Posts Tagged pregnancy ultrasound

Ob/gyn Hypocrisy Regarding 3D Ultrasounds-Part 2

In part 2 of my slowly advancing series, I will explore the often repeated argument that the ultrasound machine is a medical device and should not be used for non-medical purposes.  This is the stated position of the FDA and is what many ob/gyn doctors repeat to their patients.

So what falls under a non-medical purpose?

1. Seeing your baby

2. Determining if your baby is a boy or a girl

Yet a few hospitals in the Chicago area have 3D ultrasound machines in their ob/gyn clinics, and after the patient is done with her appointment, the doctor will quickly switch over to 3D mode and show the baby to the mother.  (This quick add-on period is added onto the medical ultrasound session which normally lasts 30 minutes.  In other words, the ultrasound session now exceeds the 30-minute threshold touted by the ob/gyn community.)

Also, it must be pointed out that ob/gyn doctors routinely check the gender of the baby at the 20-week ultrasound.  If the gender can not be determined at this time, the insurance company usually does not pay for an additional ultrasound.  The pregnant woman can sometimes plead for the ob/gyn to check the gender at another visit, ”off the record,” as my wife did when she was pregnant, or she can wait another 20 weeks not knowing whether her baby is a boy or a girl.

Ob/gyn physicians who happen to have the privilege of having a 3D ultrasound machine in their hospital often go against the rules and perform 3D ultrasounds off the books, as they have done in the past by checking the gender on extra ultrasound visits.

If 3D ultrasounds used for non-medical purposes were truly harmful and if there was truly a consensus among ob/gyn physicians that these elective ultrasounds are harmful, there would not be this growing trend of ob/gyn clinics and hospitals, including Northwestern Memorial Hospital in Chicago, to offer free 3D ultrasounds during routine screening visits of  their pregnant patients.  In fact, many of these ob/gyn clinics are starting to offer these 3D ultrasounds as a “free” service in order to attract more patients, sometimes also offering CD’s and DVD’s of the session.  By offering it for free, it appears that they are providing a service with no economic benefit out of the goodness of their heart, yet the economic benefit for these clinics from the increased number of patients is very real.

In other words, the argument currently held by most ob/gyn physicians is that elective non-medical 3D ultrasounds are harmful to pregnant women and their babies and is an affront to the medical profession and an embarrassment to the profession of ultrasound technicians, unless it is provided off the record by ob/gyn physicians in ob/gyn clinics or hospitals for their own economic benefit.  It’s fine if we do it, but no one else should do it.

This hypocrisy can only be explained by my overall premise that the current bias against 3D ultrasounds among ob/gyn physicians has nothing to do with the concern for pregnant women or their babies but has to do with money, which is a rerun of the routine elective circumcisions performed by ob/gyn’s without informed consent in the 1970′s while rabbis were prohibited from performing circumcisions without a medical license (remember that?).

(Of course, there are many other ob/gyn physicians and ultrasound technicians who are genuinely concerned for the welfare of their patients and have only had the misfortune of having been taught this bias in school and in residency training and so they have carried this bias as well.  But the source of the bias is still originally based on economics.)

Please note that this is a risky subject to deal with head on, as there is a genuine risk of sounding angry and at odds with the medical community.  As a pediatrician myself, I definitely do not want to alienate other physicians or sound like I know better than ob/gyn physicians when it comes to dealing with pregnant patients.  I simply want to point out this one isolated instance of a medical bias based on non-medical reasons.  Please note that at First Peek Ultrasound, we have a very good working relationship with the physicians and midwives of our customers, and more and more physicians are actually actively referring their customers to us.   In this series, I am only speaking about some ob/gyn physicians.

When we first started First Peek Ultrasound, the majority of ob/gyn physicians were deeply against 3D ultrasounds.  Also, it was very difficult to find good ultrasound technicians due to the fact that these technicians are taught in school that 3D ultrasounds are definitely harmful to babies (which is untrue) and other related falsehoods.  Now, we are seeing that the percentage of ob/gyn physicians  in the Chicago area who are against 3D ultrasounds have dropped (roughly to about 50%), and this is in part due to many of their patients coming to see us and other 3D ultrasound centers and reporting their experiences back to their physicians.

For our physicians who want to learn more about what we do, please visit our dedicated 3D ultrasound page for Chicago-area physicians and midwives.

Do you have any comments? We especially want to hear from ob/gyn physicians, the ones who agree and disagree with what I have posted here.

