ultrasound issues - lots of ultrasound info here

[The Morrigan]

Mother rails against ultrasounds
http://www.gentlebirth.org/archives/screen.html

Discussion around IUGR and ultrasound
http://www.gentlebirth.org/archives/usoundtd.html

Prenatal screening for birthdefects/ultrasound
http://www.gentlebirth.org/archives/preScreen.html

Ultrasound scans - cause for concern
http://www.joyousbirth.info/articles...orconcern.html

Placenta previa - 97% of early diagnoses are misdiagnosed.
Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial.
Saari-Kemppainen A, Karjalainen O, Ylostalo P, Heinonen OP
Lancet 1990 Aug 18;336(8712):387-91
The Saari Kempaainen study revealed that 150 women were diagnosed as having placenta praevia; when they got to term only 4 women actually had it. In the control arm the women who were not exposed to ultrasound also had 4 women whose placenta praevias were discovered when they went into labour. Both sets of women had caesarean sections and there was no difference in outcomes. The researchers did not investigate the amount of stress a diagnosis of placenta praevia could have caused in the 146 misdiagnosed women. This research shows that early diagnosis of placenta praevia is irrelevant and a complete waste of time, yet doctors and midwives persist in telling women they have low lying placentas.

V, Duque A, Schafer ME, Rakic P.
Department of Neurobiology and Kavli Institute for Neuroscience, Yale Medical School, Sterling Hall of Medicine, Room C-318, 333 Cedar Street, New Haven, CT 06510, USA.

Neurons of the cerebral neocortex in mammals, including humans, are generated during fetal life in the proliferative zones and then migrate to their final destinations by following an inside-to-outside sequence. The present study examined the effect of ultrasound waves (USW) on neuronal position within the embryonic cerebral cortex in mice. We used a single BrdU injection to label neurons generated at embryonic day 16 and destined for the superficial cortical layers. Our analysis of over 335 animals reveals that, when exposed to USW for a total of 30 min or longer during the period of their migration, a small but statistically significant number of neurons fail to acquire their proper position and remain scattered within inappropriate cortical layers and/or in the subjacent white matter. The magnitude of dispersion of labeled neurons was variable but systematically increased with duration of exposure to USW. These results call for a further investigation in larger and slower-developing brains of non-human primates and continued scrutiny of unnecessarily long prenatal ultrasound exposure.

PMID: 16901978 [PubMed - indexed for MEDLINE]

Prenatal Ultrasound
http://www.icpa4kids.org/research/pr...ultrasound.htm

Perhaps a more prudent approach would be to define medical necessity as "life saving" and forgo prenatal ultrasound procedures for less relevant reasons. The original axiom of medicine "first do no harm" should always beconsidered when determining "medical necessity" for ultrasound.

On the "safety" and "usefulness" of prenatal ultrasound - heap of studies
http://www.alternamoms.com/ultrasound.html

http://acegraphics.com.au/articles/wagner02.html

Quote:

Ultrasound: More Harm Than Good?
The ultrasound story begins in July 1955 when an obstetrician in Scotland, Ian Donald, borrowed an industrial ultrasound machine used to detect flaws in metal and tried it out on some tumours, which he had removed previously, using a beefsteak as the control. He discovered that different tumours produced different echoes. Soon Donald was using ultrasound not only for abdominal tumours in women but also on pregnant women. Articles surfaced in the medical journals, and its use quickly spread throughout the world.

[TOR]

http://www.midwiferytoday.com/enews/enews0802.asp


{{snip}}

Prenatal Ultrasound

'It is ironic that women who have had previous miscarriages often have additional ultrasound examinations in order to "reassure" them that their baby is developing properly. Few are told of the risks of miscarriage or premature labour or birth'...

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[TOR]

Heart Beats or Heart Messages?



Did you have a scan during your pregnancy? Maybe even more than one? Did you give it much thought? Did you investigate before you subjected yourself and your baby to this medical procedure? A medical procedure that, ironically, under medical guidelines should only be used in very high risk cases and for very good reasons.


Did you make a truly informed choice? How much did your midwife or doctor or indeed the radiographer explain to you about the procedure, its effects and implications? Keep the answer to this in mind as your pregnancy progresses and remember how you responded to the offer of a 'simple medical procedure', how well your care provider informed you or how much you listened to your heart and your baby.


Did you go along for a scan because it's what 'everyone else' does? And, of course, it is pretty exciting to catch a blurry glimpse of your baby five months before nature intended. Or did you believe it to be harmless because the health care providers you put your trust in failed to reveal all?


Did you allow your fear of possible problems with your baby to distract your decisions and sidetrack you from the answers and knowing that are all there, in your heart?


If you're considering a scan, do search long and hard about your reasons. If there are serious medical indications for scanning, carefully explore the implications of any results and the degree of accuracy. There are significant numbers of healthy babies medically aborted as a result of inaccurately diagnosed scans and subsequent tests. Any answers you need lie with your baby.


