5 Procedures I Rejected During Pregnancy
Pregnancy comes with a lot of doctor appointments and different procedures that are recommended to assure both the mother’s and the baby’s health. I regularly went to my doctor’s appointments, however there were certain procedures which I rejected, as I did not think that they were necessary for me.
1. Ultrasounds in the first weeks of pregnancy. A lot of health care providers offer an ultrasound as soon as the home-pregnancy test shows positive, however this can cause unnecessary concern to new mothers, before 5 weeks no baby can be seen on the ultrasound. The lining of the uterus will appear thick and one of the ovaries will have an ovulation cyst called corpus luteum. At 5-6 weeks a small yolk sac inside of the gestation sac may be seen inside of the uterus. The yolk sac indicates a developing pregnancy before the embryo can be seen and rules out an ectopic pregnancy. At 6-7 weeks the embryo is 5-9mm long and you might be able to hear a heartbeat. At 8 weeks the heartbeat should be detectable, and the baby showed be seen clearly on the ultrasound. By 10 weeks it is possible to see baby’s body clearly, head, arms and legs on the ultrasound.
There are several reasons why I did not want to do the ultrasound. There are no longterm studies on the safety of ultrasounds and any time something enters the vaginal tract it increases the risk for an infection. The other reason is that the due date is usually calculated from the beginning of the last period, however this is not true for everyone. Especially with women like me, who suffer from irregular ovulation it is difficult to tell the exact week of pregnancy. According to my last menstruation I was already 8 weeks pregnant, but due to ovulating late the embryo was only 7 weeks old, so a heartbeat may not have been detected this early and I would have been more worried, thinking the pregnancy was not viable.
Instead of doing ultrasounds I asked for blood tests to measure my HCG and progesterone levels. As long as the HCG levels are increasing (not doubling) in early pregnancy, there is no reason for concern. The hormone progesterone is incredibly important in the first trimester, it helps the uterus to take care of the embryo. Low progesterone levels can lead to early miscarriage. I personally prefer using bio-identical progesterone creams, however most doctors offer synthetic progesterone pills.
2. Nuchal translucency screening to detect down syndrome. This is an ultrasound, usually done between 11-14 weeks checking the amount of fluid under the skin of the baby’s neck as an indicator of down syndrome. Instead of doing the ultrasound I did the panorama test. The panorama test has an accuracy percentage of more than 99% unlike the nuchal translucency screening with an accuracy of 70-80%. The panorama test is a simple, non invasive blood test, that can be done as early as 10 weeks. The mother’s blood contains the baby’s DNA, which is then checked for several different chromosomal disorders, such as down syndrome and it also shows the baby’s gender.
3. Using a fetal doppler. A doppler is a home-device that can detect the baby’s heartbeat starting at around 16 weeks. It works by sending high frequency sound waves through the skin to the baby, once the waves encounter movement they bounce back to the device. At the beginning of my second trimester a lot of the common first trimester symptoms such as fatigue and nausea decreased, so between my symptoms decreasing and being able to feel my baby daily I was very tempted to buy a fetal doppler to reassure myself by listening to his heartbeat. However after doing my research I decided not to buy a fetal doppler. Not being able to find my baby’s heartbeat would have most likely stressed me out. On the other hand it may have given me false reassurance, if there was something wrong instead of listening to my gut feeling. Most babys do not like the sound of the waves and move away or kick against the doppler, so I did not want to stress my little one either.
4. Doing CTGs as early as 26 weeks. A cardiotocography (CTG) measures the baby’s heartbeat and mother’s uterine contractions. In my experience it totally depends on the doctor when the CTG is recommended. My first gynaecologist wanted to do CTGs at every appointment starting from 26 weeks which I refused. In my hospital in Abu Dhabi doing CTGs were recommended from 37 weeks, so I asked to only check on my child’s heart beat for irregularities and did not measure my contractions.
5. Vaginal examinations. Some doctors check the woman’s cervix for dilation at every single appointment. Braxton hicks can cause the cervix to dilate many weeks before going into active labor. I said no to all vaginal exams as there was no indications of having a premature delivery due to an incompetent cervix, infection, heavy bleeding or any other problem. The risk with vaginal exams is that every time something enters the vaginal tract an infection may occur. For some women they are also extremely uncomfortable or painful. I did not want to know if my cervix was dilated or not, as it would have only put additional stress on me.