The Risks of Medical Interventions During Pregnancy
As an advocate for natural childbirth I am very aware of the risks associated with medical interventions during childbirth and have thus always preferred seeing a midwife over an obstetrician. However for everything I've read I had never understood what the big deal was with receiving prenatal care during pregnancy from an OB. Yes, I knew I wanted to avoid OBs and hospitals during childbirth to increase my chance of a normal vaginal delivery but what about my prenatal care? What is the harm in an ultrasound every now and then or the common prenatal screening tests? My personal experience answers that question and demonstrates how a test as common as an ultrasound could lead doctors down a very dangerous and scary path.
Yippee! I'm Pregnant!
I was beyond thrilled when I got a positive result from the home pregnancy test. Excitedly I called my OB/GYN's office right away to schedule an appointment. They scheduled me in and at the appointment they happily confirmed with an ultrasound I was 7 weeks pregnant. There was no detectable heartbeat yet, and even though I had a previous miscarriage at 8 weeks, I wasn't too concerned because it was still early. They asked me to come back in two weeks for another ultrasound to check for a heartbeat.
But Where's that Heartbeat?
Sadly when I returned at 9 weeks there was still no heartbeat. I understood on an intellectual level that it was possible the pregnancy was fine and the heart just hadn't started beating; yet knowing I had previously miscarried and seeing the concerned look on the doctor's face I already started feeling a sense of failure at my inability to get past my first trimester without miscarrying.
The doctor confirmed that "yes it was possible the pregnancy was progressing fine and the heart would start beating soon." However he quickly added that he "thought it was unlikely because I was already 9 weeks pregnant." He then took some blood for tests and sent me home.
The next day he called me with the test results, which confirmed his suspicion that I was experiencing something called a missed miscarriage. This is essentially when you are no longer pregnant, but your body thinks you are and does not spontaneously abort as it would during a normal miscarriage. He told me I had two options. One was to wait for my body to dispel the contents of my uterus on its own, but that could take weeks or months. The other was to schedule a D&C which he explained is the same procedure done to abort a pregnancy. After having my first miscarriage in the Miami airport (yes it was a horrible experience but that story is for another day), I did not want to wait around for the inevitable event to occur on its own.
A Tough Decision
I agreed to schedule the D&C for that Friday which was 2 days away. I won't even get into how profoundly sad I was at losing another baby. I just wanted the failed pregnancy out of my body so I could move on with my life.
The Day of the Procedure
My husband came with me to the doctor's office early Friday morning for the D&C which was going to be performed by another OB in the practice. She looked over my records, agreed with the diagnosis that based on my high hormone levels, the date of my last period and the missing heartbeat this was indeed a missed miscarriage, and then explained how the procedure would work.
One Last Check
I don't know why but I asked her if she wouldn't mind doing one more ultrasound before performing the D&C. Maybe I wanted to say goodbye to my baby. She agreed and a few minutes later the doctor, the nurse, my husband and I were all staring wide mouthed at a thumping little circle on a fuzzy black and white screen. There it was. A beautiful heartbeat. I was speechless. The nurse cried. The doctor was amazed. We were all so happy. We rejoiced together. I left the office and practically skipped the whole way home. I couldn't believe I was still pregnant!
An Egregious Mistake
It wasn't until later did I realize what an egregious mistake the doctors' office had made. Two separate doctors had told me without doubt that I was not pregnant based on numbers they read off of a chart. What if the D&C was scheduled a day earlier and the heartbeat hadn't started yet? I would have lost a perfectly normal pregnancy! And the belief that I had miscarried again would have left deep wounds.
Luckily my story has a happy ending. I delivered a healthy baby girl about 8 months later!! But 3 years later the experience still shakes me up when I think about it. And what did I learn?
- The Power of Suggestion is Strong! After I was told that I had "miscarried", my pregnancy symptoms immediately went away. I was no longer nauseous or tired. I felt numb and sad but I did not feel pregnant. It is important to realize that how you experience your pregnancy CAN be impacted by your care provider.
- Context Cannot Be Ignored. If I had not told my doctor about my previous miscarriage I don't think they would have been as quick to judge my case as a miscarriage. Typically obstetricians see more patients at a time than midwives and have less time to spend at each appointment to give individualized treatment.
- Everyone is Unique (duh)! It's comforting to think we understand so much about pregnancy that we can map exactly what a pregnancy looks like on paper based on a series of numbers. But everyone is different and every pregnancy is different. I don't know why my baby's heart started beating so late. Maybe I miscounted when I had my period. Or maybe my babies develop on a little different schedule. But the key fact is that the doctors made a gross mistake with my case that would not have occurred if I hadn't had two ultrasounds so early in my pregnancy.
So what's a newly pregnant woman to do? I am NOT suggesting you turn down ultrasounds and screening tests. These are important tools in prenatal care. I DO recommend seeing a midwife or an obstetrician who practices the midwifery model of care. Practitioners who follow the medical model of care look for something to go wrong; and they often find it. The midwifery model looks at pregnancy as a normal life process and offers individualized care.
It is important to take responsibility for yourself and that means making the effort to find a care provider that you trust. With both my pregnancies I switched from seeing an OB to a midwife at about 20 weeks and could not have been happier with the level of care I received and the outcomes of both deliveries.
Where to Go for More Info:
For more information on midwifery and natural childbirth:
Adrienne Shulman is the founder of TinyPlayground.com, a website which provides practical resources for new moms and home to the popular cute baby contest. She has two daughters ages 1 and 3 and lives outside of New York City in Westchester county.