Why not to have an ultrasound

Some things serendipitously fall into my lap. I had been thinking about writing a post like this for a while, and then today found someone who said it even better than I did (plus has done the research that I haven’t done!) — Ultrasound and Fury: One Mother’s Ordeal.

In short, her baby girl was diagnosed by three different doctors (including at least one specialist) as having club foot, so they spent the remainder of the pregnancy researching club foot, trying to come to terms with the diagnosis. At birth, the baby was perfectly normal. Other parents and babies aren’t that lucky — aborting babies who turned out to be healthy and normal, or continuing the pregnancy under a deep cloud at a diagnosis more serious than club foot.

There are some benefits of ultrasound — some parents have said that knowing their child’s diagnosis (when it was accurate) prior to birth helped them to prepare for their baby’s condition after birth, or to prepare for a stillbirth or a short life after birth. There are a few conditions that can be diagnosed prior to birth and either fixed prior to birth (extremely rare) or (occasionally) to be ready for immediate surgery or care at birth; however, the research the author cited showed that there was no significant benefit to having ultrasound done routinely, as opposed to it being done when there was reason to suspect something was wrong — such as the baby not seeming to be growing.

Of course, if you’re the parent of a child for whom ultrasound was a benefit, then it’s significant to you. However, if you’re the parent of a child who was wrongly diagnosed by ultrasound, it’s also significant to you.

This also doesn’t take into consideration that there may be harms of ultrasound even when there is no misdiagnosis. I’m convinced that most babies sense that there is something going on when an ultrasound or Doppler is aimed at them, even if it’s supposedly out of the range of hearing. Doppler was used on me during my first pregnancy to find the fetal heart-tones, and my baby ran from it every time — far too consistent for it to be a fluke. I’ve seen recent news about doctors trying to use a blast of ultrasound to render men sterile for 6 months. I’m assuming that this type of ultrasound is not exactly the same as what is used in a typical prenatal appointment — that it’s either stronger, longer, or more directly applied… but it still makes me wonder — if ultrasound can stop men from producing sperm for several months, what else can it do? Just like electricity can be used for good, powering this computer, it can also be used for bad, maiming or killing someone. I wish ultrasound were better studied, to make sure that it was only used for good, and keeping it from harming people as much as possible.

The use of ultrasound scanning during pregnancy is now so widespread it seems almost as banal as taking a patient’s blood pressure. Unlike amniocentesis, it is considered safe, noninvasive and painless for both mother and child. Formal studies indicate that 70 percent of all pregnant women get at least one scan, and the true number is probably higher, said Dr. E. O. Horger 3d, chairman of obstetrics and gynecology at the University of South Carolina School of Medicine in Columbia. If a woman does not request ultrasound, many obstetricians will recommend it, as mine did, ”just to see how things are going.” They make that suggestion even though the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians and other medical organizations advise against the routine use of ultrasound in pregnancy.


15 Responses

  1. Thanks for this post. It’s a shame that ultrasound and dopplers are used without long term studies. I’ve read that ultrasounds make cells more permeable and makes cells differentiate and migrate differently. Autism, dyslexia, left-handedness, behavior problems, fertility issues may all one day be linked to ultrasounds and dopplers. Dopplers have more power than ultrasounds. I wonder if more midwives will go back to using Fetoscopes and Pinards

  2. Kathy, How did you sense that the baby was moving away from the doppler? Did you feel the baby moving?

    • No, I didn’t feel the baby move until around 20 weeks (which is common for a first-time mom). However, the midwife first tried to get the heartbeat at 9 weeks (my first prenatal), and didn’t find it, but she cheerily said that it is common not to be able to get the heartbeat by Doppler that early, because the baby is so small, so not to worry. At the next appt (13 weeks), she *still* couldn’t find it, and said that was not common, but most likely everything was okay, so not to worry… but she scheduled my next appt only 2 weeks later. *Finally* at 15 weeks, she was able to get the heartbeat, but it was so fleeting that she didn’t have the opportunity even to time it to see how fast it was, and couldn’t find it again, although she chased him all around my uterus with the Doppler trying to get him again. Then, every time she put the Doppler on, he would move, although later in pregnancy he wouldn’t be able to move away. [I didn’t really associate it with the sound waves for a long time; at first I thought it was just a fluke and joked that he must be hearing it and running away from it. Now I believe my “joke” was accurate. He always would kick when I pushed on my belly, so him moving/kicking with the Doppler wasn’t surprising at the time.] Even when I was in labor, pushing him out, the two times I remember her checking his heartbeat, he moved when the Doppler was applied. One time he twisted around and another time he moved back up into my uterus. Maybe it was a fluke, but with him moving (away) practically 100% of the times the Doppler was applied during pregnancy and even during labor, it seems like a huge coincidence, if it was indeed merely a coincidence.

      • With your second child how did the Midwives find the heartbeat? Did they use Fetoscopes or Pinards?

