Don't want another ultrasound - what would you do?

MaraLorien · December 2013

Hi Everyone, I've never posted on this board, but I do lurk at times, so first of all, hi! I'm 37 years old and currently 23 and a half weeks pregnant with my first child (3rd pregnancy, the other two were blighted ovums). I've had 4 ultrasounds already during this pregnancy - one at 6 weeks to make sure there was a baby in there, another at 8 weeks because I had some spotting, the 3rd at 13 weeks for the neuchal fold scan, and then the anatomy scan at 19 weeks. It wasn't until after the anatomy scan that my husband and I even thought to look into what all these scans might be doing. I guess we just kind of got caught up in the rush of "oh my gosh, it's for real this time!", so it didn't cross my mind to think twice about the scans. However, after doing some research, I decided on no more scans. Well, I saw my OB today for a regular monthly checkup and she asked me to schedule the "28 week growth scan" for four weeks out. I asked her if it was necessary and she just answered that it was standard practice. I then told her that I was uncomfortable with doing any more scans and she repeated that it was standard, and then added that it's due to my weight (overweight). I conceded because I get stupid and clam up at the first hint of confrontation and I made the appointment. I'm still against it, however, and plan to call the doctor to tell her that I will be canceling it. I guess what I'm asking is - how far do I take it when she continues to disagree with me? Switch practices? How far would you go? Is there anyone else out there that is against ultrasound scans? Thanks for your input and sorry for the stupid iPad formatting!

CDMay2006 · December 2013

I had planned only the growth scan, but doe to placenta previa and going late (42w5d) i had two more. The two additional scans each had a specific, important propose so i had no qualms about doing them.
Unless your weight interferes with feeling the baby or assessing the baby during exams, i, too, would question the need for an additional scan. However, if it does, or if something arises, then IMO the benefit outweighs the potential risk.
I'm not sure that answers your questions, but I'm also not sure anyone but you can answer them...

MaraLorien · December 2013

My weight doesn't prevent being able to feel the baby and I don't have any weight related health issues outside of pregnancy. In light of the fact that the American College of Obstetricians and Gynecologists recommends scans only for specific reasons, I feel that, of course, most practices will search to find a reason or two to order a scan. Just as I'm ridiculously labeled high risk because I'm over 35, I feel like I have been pigeonholed due to being slightly overweight. I do know that I will refuse further scans. My trepidation lies with how to handle the conversation with the doctor, given that I failed on the fist go around.

barnwife · December 2013

Well, I have 3 LOs and have never had an u/s. My MW orders an a/s at 20 weeks if you want one. We have always declined.

I would just call and cancel. If/when questioned, you can say you've done your research and without a compelling reason/concern you choose not to have any more u/s. Reiterate that as many times as possible.

If this is the only issue with your care provider, I don't know that I'd switch. If this is one of many issues with your provider, it may be time to see if you can find someone who may be a better fit.

MaraLorien · December 2013

Tangerine01 said:

I am kind of like you, and would rather listen to the doc so as to avoid confrontation. Having said that, I would avoid any future scans if I were you and wanted no ultrasounds during my pregnancy. We did not get the dating ultrasound and then I ended up in the hospital for gallstones at 11 weeks and had to have one at that time. I had the anatomy scan because I was having a home birth and my midwife said it would be a good idea to make sure everything was good to go at home.
In my experience, it is often easiest to not offer reasons and just say "We have decided not to get any more ultrasounds." Then if they question you you say "That is what we think is best for us right now." Or some other noncommittal explanation that can't really be argued with. If you go into research they will have their own to counter yours, and that is when you will get uncertain in asserting yourself w/ the doc.
Anyway, this is the approach we use with delaying vaccines, etc. If the doctor doesn't agree, just tell them that is the decision you have made for your family and there is not much they can argue with there.

Thank you for this. This is exactly how I feel. I'm one of those people that can never win at arguments because I can never remember exact details of things that I've read. And there's no way I'm going to end a discussion with my doctor with "I don't know why, I just don't like it."!

alliejoe · December 2013

I would approach it as the pp suggested. If you get push back I would consider switching. If she's resistant on something as insignificant as denying an u/s who knows what they would say about wanting to go past 40w, or pitocin, etc.

aylafsu88 · December 2013

CDMay2006 said:

I had planned only the growth scan, but doe to placenta previa and going late (42w5d) i had two more. The two additional scans each had a specific, important propose so i had no qualms about doing them. Unless your weight interferes with feeling the baby or assessing the baby during exams, i, too, would question the need for an additional scan. However, if it does, or if something arises, then IMO the benefit outweighs the potential risk. I'm not sure that answers your questions, but I'm also not sure anyone but you can answer them...

