It's given me the chance to catch up on hobbies i'd neglected for a while and start new ones. I'm doing a sewing course and am presently making baby clothes, which is really satisfying. I'm hoping once I get a bit more experienced, i'll be able to expand and make clothes for hubby and I and things for our house.
My camera/computer are being big poos lately too! My camera works fine but when I try to connect it to our computer to upload my pics, it won't read properly. I've searched online for answers and tried everything I can. The camera's batteries are fully charged. The cable seems fine, drivers seem fine. The computer accepts the camera but when it goes to get the photos, something obviously doesn't compute. I have a feeling our computer might be on it's last legs. It's slowing down a lot lately and just doing whatever the hell it likes. I've tried disk cleanup. So any ideas to fix these two problems?
As for the pregnancy, I am officially in second trimester about 14 weeks along (almost 15). According to all the info, my uterus is the size of a large grapefruit, my baby would be fully formed, it has eyebrows and is even peeing! Thanks goodness that bloody morning sickness started to ease about a fortnight ago and has almost disappeared. That was rough going for a while.
Little Mango-chan would look something like this;
I don't have an actual ultrasound picture to show as i've decided not to have ultrasounds. They haven't been proven to improve outcomes and in fact some studies have even shown some harmful effects. Here is one article by Sarah Buckley, outlining some cause for concern if you're interested. One thing from this article that should scare the shit outta anyone thinking of having an ultrasound,
There is no reason for a healthy woman progressing with a healthy pregnancy to have an ultrasound, especially if she doesn't intend to abort at any abnormal findings.''A UK survey showed that, for one in 200 babies aborted for major abnormalities, the diagnosis on post-mortem was less severe than predicted by ultrasound and the termination was probably unjustified''.
7 comments:
Whilst I respect your choice not to have ultrasounds, be careful not to introduce a selection bias into your literature searches. There is a lot of literature that supports usage of ultrasounds, and peer reviewed guidelines in Australia recommend at least two.
I haven't read the article you posted yet (I'll go through it later), but saying that 1 in 200 aborted babies were unjustified is also like saying that 199 out of the 200 were justified.
My personal opinion is that ultrasound is a very safe screening tool to reassure parents that there are no fetal malformations or chromosomal abnormalities, and to make sure baby is growing adequately. It's not a perfect screening tool, though (has been known to occasionally miss problems- but no test in medicine is perfect).
That said, I don't want to sound patronising because you are very intelligent and can easily make the decision by yourself. If you do have any questions, I've just finished my O & G term and I'm happy to give my two cents.
Kay, I took a look at the article. Interesting stuff.
My main concerns about it are that, whilst it draws conclusions from scientific papers, the article itself is quite obviously biased from the author's personal opinion. The second paragraph in particular demonstrates this:
"What influenced me the most was my feeling that I would lose something important as a mother if I allowed someone to test my baby. I knew that if a minor or uncertain problem showed up – and this is not uncommon -- that I would be obliged to return again and again, and that after a while, it would feel as if my baby belonged to the system, and not to me."
This is a perfectly valid opinion, however it means there is substantial vested interest in the conclusions she makes. People tend to remember articles they agree with and dismiss the ones they don't.
Take, for example, the first article she quotes from Cochrane, an undeniably solid scientific database with stringent protocols. The study is a systematic review by Neilson (2007), and she has quoted this:
"…no clear benefit in terms of a substantive outcome measure like perinatal mortality [number of babies dying around the time of birth] can yet be discerned to result from the routine use of ultrasound."
Whilst this is true, she has neglected to post the actual conclusion of the Neilson article, which is that:
"Routine ultrasound in early pregnancy appears to enable better gestational age assessment, earlier detection of multiple pregnancies and earlier detection of clinically unsuspected fetal malformation at a time when termination of pregnancy is possible. However, the benefits for other substantive outcomes are less clear."
Dr Buckley has obviously only referred to the last part of the conclusion. Note that "less clear" does not actually mean dangerous or a waste of time. It just means there is not enough data to make a statistically significant conclusion.
This is confirmed by the full text of the Neilson conclusion, in which the author says:
" Neither of these effects has been shown to improve fetal outcome, but much larger numbers of participants would be required to do this if such an effect were to be real."
The Neilson article notes in the results that, due to increased accuracy of dating methods when using ultrasound there was "reduced incidence of induction of labour for apparent post-term pregnancy". Induced labour is in general not as smooth as natural labour, and has a higher risk of maternal tearing and postpartum haemorrhage, but is considered necessary because of higher risks of stillbirths, hypoxic infants with brain damage and obstructed labour. If ultrasound can reduce the confusion regarding expected date of delivery, then this is clearly beneficial for the mtoher.
Regarding the sample population of the Neilson article, the method states that some of the trials "excluded the recruitment of women with risk
features, previous complications, medical problems, and any clinical uncertainty about gestational age". This means one should be careful about making the conclusion that ultrasound is not of benefit for all women. If anything, the only conclusion that can tentatively be made is that ultrasound is not beneficial in women without risk factors, previous complications, medical problems, or clinical uncertainties about gestational age. Dr Buckley does not mention this at all.
Also, the Neilson article actually only looks at early pregnancy screening, which is not the complete picture when considering ultrasound use in pregnancy. None of the data analyses the benefit of mid-trimester (fetal malformations not picked up in early screening), or late pregnancy (placental abruption, polyhydramnios etc) complications that may cause perinatal mortality and help the obstetrician gather enough information to adequate treat the problem.
All of the above comments are particularly worrying because it shows Dr Buckley is selecting data from (good quality) articles that benefits her position, but ignores the contradictory data and the sections of the article that warrant caution before making presumptuous conclusions. I would recommend you peruse Dr Buckley's article with interest, but also with cynicism.
