A womb with a view

BY HOLLY HANER-LO

We have just entered week 20. It’s been a while since my last blog post, and here I am journeying through the ups and downs of pregnancy after miscarriage. It hasn’t been an easy 20 weeks, even though physically this has been a very healthy, problem free pregnancy.

The emotional ride of counting down the weeks, waiting for the feeling of impending doom to finally lift, has been the difficult part.

Part of this healing journey has involved us making decisions that before we would have had no problem making, but this time we found ourselves cautiously choosing differently. One of the big changes for me was my feelings and opinions of ultrasounds. With our first we had the “routine” dating ultrasound because there was much uncertainty over conception date, and again the 18 week anatomy scan. Now a few years wiser (?) and more experienced, I figured with the next baby we would only do the 18 week scan, if any at all.

So here we are, heading in tomorrow for our second ultrasound. Why?

My heart and soul needed that reassurance of a little life thriving inside me before we could pick up the heartbeat externally. Not just for me, but also my husband and 3 yr old son, who asked me every morning if our baby was still in my tummy and could we please keep this one. We needed reassurance.

So what is the big deal about ultrasounds anyways? As far as interventions go, the risks are mild compared to epidurals or induction. Yet, like those interventions, ultrasounds have their place.

I think we are birthing in an intervention-heavy society in North America, while our infant and maternal mortality rates are still frightening. (But that’s a topic for another day, I could talk forever about the misuse of interventions!) When are ultrasounds a safe and necessary precaution, and when do they cross the line into preference, convenience, and entertainment? Repeat, excessive use of ultrasounds in pregnancy is shown to cause hearing damage to the baby, heats the amniotic fluid and fetal tissue, and in essence is an invasion on baby. There are even studies showing possible links to autism and neurological issues.

So what is excessive?

According to the American Medical Association, “Unnecessary Exposure” includes the use of ultrasound to:

1. Confirm the sex of the baby.

2. Assess gestational age (how many weeks old the baby is).

3. Assess fetal size and growth.

4. Confirm multiple pregnancy.

5. Determine fetal presentation (the position of the baby in the womb)

Wow! How many times have we ourselves or someone we know had “routine” ultrasounds for just these reasons? If nothing else it should certainly cause us to stop and think about it, as well as do some research of our own.

One thing I teach in Nurtured’s childbirth educations classes to couples is to BRAND every decision and procedure that is presented to them in pregnancy and birth. BRAND stands for Benefits, Risks, Alternative (options), Nothing (do nothing) and Delay (the decision). The problem is, we have been so well trained to not question our prenatal care that procedures such as prenatal testing and ultrasounds pass by as normal, routine, and 100% safe. That’s not the truth. Now we see the new prenatal testing option for gender identification being offered as early as seven weeks gestation. Raise your hand if you’d like to be the guinea pig for this one…

With the arrival of 3D and 4D ultrasound businesses comes a whole new level of risk and dilemma. Using the BRAND model, if used simply “for fun”, the risks far outweigh the entertainment benefits (I cringe to even say that). Interestingly enough, the medical field is strictly limited, by the manufacturer, in its energy level for this type of ultrasound, as well as the duration of time it takes to perform the scan. (The FDA limit for obstetrical ultrasound is 94 mW/cm2.[7]) The risk of ultrasounds would depend on the duration (length of time for each scan), the intensity (of sound waves) and the frequency (how often). While I can see the benefit to parents with a baby needing life saving surgery while in utero, or to pinpoint a serious defect, I cannot feel good about paying a non-medical, independent company to scan my baby for up to 30 minutes simply so we can have a peek. I cringe further when I read their “packages and promotions” on websites, offering 20-30% off for your second, third, and repeat visits within your pregnancy.

The bottom line is, less is best when it comes to our bodies and our babies while growing another life.

What seem to be wonderful medical advancements can become an abuse of interventions. How can I say all of this and yet admit that tomorrow we will be having our second and final unltrasound? Because for our family, this was our “less”. Will I probably drive the technician crazy by asking them to keep the scan at under 15 minutes of at all possible? Maybe. But it’s our baby, not a dolphin in there. The frequency is extremely loud, it heats fluid and tissue, and I hope it can be over as quickly as possible.

Will we find out the gender? If, in that time frame it’s seen and noted, then yes. If not, that’s fine too. All that matters is that little heartbeat. After losing our last pregnancy, we need this extra view into the womb. I’m praying in the future our faith will be restored and we can say no thanks to routine.