Re: [ozmidwifery] vaginal ultrasounds

[Andrea Quanchi]

I can't believe that woman go along with this. It just shows how intimidated they are or socialised because if I new that was going to be expected I wouldn't go.
Andrea Quanchi
On Sunday, September 15, 2002, at 08:40 PM, Smith, Anne wrote:

Dear all,

I know of a few obstetricians who routinely do vaginal ultrasounds on women at their 6 week postnatal check up routinely to check to see if there was anything left in the uterus even though they have had an uneventful post natal period.  Does this occur anywhere else?  I think this is a violation of womens rights and abuse.  I actually feel sick and women do not question this practice.  What does everyone think?

Fiona Dunmore



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Re: [ozmidwifery] Vaginal ultrasounds

[Aviva Sheb'a]

for all the good it would do, they may as well 
stick it up...oh, forgive me!
aviva
- Original Message - 
From: Lynne 
Staff 
To: [EMAIL PROTECTED] 
Sent: Thursday, September 12, 2002 8:33 AM
Subject: Re: [ozmidwifery] Vaginal ultrasounds

I wonder what the hooha would be like if they 
invented an anal ultrasound to detect prostate enlargement - somehow I don't 
think many men would consent to its use

Re: [ozmidwifery] Vaginal ultrasounds

[Mary Murphy]

Unfortunately, women are sent straight to the Obs by their G.P as soon as 
they are aware they are pregnant.  Its like an assembly line.  
MM

  
  Mary this ob can't be very booked out if he can 
  see women as early as 12 weeks! WHat a worry
   

Re: [ozmidwifery] Vaginal ultrasounds

[Lynne Staff]

I wonder what the hooha would be like if they 
invented an anal ultrasound to detect prostate enlargement - somehow I don't 
think many men would consent to its use

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 10:54 
  PM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  Once again thanks for the info re Vag Ultrasounds.  I have a gut 
  feeling that this is a dangerous procedure for the foetus as it gets so close 
  to it and is not even " filtered" throught the abdominal fat and muscle. It is 
  also a gross invasion of a woman's body.  I wonder if the operator "gets 
  off" on it?  I also wonder about all the guff that goes on about how 
  accurate ultrasound dating is at any period of pregnancy.  I would like 
  all u/s  providers to have to keep and punlish  accurate and up to 
  date data on when the babies wered actually born in comparison to when u/s 
  predicted they were due.  MM
   

Re: [ozmidwifery] Vaginal ultrasounds

[Lynne Staff]

Mary this ob can't be very booked out if he can see 
women as early as 12 weeks! WHat a worry

  - Original Message - 
  From: 
  JoFromOz 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 9:33 
  AM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  They are routine where I work too... the obs use them to get 
  more accurate dating.  Eventhough most women know pretty much exactly the 
  date of their LNMP... he still does it, to make sure.
   
  Ack.
   
  Jo
  
- Original Message - 
From: 
Mary 
Murphy 
To: list 
Sent: Saturday, September 07, 2002 
10:47 AM
Subject: [ozmidwifery] Vaginal 
ultrasounds

There is an obstetrician in Perth who routinely performs vaginal 
ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
practice and what would the reasons be for such a practice? MM  
  

Re: [ozmidwifery] Vaginal ultrasounds

[Lynne Staff]

Unfortunately many women have come to expect a peek 
at every visit. I remember a woman at an antenatal session who queried what she 
was paying the money to her ob for when all he did was aske her how she was, and 
measured her belly with a tape  I told her she didn't know how lucky she 
was!!!

  - Original Message - 
  From: 
  Kirsten Blacker 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 1:10 
  AM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  I suppose it depends on why he is doing an US in 
  the first place?
  I've never understood the mentality of "taking a 
  peek' at every appointment. Doing the US vaginally rather than abdominally 
  just means you don't need to bother with a full bladder I expect.
   
