Posted by My OB said WHAT?!?.
Aug
16
Posted by My OB said WHAT?!?.
“So, Are You Excited To Be Having A Boy?”
“So, are you excited to be having a boy?” Medical staff reading ultrasound report to couple who had indicated not wanting to know the gender of their baby, during the follow up appointment after the ultrasound.
There are 58 comments to this post.
“Not as excited as I would have been had you read the whole report.”
What’s the mechanism for transmitting that information to the medical staff? Because in an OB practice with 3 doctors and 5 nurse practitioners, I can see how the parents’ wishes might not get transmitted from one to the next between appointments. Similarly, if the parents tell the sonographer they don’t want to know the gender, but the sonographer records that information on the report, is there a standard way to indicate to the practice that the parents do not want the gender revealed?
BTW, this makes me nuts because during pregnancies following the one where my baby had anencephaly, the sonographers were “Not allowed” to tell me any information during the scan, including “That’s the skull. You can see the whole thing is there.” They said I might sue if they said the baby was fine and then I went upstairs for the read five minutes later and the baby was actually not fine. I couldn’t sign a waiver to dismiss that mistaken notion. (The first time, I read the report myself in the elevator.)
So they’re very good at not letting patients know what they do want to know. But when the parents don’t want to know something, how is that desire conveyed through the practice.
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Michelle Reply:
August 16th, 2010 at 12:29 pm (Quote)
At the place I got my ultrasound done, they didn’t indicate gender on the paperwork. Instead, in that section, they put “Parents do not wish to know sex”. I was grateful, because it prevented just this sort of problem. And also because I read my paperwork on the way home (had to go to a nearby major hospital because my base hospital doesn’t have 3D capabilities and they needed 3D to rule out a birth defect that I myself had) and I would have been upset if I’d stumbled across the sex because I was too dumb to think that might be in there.
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Christen Reply:
August 16th, 2010 at 1:00 pm (Quote)
A tech usually isn’t trained to read, only perform the ultrasound and a different person actually writes up the report (a Radiologist). The Techs know what to look for and measure, but they are NOT trained to tell you what anything means.
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Helen Reply:
August 19th, 2010 at 5:09 pm (Quote)
I am normally just a lurker but thought you may find it helpful to know a little more about this ultrasound thing from the other side. My mom is an ultrasound tech at a largish hospital in the Chicago suburbs.
Every time she alludes to anything she sees on the screen to a patient, she risks losing her license/certification. Telling the patient about what she sees is legally considered practicing medicine without a license. She can see and knows what is going on in front of her, the good, bad and ugly. In fact many (most) times the radiologists have her assign diagnostics for their reports. But legally only a licensed medical professional (dr, midwife, LPN, etc) can give the patient that information. Sure people skirt the rules often (even telling a patient the gender of their baby is technically breaking the law) but when the risk is high for litigation or acute illness/injury ultrasound techs are highly unlikely to risk their career.
Good for you reading your report on your own though! Those documents belong to you!
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Jane Reply:
August 20th, 2010 at 3:59 am (Quote)
To be clearer, I don’t blame the ultrasound techs for not saying, “The baby’s skull is all there.” I blame the hospital regulations for establishing that they couldn’t.
You wrote;
{In fact many (most) times the radiologists have her assign diagnostics for their reports. But legally only a licensed medical professional (dr, midwife, LPN, etc) can give the patient that information. }
And that’s why the regulation is SO STUPID. Because I would bet your mom knows more about how to operate and read the ultrasound machine than my midwife ever will, and my midwife — or my OB, or the LPN, or whomever — is not going to repeat the ultrasound or go back and look at the actual films.
They’re going to read the report to the patient, which means, effectively, your mom or another tech has “made the diagnosis,” regardless of which individual pronounces the words, because all that’s changing is whose mouth says the words.
That’s why I find the regulation ridiculous.
Your mother’s job *shouldn’t* be in jeopardy if she says “The femur length is X inches, which is just right for a gestation age of 14 weeks 3 days, and when I measure the skull, it’s X inches, which is also what you’d expect on a fetus of 14.3 days.”
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That is so sad that they wouldn’t share anything with you. I had a wonderful ultrasound done this week. They actually have a flat screen on the wall so you can see everything (without having to tilt your head to look at the tech’s screen), and she explained everything on the screen to me and answered any questions my husband and I had. I wish this was the standard EVERYWHERE.