        There have been no formal studies on this but some women report “jumping babies” during dopplers and ultrasound. I wonder if nuchal cords are more common today with some babies running away from the sound waves. I wish there was statistics about the amount of nuchal cords prior to ultrasounds and dopplers. With your second child how did the Midwives find the heartbeat? Did they use Fetoscopes or Pinards?

        • Mostly fetoscopes, but once they used a Doppler because it was hard to hear the heartbeat, thanks to my, *ahem*, extra maternal cushioning. :-/ But I didn’t go to a midwife at all until almost the 3rd trimester, so it wasn’t an issue about trying to get a heartbeat before then. My first son had a nuchal cord; my second one did. Possibly a coincidence. 🙂

  3. Wow, pretty sure being left handed is not a disability nor an issue. Thanks for the bias Sharon, I know my husband, son, grandfather, uncles, sister, sister-in-law, father-in-law (oh, and only ONE had ultrasounds taken of them) think they have a problem. For that matter autism is strongly linked to genetics, as in the condition seems to be inherited – as is dyslexia (again, many people in my family with that and never ever was any of those machines used in their neonate state).

    As for aborting due to club feet, are you joking? What reasonable person does that? REALLY! If they do perhaps reproduction is not something they are really ready to do. Most people I know who have seen something off about their fetus fuss about it, worry the whole rest of the pregnancy, but do not end for such piddling issues! Even when there are real problems they don’t end the pregnancy.

    Oh yeah, link does not link to anything other then a search page.

    • The link works fine for me; not sure what’s the problem. Here it is again, just in case: http://www.nytimes.com/1996/11/26/science/ultrasound-and-fury-one-mother-s-ordeal.html?pagewanted=all

      I don’t know whether people have aborted because their unborn baby has a club foot, but they have aborted because of cleft lip — there was a recent story of a baby born alive after an abortion in Italy; he was set aside to die, and when the priest came in several hours later or even the next day, he found the baby still alive, so they attempted to keep him alive, but it was too late then. I think he was aborted around 22 weeks, for cleft lip.

  4. I am so thankful I opted for an early ultrasound. It was wonderful to see my little baby’s heart beating at six weeks and take home a picture. After a second ultrasound in the second trimester (b/c they couldn’t find the heartbeat w/doppler) I found out that my baby stopped growing and I had to have a D&C because my body wasn’t letting me miscarry naturally. The memory of seeing that little heart beat and the only photo I will ever have of my child are such precious, precious treasures. I don’t want to be contrary, but I do want to shed light on both sides of this issue.

    I do agree with you that more research has to be done on the short and long term effects of these procedures. Regardless of the research findings, it will be a great benefit to our prenatal body of knowledge.

    Personal blog: http://launderlife.wordpress.com

    • Additionally, without doppler and ultrasound it can be very late in the pregnancy before a doctor can attempt to hear a heartbeat with a fetoscope or stethoscope. I can’t image going on another 9 weeks without knowing my sad loss. The body does not always naturally miscarry when the pregnancy is no longer viable. The attachment of a mother and child grows exponentially deeper with every week that passes in pregnancy, and in my mind, makes the loss all the more painful.

    • Thank you for your comment; there are always two sides to every story. 🙂

      And I am sorry for your loss; I know it was heartbreaking.

  5. Ethel, I didn’t mean that left-handedness or autism or dyslexia is a disability nor did I mean to lump them all together. Left-handedness is not a disability and I should not have included it in my last post. Sorry if I offended you.

  6. As for Ultrasound, I’m opposed to it for two reasons:
    Long term effects on first and second generations have not been studied. However, my main reason for opposing ultrasound and genetic testing is that some women abort when they find a “defect”. Many times tests are false/ positive vice versa. When i do a google search for “risks of ultrasound/doppler” I’m convinced we don’t have enough information on the effects of these powerful machines.

  7. My grandfather had dyslexia and I have a cousin who is autistic . What I meant is that the rapid increase in Autism, dyslexia, and learning disabilities may be linked to cell permeability. Ultrasounds and Dopplers make cells more permeable. Ultrasounds are used in physical therapy to break up scar tissue. If a baby has a genetic predisposition for dyslexia or autism those genes can be silenced and the autism may never show up. However, If for some reason their cells become more permeable and they can let in more “toxins” then their genetic predisposition may be heightened to express dyslexia/autism. There is a great book by Beverly Lawrence Beech called Ultrasound? Unsound? She brings together many science articles about the effects of ultrasound/doppler. I just wish this information was made available to more women. I think most women would make an informed decision and decide to make an error on the side of safety.

  8. I’ll be having just one ultrasound in my pregnancy, and it was a tough decision to decide to have one. I really needed to walk the line between making myself more comfortable in my pregnancy (being reassured that everything is okay), and also not folding to this ridiculous culture of needing to know everything at every second. Some of my friends have had up to NINE ultrasounds in a single low risk pregnancy.

    The effect of ultrasound isn’t known–mostly because its unethical to do research studies on pregnant women. And the rate of misdiagnosis is just too high for me, for abnormalities and fetal weight both.

