As this pregnancy has progressed, I always assumed I would be getting an ultrasound to determine the gender of our unborn child. I mean, its perfectly safe, right? It must be if this procedure is performed on millions of unborn babies each year, right? A doctor wouldn't ever suggest a test that isn't safe, right? WRONG!!
Never in my life would I think to second-guess the safety of a common diagnostic procedure such as ultrasound, but one night, while laying in bed reading The Pregnancy Book by William Sears, MD and Martha Sears, RN, one section in particular put me in the position to evaluate all of the assumptions I had about ultrasound technology:
"The other side of the safety question is a theoretical concern about what happens when these sound waves strike growing fetal tissues. When sound waves bombard laboratory tissues at high frequency, they shake up the molecules, heat them, and produce microscopic gas bubbles in the cell called 'cavitation.' Whether this heat or these bubbles damage the cell is unknown, but studies suggest that the changes demonstrated in research test tubes are insignificant in babies, however; this uncertainty was enough to prompt the National Institutes of Health Task Force on Diagnostic Ultrasound to conclude 'We could find no evidence to justify the recommendation that every pregnancy be screened by ultrasound. In the face of even theoretical risks, where there is no benefit, then the theoretical risks cannot be justified.'
"Curiosity about the sex of your baby, the desire to have a prenatal photo to pass around to family members, or the wish for prenatal bonding are not good enough reasons for having an ultrasound."
Being the crazy Virgo that I am, I immediately jumped to the Internet to see if I could find any information to support or refute the above information, since that book, while incredibly useful in our goal of completely unmedicated, natural pregnancy and childbirth, was published back in 1991. I am totally aware of the abundance of advances and improvements in technology that can be made in 20 years, however; what I was able to dig up online and in books I already had at home was alarming:
"Yet ultrasound itself has a direct effect in the baby, too. It produces a shrill sound that we can't hear but which is like a dog whistle to the baby, who from around eighteen weeks has a keen sense of hearing. Mothers often notice that their babies move vigorously when they are being scanned by ultrasound." Rediscovering Birth by Sheila Kitzinger
"However, there is a growing concern as to its safety and usefulness. UK consumer activist Beverly Beech has called the routine use of ultrasound in pregnancy 'the biggest uncontrolled experiment in history" and the Cochrane Collaboration - considered the top authority in evidence-based medicine - concludes:
'. . . 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 . . . For those considering its introduction, the benefit of the demonstrated advantages would need to be considered against the theoretical possibility that the use of ultrasound during pregnancy could be hazardous, and the need for additional resources . . .'
"The additional resources consumed by routine ultrasound are substantial. In the United States an estimated $1.2 billion would be spent yearly if every pregnant woman had a single routine scan." Gentle Birth, Gentle Mothering by Sarah J. Buckley, MD
"A number of biological effects have been observed following ultrasound exposure in various experimental systems. These include reduction in immune response, change in sister chromatid exchange frequencies, cell death, change in cell membrane functions, degradation of macromolecules, free radical formation, and reduced cell reproductive potential." Excerpt from the National Institutes of Health Consensus Development Conference Statement (February 6-8, 1984)
"From a medical standpoint, ultrasonic fetal scanning is generally considered safe and is properly used when medical information on a pregnancy is needed. But ultrasound energy delivered to the fetus cannot be regarded as completely innocuous. Laboratory studies have shown that diagnostic levels of ultrasound can produce physical effects in tissue, such as mechanical vibrations and rise in temperature. Although there is no evidence that these physical effects can harm the fetus, public health experts, clinicians and industry agree that casual exposure to ultrasound, especially during pregnancy, should be avoided." Food and Drug Administration
Of course, for every one source that discloses the potential hazards of ultrasound technology, there's a hundred who will gloss right over them, even denying them altogether. Understandably so when so much money is spent every year on "routine" ultrasound scanning. When digging around for information, I came across the RADIUS study that was performed in December of 1993. They were asked to take into consideration not only the efficacy and safety of ultrasound technology, but also "What 'economic scenarios' might be anticipated as a result of different policy interpretations of the RADIUS results?" Are you serious?? These scientists were asked to consider how their SCIENTIFIC findings might economically impact the health care system? How about the safety of the millions of babies that are born each year? Do you think they care about the almighty dollar? I just find it very interesting at how far the fabric of the risk-benefit assessment has been stretched in this situation.
Now, I do realize how completely hypocritical it is of me to admit that we opted to have an ultrasound performed on our unborn baby solely to determine gender. Please understand that for our family, the risks of not knowing the gender in advance are far worse than the theoretical hazards of ultrasound. Most of you do not know how badly I struggle with anxiety, and in order to do my part to have a healthy pregnancy (and hopefully a healthy baby), I need to do whatever I can to minimize or eliminate any sources of stress and anxiety in my environment. While to you, knowing the gender of your unborn child may be a casual convenience, for me it is a necessity. Laugh all you like, but the anxiety of the unknown is more than I am willing to bear when I don't have to. Research has conclusively shown that elevated levels of cortisol (the stress/anxiety hormone) has detrimental effects on the fetus. I'll take the theoretical risks of ultrasound over the conclusive risks of stress any day.
When discussing ultrasound with our midwife, she mentioned that insurance companies do not pay for gender-only scans. While this may not be a problem for many families, it was for us. You see, we aren't interested in any genetic testing or screening for abnormalities. We are aware that there are a handful of abnormalities that, if detected in-utero, can be repaired in-utero, but that list of abnormalities is short and the chances of our baby having one of those and it being detected are a fraction of a percent at best. Our desire to refrain from diagnostic testing on our baby is two-fold...first, to eliminate the stress/anxiety that comes with the elaborate testing process and second, termination of the pregnancy due to defect/abnormality isn't an option for us, so knowing about it in advance is of no benefit.
The most basic ultrasound that insurance will cover is the full fetal check where the technician takes a bunch of measurements and compares those against "normal" measurements. They also count body parts such as arms, legs, lungs, kidneys, etc., making sure they're all there, and documenting if they're not. Our first question was "Can't we just get the full fetal check but tell the technician that we only want him/her to disclose the gender?". Mary, one of our midwives, explained that while we can ask the tech only to disclose the gender to us, he/she is obligated to forward any defects, abnormalities, and/or anomalies to our her, and that she is obligated to disclose them to us. So now what?
Our choices seemed limited at this point...forgo the ultrasound altogether, or pay for a gender-only scan out of pocket...neither of which was desirable. That's when Mary told us about the local ultrasound school that will do gender-only ultrasound scans at no charge in exchange for your time as a volunteer subject for the students to practice on and learn from. This was the perfect solution to our dilemma.
...to be continued
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