Be proactive with your prenatal care

With thanks to the American Foundation for Maternal and Child Health

Published in Kindred 24 as part of Ultrasound Scans - Cause for Concern by Dr. Sarah Buckley

A good childbirth experience is dependent upon your active, knowledgeable engagement with your midwife or physician. It’s your childbirth experience. It’s up to you to let the doctor or midwife know what you want. If he or she is not in agreement with your wishes, it is far better to find that out while you still have time to shop around.

Most of the common practice patterns employed in the obstetric care of an essentially healthy pregnant woman and her baby have not been shown to be in the best interests of the woman or her baby. Do your research and become informed about the birth process, what interventions are absolutely necessary and when. Surround yourself with information, resources and people who recognise the profound capacity of a woman’s body and its ability to give birth.

When choosing your midwife or doctor, ask other mothers who have had that doctor/midwife about their experiences. Find out if they honoured the mothers’ requests during their office visits. Did they find their requests denied once they got into labour/delivery? If so, which requests were denied and why?

If you are unsure of the carer you have chosen, opt to pay at the end of each visit, rather than the full fee in advance. That way you can change course without the pressure of financial obligation.

It’s helpful to always bring along a support person who is aware of your wishes to your prenatal visits.

Remind your carer that since most medical bodies acknowledge that no one knows the delayed, long-term effects of ultrasound on human development when it is used in obstetric care, you would like to be monitored by a fetoscope. Make sure your midwife/doctor confirms that the hospital labour/delivery unit has access to a fetoscope, rather than an ultrasound doppler.

If you do not want a sonogram (ultrasound), ask the following questions:

• ‘Why do you consider this procedure necessary? What are you looking for? Is the sonogram being carried out solely to establish foetal age or multiple foetuses?’
• ‘How would you alter the course of my treatment if the sonogram discloses the condition you are looking for?’
• ‘If I am sure of the dates of my last menstrual period, what advantage is there in performing the sonogram at this stage in my pregnancy?’
• ‘Will one sonogram give you the information you need, or do you expect to do additional sonograms later in my pregnancy?’

Expressions of concern regarding the safety of ultrasound are often met with assurances such as ‘Sonograms are not x-rays’, or ‘Sonograms are just bouncing sound waves’. If the doctor or midwife continues to insist on a sonogram then ask:
‘Can you give me information from the company which will guarantee that the ultrasound will have no adverse effects on my child’s subsequent physical and neurologic development?’
(They will be unable to provide you with such a guarantee because there have been no properly controlled, long-term studies to evaluate the effects of diagnostic ultrasound on subsequent human development—but the mental exercise will make them stop and think carefully before exposing your baby to ultrasound via a sonogram or electronic foetal monitoring.)

It’s best to be clear about what you don’t want. If you don’t want an ultrasound, rather than saying, ‘I’d prefer if we not do an ultrasound’, say, ‘Do not give me an ultrasound.’

Published in Kindred 24, December 07