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Jane Reply:
August 16th, 2010 at 5:51 am (Quote)
I could see the screen too for the most part, but I’m not savvy enough to know the difference between a fully-formed 22-week fetal brain and a 22-week fetal brain damaged by a birth defect.
What I love about this policy is that they write the results down and give them to the midwife, who reads them to the patient. The midwife doesn’t repeat the scan herself. So whether the sonographer tells me “The baby has a fine head” or the midwife tells me “The baby has a fine head,” it’s all based on the same reading done by the sonographer.
But the lawyers have determined it’s better legally to have parents wait for the midwife or the OB to read the report to them than to have the sonographer say while the patient is on the table, “yes, the skull is fully-formed.”
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Catherine Reply:
August 16th, 2010 at 6:20 am (Quote)
I normally don’t post here (just lurk) but I can tell you about the other side of that coin. When I was 17, I broke my knee at dance class. My orthopedist found a bone chip on the x-ray, and sent me to the hospital for an MRI. After the whole thing was done, the technician came to give me my photos and said, “What did you do to yourself?? It’s all torn up in there!” Needless to say I didn’t take the news well.
Fast forward 48 hours, to my next appointment with my orthopedist. He takes a look at the pictures and says, “It’s just swollen, we only need to do surgery for the chip.” All that panic was for nothing. If that technician had kept his mouth shut, and just let the doctor read the results, I would have been much more calm. It ended up being an equally large surgery, but that’s a different story.
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Jane Reply:
August 16th, 2010 at 9:37 am (Quote)
THank you–I hadn’t considered severity as opposed to an on/off kind of thing. “Baby is fine” versus “Baby has a terrible condition.” A doctor who’s experienced at reading ultrasound results might be able to interpret the results better than the sonographer, the same way your tech couldn’t interpret the results the same way your orthopedist could.
Thank you for that perspective.
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Robbin Reply:
August 16th, 2010 at 10:26 am (Quote)
I think interpretation is a huge issue in ultrasound. My family doctor who was handling our pregnancy/birth with our first told us that our ultrasound at 41w with our daughter showed an enlarged left chamber of her heart and that this was an issue. During the u/s itself we did notice the tech spend a lot of time around the heart but we weren’t told anything.
Fast forward to the birth, which they pushed to induce because of her “heart problem,” and had an OB resident, peds resident and attending, the family doctor and two nurses there “just in case,” and her heart and apgars were fine. 6 weeks later the pediatric cardiologist on staff does an ultrasound and echo directly on her to ensure no problems, and informs us that “based on the ultrasound from 41w I would have informed you that what we were seeing was entirely normal for a late term infant and would not have recommended induction”. They didn’t bother to show him the pictures until after the fact, and in the mean time had pushed the induction agenda.
Because of my induction and lengthy hospital stay for recovery (more than 5 days), I had a third degree tear, two surgeries, and got MRSA.
Ultrasound can be bad, bad stuff in the wrong hands.
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The Deranged Housewife had this to say,
Aug 16, 2010 @ 5:25 am (Quote)
There has to be an easier way for doctors to remember not to tell. Like … oh, I don’t know, a big ass post it note on her chart that says “Patient doesn’t want to know sex” or something. 
In my experience, I can remember clearly seeing the sign for “female” on the top of my chart, which, I presumed was an indication to them that a) I knew the baby’s sex and b) a reminder to them.
In my third pregnancy, we said we didn’t want to know to the ultrasound tech, and she said, “Then we’re not even going to look there.” 
(or at least that’s what she said) So no one knew – not me, not the tech, not the doctor. Therefore no messing up. I guess if there were anomalies with the genitalia at birth, they couldn’t have been corrected until afterwards anyway, and it was me who said I didn’t want to look. So there you go.
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Vallery Reply:
August 16th, 2010 at 5:38 am (Quote)
Huh…that’s a good way to do it, I think. No one really needs to know, because, as you said, I don’t think there’s anything about the gender that can be affected or treated during pregnancy that would make knowing the gender necessary by any means, and if no one knows, they can’t tell you!
