Natural pregnancy: because what you don’t know can’t hurt you, right?

IMG_2599

Kate Tietje, Modern Alternative Mama, is expecting her sixth child and planning a natural pregnancy. A natural pregnancy is an ignorant pregnancy … literally.

Nearly every single aspect of modern obstetrics is preventive medicine. Nearly every test is a screening test designed to provide women with information they can use to improve their health and the health of their babies. Nearly every intervention is a preventive intervention, designed to prevent poor outcomes for babies and mothers. Natural pregnancy means forgoing information, rejecting preventive efforts and winging it while hoping for the best. If it works out fine, you’re a warrior mama (though the whole point is that you didn’t do a damn thing), and if it works out badly, tough luck for you.

A natural pregnancy is an ignorant pregnancy.

Here’s Kate’s strategy for a natural pregnancy:

  • No Doppler use
  • No ultrasounds
  • No blood tests
  • No internal exams
  • Few (if any) prenatal visits
  • No GD test
  • No GBS test

Because what you don’t know can’t hurt you, right?

Wrong.

Here’s Kate’s explanation of the advantages of ignorance.

Most of these tests are intended to check to make sure the pregnancy is progressing normally. In most cases, the answer will be yes. The tests don’t actually prevent issues from occurring; they only detect them. Some of the tests come with their own set of risks (from false positives to much more serious risks), and I don’t think that the risk of further intervention is worth “checking on” in a pregnancy that appears to be going fine.

In most cases the answer will be yes, the pregnancy is progressing normally? Duh! In most cases the pregnancy is progressing normally. But what if it’s not? Tough luck for the baby and maybe tough luck for the mother.

What about the risk of false positives? It’s very real risk, but Kate does not mention that there are ways to reduce that risk. Screening tests done on low risk populations have high false positive rates, but when applied to high risk populations they have far lower false positive rates.

For example:

If you were to give everyone (men and women, all ages) a pregnancy test, there would be false positives among the men, children and elderly who couldn’t be pregnant under any circumstances.

If you were to restrict pregnancy tests to all women of reproductive age, there would be far fewer false positives, and you would almost certainly diagnose pregnancies in women who weren’t aware they were pregnant.

If you were to restrict pregnancy tests to all women of reproductive age who have missed a period, have morning nausea and breast tenderness, false positives would be rare.

It is always the case that for those at high risk for a condition, the rate of false positives is lowest.

So when Kate implies that there is a significant false positive rate for low risk women for the 1 hour glucola test for gestational diabetes, she is correct. But for women who have had gestational diabetes in the past or given birth to a very large baby, the risk of a false positive result is far lower.

What is the downside to a false positive test for gestational diabetes? Very little, just a further test with a very low false positive rate. What is the downside to missing gestational diabetes? It could result in the death of the baby. In other words, the downside of a false positive is far less serious than the downside of ignorance.

Each specific test has a different calculus of risks and benefits for each individual. Therefore, lumping all possible tests and interventions together as a “natural pregnancy” makes no sense. Every woman should take into account her specific circumstances in order to make individual decisions about individual tests.

In contrast, Kate’s view is that ignorance is a better strategy than risking any type of false positive test result. It’s like claiming that no one should ever have their blood pressure checked because it’s better not to know than to unnecessarily treat high blood pressure. It’s like claiming that there’s no need to buckle babies into car seats since the overwhelming majority of car trips involve no accidents.

So ignorance can often be dangerous, but knowledge can be valuable even if it doesn’t change outcomes.

Consider the use of ultrasound in pregnancy.

According to Kate:

There is no evidence that routine ultrasounds improve outcomes in low-risk pregnancies.

But they do improve knowledge, providing evidence on congenital anomalies (including some that can be treated in utero or immediately after birth), twins or higher order multiples and placental problems.

Obviously the knowledge of congenital anomalies is important for those who would terminate the pregnancy in such situations, but it is important even when termination would never be considered. Advanced planning for the birth of a baby with severe anomalies can be the difference between life and death. And many people find the knowledge of congenital anomalies or multiple pregnancy valuable even when it isn’t a matter of life and death.

What’s the value of ignorance in these situations? Kate doesn’t offer any examples.

Kate makes a big deal of the potential risks of ultrasound, but there’s no evidence that those risks actually occur or affect babies in any way.

As an aside, my favorite part of Kate’s ultrasound post is this:

Since obstetrics is unfortunately a very non-evidence-based field, it’s important to look beyond what’s “commonly done” and really dive into the evidence.

The claim is simply false based, on a deliberate distortion of one paper, but it’s also hilarious for two reasons.

First, Kate claims that obstetrics isn’t evidence based and then exhorts everyone to look at the obstetric evidence. Which is it? Do obstetricians ignore the existing scientific evidence? Kate provides no examples, not surprisingly, since it isn’t true.

Second, the field of “natural pregnancy” routinely ignores scientific evidence in favor of intuition based on no evidence at all.

Kate tell us that as for herself:

I haven’t had any ultrasounds with my last three babies, and don’t plan to this time, either. I also refuse the use of the Doppler entirely.

What’s the benefit of that? Bragging rights, of course!

I personally see nothing admirable about deliberate, willful ignorance, but, hey, to each her own.

  • Platos_Redhaired_Stepchild

    “What is the downside to missing gestational diabetes? It could result in the death of the baby.”

    This is baby number 6 for Kate. She hasn’t had any ultrasounds with previous 3 kids either. I’m getting the feeling from Kate Tietje is that she really wishes she stopped after the first 2.

  • Sabrina Smith

    I was diagnosed with severe GD with my first (my levels after the one hour were 300+, not even mesurable). He was born at 35 weeks 8 lbs 3 oz. both of us almost died in the birth process but thank gd for a great OB, and since I went into labor early they gave me IV antibiotics since it was too early for a GBS test, best to err on side of caution. my second pregnancy they began testing for GD at 10 weeks gestation and fortunately I never developed it but I was required to pick my finger several times a day and record any spikes in my blood sugars. an ultrasound showed me son also “may” have DS. I declined the aminocentisis and they checked him constantly. around 28 weeks my OB was concerned cause I was measuring (fundal height) for 33 weeks, I was sent immediately up to the ADC clinic (Antenatal diagnostic clinic) and given a growth scan because measuring that big could’ve meant a serious problem (like baby not swallowing and peeing properly). Luckily it was mild polyhydraminos

    • Empress of the Iguana People

      glad everything worked out in the long run

  • Jessica

    I really don’t understand this. I tested positive for GBS and had IV antibiotics. Super easy decision: no harm to her and saved her from serious risk. Now she is almost 2 and healthy with a great immune system. A friend found out at 20 weeks that her son had a very very serious heart defect. She used that knowledge to ensure she delivered in a specialized hospital (rather than her small local one) so her son could have the immediate surgery he needed to survive. Now at 1.5 (with two of three planned surgeries done) he is growing well and there is hope of a full near normal life. Why would anyone not want that?

  • Tori

    I don’t understand why you’d be concerned about a false positive for gestational diabetes. I’ve been diagnosed in my current pregnancy, was sick when I got the test done and don’t really have risk factors for GD. Diabetes educator isn’t sure whether I actually have it, but both they and I agree that fingerprick tests 4x/day are worthwhile doing in case. If it’s a false positive it will be pretty easy to manage, and if it’s a true positive I’m glad we caught it so we can manage it the best we can. Surely it’s a win-win..

