S/O Ultrasound Q&A

Discussion in 'Pregnancy Help' started by miss_bossy18, Oct 25, 2012.

  1. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    I wouldn't agree to any routine ultrasounds. If there was an indication to have an ultrasound (confirmed or suspected monochorionicity for example) then I would discuss the risks, benefits & alternatives to ultrasound screening with my care provider and make a choice at that time.

    Generally speaking though, I prefer not to do anything during pregnancy, labor & birth for no other reason than that it's routine or protocol. If there's a specific reason why said test/procedure/intervention/etc might be beneficial to me or baby(ies) in a specific pregnancy then you have my attention. ;)
  2. Dielle

    Dielle Well-Known Member

    How could you even suspect monochorionicity without any tests?
  3. ECUBitzy

    ECUBitzy Well-Known Member

    I fell asleep with the girls for nap time, so I missed that you posted this.

    Rachel, I find your research on this topic to be very enlightening. Do you want to maybe share some of what began your interest in low intervention pregnancy and birth and how that has evolved?
  4. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    You wouldn't specifically, but most likely at some point in the pregnancy, multiples would likely be suspected at which point an ultrasound to confirm that would likely be recommended & agreed to. If that ultrasound revealed the possibility of a shared placenta then further ultrasounds, etc would be discussed. I just jumped straight to monochorionicity as an example in my previous reply as that was Tas' specific question.

    It's kind of funny - it wasn't even remotely on my radar until DH & I were actually TTC. Prior to that I used to exclaim loudly that I had no idea why any woman would ever push a baby out of her vagina when she could just have a cesarean instead. Kind of funny now. ;)

    At any rate, when Justin & I were TTC I was stage managing a show with a couple of ladies who had recently had their first babies with midwives. At first I thought that was weird, but the more they talked about it the more intrigued I became to the point that when we finally did get our BFP I knew I wanted midwives too. I was able to get on with the same practice and was very excited for my first appointment. In the mean time, I went to see my family doctor because I had a million questions. At that appointment was when we first suspected twins. Once twins were confirmed, we decided to switch from midwifery care to obstetrical care and hire a doula. I had a rough relationship with my OB and we butted heads about pretty much everything. I did a lot of research during that time trying to figure out what I actually thought about various things that my OB wanted me to do. I also leaned on my doula a lot for emotional support. The more research I did, the more I knew that I felt very strongly about the benefits of vaginal, and preferably unmedicated, birth. I felt that, for myself, barring serious complications I preferred to not interfere in the normal progress of pregnancy, labor and birth.

    When the girls were about 11 months old, I decided to pursue becoming a doula myself. As I took the course and continued to research and learn more about the intricate process of undisturbed birth and the myriad ways in which the medical model of maternity care interfered with that process, I came to prefer even more and more strongly a hands off approach to birth, for myself. I understand that there are certainly times and situations in which it is absolutely necessary to interfere with the normal process of birth to save a mom or baby's life but I am frustrated at the routine (and sometimes cavalier) use of intervention that happens in today's maternity care system that can sometimes lead to the very problems they're purported to prevent.

    I now find myself daydreaming about becoming a midwife someday.
  5. MrsWright

    MrsWright Well-Known Member TS Moderator

    I didn't read the other posts this is a spinoff of but why not have a routine u/s to make sure everything was properly growing and developing? I do ultrasounds of the heart and a lot of the serious heart defects are picked up at the 20-24wk "routine" check, and its awesome bc then those babies can he born in a hospital where their surgery can be performed right after birth....as opposed to not knowing and (in my case if it ever happend) having baby life flighted away to bigger hospital and now they are apart. Cleft palates, serious chromosomal abnormalities, all of these can be brought to your attention so you can learn about it and prepare yourself for what will happen at birth.
    I'm like you and prefer low maintenece but my fear of the "what ifs" would make me a nervous wreck!
  6. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    Absolutely! And I think that's perfectly valid and makes a lot of sense.

