Recently I came across this article which was posted by Jan Tritten, Editor, Midwifery Today. Most of the links and research resources given in the article point out the harmful effects of prenatal ultrasounds, which we have known for a while. Yet, in the face of so much gathering evidence ultrasound is being prescribed increasingly in most of urban India. There are clinics which specialize in only prenatal ultrasounds! And, mothers are being made to wait 4-5 hours to just get a “scan”. Two days back, a couple came to meet with me, and their doctor had prescribed an 8th month ultrasound to look for “AFI, Placental function, and cord around neck”!! Whatever happened to checking the mother’s abdomen and measuring the belly for growth? And what possible information can a loop of cord around neck (even if it is there) give in the 8th month?
I am increasingly becoming aware of how little testing we do in our prenatal check-ups at Healthy Mother, in the face of how much of it is prescribed in most hospitals and routine practices. We usually ask the mother to get one ultrasound done at around 18 weeks, primarily for dating, and to check the position of the placenta. In addition, this also acts as a fetal anomaly scan. The only other ultrasound that we ask for is at 41+ weeks, which is a Doppler to assess placental function and get a biophysical profile! If the baby is moving and kicking at each visit, the mother’s belly is growing in correspondence to her weeks of pregnancy, and she is generally well, that shows that the baby is well too! Of course, ultrasound is a valuable tool if something out of the range of normal is detected during prenatal check-ups – we do not want to throw the baby out with the bath water.
Our Swedish midwife Marianne, tells me that it is routine practice in Sweden and Norway to offer only one ultrasound at 18 weeks of pregnancy. And, Sweden and Norway have amongst the best maternal and fetal outcomes across the world. These countries are constantly doing research and updating their practices based upon the weight of current evidence. Obviously, they are doing something right … it is another thing altogether, that midwives are the primary care providers in most pregnancies and births in the Scandinavian countries!
It is up to each one of us – care providers and parents alike – to research the unchecked use of ultrasounds, and provide/demand the best care for the baby in the womb.
Please feel free to send in your thoughts, comments and queries.
Vijaya
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Ancientartmail
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Dr Geetika Wadhwa
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Keeptryst
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Tanujarajiv