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?

There are things that can be fixed in the womb, for example, fetal hydrops can cause anemia in the baby, and treated with an in utero blood transfusion.

However, it's quite rare so I'm not sure it will convince your friend if she has made up her mind.

Has she considered a private MW? Maybe she would get on with them better, if she feels she is paying and can set the agenda a bit more?

I think you should allow your friend to follow her own beliefs and try not to worry about her. Before there were ultrasound scans and all the other pregnancy tests, healthy women mostly had perfectly healthy babies. If your friend would not want anything done if there were problems found with the pregnancy then not having tests makes sense. Also, since she's had a baby before, she presumably knows what she wants. I had a home birth and can thoroughly recommend the experience - a home birth is a perfectly reasonable choice for a healthy woman with a normal pregnancy. As I said, try not to worry. Just support your friend and whatever choices she makes for her body and her baby.

Ok.

Tell her about my beautiful sister who wanted nothing more than to be a natural earth mother type with her lovely husband in their little self-sufficient bubble of happiness.

Tell her that she too shunned "medical intervention" and refused all scans and all but the basic antenatal care from a like-minded midwife.

Her baby was born with the worst sort of spina bifida and anencephaly. My sister had to undergo general anaesthetic to remove her child as its deformities made it impossible to be "born" even though the baby was dead. My sister is now a broken woman, on anti depressants and with PTSD. Her husband can't seem to help her, I can't help her.

If they had had a foetal anomaly scan at 20 weeks they could have been spared this horror and heartache.

Is your friend really saying that she is prepared to choose this potential outcome over the advantages that modern medicine can offer her?

She needs to think very hard about whether she is acting in her unborn child's best interests or if she is behaving really really selfishly.

Eskino, that is such a sad story. I'm so sorry about what happened to your sister.

If they had had that scan at 20 weeks what would have been done? I'm just curious as to whether they can treat it or whether you mean a termination?

I don't think my friend is being selfish. Misinformed maybe.

I had a friend who couldn't have normsl scans (living in remote Asia). Luckily she had planned to have home birth here in UK. Luckily she thought baby was breech & had a scan at 37 weeks. Baby had encephalitis (water on brain). Enlarged head- she would never have survived a VB.
so instead of planned home birth, she had section a few days later followed by brain surgery for baby who is now fine.
If she hasn't had the scan, but had a home birth, baby would probably have died during birth, and mother would have been blue-lighted to hospital.

I don't understand how a scan could have helped your sister Eskino

Let them know in advance the baby was dead/unlikely to survive, yes.

But help, no surely?

And there was a baby on one born, whose intestines were outside the belly. Seen on scan- so planned section with paeds on hand to do immediate life-saving op for baby. If she hasn't had a scan, baby would have died during birth.
It's not all about termination- it can also be about the right kind of birth, and also about having the right medical people there for the baby if needed.
PS the friend of mine had had 2 home births with no problems before this baby.

Hi cathan I do very much like the idea of home birth, i'm not really so focused on that. It's something i would consider if i ever become pregnant again. I really hope it works out for my friend and she has her home birth because I know how strongly she feels about it and i worry the alternative would be traumatic especially if (god forbid) the outcome was bad for the baby.
I haven't anything negative to her btw. She has confided in me about this and not told many other people, I think because she knows I'm also interested in "alternativey" stuff. She is a lovely person and I don't feel it's my place to judge really, she knows tons of stuff about natural birth - more than I do. I also don't think it's fair to scare pregnant women and force your opinions on them particularly as so many people aren't actually very well-informed, so i'm just trying to be supportive but part of me has this fear that some unlikely thing could go wrong or not be picked up on... and if I don't say anything now I will be partly to blame?

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.

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.

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?

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)

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.

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.

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?

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.

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?

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.

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.

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.

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

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.

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.

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.

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.