I agree with this. I had 3 scans my whole pregnancy but I was low risk and had no complications. If there is a valid medical reason for additional scans then you should do them. However, it sounds like your OB is doing them out of habit and not for medical reasons. I agree with Tangerine, tell them you have decided against it and leave it at that. I know that my OB started cervical checks at 35 weeks pregnant. Instead of arguing about it, I told them I did not want one and did not get undressed. My OB let it go and did not pressure me about it which was nice.

ncbelle · December 2013

I would decline and just be firm about it. If it turns into an issue with her, then I'd consider switching - what else is going to be "standard practice" that she's inflexible about?

This is your birth, your body, your baby. It's ok to stand up for yourself, ask questions, and demand answers. Your provider works for you - not the other way around

MaraLorien · December 2013

Thank you, ladies - I knew I could count on you to help empower me and give me the words.

I agree with the couple of you that have said that if there is a valid medical reason to have a scan, then I should have one. I just don't think there is a valid reason right now.

rooftop · December 2013

alliejoe said:

I would approach it as the pp suggested. If you get push back I would consider switching. If she's resistant on something as insignificant as denying an u/s who knows what they would say about wanting to go past 40w, or pitocin, etc.

This is what I was thinking. It sounds as though your provider is very stuck to "standard procedure" which can lead to all sorts of others interventions. Particularly if you want a natural birth, it could get tough to have any say in your delivery if this is how stubborn she is now. "standard" does not mean necessary and with C-sec rates as they are, "standard" in obstetrics isn't always a good thing.

momof2buggs · December 2013

If you're uncomfortable with a confrontation, maybe have your hubs talk with your doctor. This is not an area I had a problem with, so my first thought was, "Just tell your doctor you're not having any more scans". I was pretty bossy during my pregnancies and labors, because I was very informed and knew what was needed and also what was not needed. Sorry you're having a hard time! Hope it gets easier for you to speak your mind.

shiway · December 2013

For me that sounds like a provider that isn't concerned about your concerns and wishes. Why would you stay with that provider if you don't agree or he/she doesn't respect your concern. It's a no brainer to me. Never have I ever get pressured or bullied or ignored by my midwife. All tests, procedures and all aspects of labor birth prenatal care are discussed and I make the choices. Of course there are things they can't do and that is up to me to accept. Like I can't deliver before 37 weeks or I can't have my water broke for 6 days ad have them continue care with me but I know about these things. I have trust in them and they respect me!

MaraLorien · December 2013

I agree with everything you last three posters are saying. I think my qualms lay more with my own inability, under the smallest bit of pressure, to stick to my guns. I like my doctor a lot. Her style and practice lay parallel to the midwives that practice under her. She didn't actually push me that hard, and if I had been prepared, or if I were to keep my pregnant brain from forgetting everything I read lately, I'm sure I wouldn't have conceded so quickly. What I'm saying is that I have an internalized issue, whether I like it or not, with having confrontations with anyone with "authority". And this is something that I'm just now realizing. I think there is an inner part of me that always want to be "good". Does anyone know what I mean here? I need to get rid of that drive. I'm 37 years old, for crying out loud. Anyway, I called the nurse line at my practice yesterday, and the nurse I talked to was really good. After checking my file to make sure it wasn't a "necessary" scan, she said "you have absolute choice when it come to you and your baby. No one is going to make you do something you don't want to do. Now, enjoy your growing baby, relax your body and mind, and enjoy the holidays." It sounds like she was being condescending, now that I read it, but she was so sweet and she just said what I needed to hear at the moment.

DebateThis · December 2013

Your age and weight put you in a higher risk category for a variety of reasons, including congenital defects. Before you decline it based on an unfounded fear of an ultrasound, you should probably ask if there are further concerns that warrant the scan in your specific pregnancy. 28 weeks is when they can check for fetal cardiac anomalies (you can't really see them at the 20w scan and AMA puts you at higher risk for them) which could change your care for the next few months as well as L&D. You absolutely should have this conversation with your OB in order to assuage your fears - and if she blows you off I wouldn't hesitate to find a new caregiver.

Just to reassure you, I had ultrasounds every week from 5-13 weeks and every week from 17-34 weeks, and then again at 35 and 38w.