Babies move away from ultrasound scans, hand-held doppler heart beat detectors, electronic foetal monitoring. They know. Their wisdom runs deep. Deeper than we give them credit for. It has been known for over twenty years that cells are significantly altered by such scans, hence the strict medical guidelines mentioned. I've seen the recordings of experiments showing the obvious cellular effects and they are not pretty.


Cells that are neatly lined up and vibrating gently and orderly before a scan, are jumbled up and moving chaotically in all directions at high speed afterwards. Other mammal experimentation shows this effect continues not for the duration of the scan, nor for minutes, hours or days afterwards, but for generations!


Bearing in mind when a woman has a scan and is carrying a baby girl, that baby carries the eggs of her future grandchildren. Do we really want to subject them to cell altering (and unnecessary) tests? Is it any wonder more of our younger women are having fertility issues?


Hardly recommended for anyone, but there is some suggestion that scans cause silent bleeds, which are particularly significant to women who are Rh-, with Rh+ partners (especially if they are choosing not to have the anti-D vaccination/s). It is also not unknown for women to bleed vaginally after a scan. One woman who bled after a scan was reluctant to have one with her second pregnancy but was assured there couldn't possibly be a link. When she subsequently bled again and asked for her bleeding to be recorded, she was told it couldn't as there was no scientific evidence of a link!


I think scans are, probably inadvertently, offered routinely at a particularly vulnerable time. Mum-to-be has been pregnant for l4ish weeks (at 16 weeks); quite a long time, with little as yet to show for it. No significant telltale bump...no movements yet felt.


Often the only indications of pregnancy have been tiredness and/or nausea. For Dad, he hasn't usually seen or felt much physically, baby-wise, and may see a scan as his first connection with his baby. It's so tempting to catch an early peep to be assured that there actually is a baby alive and kicking and very real. I wonder if fewer parents would take up a scan option if it was offered 4 - 6 weeks later, once parents have felt the baby themselves?


The hand held Doppler is a quick and easy way to detect a baby's heartbeat. Anyone who has ever used one is aware of how babies move away from them. Why would they continue to use one? Do you want your lead maternity carer to have so little regard for your baby's wishes?


It seems it is too quick, too easy...no longer are midwives learning and practising to use the pinnard or stethoscope to effectively hear a heartbeat.

Or, even better still, learning and practising the ultimate skills of hearing the mother to tell her how the baby is - encouraging and empowering the mother to hear her baby and her heart - instead of relying on technology to hear merely a heart beat.

So, if you are hoping and planning for an informed, empowering birth, remember you need to own it. By your choices, actions or inaction, investigations or lack of knowledge, you create it.

If you choose to have a health care provider involved, do ensure you have someone who does not need to hear a heartbeat, but instead empowers you to hear the needs of your baby - and your heart.

Published in The Mother magazine Issue 16 Winter 2005/2006


Recommending reading:

Anti-D by Sarah Wickham
Sarah Buckley's Ultrasound: Reasons for Caution The Mother magazine, Issue 2
Ultrasound, weighing the risks Mothering, Sept/Oct 2000

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[Ilithyia]

I don't want to have any ultrasounds, but I have to confess that I am concerned that there could be something wrong that could be prepared for in advance if I have an ultrasound.

What I really want to know is; are there other ways to find out what's going on inside me. For example, what position is bub in, how many bubs are there, where is the cord and is it a safe length.
Eg. can I get a midwife to poke me and find out that info? Or do I just have to not-know and hope for the best.

I get that its all about trusting reproduction and my body, but if I can be prepared for things I would like to be.

[fleen]

yep, position and multiples can be detected by a good mw. cord length is really irrelevant anyway, your baby will have the perfect cord length for him/her.

as far as making the desicion based on being prepared, its a question of whether you would do anything differently given unexpected results. if you wouldnt then why scan?

ETA: here's a huge hug coming your way too! you'll know whats right inside yourself. we scanned coz i hate surprises!

[SassyMama]

Like Kath said, a midwife can tell most of what you asked, by feel and listening with a scope. Though, sometimes, a second heartbeat will not be picked up until later in the pregnancy, 17 weeks or so, with just a scope. Depends on where the second baby is during that check.

The cord length, no, that they cannot tell. Even with a u/s, as far as I know.

For a more personal opinion, I did get a 20 week anatomy scan. I had 2 scans the first time, but only had the first as I had been cramping off an on for a few weeks (I was 9 weeks at that time and it was starting to concern me that it wasn't stopping) and my GP said we could look and see that all was well, so a quick, few minute scan was done. A small cyst was found on the side I was cramping on which explain that, and it was gone by 20 weeks.

For me, the 20 week was just to make sure that everything was where it should be and there were no physical issues that could be easily detected, which would need quick attention at the birth. I was amazed, when the doctor at the scan pointed to hands and feet movements and then listed about 5-6 problems, that the baby did not have, as if it did, the hands/feet would not have been moving like that. I didn't know there were things that could be checked off so quickly, just by a finger wiggle.