  Kirsten
  
- Original Message - 
From: 
Mary 
Murphy 
To: list 
Sent: Friday, September 06, 2002 5:47 
PM
    Subject: [ozmidwifery] Vaginal 
ultrasounds

There is an obstetrician in Perth who routinely performs vaginal 
ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
practice and what would the reasons be for such a practice? MM  
  

RE: [ozmidwifery] Vaginal ultrasounds

[Ann green]

Dear List,
Having had the situation of needing a vaginal U/S for
gyno. problems I found Robyn Noble's description of
this being like "medical rape" ringing in my
ears!Anyone who does not think that this is an
accurate term has not had the experience.Fortunately
the results rule out fibroids, tumours,cancer and
cysts.However the womb is 30% larger than it should
be.So it is off to a gyno. next week.I asked the G.P.
for a referral to a woman gyno.I may need a D&C or
hyster/ony.Ann --- Sally Westbury
<[EMAIL PROTECTED]> wrote: > "Doing the US
vaginally rather than abdominally just
> means you don't
> need to bother with a full bladder I expect."
>  
> I think we need to be careful about thinking this is
> a 'just' situation.
> Having something place in my vagina is an incredibly
> intimate and
> private act. There is nothing just about it.. If you
> would just take
> your pants off, I'll just put this in your vagina. 
>  
> I guess this is just a slip of the keyboard, but if
> we are not careful
> about the use of language and how that empowers and
> disempowers then who
> will. Huge power issues here.
>  
> There is an incredible powerlessness if this became
> routine. I would
> rather have a full bladder than have a foreign
> object placed into my
> vagina by a doctor. Even if the doctor was someone I
> respected and
> trusted. I would still prefer not!
>  
> Sorry I'm ranting.
>  
> Sally Westbury
>  

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Re: [ozmidwifery] Vaginal ultrasounds

[Monica Hook]

  09/09/2002 at 0732 Debby wrote:
   
  -snip-
  However I personally would question how many women actually have 
  terminations at this stage even if they are told bubs condition is 
  fatal.
  -snip-
   
  Hi Debby,
  Where I work there is a small but steady trickle of families who have 
  made this heartbreaking decision and do terminate at 18-20 weeks based on 
  USS diagnoses, sometimes conditions that are "incompatable with life" and 
  other times with major cardiac or other abnormalities. A truly terrible 
  position to be in and not one that anyone can decide for them or ease for 
  them once the decision is made.
  Even though it's so awful I've not heard any of 
  them say they wish they hadn't known, or that they wouldn't have an 
  USS next pregnancy. Of course, we also have the families who choose to 
  continue the pregnancy knowing the heartbreak ahead of them; I don't know 
  which is harder.
  As this is a tertiary referral hospital we have our fair share of 
  babies born with abnormalities, purely from my personal observation it 
  seems to me that the parents and family cope better if they have 
  an idea of the likely course of events than if the abnormality comes as a 
  bolt from the blue. For that reason only I have no particular problem with 
  morphology scans though I prefer to use Mum's dates for maturity.
   
  Monica





	
	
	
	
	
	
	




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Re: [ozmidwifery] Vaginal ultrasounds

[Marilyn Kleidon]

Just goes to show how quickly the research changes. 
I just graduated and we were taught never to rely on any u/s other than a 
first trimester u/s for dating (and that only if the mom had no idea of dates as 
referred to previously). The research just 6 months ago was saying +/- 2weeks at 
18 - 20 weeks and +/- 1 week at 11-13 weeks. This was not because of the 
accuracy of the u/s but the then understood "fact" that in the first trimester 
there is little individual variation in size for most gestations that is most 8 
weeks pregnancies will have the same size sac, embryo etc. and so individual 
variation will have little or a small effect if any on size. So a relialable 
estimation of dates can be made based on size. However, from the first trimester 
individual variation takes over and not all 20 week fetuses will be the same 
size and so while the u/s sound measurement may be accurate to 1 week or even 
+/- 3 days, the variation in size due to genetics must also be taken into 
account. Please correct me if there is research to indicate that individual 
growth variations occur later in pregnancy than the 2nd trimester. This is why 
we were taught not to rely on later u/s (post 1st trimester) for dates if 
u/s was the dating method. Obviously this is a field that is changing very 
quickly. I agree that abdominal u/s for nuchal fold thickness should be the 
method of choice and vaginal u/s only used if resolution cannot be obtained, a 
decision the sonographer is qualified to make. Again continuity of care 
and  time in prenatals to discuss options with women is vital, reliance on 
technology really brings the issue of informed choice into focus.
marilyn

  - Original Message - 
  From: 
  Debby 
  M 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 2:27 
  PM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  
  
  Hi Marilyn and everyone,
  Ref the dating.  I checked with my other half who is a sonographer and 
  he agreed that US up to 20wks is accurate for dating.  He indicated that 
  US at 20wks was usually +/- 3 days, earlier than this it was +/- 5-7days 
  and later than this could vary considerably - especially in 3rd trimester 
  (hence the reason US is not a good predictor of fetal weight and birth size - 
  another scare tactic often used to encourage early induction or csec). 
   
