Posted by My OB said WHAT?!?.
Jul
4
Posted by My OB said WHAT?!?.
“Well, You’ve Certainly Got A Lot Of Hard Thinking To Do…”
“Well, you’ve certainly got a lot of hard thinking to do, don’t you?” – ultrasound technician, after handing the mother a report of her increased risk for chromosomal abnormalities after her ultrasound scan showed a thicker than normal nuchal translucency.
There are 25 comments to this post.
It sounds to me like a lack of compassion. How about, “I’m sorry the results aren’t as good as we’d have liked. I know you’ll be thinking about this a lot as you make decisions for your baby.”
This is just a screening test after all, not a diagnostic test. No one should decide about termination on the basis of a nuchal translucency screening. But too many times, the OBs and the techs seem to think of their job as “search and destroy” missions and to them it’s a catch when they find a problem; to the mom, it’s her baby’s future. Some compassion is called-for.
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what’s the tech doing commenting?! i mean, our tech showed us things like “this is the nose, and these are the toes” and “there’s the boy shot” but beyond that… not so much.
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Gem Reply:
July 6th, 2010 at 5:51 am (Quote)
That’s my first thought — I thought they were prohibited professionally from commenting at all in case of lawsuits. ONLY a doctor or midwife is supposed to interpret the data. Which then again ticks many people off, that the tech can’t just give them the info. In any case, this tech was unprofessional all the way around.
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The reason I don’t like this isn’t because of what was said, but who said it. Its not the tech’s business to advise Mom on anything. My tech (and she was in the birth center where I went for prenatal/L&D) couldn’t say a thing other than “Would you like to know the gender? It looks like a __. Congratulations, would you like pictures too?” Anything else came from the OB. I realize that they probably don’t have any more compassion, but its at least their job to let us know the risks.
By the way.. possible termination based on the results of said screenings is why I denied those screenings. The way the CNP at my OB’s office spoke of it “Some people decide to terminate based on these results, wouldn’t you want to know?” just disgusted me. Don’t misunderstand, people who make that hard choice do NOT disgust me, it was the CNP that did that with her tone and choice of words.
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Jane Reply:
July 4th, 2010 at 5:36 pm (Quote)
You know, you just made me wonder: was this the first indication from the tech that something was wrong??? Because if the mom already knew something was afoot, it’s not terrible-awful. But if he handed her the report after an apparently fine ultrasound and said that, that’s just sadistic.
My ultrasound techs were not allowed to say anything about what they were scanning, including “The skull is all there.” Really.
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Cmat Reply:
July 4th, 2010 at 6:51 pm (Quote)
Exactly.. I know the tech was taking down all kinds of info, but she walked me through a lot of it even though it was somewhat obvious. The feet, belly, head, hands, face, money shot for gender (lol) etc. At the end of it when she handed me my pictures and (thank GOD) let me go pee finally she just said “Your doctor will discuss any information or questions with you at your next appointment, congratulations again!”
I just don’t think it was the tech’s place. The mom may have family history or prior experience (other children or other ultrasounds) to go off of but the tech didn’t need to be the harbinger of doom. That’s the dreaded OB’s job.
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Jane1973 Reply:
July 4th, 2010 at 6:47 pm (Quote)
I have a lovely, healthy 4 wekk old little boy at the moment. When we got our first results with the nuchal scan, they indicated that he had a high chance of trisomy 18 and 21, and urged us the go have an amnio done.
‘
I refused to do this because I wouldn’t terminate anyway, and the test runs the risk of miscarriage. I also suspected that the results were a false positive, based on the tech’s bad attitude, and the fact that she rushed through the scan as she obviously wanted to be somewhere else!
We also had an OB tell us there was no point in doublechecking, because “these things are rarely wrong” We had the results check by the Womens and Childrens’ hospital anyway..and guess what?? The stupid tech had not only done a shoddy job of the scan, she’d also made a typo when writing the report, and the results were normal.
Our Son was born at home 4 weeks ago:)
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Cmat Reply:
July 4th, 2010 at 6:55 pm (Quote)
Congratulations on that baby boy!
I forgot what the numbers are, but from what I have been told there IS a high false positive rate with the quad screenings and all of that good stuff. I’m sure I have the flyer and info somewhere because I never throw anything away like that!
A co-worker who was pregnant at the same time I was had the screenings done because her family had a history of downs syndrome. They gave her a certain percentage chance that was apparently very high. She was very upset about it. She now has a 16 and a half month old baby girl who is perfect in every way. She would have been perfect in every way even if she had ended up with downs though.
I just figured I didn’t need the added stress. Not to mention, I’m adopted and don’t know any of my family’s medical history. What’s the point!? 
Congratulations again!
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Meghan Reply:
July 5th, 2010 at 5:59 am (Quote)
Part of informed consent, is understanding the error (therefore also the false positive rate and false negative rate) of a screening/test. My OB (before I switched to midwives), was offering the all the early screening tests. I asked about the error of these tests and got the answer, “it’s small.” Umm, not an answer. No medical professional should offer a test if they don’t understand it (the magic box mentality – I put X in and “magically” get Y…something that was drummed out of me during my undergrad days, if you don’t know what an instrument does don’t use it!) A result is meaningless if you don’t understand it’s limitations.
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We also had an OB tell us there was no point in doublechecking, because “these things are rarely wrong”
WTH? It’s a screening test! All it’s supposed to do is figure out which women would benefit from more invasive and more comnclusive tests.