    For me, I think of it this way though:
    - The chance of a baby having a heart defect is aprox 1%. This means that there's a 99% chance that the baby will be fine. If someone told me I had a 99% chance of winning the lotto, I'd buy a ticket. ;) I make a conscious effort in my day to day life not to live in the "what ifs" because, for me, that is a dangerous road that will easily spiral out of control.
    - There's a risk that a routine ultrasound can return a false positive. This would be more upsetting, to me, than wondering about the "what ifs". I would hate to spend my pregnancy worrying about something that I had been told was wrong with my baby only to find out once baby arrived that s/he was perfectly fine. If there's a problem at birth, I'd prefer to deal with it at that time.

    I'd like to clarify that I don't think we should do away with ultrasounds, or even necessarily routine ultrasounds. But I do know that, more often than not, when my OB sent me for a routine anything, she didn't (or rarely) discussed the benefits, risks or alternatives to the test, what information we hoped to gain from the test, or what we would do with that information once we had it, with me. She just filled in a req and told me to book it. I've seen this pattern repeated amongst friends, family & clients and it really irks me! What I DO want to see is more collaborative decision making amongst care givers & their clients, whether it's a routine procedure, or a medically indicated one, or elective, or whatever. I think that there are care providers out there who do practice in this way, but I think it's more common to see the "my way or the highway" variety.

    And even as I type that I think but who's to say that other people want that kind of care? I imagine there are some people who prefer their care providers to make the decisions for them. So I'm definitely making an assumption there. :gah: So really, I don't know! I just know that that's how I feel about it & why I make the decisions that I do in regards to pregnancy care. ;)
  7. ECUBitzy

    ECUBitzy Well-Known Member

    I get it. We declined all of the prenatal tests for genetic abnormalities (what was that test called? I forget). Our rationale was that 1) we had enough to worry about with the diagnoses that we'd already received and 2) it wouldn't change anything for us. We'd carry the pregnancy as planned and I needed to try to find the positive in my experience rather than dwelling on our diagnoses. (It was a wonderful pregnancy, don't get me wrong. It was just very fearful.)
  8. twinkler

    twinkler Well-Known Member

    I didn't want the NT scan and blood test (Nuchal translucency, Steph) either because it wasn't going to change anything for us but the Ob said because of my age, it was better to be prepared and now I wonder if I should have stood my ground more. For some reason, with the twins' pregnancy, I was no where as vocal as I was when I was pregnant with Aliah (a very low intervention pregnancy) - Being pregnant with twins, I felt really intimidated often although towards the end, as some of you know, after talking to y'all here, I was able to stand my ground more :). I did however decline a late stage gestational diabetes tests (against Ob's advice) just because they wanted to do it based on no other reason except for family history of diabetes.

    [font="arial][size="2"]Question, Rachel, would you say you are more in line with low intervention because of medico's failure to discuss the reasons of, as opposed to against ultrasounds because of the risk of exposure?[/size][/font]
  9. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    I'm not sure I fully understand what you're asking but the risk of exposure to ultrasound is definitely a part of the equation for me, although not all of it. I expect we don't fully understand the long or short term effects that ultrasound has on a fetus yet. It's *assumed* safe but is still being studied. I often think about the fact that x-ray was assumed safe & used on pregnant women for 50 years before they realized it could cause child hood cancer. That does kind of freak me out. So I sort of feel like without an indication to go looking, why introduce a potential risk? For myself, I feel like I'd rather deal with the consequences of something that would have gone wrong regardless rather than something that went wrong because of a factor I introduced.

