Friend refusing antenatal care

[Moominmamma86]

I have a friend who has recently become pregnant and is refusing to have any antenatal care. She is very into alternative medicine and "trusting your body" and sees the tests, scans etc as controlling/medicalising... I'm not really sure if I'm putting it the right way, she's said various things but basically she is mistrustful of mainstream medicine I guess.
She's had one baby before and that went ok. This time she is planning a home birth. I'm pretty sure she does want a midwife present at the birth at least. Am I right to be worried though? I do sympathise with her as I found being in hospital very hard with my baby, but I don't know quite what to say to her. She thinks ultrasounds are harmful too. Is there anything a scan might pick up on that they would actually be able to fix? Or that knowing about it would make a difference to the birth (other than breech) She said that even if they find something is wrong they cant do anything and she would never choose to terminate so what other reason could i give her that a scan would be wise. I can think of placenta praevia but that is really rare isnt it. What would happen if she did have that and it wasnt picked up on?

[Tabby1963]

There are some very distressing stories on this thread, I am so sad to read them and my thoughts are with the writers.

Moomin, it is surely possible for your friend to have minimal interventions during her second pregnancy. If she is planning a home birth it should be particularly important to be aware that everything has been going fine throughout the pregnancy.

I had a hb for my second, it was a great experience (relatively speaking lol), but I made sure throughout the pregnancy that I had access to midwives and monitoring. My baby's health was of paramount importance to me (as was mine of course).

No one want intrusive tests, Moomin, but as you have read the distressing stories from other MNers, we sometimes just don't know what's around the corner. Forewarned is forearmed indeed.

[MsIngaFewmarbles]

Your friend is absolutely entitled to refuse any treatment or screening she doesn't feel happy about however it should be an informed choice.

If she wants an NHS midwife to attend her home birth she will need to at least have a booking appointment so they are aware of her and any medical history which would be relevant.

I would suggest if she doesn't want the tests and/or routine appointments and also doesn't want to be flagged up to social services she could make an appointment with a Supervisor of Midwives to discuss her decisions. That way she can have the care she wants and is seen to be engaging.

[BadlyWrittenPoem]

I am in favour of the "your body is designed to do this, minimal intervention, non-medicalisation" route when a pregnancy is low risk and complication free but it sounds like she is taking it too far. I have declined various tests including dating scans in two pregnancies because either there were no particular benefits for me to have those particular things or because I knew myself to be low risk but there are certain things that I would consider to be an essential minimum such as an anomaly scan (because as has been described above there are things where the outcome has a better chance of being positive with antenatal detection) and maternal monitoring in later pregnancy (which can detect things like pre-eclampsia etc). I do think that other aspects are of value too but if I was in your shoes those would be the things my conscience would require me to suggest she had. I wouldn't keep pushing it or anything but I would want to say it once with reasoning and just ask her to consider it while also saying that I wouldn't bring it up again.

[Notmyidea]

This is really a feminist issue. While I wouldn't make the same choice as your friend they are her choices to make and need to be respected. The alternative is women who are pregnant/giving birth ceasing to have autonomy and losing their human rights.

[junkfoodaddict]

My MIL's neighbour's daughter in law decided not to have any antenatal care. She went into premature labour and it was discovered afterwards that her baby had a very serious heart condition. Had she had the scans, the problem would have been detected at her 20 week scan and a health plan put in place ready for when the baby was born. Consequently because of her choices, the baby's heart problems were not detected immediately and this caused a delay in treatment.
He is on the mend but he is been a very sickly baby and even his mum now regrets not having the scans. Her decision was a cause for her baby being a lot sicker than he would have been if she had had the 20 week scan.

[Picturesinthefirelight]

My cousin was born with her intestines on the outside. It was seen in a scan so she was born by c sec in a hospital elsewhere in the country (Nottingham I think) so that she could be rushed for surgery immediately.

She has several ops in the first 5 years of her life but is now a healthy late twenties.

[Panzee]

But it's not informed if she doesn't think there are things that can be picked up and acted on with tests. See my post about placenta previa, for example.

[Rainbowbabyhope]

I don't see the problem with this - everyone is entitled to make their own informed choice about medical procedures and healthcare. Having had a stillborn child at 26 weeks after discovery on a scan, I wish more than anything that I had carried to full term and been able to spend those extra precious months with my DD while pregnant with her. An early death of a baby is no less traumatic. The scans I had denied me the right to spend the maximum time with my little one alive. Having said that I did have scans with my DD2 because I needed the reassurance that she was developing well but if things had not looked right then I still would not have done anything about it and therefore same result as having no scans.

[Essexgirlupnorth]

Scans in pregnancy are optional and she is well within her rights to refuse to have them. I agree with other posters that this is not the best idea.