    • MaineJen

      I’ve heard people complain about the yucky Glucola drink and how much sugar it contains and blah blah blah. My response: are you for real??? It’s one can of cola. Suck it up, buttercup.

      • Heidi_storage

        Well, I hate it because it’s very, very hard for me not to throw up even on the 1-hour test (thankfully, never had the three-hour). Still, momentary unpleasantness = better than macrosomic, or possibly DEAD baby.

      • Empress of the Iguana People

        Oh I complain alright. But I gulped those suckers down in under 2 minutes. 5 times in 2 pregnancies. Sipping didn’t make it less revolting. blech.

        • Empress of the Iguana People

          (I also had an aversion to most sweets with both kids.)

  • Immerito

    Dr. Tuteur,

    Besides, “What to Expect When You are Expecting”, what pregnancy books did you recommend to your patients?

    • Empress of the Iguana People

      She’s been retired for ages, like since Dr Spock was still in use. Dr. T. has written 2 herself, though i haven’t read them. i did like Parenting with Reason: Evidence-Based Approaches to Parenting Dilemmas.

      • Dr Spock is still one of the better pediatric advice books out there, since his message was essentially “use your common sense” and “trust your instincts “. You can’t go far wrong with that. Ever since he wrote his book, I think it’s been largely fads and gimmicks.

        As for books on birth: guess what? They’re still being born the same way they were 50 years ago when I began my career.

        • kilda

          really? we haven’t created a race of mutants with huge heads and impaired bonding, with all the unnatural selection from c sections and formula? /s

  • Dr Kitty

    I do not understand this.
    I have a mild form of spina bifida with a wonky pelvis and a lumbar spine that decided it really, really wanted to be a sacrum, and a sacrum that decided it was going to take the textbook factory setting anatomy as more of a light suggestion.

    My sister died when she was a day old from a Congenital Diaphragmatic Hernia.

    At my 12 week scans you bet I had them looking at the spine and skull. At the 20 week scan I wanted to know stomach was below diaphragm and lungs and heart looked normal.

    Things can go wrong even when you do everything right.
    Knowledge is power.
    Why would you literally wish to disempower yourself?

  • 3boyz

    I’ve had gestational diabetes twice, the first time I had it was diagnosed after the fact. I had taken the 1 hour screening, and somehow it came up normal and that was the end of that. Then I gave birth to a 9 lb baby (with no epidural, because it happened to fast. Very badly traumatic for me) with hypoglycemia. And of my 3 children, this is the one that struggles terribly with weight (he’s very overweight for his age/height). I will always wonder if we had caught the diabetes and controlled it, maybe he wouldn’t have weight issues…I got GD again in the following pregnancy but this time we caught it and I was able to control it with diet and he was born at a normal weight. I also had major placental issues starting in the third trimester. Although admittedly I didn’t need screening to figure that out, waking up one morning at 27 weeks covered in blood was enough to tell me that something was very wrong…

  • Amazed

    Meanwhile, my mum attended a charity event aimed to fund the purchase of a new screening equipment of some kind for newborns. They gathered the money. A little more from a sister charity organisation which also organises such an event, and they’ll be able to buy some additional equipment as well.

    Hurrah for them. The natcherels of the world just puzzle me.

  • Dr Kitty

    A sixth pregnancy, by definition, is not low risk.

  • If this is a sixth pregnancy, and one birth was a C/S, Im actually concerned more for the mother than the baby, since uterine atony or placental complications resulting in life-threatening hemorrhage are more possible than if she was of lower parity.

    • Who?

      She at least has a choice-though her other five children may prefer to have a mother, rather than not.

      Considering the needs and wishes of children doesn’t seem to rate highly in ‘all my rights’ world.

      • Well, it’s Dunning-Kruger, as far as I’m concerned. And the chances are fairly good that she’ll luck out. It’s not as if she were choosing to use acupuncture as the treatment of choice for metastatic carcinoma. I once had an Rh negative patient who steadfastly refused to get an anti-D shot after each of her first five children, and bragged about how unnecessary it was — until she showed very high titers in her sixth pregnancy. She belonged to an odd religious group which prohibited contraception, so of course it wasn’t many years before every pregnancy ended in miscarriage or stillbirth. Since she still had a decade, at least, of childbearing ahead of her, she was going to have a very tragic time of it.

        • Who?

          I do know. And as you say, chances are she’ll be okay, and if she’s not the doctors etc who don’t manage to save/cure/successfully manage her will be the trouble, at least in her environment.

          The situation you describe is horrfying-there’s a lot of suffering in the world-adding to it deliberately, or wilfully ignoring ways to avoid it, is inexplicable and horrifying.

          But then, as they say, there’s aught so queer as folk.

        • EmbraceYourInnerCrone

          If my grandmother were living she’d probably have something to say to her, she lost her third child to Rh incompatibility. He was her third child in three years and she was 19 at the time. My grandmother was Catholic, a religion that also prohibits contraception (old Catholic joke: what do you call people who practice the rhythm method/natural family planning? Answer-parents)

  • Blair

    As a pediatrician who has seen several babies die of group b strep, I am apalled at the head in the sand idiocy of not screening. Off the top of my head: 20% of women carry it as basically a normal part of the microbiome. Screening and appropriate antibiotics leads to 1:4000 cases, while untreated leads to 1:200 cases of invasive disease, which carries a mortality rate similar to that of leukemia. Lots of morbidity after gbs meningitis if you survive

    • Heidi_storage

      And of course, if you’re highly colonized, the odds are even higher for your baby getting sick.

  • Amazed

    OT: Dr Amy’s Facebook page has left me seething with rage. I mean that fucking nurse – a NICU one, no less! – not wanting to get the flu shot but not wanting to bear the consequences for her choice either. Instead, she’d happily thrust them upon the most vulnerable of the population. How dare she!

    The only silver lining is the magnificent way the Iris pupper comported herself. Finally, she revealed what anti-vaxxers are about: all for lies if they further their aim. Informed consent: when Big Pharma doesn’t give it loudly enough for their deluded so-called minds, it’s bad, bad, bad. When an anti-vaxxer refuses parents informed consent, it’s good. Kudos for Dr Amy for being so persistent and wrenching it from Iris’ reluctant mouth.

    Anyone cares to get a screenshot? They sure love dirty deletes.

    • Krystle Dolbow

      I hope someone got a screenshot and can find where she works. I’d be glad to inform her employer how she doesn’t care about putting those so vulnerable at risk

    • Merrie

      I had someone I dealt with at work who I’m pretty sure did what that original poster was trying to do (used me as a source of falsified paperwork). And yes, I’m being vague on purpose because I don’t want to give anybody ideas on how to do this. It made me pretty mad! I looked her up online and called the employer listed on her Facebook and talked to the HR person and said that, oh, by the way, here was something I had observed happening, not naming any names, and she might want to check people’s paperwork a little more closely.

  • Kristi Berry Pedler

    This calendar year, have dx’d 3 placenta previas, 1 vasa previa, 4 sets of twins, an IUFD, and 1 serious anomaly using ultrasound. Work in a rural area, the last one will now delivery in a tertiary hospital but will still see me until 32 weeks when she will transition to seeing them (saves driving time for her). Yeah, PNC and testing affects management. Otherwise, why do it?

    Have diagnosed T18 after abnl triple screen (obviously a few years ago) followed by scan. Have dx’d several NTD…and then supported their choices (some continued the pregnancy, some chose to abort – I cared for them all). Have seen multiple fetuses with renal agenesis. Have seen GBS sepsis. It’s not pretty.

