Tuesday, August 5, 2008

Pressure to have ultrasounds and induction

This is my letter to a friend whose obstetrician recommends weekly ultrasounds to see if her womb is becoming a hostile place for her baby. Yes, that phrase was used by a medical person to get her compliance.

"I was thinking more that it is the very serial ultrasound that is making the "womb a hostile place." As serial ultrasound is associated with loss of amniotic fluid, lower birth weight and IntraUterine Growth Retardation (a dysfunction of the placenta probably due to stress or damage of the placenta)...

Marsden Wagner, past European Regional Director for the World Health Organization writes about the mistaken reliance on ultrasound. He cites a research study and states,
"...ultrasound may lead to the very condition, IUGR, that it has for so long claimed to be effective in detecting."

There are two other links in this article to medical books on Ultrasound, including Ultrasound? Unsound.


The nature of female social networking is that our stress hormones encourage us to bond tightly with those we feel have power and can help us with that power. We fear offending them lest we lose their protection. This is the "tend and befriend" response that Shelley E. Taylor writes of. I talked about it in doula class. Its a classic reaction. Women will avoid being rude, as you say, or, what that really means, setting boundaries even if it means exposing themselves and their children to theoretical risk.

In domestic abuse, its walking the egg shell life trying to avoid violent outbreaks and hoping the children aren't going to be effected. On a milder scale, its form with pregnant woman is pretty common in prenatal clinics in our nation. Especially, women who have experienced loss and trauma. The comparison of the minor harm of poor or abusive treatment (defining your body as hostile towards your baby) to the death of your child seems like a no brainer. But when you see that it isn't an either/or situation you can begin to bring about your inner wisdom, your parenting instinct, your right to say "No, I will take this but not that."

A mother who can separate her relationship from her stress might say,
"I appreciate your help and the skills you bring, but I will limit my child's exposure to ultrasound. (Or induction or separation.) I understand you are concerned about lawsuits. Let's talk parameters and I will keep the communication open."

By agreeing with a protocol which goes against your better judgment, to do serial ultrasounds, you are giving them the tool to scare the crap out of you at 37 weeks so that you can accept induction from them without blame on either part. I really am not saying this in a harsh or insensitive way. My heart is calm.

I've just watched this happen for 20 years now, since this style of "preventative" care came about (preventing lawsuits).

If you were happy to risk induction because the risk of physical harm was higher than risk of induction, that is one thing. But the risk of emotional stress is not really more harmful than the common complications of induction. We can talk about what makes induction somewhat less risky: high Bishop score, intact water, slow, gradual drip, laboring out of bed, etc.

Me, on the other hand, really will support your path. But in that support comes a bit of information. I'm not your doula. You didn't ask for that. You asked for a voice who trusts birth amidst the technocratic model you are walking. If you want me just to nod and murmur loving thoughts only, I suppose I can do that. But it is hard when I see that the care you get is potentially the cause of the thing you fear. Thomas Strong, MD writes Expecting Trouble; The Myth of Prenatal Care in America.

Disagreement seems stressful. But soon you realize you can strengthen your relationship with your care givers in other ways than compliance. Once you have established that at the clinic you will begin to relax and narrow the kind of care you get to be that which is useful and good for your baby and you.

Talk to your mate, think about it, journal about it. Practice in small ways. Maybe take a big step, maybe not. Look past the due date and ask yourself, what will I remember about this time that will shape my life to come? What has made me the mother I am today (looking back from that future date)? Is it the mother I want to be? You can't find the full answer unless you can ask these questions without gut wrenching fear.

Let me know how these thoughts impact you. You are the Mama. You get to pick your choices. Among any of the above or others unmentioned here. You get to pick.

Be kind to yourself as you walk this path. It can seem lonely at times. But there are blessings in the hard choices we make."

2 comments:

BellaMama said...

I link to your site & noticed that only the home page comes up normal. The other pages come up in just word without pictures. I've been to your site for a couple of years & it was working fine a couple of months ago. I hope this is just a construction error.

I love your site & it has helped me with the last 3 of my births!!
Thank you!!

DoulaMomma said...

So very powerfully, beautifully & lovingly said.
Not on this exact subject, but something I wrote on care provider choices:
http://www.themotherhoodmagazine.com/pb/wp_67a7f6a4/wp_67a7f6a4.html#DoulaMomma

I will make a blog entry to hopefully direct a few others to the wisdom & compassion you share here

Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.