The idea of antenatal care to pick up problems. How many women died before there was widespread ante-natal care of things we can now pick up and treat or intervene to have a good outcome.
My MIL also told me it's a red flag for social services if you don't turn up to your antenatal appointments.

[Michellephant]

I had a termination for Downs and an associated heart defect called AVSD. My consultant said my baby would've likely died a slow and painful death otherwise. I have spoken to a number of parents who didn't detect that their baby had the same problems on scans and did have to watch their child die in that way. Fortunately scans and excellent care gave my baby a pain-free, dignified death that I could prepare as best I could for and create some very special memories. Personally I'd pick my baby's ending all over again if I had to. I'd never in a million risk putting a baby through a slow death. I wouldn't want that for myself so why for my baby.

I never thought I would terminate for DS, didn't even have the screening. It was the heart defect that showed up on the 20 week anomaly scan that alerted us. It is amazing how much information you actually bother to read once you are faced with something real rather than a possibility. I learned so much about DS that nothing in this world would make me hesitate to make the same decision again. For some parents though, knowing can at least prepare them and most importantly the doctors for any intervention that is going to be required once that baby is here. My baby would've required support immediately if I had chosen to continue. Regardless of what I wanted, it is just a fact that you can't necessarily provide what your baby needs, especially not at home.

I think you should suggest that if she really wants a home birth then the right thing to do is to at least have a scan and rule out anything that could jeopardise the health of the baby. At least then she can genuinely say she checked and felt a home birth was a safe option.

[CrispyFB]

I wouldn't have DD2 if my failing cervix had not been picked up at an 18 week scan and I had emergency surgery that evening which saved her life. The doctor, one of the very best specialists in cerclages, said I was probably 48 hours from delivery. I'd had NO idea whatsoever.

[Panzee]

I had totally symptomless placenta previa. No bleeding in the entire pregnancy. Only picked up with a scan. Labour would probably have killed us both. Tell her that.

[ch1134]

I can understand why you would want to trust nature first. I have refused the Downs test for example, as I'd never terminate on that basis. But I have had some antenatal care that is very unobtrusive. My blood tests revealed an anomaly which means that after the birth my baby will need to be treated differently... if not it will be in great danger... I'm thankful to know we'll be looked after

[RainSunWind]

Each to their own but personally I can't see how it is in the best interests of the baby not to have medical checks in utero along the way. It indulges the wishes of the mother to at the expense of a potential disaster to the health of the baby

In your OP I can't see anywhere that the mother in question feels not having medical care during the pregnancy is better for the baby, except for the notion that ultrasounds are harmful (as if this would not have already been spotted in the billions of babies around the world who have had ultrasounds in utero, and their children, and their children's children....it's hardly the latest, untried technology).

Also she is not correct (as a selection of the above posts show) that "nothing can be done" if there's found to be a problem during the pregnancy. She has clearly not researched any of this, maybe she should so if she continues to reject pregnancy care, she is at least doing so with very clear knowledge and understanding of what she is rejecting, for herself and on behalf of the baby.

[AngieM2]

My god, your friend is mad....at the very least she should have a scan....what if she has placenta praevia and goes in to labour? Would she be happy 'trusting her body' to cope if she starts to bleed to death....she's being pathetic and selfish, plain and simple.

[duchesse]

A friend of mine had twins (via IVF). One of the twins had a fairly serious heart problem that would have killed her at birth had she not been in the right unit with newborn heart surgery specialists and the right neonatal unit. Because they knew in advance, they were able to plan the time and place of birth and the baby had her surgery as soon as she was born. It meant having the babies by CS in a place some way away from home but they have two children instead of one now.

Chances are pretty good that your friend will deliver a perfectly healthy baby- most babies are born healthy and well. The question is, would she cope psychologically afterwards in the event of anything going wrong? You can't force her to get ante-natal care - it is entirely her right to refuse any kind of medical intervention.

[ghosteditor]

I agree that it is the worst kind of selfish to avoid ante-natal treatment where it is available. For all of the reasons mentioned above.

I too 'trust my body' and wanted as natural a birth as possible. That didn't stop me developing Pregnancy Induced Hypertension; I was monitored throughout the pregnancy but during my (fast, drug-free) birth, my blood pressure went so high that I was in danger of having a stroke. I needed treatment immediately and things could have been very different.

Did your friend have a interventionist first birth? Does she feel she doesn't have the voice to speak up for her non-intervention ideals? Some of what she says is misguided and ignorant - maybe she would be receptive to the idea of a doula and MW led birth centre?

I'm sure all would be ok. But where is her partner in this? What about the guilt if the baby was born with complications which could have been minimised or treated if known about?