    She’s lucky her n=5 are fine. But me and every other OB, with our n of thousands, can all see the point of modern medicine.

  • When I first graduated nursing school, there were no Dopplers, no fetal monitors, no ultrasound. Blood tests were limited to a blood count, fasting blood sugar, rubella, and blood type. No genetic testing. I graduated in 1967.

    So really, all she wants to do is go back 50-80 years. Blood types were unknown until around 1920.

    To be fair, haredi women here routinely decline a great many tests, since they will not terminate a pregnancy for any reason and are willing to accept the consequences.

    • Anna D

      in Bk,NY, most religious Jewish women go through all the tests, not because they would terminate but because knowing would allow them to plan accordingly. I.e. if they are pregnant and were diagnosed with fetal hear problems due to Down syndrome they would probably go to one of the hospitals in Manhattan that is equipped to deal with neonatal heart surgery.

  • Sue

    Yet another repetition of the outdated House of God principle “If you don’t take a temperature, you don’t find a fever”, also known as “stick your fingers in your ears and shout la,la,la”.

    So, Tietje, ex-music teacher and serial child birther, didn’t get ultrasounds during her previous pregnancies. Yawn.

  • Zornorph

    Presented for your amusement; a woman who claims she didn’t EAT while she was pregnant!
    http://nypost.com/2017/06/15/breatharian-couple-survives-on-the-universes-energy-instead-of-food/

    • Azuran

      What a huge load of BS XD

    • kilda

      “Husband Ricardo, 36, believes that Breatharianism is the ideal way to slash people’s food bills.”

      well, it certainly would do that. :::dies laughing:::

      • Mattie

        as opposed to a breatharian who *dies starving*

      • LaMont

        *The ideal* way, though? *A* way, to be sure… oy oy oy

      • Petticoat Philosopher

        Yeah, your food bills won’t be very high if you’re dead.

    • Mattie

      Snopes has an interesting article about them http://www.snopes.com/breatharians/

      • StephanieJR

        I love it when Wikipedia gets sassy – ‘Though it is common knowledge that biological entities require sustenance to survive, breatharianism continue’

  • ArmyChick

    I am not pregnant (I have one daughter and this shop is closed!) but I felt very sick last Friday. I was shivering, warm…and became delirious overnight. My husband took. me to the ER just to make sure I didn’t have anything serious.

    I HAD SEPSIS. My white blood count was over 17,000. I had hypokalemia. My fever was 104. Unbeknownst to me I had cellulitis on my left leg and it had caused my immune system to go haywire. I had two IVs with antibiotics and fluids within 15 minutes of being seen. I COULD HAVE DIED WITHOUT MODERN MEDICINE!

    If it weren’t for modern medicine I would not be here.

    F U KATE! If you don’t want to go see a doctor when you’re NOT pregnant, fine. But from the moment you decide to keep that baby, you have the OBLIGATION to ensure the best outcome possible for that innocent being, you disgusting sack of sh*t!

    • Empress of the Iguana People

      Oh goodness! Glad you’re doing better

    • BeatriceC

      I’m so glad you went to the ER when you did and you came out of it ok.

    • mrsadams

      Good on you and hubby for being proactive and getting help. So glad you are okay. How scary

  • Nicole Ray

    Ultrasound showed that my second child was very unwell. He had hydrops, was unmoving, and had major heart and lung deformities. He was unlikely to make it through pregnancy, and could never survive outside of me. My husband and I were glad for the knowledge, so we could appreciate the time we had, and say goodbye.

    Ultrasound also showed that my third child was perfectly healthy and strong. Allowing me to relax and be as unstressed as I could during pregnancy. Which I’m sure helped both of us greatly.

  • mabelcruet

    I object to the way that this argument is always presented as a ‘them vs us’. No one is forced into having any antenatal tests. Expectant women have to consent to them-hospitals have information leaflets that you go and read and come back with questions and go through with the relevant specialists. You can opt in or opt out depending on what suits you, based on the information you’ve got. Why then do the alternative practitioners always present it as you have to fight the whole way to get your way and get what you want, and those horrible doctors just want to cut you, and those horrible midwives want to force you to lie on your back for 24 hours and laugh in your face when you ask questions? If Tietje has never had a ‘routine’ hospital or midwife care pregnancy, how can she speak so authoritatively about what happens and how you might be treated by hospital staff?

    • Young CC Prof

      I was once on a bus that broke down. We were all standing around next to the bus, and this guy says he’s going to get his luggage and leave. Then, he starts ranting about what he’s going to do and say if the driver doesn’t give him his luggage. He went on and on for a solid ten minutes, furious about hypothetically not getting the luggage.

      Meanwhile, I’m thinking, “Have you considered…asking?”

      Everyone got their luggage a few minutes after that.

      • Amazed

        My favourite joke is about that man who walked and walked through the desert, wishing, longing, and hallucinating about water. Finally, he saw a well but there was a dragon posited next to it. The man drew on his last reserves of strenth and started fighing the dragon. They fought for three days and nights when the dragon finally asked, “Well, what do you want?” “I want to drink!” the man replied. “Well, drink, then, why are you fighting?!”

        • KQ Not Signed In

          And *that* reminds *me* of *my* favorite joke.

          Morty was under tremendous financial stress. He was desperate for some way to pay off his debts. Every day he would drop to his knees and pray. “Oh, Lord, let me win the lottery.” Morning and evening, every day, for months. “Oh lord, if you would just let me win the lottery!”

          One morning, in the middle of his prayers, he heard a great voice booming in reply.

          “Oy, Morty, meet me half way and buy a ticket!”

    • Chi

      I’m PRETTY sure that at least one of her kids has been born in a hospital because if I remember correctly, her first child – her daughter, was born via c-section. Which Kate blames for her inability to bond with said daughter. As far as I’m aware the births of her subsequent children have been home births.

      She really is a piece of work. Espousing all this ‘knowledge’ like she’s some kind of expert, when really she’s a manipulative bitch who knows her audience and thus knows exactly what to say to get them all to dance to her tune.

      I could say a lot more but I get the feeling it’ll deteriorate into incoherent ranting because I really really REALLY dislike her because she is the epitome of the ‘all natural, anti-vax crowd’ who doesn’t like science and deletes it off her page, especially when it proves her wrong.

      • mabelcruet

        Yes, I’ve a vague memory of her writing a really horrible piece about the daughter she couldn’t love (because she was cut out of her), and then she took the hump when everyone was ‘mean’ to her about it.

        • Mel

          Was she the one who described how she’d totally pick her son instead of her daughter in a Sophie’s Choice scenario because the CS prevented her from bonding with her daughter?

          • Box of Salt

            Yes, she’s the one.
            I hope her daughter never encounters that piece and its comments (or at least until she is an adult living and thinking independently of her mother), nor her third “I hope it’s girl so I can get a do-over” child.

            I will say that reading it did make me examine my own actions and whether favoritism played a role in my own parenting. For me, unlike Kate Tietje, it made me a better parent for both of them.

          • Kristi Berry Pedler

            Both kids say I favor the other kid. I figure that is the goal!

          • MaineJen

            That’s horrifying. That book haunts me to the point where I’ll never read it again.

          • Heidi_storage

            Yep. And then she became indignant when people criticized her for her appalling post.

        • Amy Tuteur, MD
  • anh

    We found out last week my daughter has spina bifida. I’m 21 weeks. This makes me furious to the point of wanting to hit someone. Because of technology I will have a section to reduce the trauma for her. A team will be waiting to take the best care possible of her.

