Dilemma about 20 week scan and thousands dying in childbirth

[lulastic]

Hello,
bit of a funny one. I am in a dilemma about whether or not to go for 20 week scan. Did anyone else not go for one? Feel as if it is all a bit over medicalised.

And then in the midst of it all there are still thousands of women dying a day in poor countries because they can;t get enough care!

Mumsnet are backing a campaign to try and stop this:

And I have done a blog post about the first dilemma and the unfairness of things...
lulastic.blogspot.com/

20 week scan picked up my placenta previa. If I'd gone into labour both of us would have died.

I actually think it's an insult to women who are dying for lack of good antenatal care to refuse it when freely proffered.

VictoriasLittleKnownSecret, I had my scans at the Fetal Medical Center as a result of your concerns. I don't think I would terminate over disability, though you obviously never know, but I did want to be somewhere where the "fetal" and "medical" aspect were taken seriously, and where I felt the results could be relied upon.

NancyDrewRocks, I'm very sorry for your loss.

All three of our 20-week scans showed possible problems.

DS1 and DS2 had follow-up scans and were pronounced fine. Grr, we thought, load of worry and stress for nothing

DD's scan had some blood vessel abnormalities, limited fluid and suspected placental insufficiency. I was warned to keep careful track of movements from then on, and come in immediately if they stopped. I did, they induced her, she's fine -- but mightn't have lasted much longer. Well worth it.

No, its your pregnancy and if you don't want to have a scan its completely up to you and your partner. Pergnancy is a natural condition and its up to you how to manage your own baby.
You could also think "why not" they're offered to inform you and the medical people of any potential problems, not necessarily in order to abort the pregnancy but to ensure procedures are in place at the birth or even to allow in vitro surgical procedures to take place if needed.

OP, don't get upset, you will get a lot of very emotive posts on this topic.

I chose not to have a 20 weeks scan (or 12 week, or screening tests) for the reasons many have given. I got my evidence base largely from an AIMS publication called "Ultrasound, Unsound?". I suggest you do your research to make the decision that is best for you.

Of course, a pregnant woman does as she feels/believes is best for herself and her baby.

Given that in modern society we protect the weak, this is one of the remaining few situations where we see Darwin's principles at work in natural selection.

Don't beat around the bush, Cote!

I thought that was pretty clear, actually.

This is your "evidence base"? Oh my, we have been living in ignorance all this time. Ban the devil machines, save our babies!

Ultrasound Obstet Gynecol. 1995 Oct;6(4):293-8.
Is ultrasound unsound? A review of epidemiological studies of human exposure to ultrasound.
Salvesen KA, Eik-Nes SH.

Department of Obstetrics and Gynecology, Trondheim University Hospital, Norway.
Abstract
We have reviewed the epidemiological studies of human exposure to diagnostic ultrasound during pregnancy. Studies have concentrated on possible associations between ultrasound exposure in utero and childhood malignancies, neurological maldevelopment, dyslexia, left-handedness, delayed speech development and low birth weight. It is concluded that no associations between ultrasound exposure in utero and childhood maldevelopment have been proven. There are, however, some issues, such as non-right handedness and low birth weight after frequent Doppler ultrasound exposures, for which no firm conclusions can yet be drawn. These issues need to be tested in future studies.

PMID: 8590195 [PubMed - indexed for MEDLINE]

I just checked the Cochrane Review Library and found this:

www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD007058/frame.html

In it they conclude (from many studies) that routine early (pre-24 weeks) ultrasound is not associated with a detrimental effect on children's physical or intellectual development.

However, they also conclude that there was no evidence of a significant difference between the screened and control groups for perinatal death and that the results do not show that routine scans reduce adverse outcomes for babies or lead to less health service use by mothers and babies.

But they note that detection of fetal malformation was addressed in detail in only two of the trials.

So the 20 week scan (used for the detection of fetal malformations) could still improve outcomes - there just isn't the data at present. And it's safe.

It's also worth considering that the "powershift" you talk about may operate both ways.

Knowledge is power - and when you have the scan results, you have more knowledge. YOU. Not just the doctors.

Having a scan usually doesn't mean that you are automatically subjected to extra invasive procedures. It can be the opposite. A clear scan might mean that your MW supports a home birth for example - whereas in the absence of a 20 week scan they may refuse to support your request. You might find that without a scan you are unnecessarily treated as being higher risk than you really are.

Or if the scan does throw up something, advance warning can give you time to research and prepare, so that you can make a more informed decision about treatment options. Say your baby is born with an undetected condition and the doctors recommend an immediate course of treatment. Wouldn't you prefer to have the time to research the options and find out whether there are alternatives?

BTW I think that the reaction to your post is as much about your comparison to the thousands dying in childbirth.

By all means make your own choice regarding ultrasound, but personally I find it offensive when you link your dilemma to all the millions of women who would have given their lives (and did) for the chance to save their babies.

I chose to have a 20 week scan for DS2 and paid for it because we moced into an area where they don't routinely provide one. The main reason was if there is a problem you know and can prepare also more impotantly the hospital knows and can organise SCBU care. My worst nightmare was me being in hospital in Derby and baby being in hospital in Birmingham!
It' never happened thank goodness but we wanted to know. Another example is that what if your baby has a cleft pallette, you can't always see this at 12 weeks. I would go for it actually It's always lovely to see baby anyway.

Lunatic yes sorry the OP . Talking about not attending a 20 wk scan because it is too medicalised, juxtaposed with woman dying precisely because their pregnancies/labour are not medicalised enough is bizarre.

I agree with Confuzzled denying yourself available treatment will not help women who would do anything fo the opportunities we have.

There is more to the 20 week checks than finsing a disability or the sex and although if something is spotted it may cause you worry which may be unecessary in a few weeks time I find I worry about everything any way and having the reassurance that my health and my baby's health is being monitored and I am getting the best treatment available then that puts me at ease.

This is just me and you are entitled to your opinion but the fact that many women in poorer countries die because they do not have the best antenatal care should be reason enough to take advantage of what is available to you. If you are healthy and have a healthy child you can live to campaign for the rights of women who don't have the treatment we have.

It is your choice to go for the scan or not but make your decision on your own reasons not to fight for rights of women in other countries they are different issues and will make no difference to the ongoing campaign.

Lunaticfringe - I am so sorry you had to go through that
Nancydrewrocks- I am so sorry for your loss

Thanks.

I know sometimes these threads aren't really the place for the "horror" stories but sometime I just want to shake women. Of course we all think it will never happen to us - I have had two healthy babies and thought the same.

I am actually pretty laid back about stuff but really why refuse healthcare that could potentially save you or your babies life. Seriously why???

Personally I think you're bonkers to refuse any tests. What you do with the results is different, of course. But knowledge is power and all that.

I think that sometimes too much respect is given to choices, simply by virtue of the fact that they are choices. In this case, it is not just "your" choice - you are making a decision for another person, your unborn baby.

I totally agree - I think if you are happy to opt in to the nice, clean, safe hospital birth than you should also opt into the tests that help make that possible. It's not a fancy restaurant menu.

Also, I just don't get people's over-riding concern about the safety of ultra-sounds.

So much research has proved them to be safe, that to continue to put concerns about their safety over and above the knowledge and information you are armed with at the 20 week scan just makes No Sense.

It's pitched as concern for the baby - what effects do ultra-sounds really have? Well, if you're so concerned about your baby (which I don't doubt for a second you are), then find out everything you can at the 20-week scan...