    All that being said, the more I've been thinking about all this this evening the more I realized that it really isn't about being against anything for me. What I am is FOR informed choice. That is what I wish to see more of for pregnant mamas. But more often then not in the medical model of care informed consent is given cursory attention and informed choice is a pipe dream.
  10. emp59

    emp59 Well-Known Member

    You're spot on. It seems like, especially with pregnant women there aren't options being given, or even advise, just direction. Go here and get an ultrasound, drink this and let us take your blood 4 times, etc. It would be a wonderful change for women to be more informed about all aspects of their prenatal care (the risks and benefits).
  11. twinkler

    twinkler Well-Known Member

    Rachel, I couldn't agree with you more, sorry I didn't elaborate more earlier, had to rush off... I definitely think that we have a right to question our care providers without feeling intimidated and it would be great if this information was freely given instead of how Emily just put it, told what to do... thank you for your clarity :)
  12. kingeomer

    kingeomer Well-Known Member TS Moderator

    I bolded what I liked best about this whole lovely paragraph. I think a more collaborative spirit between care providers and their patients would go a LONG way. Now, when I was pregnant with the twins, my OB labeled me high risk (and I did not know until after the kids were born how much DH HATED this label. It made him feel like that they-the doctors- were not giving me or the babies much of a chance. He hated seeing it every time we had to bring out the appointment card for a monthly appointments), I did not have a problem with it because it was standard for multiple pregnancies and they were obviously going to be monitoring me more closely. The things I did like about my OB's office was their patience in answering my nervous first time Mom questions and I was glad that they did not push a c-section on me, just explained the reasons why I would have a vaginal delivery (both babies head down) vs why I would have a c-section (breech baby A, any other health concerns). Now baby A was breech, so I did have a c-section. Now if baby A was not breech but baby B was and there were no other problems going on, they would have done a vaginal delivery for both.
    I did have a u/s every month and hardly any issues during my pregnancy. Looking back on it, I probably could have had the u/s to determine how far along I was, the 20 week one and maybe one before delivery because I had no issues during my pregnancy. But I understood why the OB's office did things the way they did them.
    Stephanie, we also skipped the same test you did. I forget what it's called now but I remember the OB saying that with twins most likely the results would be either inconclusive or a false positive. So we opted out.
    Rachel, I appreciate you sharing your thoughts and experience on this!
  13. daisies

    daisies Well-Known Member

    Yes, I think this applies to ALL health care.
    I don't know about the rest of the world but in the US doctors are so sue scared they often push unneeded tests. For me, before a test/procedure I want to know: what are the possible results? how accurate are they? how will those result change what we are going to do?
    I wish more people felt empowered to ask questions AND to insist that doctors explain things in a way they can understand.
    Great thread. Thanks Rachel.
  14. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    I agree with your husband Nancy - the high risk label made me batty. ;) I felt like it created a "ticking time bomb" mentality surrounding my pregnancy which I really didn't like. Yes, there are many more potential complications with a multiple pregnancy but unless one of those complications actually presents itself, let's assume that all will go well (sort of innocent until proven guilty), you know?

    And breech birth! Another soap box of mine. :laughing: It drives me INSANE that most OBs have never bothered to learn how to attend a vaginal breech birth so that women are, essentially, forced to have a cesarean birth if their babe presents breech. In Canada, all the midwives have training (and some have quite a lot of experience, usually gained in International placements or sometimes because of surprise breech babes) in attending vaginal breech births but are not legally allowed to attend a confirmed breech babe, they have to transfer care, which usually means automatic cesarean. Or, if one felt strongly enough about it, an unassisted home birth. In my ideal world, what would happen with a breech babe is that the care provider would sit down with the expecting parents & discuss with them the benefits & risks of vaginal breech birth as compared to the benefits & risks of a cesarean breech birth and allow the parents to choose which they prefer.
  15. MNTwinSquared

    MNTwinSquared Well-Known Member

    I've enjoyed reading your thoughts on this Rachel. Looking back I certainly would have changed certain things. I was stuck having a c-section with the twins because presenting twin was breech. I LOVED my OB... he was so laid back. I had ideal pregnancies, both times. I loved my VBAC for my 10lb son. I don't know that I would have gone non-medicated, but I certainly would have held off getting the epidural as soon as I did. Thanks for the informative spin off.
  16. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    I agree that this applies to all health care. Through my doula training & experience I find myself interacting quite differently with my HCPs now.

