Testing, Testing, 1-2-3 (What is the point of all this prenatal testing?)

Testing, testing, 1-2-3, is this thing on?

Oh hiiiiii….Let’s get right down to the nitty ga-ritty…shall we?

I am at the point in this pregnancy that if I wanted an ultrasound, now is the time to set that up. With my first pregnancy, I not only had the midway ultrasound, but I had a delightful internal ultrasound around twelve weeks with an instrument that resembled something from your local sex shop (so I’ve heard).

With the second pregnancy, I opted out of ultrasounds and did not have a single one. I went back and forth with this decision. Around the midway mark when it was time to set the ultrasound appointment up, I just kept putting it off and putting it off and eventually, it was sort of too late. I didn’t do an ultrasound.

With number three, one might guess, I’m not doing any ultrasounds, no conflict of consciousness about me. Shocking, I know.

Although I am certain there are a few exceptions, where ultrasound somehow saves lives or does something miraculous, I can’t help but fall back on the rule (in my mind only, of course) of, “How does this ultrasound technology benefit me and my baby? What is it going to change or improve?” The same logic applies to all pre-natal and genetic testing (again, dear reader, in my ever so opinionated mind only).

In addition, I kept thinking, “My mother never had an ultrasound. Neither did my aunts or my friends mother’s. Heck, a whole generation without ultrasounds, and we turned out kinda sorta okay, right?”

But I digress (although I seriously used this rationale).

I recall around month eight with my first baby, attending the weekly Birthworks (www.birthworks.com) classes with other couples, learning a heap of information and thinking in ways that challenged me to the core. One couple in particular flat out said they were not doing any ultrasounds and being that I had already had my two, I was sort of mildly shocked.

“No ultrasound?! Why not? What about the what-ifs?” My eyes were wide like my belly and I was in need of information. Now.

The calm duo just looked at each other, shrugged their shoulders, and the dad-to-be asked me, “What will it change?”

Huh. You got me. I shook my head. “What do you  mean?” I asked.

He sat up straighter, adjusted his arm around his wife’s shoulders, and simply said, “If our baby is growing without an arm, and an ultrasound tells us that, who’s going to fix it and make the arm grow? We can’t fix it. The doctors can’t fix it. Midwives can’t fix it. So what’s the point? We just don’t think we need to know that kind of thing until after the baby’s born.”

Huh. Really, really, really good point.

I sat there feeling duped. All along I thought (insert cheerleader voice*), “Oh yes, I’ve been a good girl and had my ultrasounds and la dee da, look at me, all is well. Isn’t that grand!” (*no offense to cheerleaders…just painting a picture).

But the more I thought about it, and of course…I thought about it…I kept coming back to that same thinking, “What good does it do?”

And of course I started seeking out more information on ultrasound, as well as genetic testing and amniocentesis. I learned that ultrasound is an unapproved technology, that genetic testing only tests for a few deformities yet millions remain, and amniocentesis never fixed anything. Ever.

So why did I dutifully line up for the tests (minus the amnio) with the first baby? Or better yet, why wasn’t it presented to me in a different light by my then OB’s?

Why didn’t they say something, kinda, sorta like, “We can do ultrasounds, we can do genetic testing, and we can do amniocentesis and it really doesn’t fix a whole hell of  a lot. It’s your option how you would like to proceed. Let us know at the next appointment and here are some good resources to help you decide. Call us if you have any questions. We’re happy to help.”

Is anyone else laughing?!!

But seriously, that’s the thing that bugs me: The deception of it all. It seems like there’s a lot of deception and false reassurances running rampant in the medical model of care. And it irks me.

And it irks me that women are innocently drawn in like cattle to the slaughter every day, to a system that has an all time high C-section rate (and rising each year), an increasing maternal mortality rate (as the C-section rate increases, so does the maternal mortality rate), and more machines and gadgets to facilitate and monitor birth than ever before (the latest gadget attaches internally to your cervix to measure dilation. Really.).

So, what good is all of this doing? Are things improving or getting worse? You be the judge.

But I guess for me, I’ve come to a place where I don’t need to know my baby’s gender before it’s born. I don’t need to determine if it has Down’s syndrome or not and I don’t need to know if it is growing both arms or not. I’ll find that all out soon enough. And I am prepared to accept and deal with whatever Mother Nature sends me.

And I’m okay with that (and so is Dad-to-be).

Why did you have your babies at home?

As I prepare for baby number three this spring, the location of birth is not a mystery to me.  This baby will be born at home. Again. Just like the prior two. If it is breech, it will be born at home. If it is twins (dear Buddha, help me if it is), they will be born at home. Unless there is a major emergency, such as prolapsed cord, uterine rupture, premature placenta detachment, or a transverse lie (baby is side to side and won’t turn), we’ll be at home.

There’s just no place like home.

My first paid publication at www.mothering.com explained this issue. Why did I have a homebirth? So many reasons. But in the end, it came down to one big one…I didn’t want to end up with an unnecessary c-section.

I cringe for so many reasons admitting that. First, it sounds lofty (to me) and that’s not my intent. Two, I know so many women who’ve ended up with c-sections at the hands of the system, and I really don’t want to offend. Three, I cringe because there is a rare chance that I could end up with an unexpected, emergency c-section and then I’m a big fat hypocrite.

With pregnancy number one, I realized that if I labored in a hospital, I would likely be pressured into getting pitocin (if I hadn’t already agreed to be induced). This would speed up labor, make contractions one on top of the other, and ultimately be too much pain to bear, and I would agree to an epidural.

