ultrasound with a high risk preg.

jesscardona · 01-04-2007, 10:52 AM

I was kind of..I don't even know what to call it.. but yall know my sister is preg. with twins.. she's 11weks. she's considered a high risk patient b/c of previous condition of
uterine septum, well she is being seen by a specialist every 2 wks. and is having an u/s every 2wks. I don't have anything against u/s.. but having one every 2wks..

Of course I didnt say anything.. since this is a high risk with twins with a uterine septum.. it's a different story all together..

HamiltonBirthRevolution · 01-04-2007, 11:02 AM

I have a client who is also high risk and pregnant with twins (has a serious allergy) and she is also being U/Sed every two weeks. I thought it was excessive, but that's what OBs are good at!

jesscardona · 01-04-2007, 11:05 AM

Quote:

Originally Posted by HamiltonBirthRevolution

I have a client who is also high risk and pregnant with twins (has a serious allergy) and she is also being U/Sed every two weeks. I thought it was excessive, but that's what OBs are good at!

Really?! okay.. I think she told me.. that she was going to u/sed every 2wks. until birth..

I was a little shock.. all I asked if she was sure.. she wasn't too sure.. but so far everything is going well..

1stimestar · 01-04-2007, 11:26 AM

What are they looking for and what will they do with information they may find?

jesscardona · 01-04-2007, 11:28 AM

Quote:

Originally Posted by 1stimestar

What are they looking for and what will they do with information they may find?

I don't know.. I guess if they find something proceed from there..

HamiltonBirthRevolution · 01-04-2007, 12:00 PM

For my client, she had encephalic shock early in the pregnancy, and while the twins are perfectly fine, I'm guessing that they just want to continue with the high risk protocol for safety.

That being said, I'm kinda proceeding like its none of my business. I'm not about to second guess her OB. If he deems these U/Ss required then so be it. If my client decides it's excessive, I'd be happy to find info for her and help her make any care decisions she feels compelled to make at that time.

Lindsay · 01-04-2007, 12:29 PM

Quote:

Originally Posted by HamiltonBirthRevolution

For my client, she had encephalic shock early in the pregnancy, and while the twins are perfectly fine, I'm guessing that they just want to continue with the high risk protocol for safety.

Do you mean anaphylactic shock?

My husband went into severe anaphylaxis after an encounter with sunflower seeds just about a year ago (we were told we made it with about 20 seconds to spare). It's an enormous drain on the system, and in cases as severe as my husbands, can take a while to recover from, as the body is basically shutting itself down during hypotensive shock. It was probably a good month before he stopped feeling some after effects of it.

Quite honestly, having seen him go through that, if it had happened to me at the beginning of a twin pregnancy, I'd probably be okay with closer monitoring as well.

HamiltonBirthRevolution · 01-04-2007, 12:50 PM

Lindsey, you're right. Yikes! What a mistype!

My client told me that she sometimes feels like she has chronic fatigue for up to 6 mths after an episode, of which she's only had two, from what I remember of our interview.

But, your sentiments, that after anaphylactic shock close monitoring isn't such a horrible idea, is what I feel. But, as with all my clients, it's not my pregnancy, so I'm not even gonna second guess the care protocols.

b'earth angel · 01-04-2007, 01:22 PM

Quote:

Originally Posted by HamiltonBirthRevolution

Lindsey, you're right. Yikes! What a mistype!

My client told me that she sometimes feels like she has chronic fatigue for up to 6 mths after an episode, of which she's only had two, from what I remember of our interview.

But, your sentiments, that after anaphylactic shock close monitoring isn't such a horrible idea, is what I feel. But, as with all my clients, it's not my pregnancy, so I'm not even gonna second guess the care protocols.

I agree about not sticking your nose in unless your asked!
But just for our conversation here, don't you think that the u/s is just an easy replacement for other non-invasive monitoring? I mean I see a huge difference in the way a midwife examines a woman and the way most OB's do. YKWIM. A good midwife can tell fetal position, placental position, heartbeat, etc. by her exam. The woman herself can keep a dietary/lifestyle/emotional diary and monitor her own self also. But an OB/specialist has to have the u/s to do the same thing. Is this just laziness on their parts? Or a distrust in their own abilities? I'm not sure, and I know it's different for each dr.
I guess what I would want to know, for me personally, is there something else that could be done in this situation or is this the only choice?? (I think that there is always another option, but not sure what it would be in this circumstance)

Jilian · 01-04-2007, 01:32 PM

Quote:

Originally Posted by b'earth angel

But just for our conversation here, don't you think that the u/s is just an easy replacement for other non-invasive monitoring? I mean I see a huge difference in the way a midwife examines a woman and the way most OB's do. YKWIM. A good midwife can tell fetal position, placental position, heartbeat, etc. by her exam. The woman herself can keep a dietary/lifestyle/emotional diary and monitor her own self also. But an OB/specialist has to have the u/s to do the same thing. Is this just laziness on their parts? Or a distrust in their own abilities? I'm not sure, and I know it's different for each dr.

I honestly believe that so many OBs do not trust in birth or the capabilities of the female body. OBs are surgeons, so they are heavily trained on what could go wrong. There is no need to train for what could go right, because that would not require intervention$.

I can pick up on the distrust just by listening to the comments some OBs make, for example my first client was 34 weeks along with a perfectly healthy pregnancy and her OB said "Gosh I really hope I don't have to section you because stitching that tattoo back together will be hard". This was at the prenatal visit I attended and my client had a large tattoo on her very low belly. WHY would the OB even mention a cesarean? NOTHING at all pointed to my client even remotely needing a cesarean!