MaraLorien · December 2013

DebateThis said:

Your age and weight put you in a higher risk category for a variety of reasons, including congenital defects. Before you decline it based on an unfounded fear of an ultrasound, you should probably ask if there are further concerns that warrant the scan in your specific pregnancy. 28 weeks is when they can check for fetal cardiac anomalies (you can't really see them at the 20w scan and AMA puts you at higher risk for them) which could change your care for the next few months as well as L&D. You absolutely should have this conversation with your OB in order to assuage your fears - and if she blows you off I wouldn't hesitate to find a new caregiver.

Just to reassure you, I had ultrasounds every week from 5-13 weeks and every week from 17-34 weeks, and then again at 35 and 38w.

Thanks for your input, but I have a few things to say. 1. I'm only 37 and in perfect health other than the few extra pounds. 2. I don't have a fear of ultrasounds, I'm being cautious and the reasons I have are not "unfounded" 3. I did ask what the reason for apt he scan was, and the doctor told me it was to check on the growth 4. The fact that you, as well as so many women, have had so many ultrasounds does not reassure me. How do you know that no damage was done? Also, I didn't come on here to start a debate about whether or not I should continue with the scans. I just wanted advice on how to handle further conversations with the doctor.

DebateThis · December 2013

MaraLorien said:

DebateThis said:

Your age and weight put you in a higher risk category for a variety of reasons, including congenital defects. Before you decline it based on an unfounded fear of an ultrasound, you should probably ask if there are further concerns that warrant the scan in your specific pregnancy. 28 weeks is when they can check for fetal cardiac anomalies (you can't really see them at the 20w scan and AMA puts you at higher risk for them) which could change your care for the next few months as well as L&D. You absolutely should have this conversation with your OB in order to assuage your fears - and if she blows you off I wouldn't hesitate to find a new caregiver.

Just to reassure you, I had ultrasounds every week from 5-13 weeks and every week from 17-34 weeks, and then again at 35 and 38w.

Thanks for your input, but I have a few things to say. 1. I'm only 37 and in perfect health other than the few extra pounds. 2. I don't have a fear of ultrasounds, I'm being cautious and the reasons I have are not "unfounded" 3. I did ask what the reason for apt he scan was, and the doctor told me it was to check on the growth 4. The fact that you, as well as so many women, have had so many ultrasounds does not reassure me. How do you know that no damage was done? Also, I didn't come on here to start a debate about whether or not I should continue with the scans. I just wanted advice on how to handle further conversations with the doctor.

That's great, but you're making decisions based on factually inaccurate "research" and YOU asked if there were people who are against ultrasounds. This board supports evidence-based medicine as a general rule. Ultrasounds have been proven through decades of research to be safe and they just so happened to not only help create my baby but also save his life.

Advanced Maternal Age is a medical distinction for anyone over age 35 so "only being 37" puts you in that category. And AMA plus being overweight puts you in a higher risk category for many problems in pregnancy, including IUGR and placental insuficiency, which can be monitored via a harmless ultrasound. These are facts.

MaraLorien · December 2013

OK, it looks like we're going to disagree. I'm very glad that you were able to have a healthy pregnancy and baby boy thanks to the use of ultrasounds. As I said in the earlier posts, I would consent to a scan if the need arose. I do understand your viewpoint that I might not know there is a need unless I have a scan. I do plan on talking to my doctor some more about it. I also take offense at your assumption that I've been led astray by factually inaccurate research. You don't know what I've read. I'll just leave it at that and move on. Thank you for your knowledge.

momof2buggs · December 2013

Honestly, medical intervention makes things more complicated than they have to be. That isn't to say it isn't a positive most of the time. You needn't be pushed into more scans than you're confortable with, simply because you're "AMA", or "overweight". You'll be fine not having any more scans, and so will your baby.

nosoup4u · December 2013

I'm not against u/s, but having multiple growth scans when everything is healthy serves no purpose, IMO.

Being AMA doesn't automatically put in you the high-risk pg category, as does being overweight (as long as you're not going over whatever is recommended for you, etc.). And whatever your decision, it's your body, your choice.

That being said, just say no if you don't want it. You might have to sign an Against Medical Advice form, and you'll probably get a guilt trip about it, but if it's only for growth, you can point out that it's not for an actual medical reason.

