(above: one of Lee’s standing sculptures)
The following is my personal view of the benefits and risks of ultrasound. I’m not a scientist or a journalist or a doctor. Please do your research and make up your own mind. Most of my friends and acquaintances have ultrasounds done, and I love you all. I am motivated entirely by my love of babies and my belief that pregnancy and birth are safe and normal. If you disagree with me and think I’m nuts, that’s fine. You can let me know if you like. But please be respectful.
There is, for me, not *any* instance in which I would ever have an ultrasound done. Ultrasound is, I believe, a mistake, and possibly a dangerous one. It is a product of the military industrial complex and has little to no place, in my humble view, in the childbirthing year. As a diagnostic tool, ultrasound is abysmal, and it is *documented* to cause cellular change. There is reason to believe (and many qualified individuals do) that there are potential links between ultrasound and miscarriage, learning disabilities, other cognitive effects, and more.
I hear so many women say a version of the following, when they come across articles or individuals who advocate *against* the use of ultrasound: “Yes, I’ve heard that ultrasound carries some risk. That’s why I only had two done.” Or three, or one, and so on.
Ultrasound has been entirely normalized in our culture, and I find this perspective very troubling, considering how very little benefit ultrasound provides. Why consciously expose our unborn babies to this technology at all, when it is an invasive procedure, the effect of which we *do not* comprehensively understand?
I think that many women consent to exposing their babies to ultrasound because doctors present ultrasound not as an infrequently employed visual aid for the rarest of circumstances, or even an option, but as an imperative; an inevitability, standard procedure, and as a rite of passage in a North American pregnancy. And, of course, it is.
But ultrasound is also unproven (in myriad ways), and my feeling, based on the very compelling research I have read, is that ultrasound is dangerous to our tiny developing infants. Not only do doctors neglect to present ultrasound with any sense of perspective or honesty about the potential for risk, but its administration is described, in tone, as protective, preventative, and insightful, when it is emphatically none of these. Ultrasound also happens to be one of the core moneymakers of the childbirth industry.
When women decline to receive the standard dose, they are treated by medical personnel with a combination of dripping condescension and authoritative disapproval, and they are urged to “think of the health of their baby”. They are reminded of the sometimes (truly) terrible outcomes of placenta praevia, and of the terrifying (not at all) possibility of “breech” birth. But they are rarely told that the risk of placenta praevia is extremely minimal, or of the fact that the placenta migrates during pregnancy and that ultrasound isn’t even effective as an early diagnostic tool…and they are almost never told that the baby’s size, the mother’s amniotic fluid levels, and the baby’s position are all better discernible through the traditional midwifery skill of gentle palpation.
Women are also *never* informed, in the hospital or by most contemporary registered midwives, that the doppler actually exposes their baby to a higher level of ultrasonic waves than does the larger machine. A good friend of mine was recently told, when she asked to have a foetoscope used instead of a doppler during her prenatal appointment, that she couldn’t be accommodated, because the doctor did not know how to use the foetoscope.
The way ultrasound has been sold to our society, to me, is unethical, and I predict that in the next 20-30 years ultrasound will be looked upon as one of the medical mistakes of the 21st century. Then again, maybe todays world of ultrasound, stress testing, blood diagnostics and amniocentesis is only the tip of the technological iceberg that continues to infringe upon the stunningly *perfect* process of human birth.
Like the fraught question of immunization, the issue of diagnostic interventions in pregnancy and birth often comes down to worldview. My perspective is that our bodies are incredible and very smart. The vast majority of babies are born without problems, or deformities, or diseases or intellectual disabilities. This has nothing to do with ultrasound. Among the tiny minority of babies who *are* born with problems, perhaps these might have been minimized, even slightly, by avoiding exposure. Even in the rarest instance when a baby has a problem that is detected by ultrasound, there is very little anyone can do, but know and worry. Even if (goddess forbid) a baby dies in utero, there is *still* no necessity to have this “diagnosed” by a scan. Mothers should be encouraged to know their bodies can give birth to their Babies alive, and Still, and that birth is almost always safest when there is no intervention.
Perhaps most potently though, I am opposed to ultrasound, for myself, for philosophical reasons. I feel profoundly that to utilize a form of invasive soundwaves to create an image of the unborn child is an affront to the sanctity and safety of the womb. I view it increasingly as an assault. And while I respect the choices of other parents, and I do understand the pull of curiosity, I find our cultural obsession with discovering the sex of our babies prior to birth both frivolous and chilling, at a cost that is hitherto incalculable. I am deeply uncomfortable with our collective, misplaced faith in technology as a way of “knowing”. No one knows.
If you are pregnant or thinking of becoming pregnant, I *implore* you to read the following article. It gives a good overview of many of the potential risks, and I would also urge you to check out the “Doppler Danger” facebook page.
I’m so glad you made this post, Yo! I’m in complete agreement and wish more women would question the practice. I’ve already had this conversation with Wes and we’re both on the same page. Part of me really dreads the day I tell my GP I’m *finally* pregnant and tell her I decline to have an appointment scheduled. I’ve been steadily collecting pregnancy and birth articles and keeping them in a notebook for the times that I run into interference from doctors, well meaning friends or family on how I want to pursue my pregnancy and my unassisted home birth. Just like writing a research paper, a woman should always have her list of information sources at the ready (unfortunately!).