  The problem with anatomical ultrasound of the fetus much before 18wks is 
  that fetal measurements are too small to diagnose some major deformities - 
  particularly of the heart and other organs - hence the recommendation for the 
  US at this stage.  However I personally would question how many women 
  actually have terminations at this stage even if they are told bubs condition 
  is fatal.
  You are quite right about nucal fold it is only relevant if done between 11 
  and 14 wks, but like all US is only an indicator of a risk not a definative 
  diagnosis.  He also indicated that a competent sonographer can get 
  an accurate nuchal fold measurement abdominally in over 90% of clients, it is 
  rare for them to have to do vaginal US - does this raise doubts about the 
  sonography competence of some of the OBs doing this procedure?  Maybe 
  they should leave it to those who do years of training in it - the 
  sonographers and radiologists - but then their own pockets wouldn't be lined 
  (cynical I know).
  But of course all these "facts" still don't seem to justify the argument 
  for routine early first trimester vaginal ultrasounds - so we really still 
  don't have a justifiable answer - except the power thing.
  Debby
  
  
  
  
  
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Re: [ozmidwifery] Vaginal ultrasounds

[Debby M]

Hi Marilyn and everyone,
Ref the dating.  I checked with my other half who is a sonographer and he agreed that US up to 20wks is accurate for dating.  He indicated that US at 20wks was usually +/- 3 days, earlier than this it was +/- 5-7days and later than this could vary considerably - especially in 3rd trimester (hence the reason US is not a good predictor of fetal weight and birth size - another scare tactic often used to encourage early induction or csec).  
The problem with anatomical ultrasound of the fetus much before 18wks is that fetal measurements are too small to diagnose some major deformities - particularly of the heart and other organs - hence the recommendation for the US at this stage.  However I personally would question how many women actually have terminations at this stage even if they are told bubs condition is fatal.
You are quite right about nucal fold it is only relevant if done between 11 and 14 wks, but like all US is only an indicator of a risk not a definative diagnosis.  He also indicated that a competent sonographer can get an accurate nuchal fold measurement abdominally in over 90% of clients, it is rare for them to have to do vaginal US - does this raise doubts about the sonography competence of some of the OBs doing this procedure?  Maybe they should leave it to those who do years of training in it - the sonographers and radiologists - but then their own pockets wouldn't be lined (cynical I know).
But of course all these "facts" still don't seem to justify the argument for routine early first trimester vaginal ultrasounds - so we really still don't have a justifiable answer - except the power thing.
Debby



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Re: [ozmidwifery] Vaginal ultrasounds and dating

[Meaghan Moon]

Hi Jo,
I agree that professionals (often docs) don't listen to mothers enough 
about dates of conception, instead relying on u/s dates.  And this is the 
beginning of negating the mother's experience and knowledge of her pregancy 
as far as I'm concerned.  Where I work an LMP date almost seems superfluous 
to the docs. However, I always feel like my job is easier when mothers are 
certain about their LMP dates and when they had intercourse.  Just a 
reminder though that the date of intercourse in not necessarily the date of 
conception.  Remember sperm can live up to seven days in the reproductive 
tract so there is still window of seven days where conception could 
occur.  That said, if a mother is certain of dates that is what I use for 
dating pregnancy over u/s. Just had to get in my .02 cents worth of 
biological info...

