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............
�..� ���)) -:�:-
�.�� .����))
((��.�� ..�� -:�:-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
