Intuition and Ultrasonic Rays

11 Weeks 0 Days about to do some yardwork.

I’ve been really up in the air about ultrasounds and dopplers. These two things are considered par for the course in a regular pregnancy, but surprisingly enough that’s not recommended. The American Pregnancy Association only recommends ultrasounds (including dopplers) if there is a medical concern. So why do most moms have at least one ultrasound during pregnancy? When I was pregnant with Peanut, I had 3 ultrasounds (one at 6-7 weeks because I had some bleeding, one at 18-ish weeks to check the sex and all of the other regular checks, and one at around 40 weeks to check the amnionic fluid amount) and doppler used at Every. Single. Prenatal. Appointment. A healthy, young mom taking care of herself, not using drugs, and no family history of birth defects and I needed that many ultrasounds? I was the epitome of low risk and still exposed my child to these potentially harmful ultrasonic rays that many times just because I didn’t know.

The emphasis in that sentence is potentially harmful. We don’t know if ultrasounds are harmful. Most things I’ve read say that they could be. There are emotional risks too. Some studies say that babies who aren’t diagnosed with problems prenatally end up doing better once they’re born, possibly because the birth is allowed to go on normally (no induction or c-sections) and the babies get more time to cook. Not to mention the high rate of false positives (same link) when it comes to things like placenta previa. Actually, I was told I might have that when I had my second ultrasound, but luckily I didn’t stress because my doctor also told me that it would grow upward with time.

It’s always the kicker of making a decision when you don’t have hard facts that tell you to go one way or the other. If they told me that ultrasounds could give my baby a third arm, it would be easy-peasy to make this decision. If they were entirely useless, it would make the decision easy. The problem is that there is potential for the rays to heat the baby and if they do, we don’t know if it actually hurts them. There is potential for the ultrasound to diagnose life-threatening problems in time to save a life, but that’s a rare occurrence.

So here’s what I’ve decided to do: I’m not getting an ultrasound unless there proves to be a medical reason for one. The doppler is basically a higher intensity ultrasound that happens for shorter amounts of time, so the same thing goes there–with one little adjustment. I decided to hear Twig’s heartbeat at my appointment yesterday just for the reassurance. I talked with my midwife about it and she basically said that she’s there just to support my decision. She also said that pregnancy is a physical and emotional experience. She said this in the context of if I was worried about a procedure and it’s safety, I should skip it.

For me, it also applied to this situation. With a fetoscope, I wouldn’t be able to hear the baby for at least another 5 weeks, if not 9. So I decided that for piece of mind, I wanted to hear the baby once before then. Other moms might not agree with this decision, but it made me feel better to know that this tiny little thing is really growing in me. There’s something about hearing the heartbeat that makes this all more real. So I went with intuition and I’m happy about it.

I am now 11 weeks. Actually according to the midwife I’m a few days further along, but I think she was going by LMP rather than ovulation for some reason. Either way, it only changes things by a few days and Twig won’t care about a due date anyway.

Everything seems to be getting better. The nausea is still there, but getting less and less. Other than sleeping 12 hours a night, I’m getting some of my energy back. I feel like I can actually get up and do things in the day, which included a couple more Lagoon (amusement park) trips this past week. We decided to get season passes and Peanut is thrilled. Once again, if my toddler can go on a ride, I think that my pregnant self can handle it. If I get to the point where I feel like I can’t by the end of the season, then Peanut can go on the rides by herself.

I had my first prenatal appointment yesterday. We chatted about the ultrasounds and dopplers, I gave her my paperwork (basically a medical history type of thing) though we didn’t go over it, I peed on a stick to check for protein and sugar (I think?), I weighed myself (I’m not sure on my pre-pregnancy weight, but it seemed about where I’m at now, so I don’t think I’ve gained anything), and we listened to the baby. She knew I was concerned about the doppler so she made sure to figure out where the “bulk of the baby” was prior to putting the actual doppler on. Peanut was pretty scared about mama laying down on the table, but she seemed happy when she heard the heartbeat.

Home Birth Midwife Interview Questions

Today we’re meeting with a home birth midwife to see if we want to go with her. She told me to bring questions, so I took it to heart. I doubt I’ll ask every one of these any many will be covered in the answers of others, but here’s my list:

Regarding her:
What is your philosophy of midwifery care, pregnancy, and birth?
How many births have you attended?
Are you available 24 hours a day at all times?
How many clients do you generally have due in a 4 week period?
What is the plan if I go into labor while you’re with another laboring client?
What is the plan if you are sick or on vacation?
Have you ever missed a birth? If so, what was the circumstance?
Have you ever lost a mother or baby? If so, what was the circumstance?
Do you have any assistants you bring to the labor? If so, how many?
Do you visit my home at any point before labor?
Are you allergic to animals?
What things do you bring with you to a birth?
Do you file with insurance? Do you have any experience with BCBS?
What days and times are you in the Ogden office for appointments?

Regarding prenatal care:
What are your expectations of the pregnant couple?
Do you require that your clients read/watch/listen to any specific materials?
Do you require that your clients take a birthing class?
What do your prenatal check-ups consist of?
What nutrition/weight gain protocols do you follow?
What are your thoughts on a client refusing certain standard prenatal testing? (e.g. ultrasounds, blood sugar testing, etc.)
Are there any specific tests that you require?
What is your plan of action for a baby that is posterior/breech? Do you turn them? Deliver them?
What is your plan of action for group B strep positive mothers?

Regarding birth:
Here is the birth plan from my daughter’s birth, is there anything on here that you disagree with?
At what point in the labor will you come to assist me in my home?
What do you see as your role in the labor?
What do you see as your role in the birth?
What are your thoughts on the husband having a very active role in the labor and birth?
What are your thoughts about children attending births?
Do you have any limits on the number of people that can attend the birth?
What is your approach if a labor is progressing slowly?
How often do you listen to a baby during labor?
How often do you check the mother’s dilation during labor?
How often do you preform episiotomies?
What percentage of your clients tear? What is your protocol to prevent tearing?
What are your thoughts on waiting to clamp the cord?
How long will you wait for a placenta to be delivered?
Do you help with clean up?
How long do you stay after birth?

Regarding emergencies:
What is your definition of high risk?
How do you handle hemorrhage?
How do you handle preeclampsia?
Under what circumstances do you recommend inducing labor?
Do you allow a mother to go past 42 weeks and still have a home birth?
Who do you prefer to work with as obstetrician back-up?
What is your preferred hospital to transfer to?
Under what circumstances do you consider transferring to a hospital?
What is your hospital transfer rate? Does this include mothers who transfer before labor?
What is your plan of action if a transfer occurs?
What is your c-section rate?

Other:
What are your opinions on having a professional photographer at the birth?
How do I obtain a birth certificate?
Do you come visit me at home after the baby is born?
How often do you come to see me and the baby (or we come see you) after the birth?
What do these visits consist of?
Do you check the baby during these visits?
Do you do the required newborn screening blood tests?
What are your thoughts on the vitamin K shot and ANTIBIOTIC EYES?
How soon after birth do I need to take the baby to a pediatrician?
Are you a certified lactation consultant? If not, do you have one you recommend to come visit after the birth?