As we sat with my family at Thanksgiving last year, my wife announced that we were going try to get pregnant. This was happy news for my mother who has been waiting for her 50 year old son to contribute to the family line like my two sisters and brother have done previously some 20-30 years earlier. Little did we know that as we sat there, she was already 1-2 weeks along in her pregnancy. Three store-bought, do-it-yourself pregnancy tests later in the first half of December, and we find out that she's pregnant. This celebrated news was followed up a couple of weeks later with new information that we were having twins, courtesy of a diagnostic ultrasound scan due to some concerns of her doctor at that time.
A diagnostic ultrasound in our family is not a choice taken lightly. I'm a 3rd generation Doctor of Chiropractic, never vaccinated as a child, grew up on vitamins with each meal and weekly if not daily adjustments. Ultrasound is a type of radiation that can be used therapeutically or diagnostically. My educational and clinical experience with ultrasound has been as a therapy. Ultrasound produces sound waves (a type of radiation) that pass through the tissues. The tissue's resistance to and absorption of these waves causes heating of the tissues and some other metabolic effects that can be desirable in promoting healing. Therapeutic ultrasound is not recommended during pregnancy, over tissues such as the eyes, heart, spinal column, growing bones, testes, epiphyseal plates, carotid sinuses, cervical stellate ganglion, and vagus nerve. Although you may not be familiar with these anatomical tissues, they are all found in developing babies and everyone else. Given my clinical experience, I naturally questioned its use as a diagnostic tool. This philosophy of questioning comes from a statement found in the Hippocratic Oath that I took upon graduation from school that states, "First do no harm." It's the responsibility of a doctor to always assess the methods being used to determine that there is no harm being done to the patient as a result of medications or procedures.
Diagnostic ultrasound uses a similar frequency range, much like sonar on a submarine, to produce images. It is used to screen for abnormalities of the developing fetus. For more information on the benefits and risks of ultrasound, visit - http://www.ob-ultrasound.net/. Like therapeutic ultrasound, the resistance to and absorption of the sound waves, plays a role in the creation of the images. To me, this indicates some degree of heating of the tissues in a developing baby. Is this enough to create some type of damage to the baby? Currently, the risks are not considered to be relevant but the US National Institute of Health recommends against its use in routine scanning of the fetus and developing embryo and 'although its use doesn't appear to be associated with any known hazards, investigators should continue to evaluate risks.' Hmmm.
Additionally, some research points to correlations between diagnostic ultrasound and the Autism/Aspergers spectrum of developmental disorders. The bottom line on ultrasound is that it should be used based on a 'benefit vs. risk' assessment, a term that I'll talk more about later. Most doctors and sonogram technicians oppose its use by moms who want to have periodic pictures to show everyone. To me, its use is a big question mark that may or may not have complications years later.
Okay, well we had one ultrasound that seemed to be necessary, but we decide that we probably won't elect to have any others unless absolutely necessary. There is a saying that goes something like this, "Man plans, God laughs." During the course of our journey through this pregnancy, we will seem to keep God amused.
My wife's 1st obstetrics doctor recommended a list of questionable procedures (amniocentesis, CVS, Rhogam vaccine) and handed us a couple of boxes of prenatal vitamins. Medical doctors get about 5 hours of training in nutrition during medical school. This was very apparent by the box of vitamins that we were handed. The prenatal vitamin's list of nutrients and additional ingredients consisting of synthetic dyes, synthetic nutrients, chemical fillers, and toxic fats were quickly donated to the trash can in his waiting room on our way out of his office. It was time to ask around for references and interview a few OB doctors.
Obstetrics (OB) is surgical specialty dealing with the care of women and their children during pregnancy. Although our intention is to have a natural home birth attended by a midwife, we will still need an OB doctor and a hospital as a back-up. This is common practice in California for parents who choose homebirths. Unfortunately, twin homebirths in California is against the law and a midwife who attends one can end up in jail. This was interesting since other states allow this practice which dates back to the beginning of man. Concerns about the possible complications associated with mothers carrying multiple babies however, means that this is left to the hospitals and obstetrics doctors in California. I'm not sure if this is a policy based on previous experience or a philosophy of better safe than sorry.
We consider traveling out of state to Tennessee where the midwife of midwives, Ina May Gaskin, holds court when she's not teaching midwives and doctors across the country. They inform us that they like to have couples come 6 weeks before the due date and if our babies don't make it to 34 weeks gestation and decide to come out early, we would end up going to a hospital in Tennessee. Since twins seem to have a habit of coming early, this option doesn't sound too inviting. Given the logistics and hassles of travel and the possibility of an early delivery, we opt for a natural delivery at an LA hospital attended by an OB doctor, a midwife, and 2 or 3 other people. It's not home, but we want to make it as intimate as possible. I thought I heard God laughing?
We selected our OB doctor, Jessica Schneider, MD and our midwife was Elizabeth Bachner. Dr. Schneider wants an ultrasound every month once we hit 20 weeks, but we decide on one detailed anatomical ultrasound at 20 weeks and then one just before birth to determine positioning of the babies. This approach was also recommended by an assistant to Ina May Gaskins and it sounds good to us. The ultrasound comes back normal and we begin to make all of the necessary arrangements.
We have a doctor and a midwife, and my wife has become a walking encyclopedia on pregnancy, twins, and birth. She's exercising every day, eating well, taking her vitamins, and spending quiet time with herself and the babies. Her due date is mid-August and so in early April we settle into what we expect to be a nice long pregnancy...and God giggles.
Next: Cedars-Sinai, an epic voyage.