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To Ultrasound or Not to Ultrasound: Reasons Vs. Risks

Posted Oct 07 2010 12:00am

One of my good friends is pregnant.  She is at that stage early in the second trimester when the first ultrasound is usually recommended. She is choosing a home birth, but comes from a medical family who would like her to have an ultrasound.  She has medical insurance, but it does not cover any pregnancy related expenses until after her deductible is reached.  An ultrasound would cost about $2000.  Like many parents choosing a home birth, my friend is debating the necessity of this routine procedure.

Why are ultrasounds recommended?  One purpose of an ultrasound is to pinpoint more accurately the due date of the baby. If you know the first day of your last period and can count 40 weeks ahead, you can get a really good estimate of when your baby will arrive.  Each baby is different, and no test or method can pinpoint the exact date of birth, unless of course you plan to induce.

Another reason to have an ultrasound, especially for older mothers, is to rule out certain birth defects.  If you have already made up your mind not to abort a child that has a defect, do you really want to know so many months in advance?  The problem with prenatal care in the United States, including the books that are written, is they seem to be all about what could go wrong rather than celebrating what goes right.   In utero stress has been found to put children at risk .

My son was born with a congenital heart defect.  When he had his corrective surgery, a nurse asked if I had had an ultrasound.  I was treated like a horrible mother for not having one, as if I had endangered my baby’s health by not choosing to ultrasound. The truth is my son’s heart defect would only have been discovered on a Level II ultrasound, which is only used if indicated by a routine ultrasound, and my pregnancy would have been wrought with anxiety had it been discovered.  Most likely, I wouldn’t have had a home birth either.  Some people may feel I was irresponsible by not having an ultrasound, but we still wouldn’t have known about my son’s heart until he was born.

According to Obstetric Ultrasound , there are eight purposes for an ultrasound:

1. Diagnosis and confirmation of early pregnancy.

2. Vaginal bleeding in early pregnancy.

3. Determination of gestational age and assessment of fetal size.

4. Diagnosis of fetal malformation.

5. Placental localization.

6. Multiple pregnancies.

7. Hydramnios and Oligohydramnios.

8. Other areas. states an early pregnancy ultrasound is used only to determine:

  • Presence of more than one fetus.
  • Your due date or gestational age (the age of the fetus).
  • If you are contemplating having an ultrasound, it is important to weight what you would do with this information. If you do not view it as vital or that the information would not change anything for you and your partner, than an ultrasound may not be necessary for you. Sure, you won’t get that cute little picture to hang on the refrigerator or know the sex of your baby, but I think you can live without that.

    So why wouldn’t you want an ultrasound?  In my personal experience it was one less test, less medical expense, and less anxiety.  There is some fear that an ultrasound is hazardous, but some  studies refute this . Suite101 reports:

    In the last 30 years, no conclusive evidence has shown that the levels of ultrasound used on humans are harmful. However some animal studies with higher levels of ultrasound have indicated changes in cell structure or function and even cell death. These studies seem to indicate that the tissue or body part that was being examined under the high frequency waves was altered in some way.
    As a result the NIH has released the following statement, “ultrasound examination in pregnancy should be performed for a specific medical indication.”

    I do not think that determining a due date or the presence of multiple fetuses is a “specific medical indication”, especially considering there are other methods form making these determinations.

    The World Health Organization has even questioned the validity and reliability of ultrasound studies. Midwifery Today reports:

    At a 1982 World Health Organization (WHO) meeting sponsored by the International Radiation Protection Association (IRPA) and other organizations, an international group of experts reported that “[t]here are several frequently quoted studies that claim to show that exposure to ultrasound in utero does not cause any significant abnormalities in the offspring. …However, these studies can be criticized on several grounds, including the lack of a control population and/or inadequate sample size, and exposure after the period of major organogenesis; this invalidates their conclusions….”

    Early studies showed that subtle effects of neurological damage linked to ultrasound were implicated by an increased incidence in left-handedness in boys (a marker for brain problems when not hereditary) and speech delays.(5) Then in August 2006, Pasko Rakic, chair of Yale School of Medicine’s Department of Neurobiology, announced the results of a study in which pregnant mice underwent various durations of ultrasound.(6) The brains of the offspring showed damage consistent with that found in the brains of people with autism. The research, funded by the National Institute of Neurological Disorders and Stroke, also implicated ultrasound in neurodevelopmental problems in children, such as dyslexia, epilepsy, mental retardation and schizophrenia, and showed that damage to brain cells increased with longer exposures.

    This post is not to be construed as medical advice, but it is meant to provoke parents into questioning the necessity of “routine” procedures that could turn into anxiety provoking medical interventions that do not affect outcome.  Examining one’s beliefs and thoughts on the potential results can help parents decide if an ultrasound is worth the extra expense and if it would really give you the peace of mind it intends.

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