I want, as much I can be assured, that at birth, we are all full of bubbly joy, and not an OMG panic over something that could have been known. But that is just me..and as I am 36, I am in a higher risk group for abnormalities than you would be (there is also family history, we don't need to get into, which I considered). If the pregnancy is normal and the mother in good health (sans cramping at the start), I really cannot understand any other scan than a 20 week scan for anatomy, for any reason.

Just do your research and you will come to terms with what you feel right with.

Megan

[The Morrigan]

You can pretty easily tell the position of a baby if you read up optimal foetal positioning and visit the spinning babies website. It's really obvious from where their back lies and where you feel kicks. And since you're planning a freebirth that information doesn't really matter anyway since no one is likely to tell you to transfer for a posterior baby, or that breech is life threatening and you have to be chopped up.

The thing with having a "just in case" or "reassuring" u/s is that it's often anything but reassuring and once you're on that medical path it's mighty hard to climb off. No doubt you've read countless posts on JB from women struggling with just that. One dodgy result leads to more testing and on and on. Unless you would abort a baby before the legal 20 week limit, you want to think really carefully about what you want from an u/s. Doesn't the research into it give you pause for thought? Or your own opposition to the medicalisation of pregnancy and birth? What happened to that??

[Ceridwen]

The position of your baby isn't static - it can and does move numerous times during gestation, right up until it is fully birthed. An ultrasound would be useless for judging babe's position because the baby would probably move vigorously during and after the ultrasound (to get away from the ultrasound) so could be in a completely different possy five minutes later and anyway, why would it matter? Birth is instinctive and "knowing" which way your baby is lying won't help you instinctively move into the right position for birthing said baby; that just happens, and staying in a conscious mind of "preparation" can actually hinder that, not help it.

Safe cord length? What's that? Cord length can't be judged by ultrasound and it's sort of an odd thing to be concerned about...? Your baby's cord will be the perfect length for it, whether that is exceptionally long, short, or just medium...what are you concerned about here? Cord around neck/body? You know that's not a concern and there's nothing you can do about it in utero anyway, right? Short cord? What would be the problem with a short cord, other than a need for a bit of extra maneouvering when baby is born in order to cuddle/boob?

How many babies, well, you could probably tell that yourself, intuitively or through palpating your own belly if you knew how (and there are many who could explain it to you), or simply because you would eventually become stupendously huge and ponder whether there's more than one in there. Or a MW could palpate and tell you. Or you could just surrender to not knowing like you've always been so passionate about doing...right?

I'm really confused to see you posting this. I know you're extremely well informed and you've read countless articles, anecdotes, stories, evidence-based studies (etc) on ultrasound and you've always taken a firm stance on them based on that solid foundation. Obviously it's a topic fraught with more emotion when you're actually pregnant yourself instead of just talking theoretically. Still, though...what's going on?! The urge to be "in control" and "prepared" of pregnancy and birth through technology has a medicalised patriarchal core and I didn't think that sat well with you?

can I get a midwife to poke me and find out that info? Or do I just have to not-know and hope for the best.

I get that its all about trusting reproduction and my body, but if I can be prepared for things I would like to be.

That sounds like you're asking for overt permission and direction on what to do. You don't "have" to do anything! Perhaps it would be a good idea to sit with your feelings and thoughts and reflect deeply on exactly what you actually believe, think, feel, want and need, and then just act on that. There's some conflict going on internally in you and only you can figure out why and resolve it.

[alaanja]

The position of your baby isn't static - it can and does move numerous times during gestation, right up until it is fully birthed.

I'm learning palpation at the moment and agree with this - we're told at uni we can 'predict' what the labour will be like based on the baby's (apparently quite static) position - this is true to some extent but is mostly hogwash.

If you are curious about what your baby's doing at a given time you can gently feel yourself - that way you know what is comfortable for you and don't have a weird person poking you As you get to know your baby you'll be quite familar with was s/he's doing and roughly where she is - but also know that s/he's where s/he needs to be. I can give you some information from uni about palpation if you would like, or you could ask a midwife for a rough idea.

In early pregnancy, babies do summersaults and swim around happily and move all over the place, so yeah, ultrasounds = useless for position. In later pregnancy, palpation will tell you where the baby is if you want to know - and you'll know from the kicks!

It must be hard, putting all the theory into practice and learning to really trust your body - all the well meaning societal influences kick in. Love to you, just listen to your instincts - you'll know what to do.

[Morgaine]

If you are curious about what your baby's doing at a given time you can gently feel yourself - that way you know what is comfortable for you and don't have a weird person poking you

Heh, unless you're me and never work out where the hell everything is. I could always *almost* work out where everything was but ended up asking my MW for a more detailed idea at antenatal visits.

For the record, I was convinced to have a 20 week scan and I regret it. It was nice to see the baby, yeah, but I felt intensely guilty as we left the hospital. I also had a few second scan at 34 or 35 weeks to check if he had turned bum up (breech was a concern) which I can justify a little more than the 20 week scan. At least in that case we were checking something that could impact on birthing options not to mention my needing to mentally prepare for a breech baby if I had one. Needless to say, next pregnancy is a no scan zone unless otherwise indicated.