Meaghan Moon
Manitoba, Canada

At 11:57 AM 9/8/02 +0930, you wrote:
>With my last child the doctor whom I was seeing to get into the bc for a 
>vbac (yeah right!) asked me when my LNMP was and I was able to tell him 
>the date we conceived.  He questioned that and said "I think you are a 
>couple of weeks out there".  Now my hubby had gone to Sydney for a few 
>weeks and we only has sex once before he left and due the limited 
>opportunity allowed by our other children, the time before was a long and 
>distant memory(imposed celibacy or sibling contraception don't you 
>love it!  I am sure it is just a survival technique to ensure no more rivals!)
>ANYWAY..this doctor would not take the fact that I knew when I 
>conceived so I ended up asking him if he was hiding under the bed when 
>Dean and I had sex?  He went red and promptly went on to tell me that "I 
>didn't look good on paper to be in the birth centre"
>WHAT IS IT WITH PROFESSIONALS NOT ACCEPTING THAT SOMETIMES THEY CAN BE 
>WRONG?
>on the topic of Vag US, there is a private OB here who has an astronomical 
>cs rate and surprise surprise she gives vag US every visit...
>Jo Bainbridge
>founding member CARES SA
>email: <mailto:[EMAIL PROTECTED]>[EMAIL PROTECTED]
>phone: 08 8388 6918
>birth with trust, faith & love...
>- Original Message -
>From: <mailto:[EMAIL PROTECTED]>Justine Caines
>To: <mailto:[EMAIL PROTECTED]>OzMid List
>Sent: Sunday, September 08, 2002 11:17 AM
>Subject: Re: [ozmidwifery] Vaginal ultrasounds
>
>They are routine where I work too... the obs use them to get more accurate 
>dating.  Eventhough most women know pretty much exactly the date of their 
>LNMP... he still does it, to make sure.
>Ack.
>Jo
>Hi Jo and all
>
>Another furphy I suggest, as a vaginal US would be able to estimate the 
>size of the foetus better I assume but still only place it against the 
>averages of gestational sizes that US is based on, hence the +/- 2 weeks 
>stuff.  The routine totally unnecessary use of US is the catalyst to the 
>induction craze.  Women must be told their due date, hang knowing their 
>own body, just throw it into the computer of averages!!
>
>As a consumer I get so sick of women needing to be told  everything, 
>totally discounting their role as the maker and birther of a baby!!  At 
>the same time I m branded as a lunatic for taking responsibility of my 
>body and baby.  Funny thing is that after this total abdication of 
>responsibility in pregnancy and birth women are meant to fit back into 
>society as normal citizens taking responsibility for themselves and baby 
>(is this why we have so many post natal problems, women are lulled into a 
>false sense of security and then on Day 6 postnatally whammo!). The notion 
>of personal responsibility totally consistent with health policy for the 
>last 10 years, but policy makers and governments refuse to hold obstetrics 
>to account.
>
>I sincerely hope we are at the edge with the current PI crisis and NMAP 
>helping to transform maternity services in this country.
>
>A little rattled this morning
>
>Justine
>Mum and responsible for Ruby nearly 3, Clancy 18 months and Will 2 months


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Re: [ozmidwifery] Vaginal ultrasounds

[P & A Koziol]

 
That's a great idea and one which would certainly 
validate the "need" for this early invasive procedure. 
Another U/S practice which has been creeping in 
over this side of the continent (and please share if it is happening in your 
neck of the woods) is the abdo U/S at each antenatal visit from around 38 weeks. Why you ask? Well so did I.  And the answer 
that I'm being given is for the Dr to check the position of the baby. Now 
pardon my cynicism but that's what I thought an abdominal palpation was all 
about
 
Cheers
 
Alesa
 
Alesa KoziolClinical Midwifery EducatorMelbourne

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 10:54 
  PM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  Once again thanks for the info re Vag Ultrasounds.  I have a gut 
  feeling that this is a dangerous procedure for the foetus as it gets so close 
  to it and is not even " filtered" throught the abdominal fat and muscle. It is 
  also a gross invasion of a woman's body.  I wonder if the operator "gets 
  off" on it?  I also wonder about all the guff that goes on about how 
  accurate ultrasound dating is at any period of pregnancy.  I would like 
  all u/s  providers to have to keep and punlish  accurate and up to 
  date data on when the babies wered actually born in comparison to when u/s 
  predicted they were due.  MM
   

Re: [ozmidwifery] Vaginal ultrasounds

[Mary Murphy]