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Honeybee Reply:
August 17th, 2010 at 3:23 pm (Quote)
Not always. Sometimes problems with genitalia can be fixed, or at least made less problematic, if they know ahead of time. I had an ex who’s mother had to C/S with him because the cord was wrapped around his testicles during development. The doc tried to turn him and change his position, but he was worried a natural birth might increase the pressure. Sometimes if they know ahead of time they can be better prepared to fix things on arrival. But if you don’t want to know the sex, unless it’s a risk you your baby the doc should hold his/her tongue.
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Jane Reply:
August 16th, 2010 at 5:48 am (Quote)
After Emily died, we said we didn’t want to know the gender unless the baby was going to die. (That was how Ultrasonographer #2 told me the forbidden information that the baby was okay:
Her: Do you want to know the gender?
Me: Only if the baby is going to die.
Her: {flipping off the machine} Then we’re done.
But we had a follow-up U/S with that baby due to weird motions that felt like a fetal seizure, and while doing the scan, the midwife said, “Do you want to know the gender?” and when I said no, she zipped the scanner off what she was looking at.
And when they got measurements on the most recent baby, I have reason to believe he was putting his parts on display for the camera (and the sonographer slipped once and accidentally said ‘he,’ which I then told myself was “the generic he” so I could continue not knowing the gender.)
Sometimes I think it’s obvious and they don’t need to check, and they write it down anyhow. But there should be a way to indicate on the report that the parents wish to be surprised at the birth and not surprised at an office visit.
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Robyn Reply:
August 16th, 2010 at 11:32 am (Quote)
It’s amazing what the doctors won’t read even when it’s right in front of them. My father is a TB carrier. My grandfather was a double amputee due to gangreen caused by diabetes. Both of them had their issues in bold red letters on the front of their files.
My father? They did blood work once and they flipped out saying we need to do X,Y, and Z because we found you’re a TB carrier. My dad then informs them to actually read the file because he already knew he was a carrier and had the issues taken care of.
My grandfather?
Dr: What happened to your legs?
GPa: They cut them off.
Dr: *flips folder to the closed position and reads “DIABETIC” on the front*
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When I was pregnant with my toddler we told the tech as soon as we walked in for each u/s that we didn’t want to know and, like Deranged Housewife, they said if we didn’t want to know there was no need to look. I had lots (I thought) of reports for suspected big baby (7.5lbs but that is a different story) and the doctors never needed to know what the sex was at all. I am in Australia if that makes any difference & when in the public system.
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JulietsButterfly had this to say,
Aug 16, 2010 @ 5:51 am (Quote)
*insert face into palm*
Funnier is that I’ve heard some OBs won’t let mom find out the gender because like Jane said, they could be wrong. Don’t want anyone sueing if the he ends up a she or that anomaly shows up or goes away.
Good thing we know these things are never wrong.
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Beth Reply:
August 19th, 2010 at 1:51 pm (Quote)
When the nurse came in to do the b/p reading and assist the doctor in his exam, she did tell me that they had five births the week before and they were all supposed to be girls and they turned out to be boys.
I know that was supposed to make me feel a bit better, but in hindsight, it makes me shake my head at the “certainty” of gender determination via ultra sound. 
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Catherine Reply:
August 24th, 2010 at 3:55 am (Quote)
Ultrasound is completely dependent on the training and skill level of the sonographer. That is why it is important to ensure you have a certified ultrasonographer doing your exams and not some medical assistant or nurse that has learned in the doctor’s office. Most doctors aren’t qualified to do a proper US exam (High Risk OB excluded)
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Frillypants had this to say,
Aug 16, 2010 @ 6:12 am (Quote)
There doesn’t need to be a protocol for a patient’s wishes to be forwarded. Just simply ask “Do/did you want to know the baby’s sex?” and then the Dr or whoever is free to go on. Seriously simple!!
It’s not like they don’t come across people who don’t want to know? It’s a NO BRAINER!!!
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Hah, next time read the whole report.
The doctor for my “big ultrasound” with my son did tell me “Be sure to let the technician know right away if you do or do not want to know the gender.” I don’t think they actually write down on the order if we do or don’t want to know, at least not in my situation. I think the better thing to do would have been “Would you like to know what you’re having?”
One of my friends from Canada was told she could not find out the gender unless she scheduled her ultrasound after 20 weeks. Something about them not wanting her to abort if she wasn’t having what she wanted. She was shocked because healthy was all that mattered to her, she was just excited. They have some weird rules.