    I wish I didn’t know. I wish I could blunder through these next 19 weeks ignorantly happy. But I won’t because I love my daughter. I’ll carry this fear and terror so that she’s cared for.

    Fuck this idiot woman.

    • moto_librarian

      I hope that early detection will help your daughter to get the best treatment possible. Gentle hugs.

    • Young CC Prof

      Sorry to hear that. Sounds like you are already working to be the best Mom possible!

    • Montserrat Blanco

      Best wishes for your daughter. I really hope she will be fine after all. You are doing the right thing. It is always best to know that you did everything within your power to make her safe. You are a great mother.

    • Amazed

      Sorry to hear that. Looks like your daughter lucked in the mom department.

    • Empress of the Iguana People

      oh, man. *hugs for both* Good luck with her care

    • mabelcruet

      I know it must have come as a shock, but it’ll allow you to plan for when she arrives-to put everything in place so she gets the very best start (except it sounds like she’s got a great start already), hope all goes well for the future.

    • BeatriceC

      I will never understand when women think any way other than this. If the child has a problem, he or she has that problem regardless of what tests you do. Knowing early gives the kid a far better chance of survival and in some cases, full recovery. I’m sorry you guys got that diagnosis, but it sounds like your daughter has a fantastic mom, and she’s going to be alright.

      • Ehteljturner


        my best friend’s step-mother makes 85 US dollars hourly on the computer . She has been fired from work for nine months but last month her pay check was 17089 US dollars just working on the computer for a few hours. see it here ++++++++++
        ➜➜➜http://www.TopUSAGlobalJobsOnlineLife/Wage/Home….
        ✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹✹…

    • Sue

      THIS, as opposed to the pre-ultrasound days when there was no time to prepare, and the anger and terror could overcome the parents during those first few precious days.

    • sdsures

      Hugs. Breathe. Knowing about it this early means you, your husband, and your doctors and pediatrician can make plans ahead of time about how to give the little one the best life she can have.

    • Sarah

      And you will be able to make sensible, positive choices to give everyone the best chance of an optimum outcome. You did the right thing having tests and scans. You’re a good mother.

    • Dr Kitty

      Anh-
      Your daughter will be loved and cared for by people who have already accepted her for who she is before she is even born. That is a wonderful thing.

      Whatever her limitations (and they may be fewer than you fear) , she will delight, astound and amaze you.

      Lots of love for you (and prayers, but only if you’re into that).

  • OttawaAlison

    Isn’t she special.

    As a loss mom who lost her baby at 37 weeks and would have given her foot for higher lever ultrasounds to determine cord position and a more detailed placental function… what on earth can I say. She is willfully ignorant which is one thing, but the tragedy is that people listen to her.

    For anyone hate reading – babies can die in utero deaths that with proper screening may have been preventable. I wouldn’t wish what I went through on anyone.

    • kilda

      I’m so sorry for your loss. That had to be devastating.

    • Young CC Prof

      My son was delivered by planned c-section at 37 weeks. He was healthy, but so skinny his ribs stood out, and his placenta was practically falling apart. There’s no way he would have survived to term. The ONLY way we knew anything was wrong was an ultrasound at 32 weeks that showed him falling behind in growth, if that test had not been done, he could easily have died in utero as well.

      This week, my daughter had her 32 week ultrasound, and she’s a full pound bigger than he was, totally average size with perfect proportions and fluid levels! She’s been getting good test results all along, but this test, the one he “failed,” was really reassuring.

      Thousands of babies in the USA die every year during the last month of pregnancy. Many, perhaps most, are preventable.

      • fiftyfifty1

        These placentas are a mystery, aren’t they? I mean we know certain risk factors for a crappy placenta (hypertension, postdates, advanced maternal age, etc), but so often it is a one time deal. I know I’ve shared before that my second child was born at 38+4 weeks with borderline IUGR weighing a pound less than my first baby (born at 38+1) with a placenta that the L&D nurse called “old and raggedy and calcified”. Why does it happen? I had no risk factors other than being 3 years older than I had been with my first. No hypertension, no nothing.

        • Merrie

          Yep. A friend of mine was 29 when she had her second kid, skinny, no health conditions, a medically uneventful pregnancy with her first, who was on the small side at 5 1/2 lbs or so, but then again she is only about 5’1″ herself. Then she had IUGR with her second, which was caught at 31 weeks and carefully monitored, and was induced at 37 weeks and he weighed 3.5 lbs at birth. I shudder to think if she’d been planning a homebirth and hadn’t had adequate prenatal care.

        • mabelcruet

          I must have had 15000 of them under my microscope in the last 20 years, and I still get ones where my first reaction is ‘WTF?’

          There are a range of pathological conditions that can lead to ‘placental insufficiency’, or ‘utero-placental insufficiency’, neither of which are proper definitive diagnoses, merely descriptors. Some of these are only diagnosable on microscopic examination-massive perivillous fibrin deposition, chronic villitis, histiocytic intervillitis. There’s a very important one called delayed villous maturation (previously called villous dysmaturation), it was only last year that the name was finally agreed by consensus and the diagnostic criteria/standards set. But it is thought to be one of the more common causes of stillbirth. Placentas with this condition may be big, small or normal sized-on naked eye inspection they look ok. But if the placenta isn’t examined, it can’t be diagnosed. We don’t know how to screen for it, how it develops, what causes it to happen, how we can prevent it, nothing.

          • fishcake

            I read my pathology report for my placenta a few times a year. I appreciate all the detail, and wish I understood what it all meant. Also sometimes wish I would have had a chance to see it.

        • Kristi Berry Pedler

          Evidently I make crappy placentas that do IUGR & oligo. The second pregnancy added HELLP. I have 2 healthy teens thanks to modern medicine. We wanted a third kid but decided not to push our luck.

    • Montserrat Blanco

      I am so sorry for your loss.

    • sdsures

      I’m so sorry.

  • DaisyGrrl

    Isn’t ultrasound one of the tools used to identify which pregnancies are high risk? I wish the NCB community would acknowledge that screening saves lives and is used to determine which pregnancies are low-risk vs. high-risk.

    If someone wants to refuse testing, that’s their right. But don’t refuse testing and then claim to be experiencing a low-risk pregnancy. It’s simply impossible to know.

    • EmbraceYourInnerCrone

      Some of them seem to have that Magical thinking thing going, if I don’t get tested , I won’t get news that my baby, or my body has an issue that may need watching or treatment. And if I don’t get bad news then the bad thing doesn’t exist! Magic!

      Like people who avoid going to the doctor when weird things crop up (sudden unexplained weight loss, weird colors on a mole) because they don’t want to be told it’s cancer. If they don’t acknowledge it, it doesn’t exist. Schrodinger’s baby.

      I understand and sympathize with the tendency to do this and did it myself until my mid-teens but eventually you have to learn to deal with reality and prepare for possible bad news.

      • New Mom

        Several years ago, I had a miscarriage. I was sort of friends with an acupuncturist/TCM practitioner. He told me that I had a miscarriage because I thought it was possible. I’m not on speaking terms with that person anymore.

        • Cody

          “If you think it, it will happen” I hate that.

          • Juana

            In other news, did you know that you can actually fly if you jump an forget to land?

          • kilda

            well, that’s how it always works in cartoons! If you run off a cliff you’re fine, until you look down and realize you’re in midair, then you fall.

            Natural pregnancy: using the same logic as a Roadrunner cartoon!