    I also talk with my doula clients during our prenatals about what kinds of questions to ask their care provider when a test/treatment/procedure is recommended to help them get as much info as they need. I use the BRAIN acronym to help them remember:
    B - what are the Benefits? To me? To my baby?
    R - what are the Risks? To me? To my baby?
    A - what are the alternatives, including doing nothing?
    I - what does my Intuition say? Does this feel good or not good? If not, why? Do I need more information?
    N - Negotiate a course of care.

    I did read recently that there is a medical university in California that has changed it's intake criteria to focus less exclusively on grades and include more intangible things like bed side manner, ability to negotiate a course of care, etc. So that's promising! I hope that trend continues.
  17. MrsWright

    MrsWright Well-Known Member TS Moderator

    That makes sense;). I guess I have really awesome OBs bc if I had refused any of the exams they probably wouldn't have batted an eye. We didn't do the blood work or early u/s for chromosomal things but we did have all our "routine" u/s done.....'more peace of mind for me;)
  18. Kkal474

    Kkal474 Member


    I am kind of late to this thread as I haven't been on here in a while but as a health care provider myself, I want to applaud you for taking a personal interest in your own healthcare and the decision making that occurs. It is a apparent that you have done your research and have come to some conclusions for yourself about the risks you are willing to incur for/to you and your children. As a healthcare provider to pediatrics, I have unfortunately seen first hand the negative outcomes of some decisions including VBAC and breech delivery that resulted in tragic consequences for children and lifelong disability so my decision making is swayed by that to some degree.

    The difficult thing with obstetrics is that most of the time, the 99%, things go perfectly well and all is fine for mom and baby. The tragic consequence is that when those events go wrong, the outcomes are very bad for baby and often for mom. I know for me personally, if the 1% risk involved is death or major disability, then the risk is too high for me when my babies' lives are on the line. If the risk is a serious but correctable problem then my decision making might be different. That is the challenge in obstetrics. When things go well all is good, but when things go bad, they go bad very very quickly and often have very tragic consequences.

    I say this not to sway your thinking in any way as I do believe we in healthcare often over intervene without it being absolutely necessary and I believe that patients and their families should be as informed as possible and 100% involved in medical decision making to the extent that their knowledge allows. The unfortunate thing is that for many patients, this knowledge is not obtained from true research but more from evaluation of personal opinions gleaned from "Dr. Google". While the internet certainly provides for an enormous amount of accurate and relevant information, it also equally provides a great deal of misinformation and personal opinions that have no science or evidence to support it. We as consumers of the healthcare system must seek out the information that is needed to make the correct decision for ourselves while recognizing that the risks that we are willing to incur for ourselves may be different than the safety risks someone else is willing to take.

    Thank you Kristen
    3 people like this.
  19. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    It is interesting to me that we think this way when it comes to birth when in so many other areas of life, we make the judgement call the other way. For example, traveling by car. We all know that there's a very small chance that that could end quite badly & yet the benefits of that form of travel, for most of us, outweigh that small risk & so we all strap ourselves & our kids into our cars & off we go.

    I also find it interesting that these discussions tend to focus more on risks & rarely on benefits. Because whenever we make one choice over another, we're not only assuming the risk of that choice but releasing the benefits of the other choice. I think both need to be considered.

    I agree with this 1000%, especially the bolded, which is why it makes my eye twitch when I hear women say they weren't "allowed" to do something or would only be "allowed" to do X if Y occurred. This, to me, is a care provider placing their own benefit/risk assessment ahead of their client's. With the benefits/risks layed out for them, the client may make a different choice than the care provider, for whatever reason, and I think that care providers should be willing to support that.
  20. monica77

    monica77 Well-Known Member

    I am late to this thread also, but I wanted to tell you my own birth story, just to show you a different perspective.

    I was born in Romania in 1977, and I am twin. It was my mom's first pregnancy and she was slim to begin with. They didn't know she was carrying twins - her belly wasn't that big and her water broke around 35-36 weeks. There were no ultrasounds back then. My mom kept telling people she was feeling movement around 12-14 weeks when it was too early for a singleton pregnancy - but they kept telling her she doesn't know what she's talking about being that it was her first pregnancy. My mom didn't have any complications during her pregnancy and back then in Romania, you only went to the OB to confirm you are pregnant and to give birth.

