mentioned it at 20 weeks, I asked if we needed it & she said no. We decided not to. This time, I had one. Only because I had a c-section with DD & I'm planning a vbac. For my own piece of mind, I wanted to know where the placenta was. I think its one of those things that's overly used. However, I think it someone wants one, then that's fine too.<br><br>
L
 
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