          • Charybdis

            No, no no. You have to throw yourself at the ground and miss. Because you will have to land eventually. 😛

          • LaMont

            I mean, in law when assigning blame, isn’t there *motive*, *means*, and *opportunity*? The loss of a wanted pregnancy doesn’t have motive, let alone intent, so how could just awareness of the possibility actually affect an outcome? Jebus. Then they handwave *means* right out the freaking window… idk anymore.

        • EmbraceYourInnerCrone

          I so sorry about your miscarriage. I’ve had two miscarriages , one required a D/C. If someone especially someone who is supposed to be a health care provider had said that to me I probably would have smacked them. I admire your restraint.
          The “it will work if only you BELIEVE crap makes me furious”

        • Empress of the Iguana People

          What a putz. Sorry for your loss.
          I worried about miscarriage/stillbirth throughout my pregnancies, and both ended in dirty diapers and adorable onsies.

        • fiftyfifty1

          Wow, now we just have to get the word out there to women/teens with unwanted pregnancies. Think of the money to be saved by just thinking about miscarriage rather than having to pay for an abortion.

          • Who?

            Well we know don’t we that the body shuts that whole thing down if a woman is raped, so she won’t get pregnant?

            Just an extension of the same magical process.

            I don’t know the sarcasm sign, but in case it’s not obvious, take it as read.

          • Mel

            Unfortunately, I’ve had students start sobbing at my desk after a miscarriage because she blamed her fear/anger/terror at finding out she was pregnant for the miscarriage – IOW, if the teenager had been excited about the pregnancy from the start, the baby would have survived.

            I added a section in all of my classes – regardless of whether it fit into the actual subject matter – about the actual known biological causes of miscarriage and stillbirths and what we still don’t know.

        • Sue

          Considering up to 20 – 25% of early pregnancies end in spontaneous miscarriage, it would be totally unrealistic NOT to think it was possible.

        • Clorinda

          Some of that sort of “It’s my fault” guilt comes around anyway. With my son who died from Multi-cystic dyplastic kidney disease at birth, my first thoughts were “It’s because I had asthma issues and water made me vomit so I had problems staying hydrated.” So my actions or my medications were at fault. I told my dad and he said it might be his fault for Agent Orange exposure during Vietnam.

          Those are very common actions in people’s minds when dealing with grief, even if there is nothing to them. You process things and deal with the real thing, if any, and try to dismiss the fake guilt things To have OTHERS accuse you of things, is abhorrent. PPD can be bad enough without others helping feed you another level of guilt to top off what you may be doing to yourself.

    • mabelcruet

      Exactly. At the moment my father is terminally ill-he is getting palliative care. My mother refuses point blank to discuss his care with Macmillan nurses (specialist cancer nurses who provide home care) because ‘they take my hope away’. I’ve been trying to get through to her that denying it doesn’t make it go away, and denying care to dad because she doesn’t want to have the cancer nurses in the house because that makes his diagnosis real is cruel and unfair. Wishful/magical thinking might work if you’re 5 years old and waiting for the tooth fairy, but not when you’re an adult.

      • Who?

        That’s so tough. I’m sorry about your dad being sick. It’s hard to understand, let alone accept, how the dynamics work in long marriages, even, perhaps especially, when you are the child.

        I hope your dad finds some relief and you and your mother some comfort over the next few months.

        • mabelcruet

          Thank you, we’re working on her. I’m hoping its a temporary grief reaction and her way of coping but it is impacting on dad’s care so we need to get it sorted soon and get her dealing with it realistically.

          • Dr Kitty

            I’m so sorry you’re all going through this.
            Be a daughter, not a doctor, that is my advice.

            Macmillan are wonderful.
            Would it help if your mum went out for a walk or a drive or a cup of coffee with friends while the nurses saw your dad?

            Thinking of you.

          • mabelcruet

            Mum has her own health issues-she has bipolar and on lithium and quetiapine, dad has basically been her carer for many years. She has very severe social anxiety and agoraphobia and she will not leave the house without dad. She doesn’t drive or shop, she doesn’t do anything really-her life is her home, her garden and dad. She is extremely resistant to anyone coming to the house-even us. We can go downstairs but we’re not allowed upstairs. We’ve been trying to arrange home help-a cleaner, someone to do the laundry and ironing etc but she is refusing point blank. The trouble is, she won’t do the laundry or ironing (dad always did that). She’s allowed us to take the laundry away and do it, but doesn’t want strangers in the house. I’m really concerned that dad isn’t getting the care he needs-we found out a few days ago that mum wasn’t giving him his pain meds in full because they made him sleepy. But that’s always been their weird dynamic-dad does everything and mum lets him. And she is not adjusting yet to dad not being able to do anything and she has yet to step up.

            She doesn’t have any friends at all, she doesn’t go out or have a social life. She is incredibly self-conscious and has a lot of paranoid ideation, thinking that people are talking about her or criticising her. She’s currently complaining non-stop about his most recent discharge letter. In it, the consultant said that dad had a very supportive family and his daughters bring him to the day unit. Mum is in a complete snit about it because the consultant didn’t mention her at all, mum interpreted that as the consultant ignoring her and undermining the support that she gives dad. Except she doesn’t give him support-she complains that he’s sleepy and doesn’t help her with the gardening (despite being told frequently that he is at risk of infection and mustn’t do the gardening. She’s totally disconnected to reality I think. The trouble is, if you speak to her she comes across as reasonably normal-she can manage very short interactions and is good at putting on a front, but she can’t keep it up.

            She is refusing the Macmillan nurses as she is interpreting that as a criticism that she isn’t able to care for dad. I’ve tried to get her to reconsider but she is adamant. At the moment dad is reasonably self-caring, but there will come a time when he won’t be able to manage and then what? My sister is thinking about social services involvement as he could qualify as a vulnerable adult, but at the moment, he’s equally adamant about wanting to be at home regardless. And if we did that, I have no doubt that mum would block all access to dad-we have to keep on her good side in order to get dad the help he needs.

          • Empress of the Iguana People

            *hugs*

          • Dr Kitty

            Oh goodness, that is a lot going on.

            From GP experience, I’m afraid that adults with capacity, even if vulnerable, get to make horrible choices. If your dad says he doesn’t want services, and he has capacity, there isn’t much to be done.
            Only once capacity goes does the system step in to act in best interest (and at that point patient’s wishes and family preferences very much take a back seat).

            I think England is a little different, but speak to your family solicitor about enduring POA.

            I take it your mum’s CPN and psychiatrist are aware of the situation with your dad and your mum?
            Sometimes medication tweaks help if there is a new stressor.

            Your mum clearly worries about not being seen as supportive and caring- I wonder if pushing that angle will get you anywhere.
            i.e emphasising the bad appearance of refusing care and asking her to play along with proposed care plans to keep the powers that be happy.

            Hopefully someone (GP, Macmillan, Mental health team) will be an ally.

            Vent if you need to. Cake helps too.

          • mabelcruet

            I’ve spoken to her GP about her. She was obsessing about how she would be able to get her repeat prescriptions (dad does this-drives to the surgery to order them, drives the next day to collect the script). With dad not able to do it, she has been panicking-she refuses to phone (anyone at all, not just gp surgery), and refuses to drive (and refuses to take a taxi on her own, and refuses to go to the pharmacy). I picked up consent forms from the surgery that she and dad signed-I told her it was a consent form to allow me to order prescriptions online on their behalf, but it’s also consent for me to discuss their health issues with the gp, which I’m not quite sure she picked up, but it needs to be done. She has a community psychiatric nurse but only sees them annually, the GP has asked for a review and referral to medical psychiatry. The problem is though, this is normal for her. Her behaviour hasn’t actually worsened significantly, it’s just that now it’s impacting on dads health.

