Why We Are Declining Ultrasound

Please note: I am NOT telling anybody to refuse ultrasound. This is my own personal informed choice. It is up to parents to research their options and make their own informed choices weighing the risks and the benefits.

One of the first things I've been asked since announcing my pregnancy is when I am having my first scan. The first scan at 12 weeks is a momentous occasion since this is usually when parents feel brave enough to share with the world their happy news, since the miscarriage rate has significantly decreased and they now have proof that their baby is alive and well in the womb.

I haven't waited until 12 weeks to share my news with all my close friends, family and clients. The taboo around miscarriage is pervasive and I feel responsibility to do my part in shifting that. Mums should be encouraged to share the news as soon as they want to and reach out for support if needed.

However, I've found it difficult to try and explain why our intention is to decline ultrasound for this pregnancy.

I first began to question ultrasound when I read an article shared by a birth worker I really admire and respect. I discovered that ultrasound has NEVER been proven safe. I couldn't believe it. I knew that ultrasound was inaccurate - I have worked with mothers who have had their baby estimated to be of large weight, or have excess of amniotic fluid, or given due dates 2 weeks from when they know they conceived, for the ultrasound to ultimately be proved wrong. All these things are associated with increased intervention for these birthing women. Without the ultrasound, there would be no 'high risk' label, no pressure to induce, no reason to be birthing in a consultant-led unit. I knew ultrasound affected outcomes, and not always positively.

The article gave evidence of studies done on mice using ultrasound, where it actually changed the temperature of the brain and impacted neural migration. We can't prove that the same thing happens to human fetuses, but we don't really have any way of knowing. Babies have been known to squirm away and hide from the ultrasound and doppler as if it were an unpleasant experience, which is enough for many to question its use.

In some older studies (when ultrasound was weaker), the rate of miscarriage doubled when ultrasound was used in the first trimester. Ultrasound technicians were also shown to be at a higher risk of miscarriage. It is unfortunate then that those who have had many miscarriages are often offered an early scan for reassurance. Many conditions are diagnosable via ultrasound, such as placenta praevia, growth defects and growth retardation. The evidence I read showed that early detection of these did not affect outcomes for the babies and was associated with pre-term labour and interventions.

The outcome of many of these studies condemn routine ultrasound in pregnancy.

This was enough for me to decide that it was not for me. Although it was harder for Dom (as I am experiencing the pregnancy and often the two ultrasounds is when the father gets to see and bond with their unborn child) he agrees with me wholeheartedly. We will also be refusing the anomaly scan. If I had any abnormal bleeding or concerns about my baby's movements as my pregnancy progresses, I would then review my decision but as it stands I don't feel it is necessary.

It is also interesting to contemplate the psychological affect ultrasound has on the mother - when you are pregnant you feel the presence of your baby in your womb as part of you. To use the ultrasound to view it as something separate and alien, although admittedly an enjoyable experience... I wonder what affect this has on the pregnant woman's subconscious as she views her unborn child as a separate being to her that must be scanned for anomalies.

I have had online discussions with many people who think my decision is bizarre, and also many others who agree with me. Those who are pro-ultrasound have usually had a friend or relative with a baby with a diagnosable condition that required extra care after birth, whether that be neonatal unit or surgery. This is where risk perception comes in. My risk perception comes from my work with pregnant women and seeing how ultrasound shakes women's confidence and often leads them into unnecessary intervention. It's also affected by my personal beliefs around conception, my own good health and my first healthy pregnancy and birth. My own risk assessment for myself means that as it stands the risks of ultrasound outweigh the benefits. We are all different and perhaps your experience, whatever it has been, means that despite all this for you the benefits of ultrasound outweigh the risks. That is the beauty of informed choice and this is what I will always champion.



Additional info (Added 12th June 2016): Recent evidence links first trimester ultrasound with increased severity of autism symptoms in boys https://www.ncbi.nlm.nih.gov/m/pubmed/27582229/