Once again thanks for the info re Vag Ultrasounds.  I have a gut 
feeling that this is a dangerous procedure for the foetus as it gets so close to 
it and is not even " filtered" throught the abdominal fat and muscle. It is also 
a gross invasion of a woman's body.  I wonder if the operator "gets off" on 
it?  I also wonder about all the guff that goes on about how accurate 
ultrasound dating is at any period of pregnancy.  I would like all 
u/s  providers to have to keep and punlish  accurate and up to date 
data on when the babies wered actually born in comparison to when u/s predicted 
they were due.  MM
 

Re: [ozmidwifery] Vaginal ultrasounds

[Marilyn Kleidon]

Hi Debby: It is my understanding that only u/s in 
the first trimester is accurate enough to give reliable dates with u/s (I only 
repeated that becauseI firmly believe that the woman is the most reliable source 
however sometimes the mum doesn't know: irregular menses or lactation ammenohrea 
(sp) and (amazingly) frequent intercourse and so, if dates are going to be an 
issue (postdate protocols) then a first trimester u/s may be justified. I 
think the 20 week u/s may be the one that is deleted because if the mum is 
interested in nuchal fold thickness then (I think) the optimal time is either 11 
weeks or 14 weeks (I can't remember which one, but there is an article in the 
BIRTH journal on this 2000 or 2001) definetly not 20 weeks. So, if this nuchal 
fold thickness measurement is important for clients regarding continuation of 
the pregnancy, then I guess a first trimester vaginal u/s is required. I 
shuddered when I saw my first vaginal probe. I guess there is no way to make 
them differently (they just are very phallic) which is why great 
sensitivity must be employed by caregivers using them. The 20 weeks u/s has been 
used for scanning fetal anatomy for anomalies but is not reliable for dating. I 
peronally don't advise any of this without a medical concern, but, women need to 
be aware of all available services and so we do discuss these options too. 
marilyn

  - Original Message - 
  From: 
  Debby 
  M 
  To: [EMAIL PROTECTED] 
  
  Sent: Saturday, September 07, 2002 11:28 
  PM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  
  
  Hmmm - ultrasounds to confirm womens dates this early on - I 
  thought that the 20wk ultrasound was supposed to do this.  Surely 20wks 
  notice is sufficient of an impending birth if the OB wants an accurate 
  date?  And this way the woman would only "have to have" one ultrasound in 
  her pregnancy - maybe a pertinent argument as there seems to be some 
  (questionable) link between autism and frequent ultrasounds.  I wonder if 
  they would change their minds if this link was proven or if someone just tried 
  to sue on the suspected risk anyway.  After all they are all scared of 
  being sued for cerebal palsy caused by birth injury even though the evidence 
  these days is that this condition is more likely a defect in formation than a 
  problem caused by birth.
   
  Debby
   
   
  
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Re: [ozmidwifery] Vaginal ultrasounds

[Debby M]

Hmmm - ultrasounds to confirm womens dates this early on - I thought that the 20wk ultrasound was supposed to do this.  Surely 20wks notice is sufficient of an impending birth if the OB wants an accurate date?  And this way the woman would only "have to have" one ultrasound in her pregnancy - maybe a pertinent argument as there seems to be some (questionable) link between autism and frequent ultrasounds.  I wonder if they would change their minds if this link was proven or if someone just tried to sue on the suspected risk anyway.  After all they are all scared of being sued for cerebal palsy caused by birth injury even though the evidence these days is that this condition is more likely a defect in formation than a problem caused by birth.
 
Debby
 
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Re: [ozmidwifery] Vaginal ultrasounds

[Debby M]

Hmmm - ultrasounds to confirm womens dates this early on - I thought that the 20wk ultrasound was supposed to do this.  Surely 20wks notice is sufficient of an impending birth if the OB wants an accurate date?  And this way the woman would only "have to have" one ultrasound in her pregnancy - maybe a pertinent argument as there seems to be some (questionable) link between autism and frequent ultrasounds.  I wonder if they would change their minds if this link was proven or if someone just tried to sue on the suspected risk anyway.  After all they are all scared of being sued for cerebal palsy caused by birth injury even though the evidence these days is that this condition is more likely a defect in formation than a problem caused by birth.
 