I'll end here because this is too long already, but bear in mind that this is my response from the first study she directly quoted and I didn't even look at any other studies.
That's awesome that you have time for hobbies. Making things always relaxes me. I mean, I might be stressed as heck during sewing, trying to figure out a corner or whatnot, but I forget my other problems then. Plus it's just so satisfying to complete something tangible, ya know?
As for ultrasounds- I understand your rationale behind the refusal. I was worried about how many u/s they have in Japan compared to most other countries. But after having 3 miscarriages before my son (1 after) my pregnancies have become very high-risk. I was super lucky to have the u/s so often because they did catch a couple of problems that don't show up on blood tests. I do totally believe that having lots of u/s (I think I had a total of 23 in 40 weeks) was one of the main reasons I was able to carry to term.
I think the best thing is that we are able to choose. In Canada I couldn't choose to have that many ultrasounds, but in any country there's a choice not to. I am glad you are exercising your choice!
I want to see pics of the clothes you are making. :)
I also had a lot of ultrasounds in Japan. I had a lot of problems during my pregnancy (bleeding and hospitalization twice for pre-term labor) so the ultrasounds were reassuring for me to see that the baby was still in there! :) But everyone has their own rationale for what they do and don't do during pregnancy so go for whatever you feel is right for you and your family!
I can finally comment on blogs again!
I'm so glad your pregnancy is starting to get more comfortable. It's an exciting time, the 2nd trimester is awesome, I felt really great for those few months.
As for ultrasounds, you might consider doing one later on, because there are some things that can be caught with an ultrasound that have nothing to do with abnormalities or aborting the fetus. For example, I found out at my 35 week ultrasound that the baby has the cord around his neck ... while this isn't a very serious problem, the doctors have told me to be more watchful about the baby's movements and I will have another ultrasound this week to make sure the placement is still ok to do a vaginal birth. You also need to be careful about the placenta -- as far as I know, placenta previa can only be diagnosed by ultrasound (although I'm not an expert) and if you have full placenta previa then a c-section is pretty necessary (as an aside, my grandmother had placenta previa with my mom in 1951 and my mom was born at home and 2 months premature and baby and mother were only saved by the heroic efforts of my aunt! Makes for good family folklore anyhow! ;))
All this isn't to say that you should get ultrasounds, but just some things to ask your OB about so that you make sure you go into your birth as safe as possible. I personally don't think there's too much need for early ultrasounds with a normal, healthy pregnancy, but later on you might find that having a bit more information going into the birth could be helpful. In any case, I agree with Jen, it's great that we have the choice. I'm sure that in Oz you're getting good care and are in good hands!
I worried about the amount of ultrasounds I had here too!
Like medea says its great to have the choice and I really applaud you for making yours and for your thought process around it.
Sorry it's taken me so long to reply to your comments. Thank you everyone for your thoughtful comments. I really would like to reply to each of you.
Cam- Where did you get the time to read and critique that article? I guess you have that down to an art by now with all your years at uni. I respectfully have to disagree with a few things you said. The first being that I don't introduce a selection bias into my literature search. I don't believe I have. I only quoted from one article I looked at. I also haven't approached this as a scientific literature review. As a pregnant woman, a lot of what you decide comes down to your gut feelings... Which is another point of yours where you say Sarah Buckley is biased by her personal opinions. While I agree she does bring her own flavour to the article, it is hardly surprising as a woman who has been through it all and she does not hide this fact and I don't believe it makes her article/study review biased. Having said all this, I also don't 100% agree with everything she says and I have viewed her article and the studies contained therein as interesting sources of information and not as the unadulterated truth.
The Neilson article and it's conclusions also help to strengthen my decision to not have unneccessary ultrasounds. His and your points about u/s giving increased accuracy of dating methods is a valid point. But how about this? Why look at the due date so prominantly in the first place? Why place so much importance on a date that could quite as easily be three weeks previous or later? If the western world wasn't so preoccupied with due dates, then babies would just come on their birthday and risks associated with unneccessary inductions could be lowered. I would LOVE to chat with you about this Cam. I am not particularly eloquent in writing (not that I am in conversation either but I get a lot more out of the nice back and forth of a convo as opposed to the sporadic writings on a blog).
Medea- I posted pics of the clothes...finally! That is interesting you thought the u/s helped you carry to term. I'm sure you don't wanna go into details on here but i'd love to hear more about that if you're ok to share?
Kuri & Ping- u/s being reassuring is a huge reason for a lot of woman. I get this, I totally do. I guess I'm lucky in that I have a highly energetic baby that lets me know every hour or so how healthy it is.
Jessica- thanks for your point about later u/s. I will review how I feel later in the pregnancy for sure. I think there is a lot to be said for being in tune with your body and 'knowing' if there is something wrong or not. I'm just not comfortable going along for an u/s just for the sake of it. If I felt there was something wrong or symptoms pointed to the fact, then it certainly would be an option. I don't think docs give enough credit to women for their inner knowing and knowledge about their body and a lot of women rely too heavily on what doctors say and don't utilise other sources of info (being pregnant for example- why do we need to go to a doc to get it 'confirmed'? I sure had it confirmed by my sore boobs, lack of period and then the sickness). As far as I know, a lot of the potential problems you mentioned can be picked up by other means (bleeding, pain etc). Cord around the neck can be slipped back during birth. By the way, how did your cord go at your birth?
Muriel- yep, choice is it.
So everyone, thank you so much for your comments. I hear what you're saying and I hope you hear what i'm saying. Basically I feel that pregnancy and birth need not be so medical and that modern medicine might gain from the wisdom of pregnant/birthing women if they let us be. Of course doctors, hospitals and u/s have a place but why not leave them for when neccessary and free up some of those resources for the women that truly need them?
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