      • Sarah

        Difficult. I imagine it is very tough for everyone concerned.

        • mabelcruet

          Thanks-I’m hoping with time mum will accept the diagnosis and start to support dad more appropriately, but its a big problem.

      • DaisyGrrl

        So sorry about your father’s illness. I hope your mother is able to accept proper care for your father and accept support for herself. I had a friend go through something similar recently and it was very difficult for all concerned.

    • Chi

      I think a major reason they do it is because if they don’t do the tests then they (the midwives usually) can put their hands on their hearts and SWEAR that this was a low-risk pregnancy.

      Because they don’t want the tests to show something that would mean them having to risk out their patients and lower their potential income.

      • DaisyGrrl

        I absolutely agree that this is why they do it. It just drives me bananas because the result is the opposite. If they show up at the hospital in labor and announce that they’ve had no prenatal care, the doctors aren’t going to react as though they’re low risk (because they aren’t).

        • Azuran

          Indeed, if they show up without any medical information about their pregnancy with a labour emergency, then the doctors are basically going to need to start from scratch, and they are going to need to move a lot faster that they usually would.
          That means more tests, done more quickly, with less time to explain what is going on. And then they get additional bragging rights about how horrible the evil doctor where to her.

          • Chi

            And yet there is NO acknowledgment that the EVIL, UNCARING, RUSHING doctors probably saved the lives of both them and their baby.

            The hypocrisy and ingratitude is overwhelming.

  • Gene

    This is a similar argument to declining specific prenatal testing for aneuploidies like Trisomy 21 (Down Syndrome). The premise being that the woman declines the test because she wouldn’t terminate anyway, so why test. And if you DO test, it means you are an evil sinner who would kill any baby that wasn’t perfect. (Tell that to my rabidly pro choice relative who knew her child had Tri21 and happily continued her pregnancy…)

    However, some disorders like Tri21 are associated with correctable disorders like congenital heart defects that, if unrecognized, could cause death if not identified immediately after birth. So knowing in advance will allow you to give your child a better chance by, say, giving birth at a hospital with great Peds cardiovascular surgery instead of in a muck filled pool.

    • crazy grad mama

      YES. I respect the decision to decline genetic screening, but I always kind of cringe when I hear people say they skipped it solely because they would never consider termination. It kind of made sense before the availability of cell-free DNA tests, because a positive screen meant deciding whether or not to take the risk of an amniocentesis, but now you can get a firm yes/no on the trisomies from entirely non-invasive tests.

      • AA

        “now you can get a firm yes/no on the trisomies from entirely non-invasive tests.” Not true, the cell-free DNA tests, in conjunction with a genetic counselor, can be used to determine a patient-specific risk of trisomy, but it is not a diagnostic test.

        • crazy grad mama

          Yup, you’re the second person to note that. I’ve added a correction to my original post.

      • Cody

        This is an unpopular opinion, but I don’t think not terminating is kind in certain circumstances. Trisomy 21 almost seems like no big deal when you compare it to something like Trisomy 18. A soft marker for trisomy 18 showed up during our last pregnancy and upon further investigation we found out that our baby likely did not have it (and she didn’t). As a consequence, I ended up learning a lot about it.

        What a horrible thing for a baby to have. Most die before they are before they are born. There are so many congenital abnormalities that are painful and horrific for the baby experiencing them and many of these babies will dies anyway. Termination in many of these rare circumstances is a very humane choice. I would certainly risk eternal damnation to know that I minimized my child’s suffering. But I’ve been told that makes me a bad person and a bad mother.

        • kilda

          yes, the other trisomies (13 and 18) are terrible. For T18 the lifespan is something like 1-2 weeks. If I were carrying a baby with either of those I would terminate, without question.

          • LaMont

            Are these things that can only be discovered after 20 weeks? Because in lots of states you’d just be out of luck at that point. I love how the 20-week bans (hi, Ohio!) are seen as so “moderate” relative to the heartbeat or personhood bills, but they’re pretty much surgically pointed at women who just discovered that their child cannot live. Gotta love a law designed *primarily* to harm women who just found out their wanted child won’t make it. That’s when I lost my last shred of respect for the “pro-life” movement. Evil.

          • MaineJen

            Yes, the 20 week bans are particularly cruel.

          • Young CC Prof

            Trisomy can be diagnosed earlier if you get noninvasive testing around 13 weeks, but yes, a lot of rapidly terminal conditions are diagnosed at the anatomy scan, which is why 20-week bans are in fact incredibly cruel.

        • mabelcruet

          There’s a type of skeletal dysplasia (dwarfism) called osteogenesis imperfecta. There are a few subtypes and depending which type you have, you can survive with it, albeit at risk of fractures-its called ‘brittle bone’ disease. But the lethal fetal type is very different. In this type the baby’s bones fracture in the uterus-spontaneous fractures. By 20 weeks gestation, the baby’s arms and legs are shortened and curving and becoming deformed because of the repeated fractures and the aberrations caused by bone healing. The ribs have multiple fractures all along their length, and as the fractures heal, the ribs get shorter and shorter. This means that there is no space for the lungs to grow-the thoracic cavity is much reduced in size and the lungs simply stop growing. During delivery, the pressure from the birth canal causes multiple fractures all over.

          I don’t know if you’ve ever broken a bone, but it can be extremely painful. Imagine breaking bones simply as a result of turning over or moving, that’s what happens to these babies. Do they feel the pain of the fractures? Are their brains and nervous system sufficiently developed to feel and suffer pain? I don’t know, but certainly premies from 24 weeks can feel pain, so I suspect that these poor fetuses are suffering. And where I am (Ireland), we can’t legally terminate on the grounds of lethal fetal anomaly. These babies with the lethal fetal type all die either during or shortly after birth because of the lack of lung tissue. There is no chance of survival. They are destined to suffer 10s, even 100s of fractures during their existence.

          Personally, I think any dickhead who considers termination on the grounds of lethal anomaly a sin and against God’s laws should be volunteering to have every bone in the hand smashed to pieces with a hammer to give them an idea of what it feels like, what these babies are going through.

          • BeatriceC

            I’m in a bit of an argument with a friend over late term abortions. I’ll never get her to read this site. May I copy/paste this into my messenger conversation with her?

          • mabelcruet

            Feel free-there are a number of other horrible conditions that can occur in utero and cause great suffering. Take lethal multiple pterygium syndrome-in this condition the skin doesn’t develop properly and forms tight ‘wings’ of flesh tethering the major joints. The baby’s limbs are all pulled tight into the body. They can’t move in the uterus, and muscle problems affect their ‘breathing’, so they don’t breathe in the fluid and their lungs subsequently fail to grow and don’t develop. Thankfully its rare, I’ve seen about 8 cases in my professional career, most of which were stillborn. But a couple were liveborn-their skin physically tore during vaginal delivery. Huge gashes and lacerations caused simply by delivery, the joints too fixed to extend properly and just the act of trying to pull the baby out ripped the skin to shreds. No-one can tell me that open lacerations like that aren’t painful.

          • BeatriceC

            Holy shit. I don’t know if I could do your job if I had to see that even once. I can normally handle medical stuff fairly well, and compartmentalize the really bad stuff so it doesn’t get to me too bad, but that’s horrible. I had no idea a condition like that even existed.