Debby

 

 
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Re: [ozmidwifery] Vaginal ultrasounds

[Jo & Dean Bainbridge]

Title: Re: [ozmidwifery] Vaginal ultrasounds



With my last child the doctor whom I was seeing to 
get into the bc for a vbac (yeah right!) asked me when my LNMP was and I was 
able to tell him the date we conceived.  He questioned that and said "I 
think you are a couple of weeks out there".  Now my hubby had gone to 
Sydney for a few weeks and we only has sex once before he left and due the 
limited opportunity allowed by our other children, the time before was a 
long and distant memory(imposed celibacy or sibling contraception don't you 
love it!  I am sure it is just a survival technique to ensure no more 
rivals!)
ANYWAY..this doctor would not take the fact 
that I knew when I conceived so I ended up asking him if he was hiding under the 
bed when Dean and I had sex?  He went red and promptly went on to tell me 
that "I didn't look good on paper to be in the birth centre"
WHAT IS IT WITH PROFESSIONALS 
NOT ACCEPTING THAT SOMETIMES THEY CAN BE WRONG?  
on the topic of Vag US, there is a private OB here 
who has an astronomical cs rate and surprise surprise she gives vag US every 
visit...
Jo Bainbridgefounding member CARES SAemail: [EMAIL PROTECTED]phone: 08 
8388 6918birth with trust, faith & love...

  - Original Message - 
  From: 
  Justine Caines 
  To: OzMid List 
  Sent: Sunday, September 08, 2002 11:17 
  AM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  They are routine where I work 
too... the obs use them to get more accurate dating.  Eventhough most 
women know pretty much exactly the date of their LNMP... he still does it, 
to make sure.Ack.Jo
Hi Jo and allAnother furphy I 
  suggest, as a vaginal US would be able to estimate the size of the foetus 
  better I assume but still only place it against the averages of 
  gestational sizes that US is based on, hence the +/- 2 weeks stuff. 
   The routine totally unnecessary use of US is the catalyst to the 
  induction craze.  Women must be told their due date, hang knowing 
  their own body, just throw it into the computer of averages!!As a 
  consumer I get so sick of women needing to be told  everything, 
  totally discounting their role as the maker and birther of a baby!! 
   At the same time I’m branded as a lunatic for taking responsibility 
  of my body and baby.  Funny thing is that after this total abdication 
  of responsibility in pregnancy and birth women are meant to fit back into 
  society as normal citizens taking responsibility for themselves and baby 
  (is this why we have so many post natal problems, women are lulled into a 
  false sense of security and then on Day 6 postnatally whammo!). The notion 
  of personal responsibility totally consistent with health policy for the 
  last 10 years, but policy makers and governments refuse to hold obstetrics 
  to account. I sincerely hope we are at the edge with the current 
  PI crisis and NMAP helping to transform maternity services in this 
  country.A little rattled this morningJustineMum and 
  responsible for Ruby nearly 3, Clancy 18 months and Will 2 
  months

Re: [ozmidwifery] Vaginal ultrasounds

[Justine Caines]

Title: Re: [ozmidwifery] Vaginal ultrasounds



They are routine where I work too... the obs use them to get more accurate dating.  Eventhough most women know pretty much exactly the date of their LNMP... he still does it, to make sure.
 
Ack.
 
Jo

Hi Jo and all

Another furphy I suggest, as a vaginal US would be able to estimate the size of the foetus better I assume but still only place it against the averages of gestational sizes that US is based on, hence the +/- 2 weeks stuff.  The routine totally unnecessary use of US is the catalyst to the induction craze.  Women must be told their due date, hang knowing their own body, just throw it into the computer of averages!!

As a consumer I get so sick of women needing to be told  everything, totally discounting their role as the maker and birther of a baby!!  At the same time I’m branded as a lunatic for taking responsibility of my body and baby.  Funny thing is that after this total abdication of responsibility in pregnancy and birth women are meant to fit back into society as normal citizens taking responsibility for themselves and baby (is this why we have so many post natal problems, women are lulled into a false sense of security and then on Day 6 postnatally whammo!). The notion of personal responsibility totally consistent with health policy for the last 10 years, but policy makers and governments refuse to hold obstetrics to account. 

I sincerely hope we are at the edge with the current PI crisis and NMAP helping to transform maternity services in this country.

A little rattled this morning

Justine
Mum and responsible for Ruby nearly 3, Clancy 18 months and Will 2 months

Re: [ozmidwifery] Vaginal ultrasounds

[JoFromOz]

They are routine where I work too... the obs use them to get 
more accurate dating.  Eventhough most women know pretty much exactly the 
date of their LNMP... he still does it, to make sure.
 
