First Peek Ultrasound Blog

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Can I get a 3D ultrasound while on bedrest?

Aug 21

Posted by firstpeek in Ask the Medical Director | No Comments

Once in a while, someone will ask us if they can get a 3D ultrasound if they’re on bedrest.  Once, the fact that one of our customers was on bedrest came out after the appointment was made.

By the way, I’m on bedrest. Is that okay?

It used to surprise me whenever one of our pregnant friends would meet up with us for dinner and casually mention that she is supposed to be on bedrest.  I thought you were supposed to take that seriously!  It turns out that there are many different levels of bedrest:

A decrease in your activities – usually a decrease in exercise, heavy lifting, sex, and other specific activities related to an individual’s career or lifestyle.  For example, a doctor who is pregnant may be advised to not take overnight call while pregnant. Of course, not all pregnant doctors need to avoid call, but certainly, this may be prescribed for some pregnant doctors with specific risk factors.

“Taking a break” – which is not bedrest, per se, but is a way for a doctor to prescribe a pregnant woman to take a break from work or get light duty at work.  This is also used to encourage the children, husband/significant other to help out with chores.

Scheduled resting – In order to avoid full bedrest, scheduled resting requires the expectant mom to lie down and rest for a few hours each day.  This is especially prescribed for pregnant moms who may not have specific problems currently but have risk factors, such as a history of early delivery or miscarriage in previous pregnancies.

Modified bedrest – This is a balance between minimizing the risks to the baby while still allowing some flexibility with the understanding of the inconvenience that strict bedrest imposes.  Strict bedrest is not without risks itself, such as bedsores, hypercalcemia (too much calcium in the blood), muscle atrophy, and depression from not being able to continue activities that you enjoy.   Strict bedrest may not even be feasible for some pregnant women without access to outside help.   Modified bedrest allows for going to the bathroom, walking to different rooms in the house, making yourself a meal, and other tasks around the house.  In some circumstances, depending on the pregnant woman’s specific situation, a health care provider may suggest that going out once a week for dinner or a movie is fine as well.  Modified bedrest is sometimes called “house arrest.”

Strict bedrest – This means staying in bed.  This is strict and is reserved for situations where the mother or the baby are at risk for miscarriage or early delivery.  It is very important to stay in bed while on strict bedrest, except for going to the bathroom, taking a shower, and sitting up to eat.  Health care providers will often give a detailed breakdown of what can and can not be done.

Hospital bedrest – This isn’t actually bedrest, per se, but all out hospitalization.  This involves getting IV fluids and using a bedpan instead of getting up to go to the bathroom.  This is done in the most urgent of situations, such as when a pregnant woman shows signs of labor at 22 or 23 weeks, just before the age of viability, or during placental abruption, severe pre-eclampsia, or eclampsia.  There is usually also monitoring of the baby as well as other medications given to the mother.  There are some cases of hospital bedrest which may be delegated to the house, such as when compliance is guaranteed or when there is no hospital nearby, and there are some cases of what should be strict bedrest that are treated in the hospital, such as when compliance is expected to be poor or the social situation is unstable, or if there is no access to help in the house, or in certain politically sensitive situations,  (such as in the military, women of the prison population, minors under 18 years old, illegal immigrants, refugees, and where domestic violence is present).  If illegal drug use, alcohol use, or heavy smoking is a factor in the preterm labor or risk for preterm delivery, hospitalization may be preferred to ensure avoidance of these substances as well.

So can you get a 3D ultrasound?

Decrease in activities/taking a break/scheduled resting: If you are simply told to decrease your activities or “take a break” or take off from work or take scheduled rest breaks, and if, in general, it is expected that you can leave your home for errands, then you can generally get a 3D ultrasound.   This is of course assuming you live not too far from our 3D ultrasound studio.  We do often get pregnant customers coming from out of state, as far as Michigan, Indiana, Wisconsin, Kentucky, and Ohio. So if you have to drive or ride in a car for more than a couple hours to get here, you should generally discuss this with your doctor before coming.  Definitely, a long road trip to First Peek Ultrasound does not fall into the category of “taking a break.”

Modified bedrest: If you are on modified bedrest, this usually means that you should not go out for non-essential activities.  Although your ob/gyn physician or midwife will of course allow you to leave your bed to go to your ob/gyn (or midwife) appointment, this allowance generally does not carry over to your 3D ultrasound appointment.  As much as seeing and bonding with your baby may seem to be essential to your well-being, the health of your baby is the most important, and you will have to wait to see what your baby will look like after he or she is born.