    The birth started like an unmedicated vaginal birth with Twin A - my sister being breech -they were trying to deliver her breech, not knowing I was in there also, and her chin got stuck on mine, I was vertex. By the time they realized there must be another baby in there, my mom was bleeding VERY badly so they put her to sleep and started an emergency C-Section. My sister died due to complications at birth - she was a perfect little baby but the whole trauma she swallowed too much amniotic liquid and they weren't able to revive her. Probably if they had more nurses on hand, someone could have focused on her, but my mom was in danger also, and they chose to focus on saving her life. My mom was in a coma after our birth and I was born under 4 pounds, and I was in an incubator for about a month - but I made it, and my mom is OK, although she has liver issues that are due to her blood transfusions. I suspect we had TTTS being that my mom says my face was red for a while after I was born, and there was a big weight difference between us, my twin was bigger. I also have a tendency to have severe headaches, since I was a child and some doctors blame this on the my birth.

    I can't explain to you how thankful my mom was that I had the oportunity to have ultrasounds with my babies, and so was I. When my OB told me we have to schedule a C-Section because my Twin A was breech, I didn't question it at all.
  21. Kkal474

    Kkal474 Member

    You are correct in your assertions that we make judgment calls in other areas of our lives that also incur risk. Although the risk of fatal injury is significant with automobile crashes and the number of deaths each year speak to this, the alternatives are limited in our society. If I were not to drive a vehicle, I would not have access to employment nor necessary access to supplies such as food as there is no option of walking to obtain these things. In many other cultures that is very different. I spent many summers in Germany due to having a lot of family over there and I would have been able to survive there without a vehicle most of the time, thereby not having to incur this risk. Our society in America, as we have it currently established, is not set up this way. As a result, I am forced to accept this risk if I want to be able to feed my family. I suppose there is an alternative which is to live off the grid and raise our own food and grow our own vegetables, but this is not a realistic option for most of us. When it comes to the safe birth of my child, I am given two alternatives, one being a vaginal birth and the alternative being a c-section.

    My first daughter was breech and I had this direct choice to make as it did directly impact the life and well being of my child. The risks of a breech birth, particularly coupled with the fact that IU was a FTM with an unproven pelvis, made the decision to proceed with a c-section an easy decision. Now that I am pregnant with the twins, I am presented with the alternatives of repeat c-section vs VBAC. I can tell you that VBAC is not something I will even consider, particularly with twins.
    Women should have the right to have a say in their healthcare but so should the healthcare provider that is caring for them. Physician are by no means all knowing beings and are human and are flawed, but they do have significantly more training and experience than any women who has not had medical training in obstetrics. Therefore, the opinions of a physician should most definitely be considered when making a decision. Admittedly many of the decisions are somewhat swayed by the fact that we have a very litigious society who wants someone to blame when things go wrong. For a lay person to consider their degree of knowledge to be superior to that of their healthcare provider is presumptuous at best and I don't blame a healthcare practitioner for refusing to participate in the care of a person who was so resistant to the suggestions of their provider that they refused proper care. While care provided should respect the patients wishes, the patient should also respect a providers right to refuse to agree to compromise to what they believe be safe simply because the patient says so.

    In the end each woman must make a decision about what risks they are willing to incur in their own lives and in the lives of their children and must live with the outcomes of those decisions. For me, the benefits do not outweigh the risks and therefore I will be scheduling a repeat c-section with my twins.
  22. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    And I think that's great that you were able to make a choice that felt good & right & safe FOR YOU with a care provider who supported your choice.

    Again, I think it's great that you are able to make a choice that you feel confident about with a care provider that is supportive of that.