          • mabelcruet

            I love my job, really I do. I see it as preventative medicine-anything I find, whether its from an autopsy examination or from a placental examination, will help towards the next pregnancy. If we pick something up which might cause problems next time round, then the obstetricians and midwives can deal with it-knowledge being power and all that. And it answers a lot of questions for the family-losing a baby must be the most awful thing for a family to deal with, but losing a baby and not knowing why is worse. So I approach it like that-the actual physical aspect of what I do I can reduce to mechanics in my head, and just try to concentrate on outcome.

          • Mel

            It makes all the difference in the world to the families, believe me.

            My middle brother died at almost one year when he became septic from an ear infection. No history of other major illnesses before that.

            My mom was just over 5 months pregnant with a surprise baby when David died.

            The autopsy let us know that David had been almost normal – but he was missing his spleen. The splenic artery stopped at a blind end so the best guess was that he had a random blood clot form there at some point during gestation and that stopped the spleen from forming.

            My parents consulted a geneticist who reassured them that they had never heard of a genetic syndrome that just destroyed spleens with no other organ problems. On top of that, my great-uncle Tom who was also a pathologist hit the stacks of the nearest research library and verified that he couldn’t find any syndromes like that either. (That was very sweet of him and greatly comforting to my parents.)

            When little brother was born, the pediatricians checked that he did have a spleen through ultrasound and placed him on antibiotics until he could get a clean blood cell test. In true form for a relative of Mel, it took 10 months for LB to get a clean blood test since each CBC panel showed a slight variation outside of normal ranges of different cell types each time. My brother got an ear infection as soon as he went off the antibiotics – but a course of a different antibiotic took care of that.

            LB is now 30 years old.

            Having a plan makes a huge difference in terms of managing anxiety.

          • mabelcruet

            Absence of the spleen with no other anomalies is very rare-usually it goes along with situs inversus where everything is on the wrong side of the body. In this you sometimes don’t have a proper spleen and instead have mini nodules of splenic tissue (called splenunculi). But if he had an autopsy it would have been obvious to the pathologist if everything was on the wrong side. Its probably going to turn out to be a single gene disorder with some sort of isolated mutation.

            Making a decision to consent to an autopsy is a very difficult choice for some parents, but there’s a lot of data showing that in the longer term, more parents regret not consenting to one than regret having one done.

      • swbarnes2

        You can get a firm “no” from a non-invasive test, but not a firm “yes”. The false negatives are still too high. A “yes” means a firm “get a diagnostic test , like amnio, done”.

        • crazy grad mama

          My mistake – I’ve not had to consider tests past the initial screening, thankfully.

    • guest

      I wanted all the tests with my pregnancies. Wasn’t sure if I would terminate or not, but if I was going to continue a pregnancy, I wanted to be as prepared as possible. I don’t understand why people prefer not to know.

      • Juana

        Me too. In German, we have this old phrase for being pregnant “guter Hoffnung sein” – literally translated “to be in good hope”. I’ve heard people in NCB/homebirth circle wonder why women are not “allowed” to just hope for the best these days with all that pesky modern medicine that’s just out to scare them.
        They totally don’t get where the notion of hoping for a good outcome came from: from millenia when hoping for the best was all that expecting mothers could do, because that was all they had. They all knew less good outcomes first hand.
        Personally, I have no desire at all to go back there – no information could be scary enough to convince me of that.

    • BeatriceC

      My cousin’s middle child is alive only because of prenatal screening. They knew in advance that she had Down Syndrome and a severe heart anomaly, so had the appropriate specialists in the OR when she was born ready to intervene immediately. Even the delay of getting a neonatal cardiologist who was already in the hospital might not have been fast enough to save her life.

      • ChickyDee

        I have a family friend who lost her twins because of TTTS and​ an early ultrasound not being done (which would have identified the issue soon enough for in utero treatment to be attempted). I have another friend who’s one twin survived TTTS because of that early ultrasound and treatment (the other twin, unfortunately did still pass away)

        I have a student with Spina bifida that was managed quickly and is doing well because his condition was found before he was born. My (staunchly prolife) aunt is still traumatised because 45-odd years ago, when my cousin was born with Spina bifida, they only found out after he was born.

        My friend with gestational diabetes had two happy, healthy children because her condition was diagnosed and treated properly (even if she didn’t enjoy the insulin injections and early inductions – her babies were born safely).

        I know of so many other examples of people I know, who have, healthy kids *because* of prenatal testing and the ability to plan for and/or treat conditions quickly. I just don’t understand why people think bad things can’t happen to them or their children.

    • MaineJen

      A thousand times this. We had a T21 “scare” with my daughter, when her quad screen came back elevated risk (1:43). I was more than a little alarmed, as I had another relative with DS. I never considered termination. But I knew there was a risk of heart defect, as my relative with DS had heart problems which ultimately killed her.

      So I went in for the high level ultrasound, thinking to myself that if anything at all abnormal showed on the scan, I would get the amnio done, just for the sake of knowing and being prepared. The ultrasound was clear and my daughter ended up having typical chromosomes, but I too get mad when I hear people say they didn’t want any testing like the quad screen done, because “they wouldn’t terminate no matter what.” You don’t know what you would or wouldn’t do until you’re faced with that situation! And T21 isn’t the worst news you can get.

      • Lilly de Lure

        Another T21 scare here – 1:26 in my case. Like you I found the fact that I knew about the risk in advance helpful as I was able to prepare myself for the possibility of a DS baby in advance and read up on the issues my son was likely to face if he had had DS. I was however furious that the harmony blood test was not available for me in the UK so I could make sure whether or not he actually had DS and prevent 6 months of uncertainty (i didn’t go for an amnio test as I’d had a few issues with the pregnancy as it was (we nearly lost it altogether at 19 weeks) and didn’t want to risk triggering a miscarriage). Having said that I’d rather have the months of uncertainty than find out that sort of thing as a surprise when the baby is born.

      • Sabrina Smith

        same thing with us. all we had was “soft markers” I declined amino until we did a more in depth ultrasound and it didn’t show anything else but they kept an eye on him nonetheless

    • J.B.

      I do think that you should consider what you’re going to do (broadly) before diagnostic testing. Doesn’t mean skipping it!

  • lawyer jane

    Is she not even going to get her blood pressure checked? Wow.

    • Juana

      Well, you know, it doesn’t get lower from being checked, so what’s the point? /s

  • Mel

    A routine blood test when I showed up at the hospital with sudden onset high blood pressure saved my life and my son’s life. I was at the hospital because I was having cyclic stomach pains at 26 weeks gestation and my OB wanted to rule out premature labor. I was certain I was having gas pains and looked forward to telling that to my son when he was older. Hell, I had just walked three miles earlier that day and stopped only because of hip pain. I felt pretty good for being at the end of my second trimester…

    I’ve never walked into a hospital critically ill before – and I hope never to again. My body was starting to fall apart from pre-eclampsia with HELLP but hadn’t had anything fail severely enough for me to notice…yet.

    I’m a naturally optimistic person, but my platelets were at 44 when the normal range is 400-140. I had scabs from blood draws re-opening when phlebotomists touched them to see if they could draw blood from that vein 6 or more hours after the draw.

    A resident described my liver enzymes as “scary” and couldn’t believe I wasn’t having abdominal pain.

    At some point, one of my organs would have failed and then I would have noticed something – but the outcome for my son would have been bleak. Born at 26 weeks, no prenatal steroids, likely compromised from my organ failure….. his chances of dying would have been much higher.