The epidural would likely take away the pain of non-stop contractions as well as slow them down, even to a standstill. I would be dubbed a “failure to progress.”

I would then be pumped up with more pitocin to crank those contractions back up. My baby would be in distress (from continuous contractions causing decreased blood and oxygen supply) and off to the ER I would be whisked. C-section number one, for this first time mom.

In addition,  my first labor was 34.5 hours long. As a first time mom, I’m certain I would not have been permitted to hang out and labor that long (gotta turn those profitable rooms over, just like a busy restaurant).

Being that I like data, facts, statistics, and science (I have a degree in Environmental Science) I couldn’t ignore the statistics I learned the first time around.

First time mothers have  over a fifty percent chance of c-section if they agree to induction. The national average for C-section is 3 outta 10 births…31% to be more specific. Just entering the hospital to give birth lowered my chance of vaginal birth by over thirty percent. Also, the more c-sections a woman has, the higher her chances of having a complete hysterectomy, sooner rather than later, due to scar tissue and other surgical complications. In short, c-section scared the crap out of me.

But, in an emergency such as prolapsed cord (the cord comes dangling out before the baby=bad!!), c-section reassured me. It comforted me. It still does. But if I could avoid it, that was my plan.

So if I would have had a c-section for baby number one,  I would have automatically been scheduled for  c-section for number two (or would I? Hmm… maybe I woulda had a VBAC <not statistically likely>, or better yet, an HBAC. Ahh, we can ponder that later).

And now, with pregnancy number three on the horizon, I would again be automatically signed up for c-section number three. A third abdominal surgery. A third major recovery from surgery. A third time around under the knife.

Another big reason I am having a third homebirth is because of my second. Baby number two, my son, weighed in at 11 pounds 6 ounces and measured 23 inches long. As Joe Walsh sings, I’m just your ordinary, average girl. I’m not 7 feet tall…I’m 5′7″. I don’t come from a long line of big-boned people either. Everyone in my family is pretty much within a standard chart of normal weight range. I’m a buck forty, pre-pregnancy.

I feel certain that the medical model of care looks at 11+ pound babies as freaks of nature. On the day he was born, my midwife only commented, “Is this baby 11-6 or 11-7? My scale only goes up to 12 pounds!”

She never ONCE mentioned my weight gain (90+ big ones), guessed the size of the baby (“You have a nice sized baby in there.”), or told me to stop eating so much (did I mention I was ravenously hungry the entire pregnancy?). She only instilled in me that my baby knows how big to get and how to be born. And that I will know how to birth it, just like the time before.

Now I can just hear the stories…”Well, my friend-sister-cousin-neighbor-coworker had a ten pound baby and had to have a c-section. She couldn’t get it out. It was stuck because it was sooooooooo big.”

Which always prompts me to ask…was she lying down or upright? Was she numbed from the waist down from the epidural or could she feel to push? Did she have freedom of movement so that she could crawl, walk, lunge, squat, or  get on all fours to better position herself for birth or was she supine, restricted by monitors, IVs, and protocols? While I do believe there are a few exceptions to the rule, I think left to their own devices, mothers know how to birth their babies, big or small.

But I digress.

So my point…I had this big, big baby, and I feel pretty darn certain that if I were in the care of an obstetrician right now, for number 3, I would be pressured into induction (gosh, don’t want to grow another big baby, even though it all worked out last time and he’s perfect), I would be continually pressured into ultrasounds to calculate fetal weight (which can be off by up to 20%…if they say your baby is 10 lbs, it could really be 8 or really be 12), and I would be simply considered high risk for macrosomia (big baby) and gestational diabetes (of which, no, I did NOT have, thank you very much. Yes, I’m sure. I. Didn’t. Have. It. I was just friggin hungry. And stressed. The end.).

I doubt that it would be taken into consideration this time around that the father of baby number three is smaller in stature than the father of my first two so I simply think genetically, I’m not going to grow another 11 pound baby.

And would it be taken into consideration that I’m not stressed this time around, as I was last time, which I believe caused me (in part) to be ravenously hungry and eat for comfort as well as nourishment?  

Also, I doubt it would be taken into consideration that hey, I friggen did it. I have what many call a “proven pelvis.” I birthed an 11 pound baby once, so chances are good I could do it again.

If I were in the medical model of care, I’d be fighting a steep, uphill battle with all of it. 

Joy.

Can I prove it, beyond a shadow of a doubt? (Insert sarcastic voice…) well, nooooooooo, of course not, but I feel pretty darn certain that this is what I’d be dealing with. And furthermore, it’s a chance I’m not willing to take.

So I’d be facing a c-section this time around, too.

Why did I have my babies at home? The answer is both simple and complex for me. I wanted to avoid unnecessary interventions that I either didn’t believe in or weren’t supported by evidence that proved them necessary. I knew that the only way for me to do that was by not entering the hospital. Therefore I stayed at home.

I’ve realized in the 5.75 years since I first did this that this reason is still incomprehensible to so many…what about the pain? What about emergencies? What about the pain, the pain, the pain, the pain….oh the fricken pain question….but that’s another rant (oh wait, I covered it before, nevermind).

What if? What if? What if?

What if I just decided to take responsibility for myself and my unborn child and my choices?

What if I decided to face my fears which ranged from being nervous about being naked in front of my midwife and doula to death?

What if I just decided I am capable of deciding?

What if…….