    I agree that it's important to rely on the training, knowledge & experience of your care providers. For me, I rely on them to provide me with ALL the information I need, in as unbiased a way as possible, to allow me to make an informed CHOICE on my care. I do NOT rely on my care providers to make that choice for me or to pressure me through fear or scare tactics to choose the care they prefer. It is my responsibility and my choice. I am the one who must live with the consequences. I respect a care provider telling me "I am not comfortable attending a vaginal breech birth as I have not been trained to do so" rather than "If your baby is breech, you must have a cesarean". I would be frustrated that my options were limited due to a care provider's incomplete skill set & I would likely look for another care provider but I would respect the truth of the statement & the sharing of all relevant information.

    For me, the bolded is the crux of the matter. No care provider has a crystal ball. They believe a certain course of action is best or safer, but NO course of action is 100% safe, so it should be up to the client, who may believe differently than the care provider, to choose the set of benefits and risks they are most comfortable with because, again, they are the one who has to live with the consequences.

    I also agree that whenever possible you should choose a care provider who's approach is as similar as possible to your own, however, this is a luxury reserved for those of us who live in densely populated urban centers. Many rural ares are lucky to have one care provider available to them. So on a deeper level I think the care provider/client relationship needs to be redefined. I do think this is already happening in many ways and hope it continues to happen.

    Again, I agree.

    To clarify, I am NOT trying to say we should do away with medical technology or that any given approach to care is better or worse than another for anyone else. I am trying to explain my own thought process & approach to making choices in my own care as I was asked to do in another thread & am happy to share. I am also trying to make the point that every choice comes with it's own set of benefits & risks - no choice is 100% safe. A repeat cesarean has a different set of risks and benefits as compared to a VBAC but neither one is inherently more or less safe than the other, just different. You have chosen the course of care that feels right to you, with the benefits & risks that you prefer to have and a care provider to support you and I think that's great. I just wish that women who would choose differently than you have could say the same.
    2 people like this.
  23. Kkal474

    Kkal474 Member

    I agree that there are risks involved with every course of treatment we may employ, just as there are risks with non-treatment. Lack of prenatal care is a strong risk factor that increases the risk of complications in obstetric medicine. This is well-documented. A patient has a right to seek no medical care whatsoever and choose to deliver at home without any attendant present at all. That is your right and doesn't impinge on the rights of anyone else with the exception of the unborn baby. You can choose to not comply with medical treatment for cancer but you also probably won't get better without it.

    My ultimate statement is this I guess. Yes, you have the right to determine your medical treatment but it is your obligation to find a provider that is willing to accept the same risks and liability that you are. You cannot force a provider to go along with your decision if they believe it to be unsafe. That provider has the right to terminate your care for non-compliance and necessitate your seeking healthcare elsewhere.
  24. Kkal474

    Kkal474 Member

    I just want to clarify that I am referring to regular medical care not with regards to emergent medical care. I would hope that someone who is adamant about having a specific treatment modality would not be irresponsible enough to simply avoid medical care altogether only to present to the ER in extremis in the hope that it will force the hand of the care provider to give them what they want, even if it is against standard medical practice.
  25. Rollergiraffe

    Rollergiraffe Well-Known Member TS Moderator

    I think that discussing birth methods a "specific treatment modality" is exactly what is different about your arguments. OB's tend to medicalize pregnancy and birth in a way that midwives don't. It's a difference in how it's practiced; OB's don't have the time to attend an entire birth, midwives often do. There's no judgement there and in both cases the overwhelming majority of births result in a healthy live baby. Knowing Rachel well, as I do, and having witnessed the passion her and her community of doulas and midwives have for the birthing process, I know that they would never take risks for themselves or their clients. The issue is more one of not being treated impersonally, and celebrating and respecting the gravity of what you're going through in the process of birth. And those ladies know their stuff; I am completely confident that they'd be able to spot complications as well or better as any OB out there.