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Jane Reply:
August 16th, 2010 at 6:34 am (Quote)
That’s a bit odd. I don’t know anything about Canadian regulations on abortion, but if it’s legal “on demand” then how do they justify the notion that it’s fine to abort for reasons of health, finances, state-of-life, or poor timing (or any other reason the mother has), but aborting because of fetal gender is wrong and something to be prevented?
It’s a strange double-standard, isn’t it?
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hypatia Reply:
August 17th, 2010 at 9:10 am (Quote)
There is no legal reason to prevent gender identification before the 20 week mark. Nor to try to prevent gender specific abortions.
These are individual policies by doctors/clinics/hospitals and have no reflection on the legal situation of abortions in Canada.
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jennifer Reply:
August 16th, 2010 at 6:50 am (Quote)
I’m in BC Canada and its only certain areas of the country that has an abundance of certain cultures who prefer one certain sex over the other. Unfortunately we had our only u/s in a city that doesn’t allow it and we weren’t able to find out the sex b/c of this and i made me really mad.
My Naturopath is of the culture that is known for doing this and he is so disgusted and angered that people even consider aborting a certain sex that he can’t even discuss the subject.
Next baby i’m going to book my u/s for after 20 weeks b/c we DO want to find out and i’ll make sure i go to our city that will tell the doc/midwife and THEY tell the parents what the sex is.
Its so rediculous that we have to go through such hoops b/c of certain cultures that do abortions due to the sex of the baby.
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I hope you find out next time.
When having my u/s, the tech focused right on the “money shot” before asking if we wanted to know. We said “NO!” and she whisked the wand away, but the damage was done. I was so upset. A-holes. I am still angry about that.
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Maria Reply:
August 16th, 2010 at 6:57 am (Quote)
Oh and I didn’t say “We don’t want to know the gender” the second we walked in the door because I was “afraid of offending her.” I was treated a little rudely when I did that at my daughter’s U/S.
I can’t even explain how angry I am that it was taken from me.
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Mary S Reply:
August 16th, 2010 at 11:09 am (Quote)
You could tell what it was just by looking? I thought for sure my daughter was a boy when I looked at the screen until the tech told us what he was looking for.
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Cmat Reply:
August 16th, 2010 at 12:27 pm (Quote)
There was no doubt that we were having a boy when we got the money shot with DS. The tech thought it was pretty funny because her last few appointments had legs crossed etc and this one was just so easy for her!
It wouldn’t have killed her to ask “are you hoping to find out the gender?” and why be offended about a patient not wanting to know?? Cmon, some people like surprises!
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I wasn’t going to find out the sex of my second child but the tech headed down there and put it on the big screen without telling me not to look. There was the turtle for all to see whether we wanted to or not. We spent the rest of pregnancy hearing things like, “Oh, another boy? Are you going to try again for a girl?” *grr*
With our youngest child we had them put a bright pink post it on the front and inside flap my chart that said to not tell us the gender.
Oh, I also wrote “DO NOT REVEAL GENDER!” across my abdomen prior to the ultrasound. 
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Kelly Scherrer Reply:
August 16th, 2010 at 7:43 am (Quote)
With my first two, we opted to find out the gender mostly because of naming issues (#1 we couldn’t decide on a boy’s name, #2 we couldn’t decide on a girl’s name) and we wanted to know if we should continue arguing – both were girls. However, we’ve decided if we ever have a 3rd baby, we won’t find out the gender – I’ve had 2 unexpected c-sections and because of the complications of #2 we know any future children will also be c-section – I want to look forward to my children’s births and this will give me to be excited rather than anxious about (both my experiences have been very negative…). I LOVE what you did, KDB – I’m making a mental note right now!
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Our ultrasound tech seemed like she was guarded and untalkative. (Makes sense, she didn’t know ahead of time if she’d be dealing with extreme joy or extreme anguish) She did all the measurements and carefully noted the lengths of bones, size of head and all that. When she had finished she asked us “Do you have any other questions for me?” She hadn’t even looked at the gender at that point yet. That was the perfect way to handle things. We did want to know the gender during that pregnancy so we asked her. Even she cracked a smile at our infectious joy when we found out we were having a girl.
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This was my submission. It was very frustrating at the time and of course, was brought up before my blood pressure was taken . We made sure that we told the tech, nurse, doctor and everyone we thought would be in the position to “slip”.