    Depending on which organ failed first, my outlook would have been bleak. Would I have stroked out? Bled out from a liver hematoma? Bled out from a placental abruption? Developed DIC?

    I thank God everyday for that blood test.

    It’s given me a happy-go-lucky little boy who is talking to a toy elephant right now when he’s not whacking at his play gym and it’s given that little boy his mom.

    • Montserrat Blanco

      I love to hear your Spawn updates! And you are right, your chances would have been far lower without prenatal tests.

    • mabelcruet

      That seems like no time at all since Spawn graduated from the intensive care unit-lovely to hear he’s doing well (and in good voice!)

    • Empliau

      I too am glad to hear that Spawn is thriving. May I request more cowbell?

      P.S. Toy elephant is awesome. Mine had a rhino.

  • Amy M

    They don’t know the definition of evidence. To people like this, evidence means: “I’ve seen it with my own eyes, or believe I’ve seen it with my own eyes.” Of course that is ridiculous—if I thought like that, Antarctica doesn’t exist because I’ve never seen it. I don’t know anyone from Antarctica either. So therefore, there is no evidence for its existence. 🙁

    I can understand that Kate here and her ilk can’t find and/or understand the bodies of medical evidence available, but she should be able to grasp that there IS evidence, just not personal experience. If someone found all the obstetric evidence for current practices and translated it to lay-person speak for Kate, would she accept it then? Would she understand that it is evidence, at that point, or would she still insist that only personal experience is evidence? Could we convince her that she isn’t interested in evidence and maybe she should stop using that word?

    • kilda

      actually, it’s not just “I’ve seen it with my own eyes.” It’s “someone else I talked to has seen it with their own eyes AND it fits into what I want to believe.”

      Not to be confused with “someone has seen it with their own eyes and it DOESN’T fit into what I want to believe,” which of course she will not accept as evidence.

      • Amy M

        Excellent point! Even if they DO see it personally, if it doesn’t fit the narrative, it can ignored. “Sure, my friend down the street lost a baby in homebirth, but all the women in my online homebirth group had live babies, so its safe!” <—-not me, just an example of something one of these people might say.

  • Empress of the Iguana People

    Bah. Although the thought of having another glucose test is kinda making me gag right now, it’d be plain stupid to forgo it if I were to get pregnant again. Better to know and then find ways to deal with the issue than to assume all the things are going swimmingly and have a catastrophe at the end.

    • Amy M

      Yep–my twins are mono-di. We had lots of ultrasounds when they were in utero, to watch out for TTTS. We were lucky, it didn’t happen, but if it had we could have intervened. If it happened and we didn’t know, both of them could have died. That wasn’t something I was willing to risk. The u/s also warned us of threatened pre-term labor, so the OB tried to intervene to stop or at least delay that, and we were prepared when it happened.

    • J.B.

      Both pregnancies, I failed the 1 hour by a little bit and had to do the 3 hour test. Which is no one’s idea of fun, but not as bad as diapers, vomit and all the fun kid things that are coming. Reassuring to know I passed the 3 hour though.

  • Angela

    There are women living in the world right now who would love access to these tests, and don’t have it. For most of human history these tests would have been welcome and wanted by women.

    I’m so glad I’m living in a time and place where I was able to get such great prenatal care and give birth in a hospital. I was never afraid I was going to die in childbirth.

    Kate thinks she knows better than people who are actually experts in this field. She’s what, done a lot of reading? I bet she doesn’t even really understand the studies she reads.

  • fiftyfifty1

    She’s on baby #6. That makes her a grand-multip. So she’s not low risk. That’s higher risk to both the baby and herself.

    • The Bofa on the Sofa

      Does that take age into account naturally, or is age a second consideration with grand-multips?

      I would assume a 30 yo on their 6th would be very different from a 40 yo on their 6th?

      • Young CC Prof

        Advanced age and large number of previous babies are independent risk factors, and they lead to different problems.

        • The Bofa on the Sofa

          But I bet they commonly happen together, esp for grand-mutlips.

      • cookiebaker

        I was 37 when I had my 6th (all hospital births.) With my last few babies, my labors needing to be augmented. I was told it’s because I’ve had so many babies, my uterine muscles have gotten worn out and don’t work as effectively.

        Also, there’s always a flurry of activity in the 3rd stage. No one has ever said the word hemorrhage, but they flood me with pitocin, mash on my stomach and stare at my nether region with concerned looks for a while. I’d be terrified to deliver at home without the means to control a potential PPH.

        My 5th was an emergency induction at 40w5d for low fluid and late decels on a NST. They had stripped my membranes, which started light contractions immediately, then hooked me to a NST and saw after every tiny contraction his heart rate was dropping just a bit, so I was sent for an immediate induction. Once I got an epidural, his heart rate settled, I slept all night and woke up fully dialated and delivered at 8:01.

        As a grand-multitip of advanced maternal age, I <3 modern medicine.

      • fiftyfifty1

        Yep, age and parity are different considerations and additive. A 40 yo grand-multip is different than a 30 yo grand multip (and different than a 40 yo non-grandmultip. )

    • Young CC Prof

      Hemorrhage, for example, especially if the babies were relatively close. One woman in the UK died at the unassisted birth of her sixth baby, ordinary PPH, would have been routine to save her in the hospital.

    • Empliau

      She’s also had a couple of miscarriages, if I remember correctly.

  • namaste863

    But doncha know? She’s such a speshul snowflake, nothing bad can possibly happen to HER!

  • kilda

    right, the tests don’t treat the problems, they FIND the problems. Then the doctors use evidence based medical care to treat the problems. What an idiot.

    My friend gave birth 3 months ago to a baby with Down syndrome and a heart defect. She’s damn glad she had the prenatal care that led to finding out these issues before he arrived, and enabled the doctors to give him lifesaving care as soon as he got here. If she had skipped prenatal care, or God forbid had the baby at home, there’s a good chance he would be dead, instead of recovering from life saving heart surgery.

    • LaMont

      Given that these loons believe that overly-monitored birth and early-infant “trauma” can severely affect people and turn them into violent, even warlike, maniacs, they probably think that babies who need *surgery* shortly after birth are just doomed to be a blight on society. Your friend’s and Jimmy Kimmel’s son will be the beginning of the end, apparently. Seriously, though, thank goodness for the care that is available today…

      • kilda

        yep, they weren’t meant to live and all that.

        • BeatriceC

          Their thinking is startlingly close to the idea of a “shredder” in Atwood’s “Handmaid’s Tale”.

          • mabelcruet

            The new Hulu production of the Handmaid’s Tale is currently showing on channel 4 in the UK (I think USA got it ages ago). Absolutely stunning production, horrible to watch-very dark, very true to the book. But its frightening that some of the aspects of life in Gilead are hitting fairly close to home and seem very plausible, -the patriarchal authoritarianism, the control of women, the male control of fertility. I’ve seen it happening in Ireland in certain areas.

    • Young CC Prof

      My cousin’s baby with hypoplastic left heart syndrome recently celebrated his fourth birthday. Thanks to the anatomy scan, he was born in a specialty hospital, getting exactly the right treatment the minute he was delivered and surgery a few days later. He’s developing well, still vulnerable to infections, but an awesome kid.

      • Liz Leyden

        My HLHS baby turned 3 back in March. Thanks to the anatomy scan, we were able to arrange her birth (I had to be transferred via helicopter) and surgery at a hospital 250 miles away.