I think medical conditioning is partly to blame. I have a friend in nursing school who just gave birth to her first child. I sent her tons of natural books and she was really surprised at what she read. She said her nursing school training always taught her that birth was dangerous and after reading the books she was more trusting of birth.

IMO, most medical training is fear-based and most OBs are more concerned with potential lawsuits than the well-being of their patients.

purpleheather79 · 01-04-2007, 01:43 PM

Quote:

Originally Posted by jesscardona

I was kind of..I don't even know what to call it.. but yall know my sister is preg. with twins.. she's 11weks. she's considered a high risk patient b/c of previous condition of
uterine septum, well she is being seen by a specialist every 2 wks. and is having an u/s every 2wks. I don't have anything against u/s.. but having one every 2wks..

Of course I didnt say anything.. since this is a high risk with twins with a uterine septum.. it's a different story all together..

Is your sister in Atlanta too?

When I was pregnant with my twins the backup OB wanted u/s twice a week during the 3rd trimester. @@ I was "high-risk" too because it was twins, a VBAC, and Baby A was breech with a SUA. Of course the risk is all relative. I didn't consider myself high-risk so I didn't do the u/s. I did go for a few u/s at the end but I refused the rest. What are the doctors looking for with your sister's u/s? Will it change her care? Will it change outcome for her or the babies?

BTW, congrats to her! Twins are awesome.

HamiltonBirthRevolution · 01-04-2007, 01:45 PM

WEll, I think for the two women in question here, they are being seen as high risk patients. As skilled as midwives are, I think that there are definitely situations where the specific low interventive birth arts they use limit their ability to get a fuller picture of what's going on in utero.

I'm not nescessarily saying that 2 week U/Ss are warranted in either of these two situations, but then I'm not a medical doctor. Like I was saying for my client, the effects of anaphalactic shock (and I believe my client briefly arrested, so there was a confirmed period of zero oxygen exchange) can last for months and it's likely there is little known about all the effects on infants. Twins being a more delicate proposition overall, I would not agree that in this case the OBs are being "lazy" but merely careful in a situation full of unknowns and special circumstances.

Lindsay · 01-04-2007, 01:47 PM

Quote:

Originally Posted by b'earth angel

I agree about not sticking your nose in unless your asked!
But just for our conversation here, don't you think that the u/s is just an easy replacement for other non-invasive monitoring? I mean I see a huge difference in the way a midwife examines a woman and the way most OB's do. YKWIM. A good midwife can tell fetal position, placental position, heartbeat, etc. by her exam. The woman herself can keep a dietary/lifestyle/emotional diary and monitor her own self also. But an OB/specialist has to have the u/s to do the same thing. Is this just laziness on their parts? Or a distrust in their own abilities? I'm not sure, and I know it's different for each dr.
I guess what I would want to know, for me personally, is there something else that could be done in this situation or is this the only choice?? (I think that there is always another option, but not sure what it would be in this circumstance)

In normal circumstances yeah, absolutely, u/s is a replacement for an actual exam and relationship building practices. My midwife knew ME. She could tell if I had a bad urine dip and high BP because of stress, as opposed to something actually causing concern. She could tell me my baby's position based on feeling my belly alone and could locate the placenta based on sound. She taught me how to tell my child's position. The OB I have now does palpate for fetal positioning, but also uses u/s at the request of his patients.

I just don't think they're taught how to do these things anymore. My OB will tell me stories of residents he gets that just don't know how to do anything without their machine that goes "Ding". I'm really sad that the very vital and valuable skills that midwives have aren't even really being taught to OBs anymore. No wonder they have an absolute lack of trust in birth. It's all in what the machines say.

purpleheather79 · 01-04-2007, 01:59 PM

Quote:

Originally Posted by Lindsay

I just don't think they're taught how to do these things anymore. My OB will tell me stories of residents he gets that just don't know how to do anything without their machine that goes "Ding". I'm really sad that the very vital and valuable skills that midwives have aren't even really being taught to OBs anymore. No wonder they have an absolute lack of trust in birth. It's all in what the machines say.

They aren't. That's why most doctors don't do breech births. The doc that delivered my last client's breech baby was awesome. He is the BEST OB I have ever had the pleasure of working with and this says a lot coming from my homebirthing self. LOL This doctor brought in a resident and actually taught her and guided her as she caught the baby. She would never learn that in school-he even said that. Then he asked if she'd be doing breech births when she starts her own practice. She just said "no." I think it's sad that this new generation of doctors doesn't know how to deliver breech or palpate a uterus. They know technology and that's the only way they know how to handle birth.

jesscardona · 01-04-2007, 07:06 PM

Quote:

Originally Posted by purpleheather79

Is your sister in Atlanta too?

When I was pregnant with my twins the backup OB wanted u/s twice a week during the 3rd trimester. @@ I was "high-risk" too because it was twins, a VBAC, and Baby A was breech with a SUA. Of course the risk is all relative. I didn't consider myself high-risk so I didn't do the u/s. I did go for a few u/s at the end but I refused the rest. What are the doctors looking for with your sister's u/s? Will it change her care? Will it change outcome for her or the babies?

BTW, congrats to her! Twins are awesome.

Yes.. she's here in Atlanta.. I really don't know the why they're doing the u/s.. for the 1st trimester she is being seen by the specialist who did her surgery, then she'll go to the regular OB..