Did you see the Guardian article about the foolish woman who refused to let the NHS Be involved and found out on the day she was having twins and they were transverse and breech and she was unable to deliver naturally?

[greengoose]

I really don't have the time for this, or this way of thinking, it takes very little research to answer that ultrasounds and antenatal care save lives, so why ask for answers from those who can only give them if they have been through hell? (I have answered this so many times, sorry my patience is low with this now).

Put simply, my little girl was found to have tumour at 20 wks. It was monitored by scans. We were referred to GOSH, the only place they have the expertise to do the op to remove the tumour. I developed mirror syndrome, baby developed Hydrops, and I was very very close to dying. My baby was delivered, and because of a very rare complication when they tried to remove her tumour, she died at six days old. I lived. I only lived because they were aware of what was wrong, and we're prepared to help me, because of the info from the scan.
If the tumour hadn't been spotted, I would have died, she would have died. My other children would be without a mother. Bar for the complication my daughter would have been perfect after her op. both her life and mine would have been saved.
Your friend is being selfish, she has other children, and one growing inside. Lots of people every day do things they don't feel greatly happy about for their kids, it's part of being a parent. She is putting herself at risk. Does she think she has some protection from being 'the one' where it goes wrong? It shouldn't and probably won't, but not through and part of the bad choice she is making here.
She needs to look at the FACTS, and, I'm sorry, but she needs to grow up and start taking responsibility for her child. So many women would chew their arm off to be offered the care she is being offered, why on earth does she think her life is immune to bad things happening? I can, from my life, tell her that she isn't, nobody is.

[WhatKatyDidnt]

Antenatal care saved my life and my DD's life. A scan showed she wasn't growing properly at 20-something weeks, then I developed pre-eclampsia and HELLP. She was taken out by c-section at the optimum time to stop me dying and give her the best possible chance of survival. She made it, but only just.

Having spent many months in various neonatal units I can say they are full of parents who never in a million years thought that they would have a premature or sick baby. We all tend to think that bad things won't happen to us, it's natural, but sadly someone has to be that one in however many thousands. Could your friend forgive herself if something crucial went undetected?

[specialsubject]

she thinks ultrasounds are harmful... it produces a very small amount of heat, nothing to make any difference.

there are some conditions which can now be treated in utero if spotted then, and can save the baby's life. These are rare.

still, her call. She seems quite proud of her ignorance. I hope her children will not be.

[AuntieStella]

Well, of course most women had babies perfectly well before widespread scanning. But the perinatal infant death rate was about 5x what it is now.

Placenta praevia isn't that uncommon, and a major one is likely to cause death of the baby and can cause the mother to bleed out too.

A footling breach or other position undeliverable vaginally is better discovered when there is still time to plan a section rather than have transfer of an exhausted labouring woman for an emergency one.

Some anomalies can be diagnosed in utero, and if specialist intervention indicated shortly after birth, then delivery can be in a hospital which offers those services (rather than blue-lighting a new born to nearest place which might).

Some conditions can even be treated in utero.

Or if something disastrous is found, then the parents have a chance to make active decisions on whether to continue and let nature take its course, or whether to intervene by termination.

Now, none of that applies to most babies But you cannot predict which babies might have problems, nor how fixable they are.

The likelihood may low, but the (possibly avoidable) consequences are huge. Has she really, imaginatively, thought what it would be like to live with the consequences should there be permanent averse consequences for want of a scan? If she has, and is still at peace with her decision, then you won't be able to persuade her and it is her choice.

[DontmindifIdo]

If she wants a home birth with NHS midwife in attendance, then she needs to get in the system and ask for one, you can stress the "why pay a couple of grand for a private midwife when the NHS will send one? You pay enough tax over your lifetime, why not get it for free?" (which might lead to them insisiting she 'goes through the motions' of the tests just so they know what they are dealing with)

[ivykaty44]

tell your friend that woman had to fight for the rights to anti natal care, unions helped with this mission so that woman didn't die during pg as very simple tests can be carried out which save lives - why ignore these tests that woman for 2000 year would have rejoiced in having to make pg safer?

[littleducks]

There are some medical conditions were although nothing can be done during the pregnancy having a paediatrician at the birth and immediate treatment or surgery means the baby has a far greater chance if survival.

I have refused some tests as I wouldn't have an abortion whatever the circumstances but took the view that other tests could provide useful information relevant to the pregnancy or birth.

[Eskino]

Thanks Moomin, I needed to get it out.

No nothing could have been done but a termination. But had they had the foetal anomaly scan they would have known that the poor little thing wouldn't be able to survive outside the womb and made an informed choice that they would have been prepared for.

We are so lucky in this country that we have good antenatal care. I think sometimes its taken for granted everything will be fine.