From Pregnancy-ETC:
A nuchal scan will correctly detect the abnormality in about 80% of pregnancies with Down syndrome babies. Used in conjunction with other screening tests such as an amniocentesis or CVS, this rate increases to 90%
BabyCenter.com gives similar numbers:
http://www.babycenter.com/0_nuchal-translucency-screening_118.bc?page=4#articlesection7
How does ten to twenty percent wrong equal “rarely wrong”? I’m sorry you had to deal with such idiocy, and congrats on your son!
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This is mine. The tech was already pissed off because it had taken her along time to get the measurement, and there were people waiting for the next appointment. When she finally got it, she barked, “that’s definitely abnormal” and told me and DH to wait in the waiting room so she could put the numbers into the computer to get the actual risk assessment. The above quote is what she said to me as she handed me that report 5 minutes later in front of the other people waiting.
I was too shell-shocked by the results to tell her how out of line I thought she was. I did feel it was patronizing, as if I was somehow too dense to understand the seriousness of the risk, and she wasn’t my care provider, so it really wasn’t her business to comment anyway, esp in front of others. I almost felt like she was chiding me for something I’d done wrong and now had to go and reflect on my actions.
I did write a letter of complaint to the radiology practice later, and they apologized.
Needless to say, I have learned my lesson about prenatal screening and the tentative pregnancy experience, and it’s not one I plan to repeat in the future.
And my daughter is a 46XX and perfectly healthy except for the bruise on her forehead from learning to walk.
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Cmat Reply:
July 5th, 2010 at 5:48 am (Quote)
She sounds like a pita. As though its your fault they overbooked her??
I’m glad you wrote a letter of complaint and made them at least acknowledge what they (she) did. I don’t think she had any business commenting to you in the first place.
As for the bruises.. yeah we have a few of those here with my 16 month old. A few new ones every day lol.
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Sarah Dorrance-Minch Reply:
July 5th, 2010 at 6:20 am (Quote)
The technician needs to find a new line of work if she feels a need to get into pissing contests with the patients, or can’t handle a fast pace.
So glad things turned out well. (Including actually getting the technician reprimanded and a letter of apology from the radiology clinic, although it’s probably easier to get low-status technicians reprimanded than high-ranked doctors, if someone has given offense.) My goodness.
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Tara Reply:
July 5th, 2010 at 8:49 am (Quote)
Wow, I’m sorry you had this experience. She was completely out of line.
OTOH, I have never heard the phrase, “tentative pregnancy experience” before and I love it. Off to google…
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Jane Reply:
July 5th, 2010 at 9:09 am (Quote)
There’s a book written after the advent of amniocentesis called The Tentative Pregnancy which explores the changes in our perception of motherhood when the right to be born becomes conditional on passing certain tests. The author says that every pregnancy becomes tentative and parents delay their emotional bonding until the child proves himself worthy of the parents’ energy and time, and she speculates on how that impacts the way we love and parent our children.
It’s a very interesting book, even if you don’t agree with her premise.
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The Deranged Housewife had this to say,
Jul 5, 2010 @ 7:48 am (Quote)
“Most definitely! Like, breastfeed or bottle feed? Should I paint the nursery green or yellow? Bradley classes or Lamaze? Yep, a LOT of hard thinking!”
Good Lord. This tech is SOOOOO out of her freaking’ league.
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I got results like those. I did have a lot to think about. Did I want my baby to die on his own, or did I want to deliver him early and maybe get to meet him alive (we chose the latter). I know the terror of now knowing something is wrong, but not knowing what or what it means. To have an ultrasound tech speak to me in such a degrading manner would only have worsened my agony. My ultrasound took a long time too, and you know what? My tech wasn’t rude, in fact she looked pretty sad for us.
I’m glad you complained, and I’m even more glad your daughter is okay.
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This is quite timely for me, since I just underwent a termination of my pregnancy after a very bad diagnosis at ultrasound, later confirmed by a specialist at a second ultrasound.
The tech at the first ultrasound simply showed us what she had seen, that it could indicate a problem. She said that she was not an expert and not able to diagnose a specific problem but that we should seek expert advice. No mention of anything else or hard thinking. Ultrasound techs are trained to spot potential problems but the way this is handled is poor, talking about possible choices should be left to the trained specialist.
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I’d rather a tech tell me there ‘might’ be something wrong (but to get it checked by a doctor to be sure) than to walk out of the ultrasound not knowing much more than when I walked in.
I’m not in any high risk category but if there IS something wrong, TELL ME! 99% chance I wouldn’t abort (1% would be an unfixable problem causing severe fetal pain) but I sure as heck want to know what to expect.
Of course the way this tech did it… ugh. She needs to get a job where she doesn’t have to deal with people.
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Add Your Comment.
Well, she does? I realize a lot of ppl are not for termination. I personally, am completely against it, but how would an u/s tech know that? Even if you do decide to keep a baby, you could still get help from counseling or a clergyman – as bringing home a special needs baby can be very difficult. I don’t see this as “bad” at all.
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MK Reply:
July 4th, 2010 at 4:41 pm MK(Quote)
Agreed, but… its just one of those things that doesn’t need to be said. For one thing it does imply that she should consider aborting, and even if someone is ok with that (I’m not either) that person would know she’d have to decide whether to or not, and someone who’s not ok with it would know that she needs to think about how she’s going to handle things. It just didn’t need to be said.
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Candyg Reply:
July 4th, 2010 at 6:13 pm Candyg(Quote)
For me, there is no option, but even for those who would consider abortion, this comment is out of line. I have had an ultrasound come back with a possible problem, it was the midwife that told me, not the us tech.
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MK Reply:
July 4th, 2010 at 6:15 pm MK(Quote)
Exactly what I was trying to say. I’m sorry you went through that btw.
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