Ack.
 
Jo

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: list 
  Sent: Saturday, September 07, 2002 10:47 
  AM
  Subject: [ozmidwifery] Vaginal 
  ultrasounds
  
  There is an obstetrician in Perth who routinely performs vaginal 
  ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
  practice and what would the reasons be for such a practice? MM  

RE: [ozmidwifery] Vaginal ultrasounds

[Ken Ward]

Vaginal ultrasounds give a clearer picture, but why ultrasound 
everyone?  Look at what he is charging for this service. I once worked with 
a GP who was off on a O/S holiday. He did an awful lot of CTG's in the weeks 
leading up to departure. We discovered that he was charging for us doing the 
CTG's  [at a public hospital] and then charging to 'read' them. Seeing as 
how they never left the unit, we would ring him to say they were ok, [all were] 
we figured he was making spending money. We soon dobbed him 
in.   Maureen  -Original Message-From: 
[EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED]]On Behalf Of Mary 
MurphySent: Saturday, September 07, 2002 10:47 AMTo: 
listSubject: [ozmidwifery] Vaginal ultrasounds

  There is an obstetrician in Perth who routinely performs vaginal 
  ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
  practice and what would the reasons be for such a practice? MM  

Re: [ozmidwifery] Vaginal ultrasounds

[Debby M]

This is probably a bit of an agressive attitude - but if there is no clinical justification for his practice, such as those suggested by the other ladies (IVF confirmations, suspected ectopic, etc) then isn't this tantamount to a form of sexual abuse - disguised but surely any procedure that is that "intimate" that is done without justifiable medical reason just can't be right.
I have only ever had one vaginal ultrasound in my life and that was for suspected ectopic and in that case it was done on OB referral to a qualified sonographer who first did an abdominal to see what she could view that way.  Even abdominally at 5wks gestation she was able to eliminate ectopic but did suspect a placental bleed.  She asked my permission to do the TV and explained why (the abdominal picture for such a small gestation is not clear) and I gave her permission - fortuneately it was just a small implantion bleed next to the gestation site and I am about to give birth to the baby any day - but this protocol seems much more professional than that which the OB in Perth seems to be doing.
If there is suspicion of suspected covert sexual abuse his actions should be reported to the AMA and the police.
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RE: [ozmidwifery] Vaginal ultrasounds

[Judy Chapman]

I feel as you do Sally. Was in the situation many years ago when I went for USS for a gynae problem and finished up with a totally unexpected vaginal USS. Felt violated. This was in a private radiology practice. 
Next time I was ready, it was in a public hospital and I was more prepared. Well handled by the staff. The male sonographer went out of the room and the RN gave me the probe so I could insert it myself under the covers. He then came back and reached under the covers to be able to direct it as necessary. A much less traumatic experience where I felt my dignity was more respected. 
Judy




From: "Sally Westbury" <[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED] 
To: <[EMAIL PROTECTED]>
Subject: RE: [ozmidwifery] Vaginal ultrasounds 
Date: Sat, 7 Sep 2002 21:32:04 +0800 

"Doing the US vaginally rather than abdominally just means you don't 
need to bother with a full bladder I expect." 

I think we need to be careful about thinking this is a 'just' situation. 
Having something place in my vagina is an incredibly intimate and 
private act. There is nothing just about it.. If you would just take 
your pants off, I'll just put this in your vagina. 

I guess this is just a slip of the keyboard, but if we are not careful 
about the use of language and how that empowers and disempowers then who 
will. Huge power issues here. 

There is an incredible powerlessness if this became routine. I would 
rather have a full bladder than have a foreign object placed into my 
vagina by a doctor. Even if the doctor was someone I respected and 
trusted. I would still prefer not! 

Sorry I'm ranting. 

Sally Westbury 
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RE: [ozmidwifery] Vaginal ultrasounds

[Sally Westbury]

“Doing the US vaginally
rather than abdominally just means you don't need to bother with a full bladder
I expect.”

 

I think we need to be careful about thinking this is a ‘just’
situation. Having something place in my vagina is an incredibly intimate and
private act. There is nothing just about it.. If you
would just take your pants off, I’ll just put this in your vagina. 

