3rd trimester ultrasounds - but...

ChavayJakov

I'm beginning to question the necessity of ultrasounds in the third trimester.  I'd like to pick your brain, hear your experiences, and hear if you are planning to take a different course of action.

My situation is set up like this:  

Conceived at 41, will deliver (in about a month's time) at the age of 42.  This is my fourth baby, but my first in 20 years.  My first child was a c-section due to placenta prevera (or however its spelled) with the other two delivered vaginally and full term with absolutely no complications.   Each child weighed more than the last.  My son (my only all-natural birth) was just eeking under 10lbs.  

So the things I have against me are, my age, my state, my propensity to have large babies. 

As many of you have run into, we are considered "high risk" for no other reason than our age.  My personal circumstances:  I'm in great health, as is my child.  We've passed through this pregnancy with flying colors, and no anticipated problems.

My state is #1 in the country for repeat c-sections.  My state also dictates "once a cesarean, always a cesarean" therefore it is downright difficult to find an OB and a hospital who will work for a VBAC.  Birthing centers are illegal for us VBAC seekers even if we already have a proven uterus, like myself.  

The OB and hospital I have found will allow me to attempt a VBAC as long as the baby is under 10lbs.  As you know, there is no way to weigh the baby pre-birth...and best guesses are through ultrasounds (sonograms) and fundal measurements (when the doc takes a tape measure to your abdomen).  As you may also know, those are accurate within a +/- of 2 pounds.  Meaning, worst case scenario, I have an 8lb baby and they measure it at 10lbs.  (True, it could also mean I have a 10lb baby and I end up with a 12 pound whopper.)

My orders are, beginning next week, to have a sonogram on a weekly basis up until I give birth.  Again, they've found nothing wrong with him, they just want to keep us monitored.  I'm sure there are reasons...but they aren't being explained to me.  All I get is "well, we just want to keep you and the baby monitored because of your age category"...so I'm thinking is it likely to be medical?  Honestly, it doesn't even sound like good CYA reasons...maybe just to make money?  And while I've not had a red flag about the safety of the procedure, I'm not as confident about the safety of the frequency of the procedure.

Since it is just another source to judge the baby weight and possibly force me into a repeat c-section (which I definitely do not want) I'm wondering if I should just drop it altogether.  Or, playing devil's advocate, what if it says I'm under when the fundal measurement might say I'm over?  The doc, in my imagination, is going to do the CYA thing and choose whichever supports the c-section?  But again, I'm a glass half empty person and could just be paranoid.

Any one else going through this?  Any one else considering pulling back from their 3rd tri ultrasounds if they and their baby is otherwise healthy?   

YaraC

I can't know your OB's thought process but from what you have said, weekly u/s seem a bit extreme. And given that your state is big on RCS's, I would also be worried that they will find any excuse to to try to section you.

I am also hoping for a VBAC and have large babies- the difference is that my OB is very VBAC friendly and doesn't consider large babies a reason to operate. I do have one growth u/s scheduled for 32 weeks, that was ordered by the perinatologist who did my other u/s not by my OB. I am only going so that I can see the baby and re-confirm gender. My OB doesn't have any testing scheduled until I go past 40 weeks and then it is just NSTs. I'm 38 and will be 38 or 39 when I deliver.

I would probe further and see if there is any reason other than age to call for so much testing.

wedsept

With my first pregnancy, I was 35 (so I was considered in the high risk category).  Everything was so easy for me.  No morning sickness, no complications, nothing.  Everything was great.  I didn't even gain much weight.  I had no issues at all.

Then, 10 days before the birth of my LO, out of nowhere, my amniotic fluid started to decrease slowly.  The way the OB knew my amniotic fluid decreased was because of those ultrasounds during the last few weeks of my pregnancy that she did weekly.  I am glad she did them because the fluid became so low that I had to have an unscheduled c-section at 37 1/2 weeks.  If it wasn't for those ultrasounds, we would have never known there were problems. 

There are reasons for them IMO.  My OB also said it is veyr common for this situation to happen--it happened to my OB as well with the birth of one of her 4 children only.  Sometimes, things just happen.       

MrsJordanalmond

context ... my ob practice is made up of pretty cool women in their 30's and 40's.  they are supportive of vbac, drug free birth, acupuncture, have a low c/s rate, etc. 

however, they are also md's and have other policies that are more on the conservative side.

one of those policies is weekly u/s for women over 40. when i questioned them, they explained the increased risk that mother's over 40 have of unexplained fetal death in the last few weeks of pg.  i work in public health, so i went to the office and did the research ... while i am healthy and my baby is healthy :::knock on wood::: the reality is that we are at greater risk for a bad outcome and so i'm willing to do the weekly u/s.  HOWEVER, i am very confident that my obs are not looking for an excuse to do a rcs ... 

good luck, i would hate it if i felt like i needed to question the motivations of my providers ... who i should trust at such an important time.  do what you think it right for you.