I turned down a BPP u/s with DS2. I had some late u/s with DS1 that eventually led to me being trapped in the hospital way too early in labor, etc. etc. so I had some misgivings about them bc of that. Anyhoo, I told them I wasn't going to do the u/s portion. I had to talk to a MW on call about how I was fully aware of what I was refusing, and I signed the AMA form. I was incredibly nervous saying no (had to do it without DH being there for moral support), but everyone was very nice about it and didn't push it after I told them my reasons.

Last thing: If your provider does give you a hard time about it, then you still have time to find someone else. I would call or contact her ASAP to see what she says if this is really what you want to do.

Good luck!

shiway · December 2013

I agree with Mara- there is no research that ultra sounds don't cause harm. And it's a valid fear. People think because its medical and doctor says they need it than it must be safe without risk! Maybe your baby is fine with 20 scans but maybe another baby won't be. And to have scan every week is quite excessive. Do you know that when the ultra sound is being performed it sounds likes train going by. It is super loud and it also generates quite a bit of heat in the womb. Now that doesn't sound like a very enjoyable experience for baby. Especially every week. So you go ahead and have your weekly scan but his mama doesn't feel comfortable with it! My best advice is be frank and say you will decline the scan. They can force any medical procedures on you. If she gives you more hassle consider changing providers. One that respects your concerns and helps you come to decisions as a team!

shiway · December 2013

Sorry they CAN'T force any medical procedure on you

L0L0 · December 2013

I totally understand how you feel. The hospital pediatrician told me I had to feed my baby formula or they would put her on an IV. So I did. Then later even though she was EBF I felt all guilty that I caved In and ruined her gut bacteria. But she was thriving, and I really don't and can't know what affect the formula had, good or bad. I think second time around I will stick to my guns a little more, but still, it's so hard to know what is best and it's hard to fight against experts who ultimately have the same goal as you (a healthy baby), though their philosophies differ from yours. The hospital ped also made me feel like a moron for refusing the eye medicine, so I caved on that too. I don't know if this is helpful in any way, but I do feel for you and hope you can stick up for yourself and feel good about the treatments you consent to and those you decline.

Flyingtoast · December 2013

I refused extra ultrasounds because it's 'standard'. I had a long conversation with my MW, explained my stance and she accepted it after I had shown her that I was knowledgable and could back up my stance with facts. I did not just use knowledge from the overly afraid of law suits and liability US medical, but all first world counties with as highly rated medical care. I shared what I found with her, and she seemed truly surprised by the HUGE difference in 'standard' in care with the same rates in other countries.

As moms, we are not only caring for ourselves, but our growing babies. After research, if you do not feel a procedure is nessecaey, and your OB/MW can not explain why they want a procedure done, other then it's 'standard', do not feel guilty by othes who are so afraid, they cant think for their selves because they can not balance little risk vs harm.

There has been NO conclusive study that has been succesfuly repeated to show U/S are safe. 1 study showing its safe, 20+ having inconsusive results does not make it safe, makes it unknown. When a red flag is raised, the risk/reward balance obviously changes. Out of curve growth, heart beat irregularities, ect. But just because it's standard is not a reason.

Yes standards are made for a large populations care to cover EVERYONE. But when advocating for your own personal care plan, everyone's care plan does not automatically work for you.

Those are roughly the same results as the x-rays ( the previously imaging method). It's amazing how what was formerly safe, is now common knowledge as risky.

There is nothing wrong with thinking for yourself and your child, researching, and making informed choices.

dannie2011 · December 2013

Lurker here, and I'm 40 my OB does not do any growth scans even at my age. I won't be having any more unless something comes up that they are needed. Also I'm not considered high risk just because of my age and a few extra pounds.

huntjul · December 2013

ncbelle said:

I would decline and just be firm about it. If it turns into an issue with her, then I'd consider switching - what else is going to be "standard practice" that she's inflexible about?

This is your birth, your body, your baby. It's ok to stand up for yourself, ask questions, and demand answers. Your provider works for you - not the other way around

This, all of this. You can also ask for specifics about what they are looking for. "Growth of the baby? Do you have a specific reason to be concerned about that?" And remember its always your right to decline, but I father think you're making a big mistake, they will continue to badger you or may even fire you as a patient--in either case, you would need to go elsewhere.

HNRomance · January 2014

I would just tell them in no uncertain terms that you will not be authorizing any other U/S for "routine" or "standard" procedures and if you feel there is a need for one, you will request it. Once you start saying no it gets easier

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