That being said, there are some levels of modified bedrest where you may generally be allowed to go out once in a while, or once a week, depending on how urgent or severe your situation is.  This decision is made on a case by case basis, and so, if you are on modified bedrest, you should discuss your desire to get a 3D ultrasound with your physician or midwife before making your appointment with us.  Your health care provider should weigh the benefits and harms while taking your desires into account so that you can make an informed decision based on your physician’s advice.  You may be surprised that your ob/gyn physician or midwife may allow or even encourage you to go get your first peek of your baby in 3D, since it has been shown that visualization and bonding with your baby through 3D ultrasound can improve compliance with health recommendations (such as adhering to bedrest) and discourage unhealthy behaviors (such as smoking and alcohol use).  At First Peek Ultrasound, we strongly discourage going against your physician’s advice regarding bedrest.

Strict bedrest: Strict bedrest is just that. You are just one step away from having to stay in the hospital. You’re lucky you are still allowed to get up and go to the bathroom.  You can definitely not get a 3D ultrasound while on strict bedrest, unless you plan on having a 3D ultrasound machine and an ultrasound technician come to your house.  However, once you are on strict bedrest, this does not mean you will be on strict bedrest for the rest of your pregnancy.  Your level of bedrest may change based on the course of your pregnancy and how far along you are. Consult with your doctor for when it’s safe to go out again.

If you have a 3D ultrasound appointment with us and you later find out that you have to be on bedrest, please contact us as soon as possible to reschedule or cancel your appointment.

What are your thoughts of getting a 3D ultrasound while on “bedrest”?  Do you have any advice for expectant moms who have to go on bedrest?

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Is 3D ultrasound safe?

Sep 15

Posted by firstpeek in Ask the Medical Director | 4 Comments

Every once in a while, we get a question as to whether 3D ultrasounds are safe. As a board-certified pediatrician, I have a bias towards making sure things are safe for the baby, and I researched the safety of 3D ultrasounds extensively before deciding to see my own baby in 3D when my wife was pregnant. As a father, being able to see my baby through this window moved me so much, that I felt like I had to bring this experience to others.

Just to set the record straight, 3D ultrasound uses the same ultrasound waves used in your doctor’s office, with the same intensity, and for the same length of time. In 35 years of widespread almost universal use of ultrasounds, there has not been a single known case of a miscarriage or abnormality attributed to the use of ultrasounds. Its safety profile has been proven over the decades.

This being said, I do want to deal with a few arguments here. Also, I am so sure about the safety of what we do that I will open it up for discussion here on this blog. If you have any research or factual evidence on 3D ultrasounds being unsafe, then please bring it here. If you prove to me that 3D ultrasounds are unsafe for either the mother or the child, I will be the first to close down this studio and be on the forefront of shutting down all the others as well.

The arguments that are not valid are as follows:
“We just don’t know about the safety, and it is not necessary, so we should avoid it.”
That argument can be used for cell phones, microwaves, and a thousand other things and dismisses the very real benefits that pregnant women get when viewing their baby while pregnant. Also, it is impossible to prove something is 100% without any harm. We can only prove if there is a harm. The best we can hope for is a long track record of use without any known harms, which already exists for ultrasounds.

“It is not medically indicated.”
Who said this is a medical procedure? Seeing your baby for the first time while you are pregnant is an emotional, social, and cultural phenomenon that is spreading and soon taking over. Baby showers and bar mitzvahs are also not “medically indicated.” Also, just to point out the hypocrisy of those bringing forth these arguments, there are ob/gyn physicians who strongly advise against 3D ultrasounds because they are not medically indicated and yet perform elective circumcisions on a routine basis (also not medically indicated), perform elective C-sections for social reasons or to fit their own schedules (also not medically indicated), and even will allow their own patients to come back for an extra 2D ultrasound, off the books, to see if it’s a boy or a girl. It makes me wonder if the real issue they have with 3D ultrasounds is that they are not making any money off of it themselves and begrudge those who do. Meanwhile, there are plenty of ob/gyn physicians who have set up their own 3D ultrasound clinics across the U.S. after they have retired from their regular role as a physician.

“This is not what this medical device was intended for.”
It is a curious state of affairs when GE’s official policy is that the 3D ultrasound machine is not intended for non-medical or entertainment purposes and yet on their website and on all of their brochures, a picture of a pregnant woman seeing her baby in 3D is prominently displayed (and she is not wearing a medical gown). What irks me more is that major advances in 3D ultrasound technology and 3D ultrasound techniques have grown out of the increased use of this machine by ob/gyn’s and ultrasound technicians, spurred by the demand of these elective ultrasounds. You can’t have it both ways, GE. You can’t have your biggest clientele be 3D ultrasound studios and yet declare publicly that you have no idea that these machines are being used in this way.

