I know of a woman who was booked in for a termination because at 18
weeks the ultrasound picked up a leak in the membrane and they said that
the baby would end up with no fluid and would die. She was so
destraut that she went and had another ultrasound done the day before the
appointment - the leak had stopped, baby had moved and blocked it some
how.
He was born full term and healthy.
She was a low income woman - Dad had been in and out of jail about 30
times, they were as rough as they come but lovely people really and I
was sure they looked at her and did not question termination bassed on her
"social standing" rather than checking as she had to go and have a
private second oppinion. I told her that she had the right to do
this and she was so glad that she had.
Another thought to bring up (gently, if they are afraid) is the great
possibility for error, not only in judging the size of a baby, but also
any potential problems. How often have parents been needlessly
frightened about potential "deformities" only to have perfectly healthy
children born to them? What if they decided to abort based on that
information - and then were wrong? A friend of a friend :) was told
that her baby was cephalic (!!!!) and strongly advised to terminate
immediately. Despite strong pressure, she decided to carry her baby
to term regardless of the outcome. Meanwhile she, her husband and
many friends and family were praying for them. When their child was
born (at term) she was PERFECT!
What if....what if....what if............
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((��.�� ..�� -:�:-Blessings,
-:�:- ((��.��* Aron
"Whenever I feel blue, I start breathing
again."
----Original Message Follows----
From: "Sally Westbury"
<[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
Subject: RE: [ozmidwifery] FW:
[birthnews] Social use of Ultrasound in Pregnancy
Date: Fri, 15 Nov
2002 08:44:11 +0800
The women I work with usually don't have
ultrasounds. It is easy with
this group of women who are making
informed choices throughout their
journey.
I approach
ultrasound discussions from many viewpoints.
1. Safety?? Or lack
of??
2. The usefulness of the u/s,ie what will we do with the
information that we gain, will the information change the pregnancy or
birth plan. In the harshest terms if at 18 week scan there was an
abnormality would she terminate the pregnancy?
When put in
this light many choose not to have one.
Sometimes the benefits
outweigh the disadvantages, for example a woman
so worried about
whether her! ! baby is 'normal' an ultrasound can be of
great benefit.
Even then it just shows me that in fact what we need to
do is to work
with this woman's belief in herself and trust in her
pregnancy,
birthing and parenting and so another bridge is crossed on
this
particular journey.
It is not often clinically needed and even
then often is not as
enlightening as we would hope. For example a
woman really worried about
having another big baby after a 3rd degree
tear first time around was
assured that her baby was 3.6kg one week
before the birth (even though
we thought this was not correct) was in
fact 5.2kg.. (no this is not a
mistake 5.2kg)
I guess in
having a little review of the literature one that reassures
me that my
general way of practicing is on track is that the use of
ultrasounds
has not changed outcomes for mother or baby. So in light of
the
research u/s is just causing a lot of angst with misdiagnosis and
cost! ! s the health system huge amounts of money. (see Cochrane
review
http://www.update-software.com/abstracts/ab001450.htm )
Sally Westbury
-------------------------------------------------
I had a chat
with my hubby about this issue as he is a sonographer.
On the accuracy
of the image representations they are actually very
accurate. Yes the
image is a computer composite of ultrasonic images
but the information
received is accurately calculated into a composite
picture - not an
interpretation - based on the measurements that bounce
back off the
item being ultrasounded be that a kidney, bloodflow or a
baby. The
images are an exact representation of what the ultrasound
wave bounced
off not an average or range in the same way that percentile
graphs
are.
Hubby indicated that the best analogy for how an ultrasound
image was
produced was a photograph. The only difference being that
normal
photography uses light waves! ! while ultrasound uses
ultrasound waves.
They are all the forms of energy just osillating at
different
frequencies and thus the energy's ability to penetrate and
the output as
visualised by the human eye differs. What ultrasound
scanning does via
the computer is allows us to see what ultrasound
energy can see that is
usually not visible to the human eye.
As for the safety, hubby has indicated this is a very contentious
issue
in the industry. Whilst there have been no studies that prove
that
ultrasound is safe - there is nothing but anecdotal evidence and
weak
correlations that prove it is dangerous. It is a naturally
occuring
form of energy in our environment - given - not usually at
the
intensities used in ultrasound scanning. Realistically to choose
to or
not to have ultrasound - whether for fetal wellbeing or anything
else -
is just a risk analysis. The only difference between this and
other
things related to pregn! ! ancy and childbirth is that we don't
have a
specific bad outcome that says its risk percentage is X%.
Using the arguement that it hasn't been proven safe will never
work as I
am sure that I could also prove using statistics that of all
the babies
born with Downs Syndrome that 80%+ of their mothers ate
potatos or rice
- does this then mean that these cause Downs Syndrome
or alternatively
if you eat these you have a X% risk of Downs
Syndrome. Until we have a
specific outcome that can be proven to be
caused by ultrasound, whilst
eliminating other possible causes, we
have no choice but to assume it is
safe - if we don't then women
should also be counselled against a myriad
of other normal life
activities that have at one time or another been
questioned for links
to medical problems (I remember computers and
photocopier radiation to
unborn babies being an issue in the early 80s).
By all means
exercise caution and do not re! ! commend unnecessary
procedures but
don't scare women of possible consequences when no such
consequences
have ever been proven. Women get enough fear instilled in
them from
the obstetricians.
Far more valuable is to spend time educating
women of the ones we know
are dangerous with proven risks like drugs
in pregnancy and unnecessary
caesarean sections.
Debby
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