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?

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.

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.

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.

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.

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.

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.

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.

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.