But assuming that the above statement is true, that 3D ultrasound machines are not being used “as intended,” this still is not a valid argument, as most medical instruments have been used in more ways than as intended. For example, the stethoscope is intended to be used by a physician or nurse to hear heart sounds. However, as a pediatrician, I have used my trusted stethoscope to hear arterial blood flow in a baby’s head to diagnose an AV fistula. No one chided me for using the stethoscope as something other than what was intended. I have knocked it against a child’s knees to test for reflexes; I have used it as a toy pendulum to distract an infant as I examined his ears; I have held it outside my car window, using it as a signal, as I rested on my horn, and sped through red lights reaching the hospital just in time to resusscitate a blue baby just born who wasn’t breathing. I have worn my stethoscope around my neck as part of my uniform and clothing so as to indicate to others who was running the code. I have used that same stethoscope to hold my seat at the hospital cafeteria. I have used it as collateral when I needed money to eat and my paycheck wasn’t going to arrive until the next week. I have tried to use it to hypnotize someone, swaying it back and forth in front of my 2-year-old son, trying desperately to get him to sleep, but it didn’t work. I have even once used my stethoscope as a short-range weapon when stationed in Iraq (don’t even ask me about that one!), and I now have it hanging in my closet as I currently use it as a reminder of my crazy past. Ultrasounds were never meant for medical use to begin with–they were initially used to find cracks in dams. It was a doctor who decided to use it to detect abscesses and other things within the body which led to how it is used today. At that time, you could have told the doctor that it is not being used as intended, but I am glad no one did.

The FDA advises against it.
The FDA knows that there is no evidence linking any harm to the use of 3D ultrasound, as stated on their website, and so they are not legally allowed to ban 3D ultrasounds. They can say that this is a medical device used for non-medical purposes. But I can also easily say that this is a non-medical device sometimes used for medical purposes.

It’s not natural.
Yes, using a 3D ultrasound machine to see your baby has not been done in the more natural state of things during the caveman days. However, it is very natural for a woman to want to see her baby, bond with her baby, and these feelings begin while you are still pregnant. It is also very natural for a father to want to experience this joy as well. From the beginning of time, cavemen dads have been putting their ears up against the cavemen mom’s belly, using regular sound, not ultrasound, to hear their baby’s heart beating. The 3D ultrasound is just a natural extension of these deep desires.

Also, just as it is not natural to drive or fly by airplane, we do many things that are in retrospect very natural when you consider the other animals that can run as fast as a car or fly as high as an airplane. Likewise, there are many animals that employ ultrasounds to communicate and navigate through their world, including elephants, dolphins, and bats. When the tsunami hit Indonesia, it was natural ultrasound signals created by the tsunami that warned the elephants to flee from the shoreline moments before the tsunami struck. It was the humans who followed the elephants that benefited from these natural ultrasounds.

Do you have an argument against 3D ultrasounds? Do you have research or evidence showing that it is unsafe? Please write it here in the comments.

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Prevent Sibling Rivalry

Aug 16

Posted by firstpeek in Ask the Medical Director, Pregnancy | No Comments

Sarah is the owner of First Peek Ultrasound. Have a question for the medical director? Email her at firstpeek@oakparkultrasound.com.

I’m going to have a baby soon.  What are some of the ways of preventing sibling rivalry to the newborn

When you have a baby, it is natural for all your efforts and focus to shift to your newborn.  With each baby, there is always so much more to learn.  One of the first things you will encounter with your second baby that you did not have to deal with for your first is sibling rivalry towards the newborn, which can sometimes last until the newborn baby is 4 or 5 years old.  The good news is that there are many easy things that you can do to help prevent this from becoming a problem, and many of these things you can start right away while you are still pregnant.

How do you know when you are dealing with sibling rivalry?

Usually it is obvious. The most common symptom of sibling rivalry is the increased need for attention.  He or she may want to be held and carried more, and the demands for attention often happen especially when you’re busy caring for your new baby.  Another way your older child can react is by regressing, or acting like a baby again.  This can include bedwetting, thumbsucking, and crying, but can include anything that your newborn does which you find adorable (but is simply not cute when your 5-year-old does it).  Occasionally, your older child can act aggressively toward the newborn, such as by “accidentally” dropping the baby, hitting the baby, or in one case that I know of, even trying to shake the baby when you’re not looking.

The following are simply tips–you will find your own style and what works best for you and your child. The most important underlying message is to get your child involved with the baby, and to be sure to set aside some time and attention for your older child so that he or she will not attribute the new addition to your family as something necessarily bad.