    There is a lot to be said about how people view risks differently. I am sure as a health care provider you're well aware that ALL procedures carry some inherent risk, and I am sure that you've seen the outcome of things that have gone wrong. Breech extraction is one example; how often are there complications either in the mother or child from c-sections? Perhaps breech extraction would have reduced the risk in some of those cases, but they're not an option in a system that goes with lowest risk. And I fully agree that a health care provider should not have to perform a procedure that they're not comfortable/capable of doing. But the point again is that there should be an opportunity to discuss with your provider ahead of time what your expectations are, rather than being dictated to.

    I also wanted to add that I think it's unfair to turn a negative outcome out on doulas or midwives. Would you expect an OB to stop recommending c-sections or vaginal births if they had a bad personal outcome? No. You'd expect that they'd rely on their medical training, take the appropriate time to grieve, and carry on as professionals. Midwives and doulas would do the same.
    2 people like this.
  26. miss_bossy18

    miss_bossy18 Well-Known Member TS Moderator

    I just wanted to speak to this - as a DONA certified doula I am held to a strict Standard of Practice & Code of Ethics that includes the following:

    "C. Advocacy
    The doula advocates for the client's wishes as expressed in her birth plan, in prenatal conversations, and intrapartum discussion, by encouraging her client to ask questions of her caregiver and to express her preferences and concerns. The doula helps the mother incorporate changes in plans if and when the need arises, and enhances the communication between client and caregiver. Clients and doulas must recognize that the advocacy role does not include the doula speaking instead of the client or making decisions for the client. The advocacy role is best described as support, information, and mediation or negotiation." (emphasis mine) (Link)

    I don't promote any method of delivery to my clients or friends, certainly not against the recommendation of their care provider (although I may discuss with them their fears & concerns & help them formulate questions to ask their care provider if they're unhappy with a course of care that's been recommended). I'm passionately supportive of their own individual preferences that may or may not coincide with what my personal choices would be.

    Further, if I had personally had a tragic outcome during pregnancy, labor or birth, I would hope that I had done enough processing and self-care before going back to work to leave any fear associated with that at the door when I walked into a birthing space with my clients. Even with the very positive birth experiences I've personally had, I still have to leave a lot at the door before going into a birthing space with my clients - their birth is just that: theirs. What makes a positive birth experience for them may not be what makes a positive birth experience for me and that's fine - I'm there to support them in their wishes.

    I feel like the rest of our discussion is simply going around & around as at the moment I would just be making the same point I've been making all along so I won't make it again.

    I will thank Jen for being so eloquent though - she's much better at this writing thing than I am. ;)
  27. Kkal474

    Kkal474 Member

    I agree with you 100% that no person should have there medical care dictated to them by any person or medical professional. It is extremely reasonable and beneficial to both parties for patients to be informed of the alternatives and options and the risks associated with those choices and permitted to make a decision, even though it may necessitate changing healthcare providers. I am not trying to turn a negative outcome onto midwives or doulas in any way as I respect certified nurse midwives and doulas for their roles in delivering healthcare and improving the healthcare experiences for patients. We are a system that goes with the lowest risk as you yourself said which is part of the reason I hold the position I do. We may disagree on what is safe and what isn't safe with regards to this topic but I fully respect an individual woman's right to take that risk for her and her child just like I equally support the medical community not agreeing to participate in a particular risk behavior.

    Rachel- I mean you no disrespect as doulas play an important role as a labor coach and support person during labor. I am glad to hear that you seem to be able to separate your personal feelings completely from your practice as a professional. It would take a very strong person to continue to advocate for something that caused them personal tragedy. While we may have to simply agree to disagree on the actual decisions that we would individually make, I nonetheless have enjoyed having an open and honest discourse with you about this topic.
Similar Threads Forum Date
Twin ultrasound question? Pregnancy Help Mar 21, 2018
Twins weight discrepancy - They now have me scheduled for an ultrasound every week Pregnancy Help Jan 8, 2015
Empty Twin Sacs on Ultrasound Pregnancy Help Oct 28, 2014
Early ultrasound question Pregnancy Help Jun 10, 2013
help (placenta previa question)..so confused for my 20 week Ultrasound this thursday Pregnancy Help Jul 30, 2012

Share This Page