 

I guess this is just a slip of the keyboard, but if we are
not careful about the use of language and how that empowers and disempowers then who will. Huge power issues here.

 

There is an incredible powerlessness if this became routine.
I would rather have a full bladder than have a foreign object placed into my
vagina by a doctor. Even if the doctor was someone I respected and trusted. I
would still prefer not!

 

Sorry I’m ranting.

 

Sally Westbury

Re: [ozmidwifery] Vaginal ultrasounds

[Mary Murphy]

Thank you for your replies.  I actually think we have none of those 
very valid reasons.  It makes me want to ring him up and object, or put a 
sign up outside his offices,  but I know it wouldn't be a good strategy, 
even for me.  MM

  - Original Message - 
  From: 
  Marilyn 
  Kleidon 
  To: [EMAIL PROTECTED] 
  
  Sent: Sunday, September 08, 2002 5:30 
  AM
  Subject: Re: [ozmidwifery] Vaginal 
  ultrasounds
  
  The most common reason I have found for early u/s 
  is infertility. I had a couple of clients in the Seattle who were undergoing 
  fertility treatment and they had weekly u/s plus serial HCG titres done by the 
  fertility clinic routinely. These were IVF clients I seem to recall. Both of 
  these ladies transferred care to our midwifery clinic once their pregnancy was 
  established. For one of these women the u/s had become very reassuring so when 
  at 10 weeks we were unable to detect a heartbeat with a doppler (also u/s , I 
  know) she requested being sent back to the clinic for a vaginal u/s despite 
  our advice, all was ok and she went on to have a lovely birth. So, maybe this 
  OB is a fertility specialist? The only other reasons I know of for doing a 
  Vaginal u/s would be suspicion of an ectopic pregnancy and to accurately date 
  the pregnancy for an abortion. marilyn
  
- Original Message - 
From: 
Mary 
Murphy 
To: list 
Sent: Friday, September 06, 2002 5:47 
PM
Subject: [ozmidwifery] Vaginal 
ultrasounds

There is an obstetrician in Perth who routinely performs vaginal 
ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
practice and what would the reasons be for such a practice? MM  
  

Re: [ozmidwifery] Vaginal ultrasounds

[Marilyn Kleidon]

The most common reason I have found for early u/s 
is infertility. I had a couple of clients in the Seattle who were undergoing 
fertility treatment and they had weekly u/s plus serial HCG titres done by the 
fertility clinic routinely. These were IVF clients I seem to recall. Both of 
these ladies transferred care to our midwifery clinic once their pregnancy was 
established. For one of these women the u/s had become very reassuring so when 
at 10 weeks we were unable to detect a heartbeat with a doppler (also u/s , I 
know) she requested being sent back to the clinic for a vaginal u/s despite our 
advice, all was ok and she went on to have a lovely birth. So, maybe this OB is 
a fertility specialist? The only other reasons I know of for doing a Vaginal u/s 
would be suspicion of an ectopic pregnancy and to accurately date the pregnancy 
for an abortion. marilyn

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: list 
  Sent: Friday, September 06, 2002 5:47 
  PM
  Subject: [ozmidwifery] Vaginal 
  ultrasounds
  
  There is an obstetrician in Perth who routinely performs vaginal 
  ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
  practice and what would the reasons be for such a practice? MM  

Re: [ozmidwifery] Vaginal ultrasounds

[jireland]

Mary I have noticed that the u/s person who has 
been and remains the person  I refer women to is doing more and more 
vaginal u/s when there is a problem ie not a good veiw etc but always after 
asking the woman who often declines.
But as a routine sounds very unusal 
practise. jan 

  - Original Message - 
  From: 
  Mary 
  Murphy 
  To: list 
  Sent: Saturday, September 07, 2002 10:47 
  AM
  Subject: [ozmidwifery] Vaginal 
  ultrasounds
  
  There is an obstetrician in Perth who routinely performs vaginal 
  ultrasound in his rooms before 12 weeks gest.  Is this an accepted 
  practice and what would the reasons be for such a practice? MM  

[ozmidwifery] Vaginal ultrasounds

[Mary Murphy]

There is an obstetrician in Perth who routinely performs vaginal ultrasound 
in his rooms before 12 weeks gest.  Is this an accepted practice and what 
would the reasons be for such a practice? MM