While you’re still pregnant

1.  Prepare the sibling for the newborn.  Your older child thinks in concrete terms, from his or her own point of view, and can even have magical thinking, according to Piaget’s stages of cognitive development.  So he or she will respond more to things he or she can touch, feel, see, and hear.  Talk about the pregnancy. Show your child pictures of babies in books.  Show your child your belly as it grows.  Let your child feel your baby’s movements inside your belly.
2.  Young children have difficulty understanding the concept of time.  One way to help your child anticipate the arrival of the baby is to have a large calendar on a wall or your fridge with the due date, while crossing off of days as you get closer to your due date.  This makes the timing of the arrival of the baby more real for your older child.
3.  Try to give your child a chance to be around another new baby (i.e. a cousin or friend’s child) so that he or she has a better idea of what to expect.
4.  An excellent way of allowing your older child to visualize the new baby is to bring your older child along to your 3D ultrasound appointment. Point out to him or her the baby’s nose, face, and other features. This is one of the benefits of 3D ultrasound.
5.  Encourage your child to help you prepare the baby’s room.
6.  If you are going to make major changes in the arrangement of the rooms or by starting a daycare service, make these changes a few months before the baby’s arrival.  This way, your child does not have to go through additional major changes while having to get accustomed to the major change in the family.
7.  Praise your child for mature behavior, such as talking instead of crying, feeding, dressing himself or herself, and playing games.
8.  Don’t make any demands for new skills (such as toilet training) during the months just preceding the delivery. Even if your child appears ready, postpone these changes until your child has made a good adjustment to the new baby.
9.  Tell your child where he or she will go when you go to the hospital.  If you are taking trips to the hospital yourself to scout out the route and what to expect, take your child along.
10.  Look through family photographs and talk about your child’s first year of life.

While you’re in the hospital

1.  Have your older child visit you and the baby in the hospital.  Most hospitals now know the importance of the other children visiting and should now allow for this.
2.  If your child has to stay home, call him or her frequently while you are in the hospital.

As soon as you come home

1.  Give the older sibling a gift “from the new baby.”
2.  Ask visitors to give extra notice to the older child. Have your older child unwrap the baby’s gifts.
3.  From the beginning, refer to your newborn as “our baby.”

Further steps to prevent sibling rivalry

1.  Give your older child the extra attention he or she needs. Help him or her feel more important. Try to give him or her at least 30 minutes a day of exclusive, uninterrupted time. You can employ the father and other relatives to spend extra time with your older child during the first month. Give your older child lots of physical affection throughout the day.
2.  When you are taking care of the baby, include your older child as much as possible.
3.  Encourage your older child to touch and play with the new baby in your presence. Allow him or her to hold the baby. Avoid such warnings as “Don’t touch the baby.”
Newborns are not as fragile as they look, and it is important to show your trust. Your older child can hold the baby while you make sure to support the baby’s head and neck.  However, you should not allow the sibling to carry the baby alone until he or she reaches school age.
4.  Enlist your older child as a helper. Encourage him or her to help with baths, dry the baby, get a clean diaper, or find toys or a pacifier. You can also encourage your older child to feed or bathe a doll when you are feeding or bathing the baby. Emphasize how much the baby likes the older sibling. Make comments such as “Look how happy she gets when you play with her,” or “You can always make him laugh.”
5.  Don’t ask the older siblings to be quiet for the baby. Newborns can sleep fine without the house being perfectly quiet. Asking your older child to do this may cause him or her to resent the baby. After all, kids will be kids, and as much as your newborn needs to sleep, your older child needs to play.
6.  Your older child may start thumbsucking or clinging more. Accept this as something your child needs to do temporarily. Do not criticize him or her about it in the first few months the baby is here.
7.  When your child behaves aggressively, stop him or her right away. Tell him, “We never hurt babies.” Stenly and immediately, send your child to “time-out” for a few minutes. Don’t spank your child or slap his hand at these times, as he or she will eventually try to do the same to the baby when “the baby is bad.”
8. For the first few weeks after the baby is born, don’t leave the two of them alone together.
9.  If your child is old enough, encourage him to talk about his feelings about the new arrival, and suggest an alternative behavior.  For example, “When you’re upset with the baby, come to me for a big hug.”

For the future

Most fights and sibling rivalries in older kids can be prevented by teaching communication skills and social skills, such as taking turns, sharing, and expressing anger in words rather than hitting. However, don’t underestimate the younger child’s role in creating these rivalries.  Many younger children may purposely begin to harrass or pester the older sibling as they may see this as the only way to get the older sibling’s attention.  Finding alternative ways to get attention or finding common activities the children can do together can help tremendously with preventing sibling rivalry in the future.

What has worked for you? Feel free to add your comments on ways you have prevented sibling rivalry or sibling jealousy from an older child to your newborn.

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