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3D Ultrasound Checklist

3D Ultrasound Checklist

  • Fetus
  • Friends
  • Family
  • Toys and books for other kids
  • CD of music you want playing in the background of your DVD (optional)
  • Cell phone (to call friends and family immediately when finding out if it’s a boy or girl)
  • Kleenex (in case you or Dad get emotional)

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How to get the best pictures on a 3D ultrasound

Many people ask us how to get the best pictures on their 3D ultrasound.  We have included a number of tips below.

  1. Go at the right time within your pregnancy.
    • If you are just interested in checking the gender, you can go as early as 15 weeks to First Peek Ultrasound.  Any earlier, and the results may not be accurate, leading to an extra coat of paint for your bedroom.
    • If you want to see pictures of your baby, it is not recommended to get a 3D ultrasound under 17 weeks.  In one study, mothers seeing their baby under 17 weeks actually decreased bonding, since the mothers felt that the baby did not look like a baby.
    • To get good pictures, 3D ultrasounds are best performed between 20 and 32 weeks, and the best pictures are between 24 and 30 weeks.
    • Mothers with twins or triplets should come a little earlier, between 22 and 28 weeks.
    • Heavier-set women have a much more narrow window of opportunity to get good pictures, and it is best for them to come between 28 and 30 weeks.
    • If you would like to get a closeup shot of the face, then 28 to 32 weeks is the best time.
    • After 35 weeks, there is less fluid around the baby to work with, which can lead to suboptimal results. Also, after 35 weeks, the baby may have already descended into the pelvis, making getting any view of the baby impossible
  2. Drink plenty of water for 1-2 weeks before your appointment.
    • This means eight 8-ounce glasses a day.
    • This helps clear up the amniotic fluid and
    • Ensures that there is enough fluid around the baby.
    • Start well in advance; it doesn’t do much good to only drink water the night before or the morning of your 3D ultrasound.
  3. Be comfortable.
    • You do not need to have a full bladder, as you would with your medical ultrasound.
    • This is your time, and you want to be comfortable and relaxed so you can enjoy watching your baby
  4. See your baby move in 4D by scheduling your appointment at a time that you think your baby is most likely to be awake and moving.
    • After 19 weeks, your baby is already developing a sleep pattern, and you may be able to predict the time that your baby is most likely to be awake.
    • If your baby is asleep at the time of your ultrasound appointment and you want to make your baby move, try drinking some orange juice. This has been shown to help stimulate the baby to move.
    • For some women, chocolate also works. 
    • Otherwise, try walking around and then come back.
    • Drinking coffee, soda, or other caffeinated beverages may be harmful to your baby and are generally not advised.  In the past, ob/gyn physicians have recommended that pregnant women drink no more than one cup of coffee a day.  More recently, a study has shown that even one cup of coffee a day can have some minimal effect on the baby as well.
  5. Maintain a good weight through your pregnancy.
    • It is a well-known secret among ultrasound technicians that they have a much more difficult time getting beautiful images of the baby on obese pregnant women as well as diagnostic images.  In some cases, obesity has been associated with adverse medical outcomes precisely because of the difficulty of obtaining diagnostic imaging to detect and prevent medical problems.  Obesity in pregnancy can lead to many other problems besides not getting the ideal 3D ultrasound images, such as worsening heartburn, increased back pain, a higher risk of gestational diabetes, a higher rate of C-sections, and even congenital heart defects in the baby.  Also, obesity in the mother during pregnancy has been linked to obesity and Type II diabetes in the child.  If you are already overweight, at least be sure to gain the recommended weight gain of pregnancy, and you will be way ahead of the game, since most obese women gain much more than the recommended weight during pregnancy.  See our full article on obesity in pregnancy here.
  6. Make sure you go to a 3D ultrasound center that allows you to have sufficient time during your appointment. 
    • At First Peek Ultrasound, the Premium Package allows you more than enough time to get really good pictures of your baby and a free return visit if you are not able to get good pictures of your baby the first time.
  7. Finally, have a positive attitude.
    • Not every baby is going to cooperate or be in the perfect position to get good baby pictures.
    • The pictures you get depend on a lot of factors, including the position of the baby, the placenta, and the umbilical cord.
    • Although for some women, the pictures of their baby may not look as clear or as ideal as the pictures on our website or brochure, yet many of these women have told us that their 3D ultrasound pictures are even more beautiful, because it is their baby.
    • Likewise, some babies may have their hands in front of their face.  This actually makes for very cute pictures and even gives you a glimpse into their personality.  I myself was pleasantly amazed when I saw my newborn son repeatedly put his hands in front of his mouth whenever he was laughing.  I then realized that what I saw on his 4D ultrasound was him laughing!

If you have any additional tips, please write them below in the comments.

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