P.S. I can’t wait for our date!! xo
I have been following this blog for some time and and find it very interesting and enjoyable. My husband and I just found out we are pregnant and committed to a home birth with zero interventions. In interviewing midwives a few have mentioned using a doppler. I know I don’t want an ultrasound at all, if a doppler is also not used is there another way to hear the heartbeat? Or do you just let your body do what it does naturally and wait patiently? I am fairly new to this information and pretty overwhelmed but serious about making the best choice for my unborn child. Any advice/info would be greatly appreciated. Also, thank you for writing about such important things that everyone else seems to ignore. It is very helpful to me 🙂
hi there Kat, thank you so much for your message, and huge congratulations on your pregnancy! This is a very good question, and you are absolutely right to question the use of the doppler. In fact, the doppler will subject a baby to *more* ultrasonic exposure than the large ultrasound machine, so I decline both. Any midwife worth her salt will be proficient in using both a foetoscope and a pinard horn. The foetoscope is essentially the same as a stethoscope, and the pinard horn is a wooden cone-shaped instrument. Both the foetoscope and pinard horn work the same way, in that they actually amplify sound. Unlike a doppler which can detect a baby’s heartbeat quite early on during pregnancy, one won’t be able to hear the baby’s heartbeat with the foetoscope or pinard horn until about 20 weeks. This is often presented as one of the reasons to go ahead and listen with a doppler. But there is no real benefit at all to listening to the baby’s heartbeat prior to 20 weeks, and as I pointed out in my piece, there are potentially many reasons to avoid ultrasonic pulses. Another benefit of listening to the baby’s heartbeat with these traditional instruments, is that this method will actually give a good midwife *much* more information than a doppler. The foetoscope and pinard horn are very sensitive, and a skilled midwife will often be able to glean a baby’s position in this way.
I would stay away from any midwife or birth attendant (or doctor) who doesn’t know how to use a foetoscope or pinard horn. For me, this would be indicative of a very different approach to birth than what I am interested in. Using a foetoscope and pinard horn correctly does take skill and sensitivity, but I personally feel this is a benefit, and allows for, as well as creates, a greater bond between the pregnant woman, her baby, and her caregiver. The doppler is an aggressive and invasive instrument (despite the fact that the “invasion” is invisible). It gives a flat, dull, and lifeless electronic “heartbeat” sound, that is removed from the actual living child in the womb, whereas the sound from a pinard horn is warm, alive, and somehow *real*.
You also bring up the option of simply letting your body do what it does naturally, and actually, with each of my subsequent pregnancies, this has increasingly been my choice. This may sound quite harsh, but barring the most radically rare of circumstances (major heart abnormalities), a baby in utero will either have a heartbeat…or not. So for me, it has become less and less important to document heartbeat during my pregnancies.
When I was prengant with Felix however, I did use my foetoscope just once, when I was about 36 weeks pregnant. I was alone, in my room, and I just had an inkling that I would like to hear this baby’s heart, and so I dug out my foetoscope, and I took the time to tune in, and locate my baby’s heart, which can take several minutes. At first, the louder WHOOSh of the placenta is heard, but if you stay with it, as I did, you’ll hear the underlying faster beat of the baby’s heart. For me, this one listen to Felix’s heart was absolutely magical and intimate, and it totally made me cry!
In a hospital birth setting, a woman’s abdomen is often spattered with electrodes that connect her to a computer screen which indicates the baby’s heartreate. This is called Electronic Foetal Monitoring. EFM is often standard and also involves ultrasound. Dopplers are also generally used with great frequency during the birth process itself. This tends to create many problems, precipitating a cascade of interventions that would be unacceptable for me.
During my very first birth, I was attended by two wonderful traditional birth attendants who only once or twice (during a 30 hour birth process) listened to my baby’s heart tones with a foetoscope. In my 4 subsequent births, I did not have anyone listening to heart tones at all, with anything.
If you haven’t already, I urge you to check out Dr. Sarah Buckley’s book, “Gentle Birth, Gentle Mother”. Dr. Buckley is an Australian physician, who has also had 4 unassisted births, I believe. Dr. Buckley has also, herself, declined the use of ultrasound during her pregnancies, and her book is *excellent*, factual, and backed by scientific references.
I wish you the best of luck!
April Rushing says
I have to say as a professional nationally licensed sonigrapher, I highly disagree with most of this. The only part of ultrasound thatis dangerous to a fetus of any age and that is not commonly done is called power doppler. It is the part of ultrasound that allows you to see as well as hear the heart beat at the same time. It causes heating of the tissues. The 20 week ultrasound or anatomy ultrasound is the only one I would strongly encourage women to get. It is extremely diagnostic in identifying different problems that can prepare not only the parents but doctors as well for many things. In the last 60 years there have been no proven links to any birth defects with ultrasound. 3d and 4d are still too new so I would avoid those if possible.
Thanks for your comment, April. I urge you, too, to read the article published by Midwifery Today. Here is that link again:
The references in this article seem to me to be quite sound and scientific, and for me, even the slightest possibility that ultrasound could have a negative effect on my child’s development, is enough for me to say no. Especially since humans have so successfully procreated and given birth without ultrasound, for so many millions of years!
I am interested in what you mean when you refer to the 20 week ultrasound as being “extremely diagnostic in identifying different problems that can prepare not only the parents but doctors as well for many things”. Diagnostic in what sense? It is true that an ultrasound can confirm whether or not a baby has two arms, two legs and a heartbeat. But I personally feel quite comfortable in assuming that is the case. Yes, in an absolutely *minute* percentage, ultrasound can detect major physiological abnormalities. Whether or not ultrasound is used, we must all, unfortunately, recognize the possibility that our children might be born with a congenital “abnormality”.
Ultrasound has only been standard to the degree it is now, in the past 25-30 years. This is not enough for me. Furthermore, I can’t discount the possibility that the high degree of ultrasound exposure that our children are subjected to, might be connected with the outrageously high numbers of children–again, in the past 25-30 years–who suffer from learning disabilities, autism spectrum, and other cognitive issues. And the fact that it would not be possible, ethically, to properly prove the safety of ultrasound, is unacceptable to me.
I wish you good health in what I consider to be a high-risk profession.