    My baby also ran from the doppler, at both 10 and 12 weeks.

  9. (apologizing in advance for the length of this comment!)

    I find this post interesting-having been on both sides of this experience.
    I have always looked forward to that one prized mid-pregnancy u/s to get a peek at the little one growing inside me, and-selfishly-so I could know whether it was a boy or a girl that I was planning for. Honestly, with my first child I don’t think I even gave much thought to whether or not things were “ok” in there, I just wanted to know pink or blue!

    Jump a couple of years to two of my other babies. Both of these babies had choroid plexus cysts. With the first of these babies, it was a single cyst, I was told “it will be fine, go away on it’s own, it happens all the time.” Thankfully I had a care provider that was a close personal friend and someone I absolutely trusted, so I took his word on it. And he was right. With the second of my CP cyst babies, there were multiple cysts, some of significant size. Since my first was also before the days of googling oneself into a panic, I now delved in to the online stories of what all of these cysts might mean. Panic ensued, and the wait of 6-8wks for a follow up u/s was excrutiating. Thankfully everything turned out fine, the cysts disappeared on their own, just like the first time we’d experienced this.

    Fast forward to now. I am 30 weeks pregnant with my eighth child. I have continued to have that one u/s during my pregnancy, despite the scares in the past. And this time, at 18wks we again took a peek at our little boy. It was only minutes after returning home from that u/s that my midwife called and said the words that are forever burned into my mind, “Can you meet me at my office? I need to talk to you about your u/s and I’d really rather not do it over the phone. We have some concerns about your baby’s brain….there are some problems.” I knew this was more than the “concerns” with cysts had been in the past. Turns out my baby has a fairly severe case of hydrocephalus. Hopefully that is all, though there are other “iffy” things that we have found with follow up u/s within the structure of his brain, and hopefully the MRI and consults with neurologists that we have scheduled in the next week will shed some light more accurately on what we are dealing with. Had I not had that routine u/s, I would never have known, as everything pregnancy-wise has progressed perfectly, the same blissfully boring pregnancies I have always been blessed with.
    I guess it is my current state that makes me scoff a bit at the article about the club foot. I know how traumatic it is to sit on the other side of things and have someone tell you that something is wrong with your baby, whether it is a minor correctible issue, or something that could shorten life. To have a team of drs running through a million different possibilities, suggest termination, tell you that your baby may or may not survive until birth, and even then may not actually survive birth or the days thereafter. I certainly don’t mean to belittle her feelings or experience, but I look at that and think “how easy it would be if this was something as easy as a club foot or cleft palate!” In fact in one of my first consults with a perinatologist I was told, “unfortunately this isn’t something simple and definite like a club foot or cleft lip or palate-with those things you know what is wrong and you know that you can fix it and how. With this diagnosis (hydro), we don’t know how bad it is, how much or how fast it will progress, and what the outcome will be. We just have to take it one week at a time, and do the best we can to get baby here.”

    So now I have unfortunately joined the frequent u/s club. Thankfully I have been blessed with a perinatologist who understands my desire to avoid the further complications related with a cesarean, who is monitoring my baby’s head growth very closely in hopes to facilitate a delivery timed such that we can avoid surgery and delivery vaginally as I always have.
    Knowing that if I hadn’t had that u/s at 18 wks we would be unaware of the complications with this baby, and just continuing on expecting a normal delivery around 40wks scares me a little-for the sole reason that hydrocephalus babies almost always have a larger than (vaginally) deliverable head size, and being one of those women to whom birth experience is extremely important, ending up in an emergency section would be horribly difficult for me. I have now been able to take the time to find a perinatologist who understands not only the risks to myself and my baby with our current situation, but also the added risks of a cesarean to mom and baby even under the most ideal circumstances. It is such a blessing to have a care provider who is wiling to work with me in doing everything possible to facilitate a vaginal birth, if at all possible, and even if it means delivering a few weeks earlier than we might have planned. And while it has been unbelievably difficult to go through the process of grieving a “normal” child, it has been invaluable to prepare for the things that we are facing in the coming weeks and months.
    I am reminded of one of my close friends who is adamantly anti-home birth. When one of her children was born, a day later a nurse at her hospital happened to catch a lung issue-on a whim-that turned into his life hanging in the balance 24hrs later. She is sure that had she even considered a home birth he would have died, and thus no one should ever even think of birthing at home. Does this mean I will never have a home birth because of her experience? No. I expect to take into consideration the possibilities, weigh the pros and cons, and make an educated decision.
    Does my current experience and the complications that could ensue without constant monitoring of my baby’s condition mean that I feel everyone should always have an u/s, or that I will nag my friends who choose to not use u/s? No. I would expect everyone to do their research, weigh the pros and cons and make an educated decision that is best for them.
    Yet another one of the things that makes me so grateful to live in a place where I can make those choices for myself and my baby, and for the freedom to shop around for the appropriate support for my preferences.

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