It was actually the young woman who did the weighing and b/p check for the doctor. She wasn’t a nurse, a Medical Assistant perhaps?
I said “We weren’t supposed to know!” The doctor came in and apologized to us over and over and over again. I have wondered what he said/did to her after we left.
It was exciting to know what we were having, but really did take that suspense that comes with not knowing.
We switched to a midwife for a homebirth shortly there after (not related to the slip). She didn’t request/require an u/s unless she suspected a problem, so with #2, we were totally surprised and it made for fun banter between my husband and myself. I was under the care of an ob for my third child (b/c we moved and could not find a mw) and at the twenty week u/s, we said, as soon as we walked in the room, we did not want to know what we were having and told the previous story. No slips, not even a scan in that area to “check things out”. (Not that it mattered, we moved a few weeks later and were able to find another midwife.)
Just wondering, how would you have handled this situation? In my pregnant hormonal state, I thought “that girl should not be allowed to deal with pts, ever!”.
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Jane Reply:
August 16th, 2010 at 10:38 am (Quote)
Did the nursing assistant apologize for what she said? Because that would make a difference to me. I think if she looked like she didn’t care, I’d have been right in her face yelling at her that she had NO RIGHT to do that and why was she even reading through my records to begin with when all she had to do was record my blood pressure and the number on the scale.
To the doctor, I would request that gender information NOT be placed on the front page of the chart where it was easily seen. It’s not as if they treat pregnancies differently based on the gender.
(Yes, female preemies have a better survival rate than boys, but I would assume the protocols are the same.)
You know, when you left the practice, no matter what reason you gave, I bet that young woman assumed it was because of what she did. I hope it made her a more conscientious caregiver afterward. Sometimes an incident like that early in a medical career is eye-opening for the person who screwed up, and she can carry that forward into decades of compassionate work.
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Beth Reply:
August 19th, 2010 at 1:55 pm (Quote)
It has been five years, so I remember the apology from both her and the doctor but I can’t remember the level of sincerity. I am sure she was sorry and I must have been one in a million who didn’t want to know, so she had never had a problem when making conversation before!
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My child’s sex wasn’t even mentioned by the midwives after my scans. With my first we didn’t want to know (and he wasn’t showing anything anyway). With my daughter we did find out, but the tech asked us beforehand and said she’d turn the screen away so we didn’t get any accidental shots when she was doing the measurements if we didn’t want to know.
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Brittany U. had this to say,
Aug 16, 2010 @ 9:35 am (Quote)
I had a client recently who didn’t want to know the sex of her baby. The ultrasound pictures were very clear but thankfully she couldn’t tell what she was seeing. After a very long labor and unplanned section, the nurse (also a doula) made sure everyone in the OR never said he or she, just “your baby”. After getting back to the LDR room, the client was still not ready to find out. Her baby was half an hour old before she unwrapped the blankets and very quietly and reverently announced to everyone “Oh, I have a boy and he’s beautiful.” Her care providers were great about not saying, but the tech should’ve kept the pictures that showed his gender bc it was very hard to remember to also call her baby a girl on occasion during her pregnancy (I have never been able to call an unborn baby “it”). I’m sure the assistant just assumed you knew since a lot of people want to know. Next time, maybe buy a white shirt and in big letters write “We’re excited to find out our baby’s gender on his/her birthday! ” Hopefully everyone will look at you before your chart. And maybe you’ll have a modest baby who will hide her/his gender with a foot or by being turned. Congratulations on your baby!
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I need to start writing these things down for a CafePress store.
Maternity t-shirt, in bold across the chest: WE DON’T WANT TO KNOW THE SEX OF OUR BABY. Hopefully attention grabbing enough to be noticed by techs, doctors, nurses, and staff. Also great for deterring questions from other folks.
This is all assuming people are actually looking at you, of course. Alas, many times, they don’t.
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Robbin Reply:
August 16th, 2010 at 10:31 am (Quote)
Those shirts would be nice for the public at large though. I’m tired of family and friends asking us what we’re having and thinking we’re weird for not wanting to know.
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Jane Reply:
August 16th, 2010 at 11:48 am (Quote)
Talk for thirty minutes (without stopping and without responding if they try to interrupt) about gender programming and societal expectations and feminism and your philosophical objections to gender bias, and they won’t ever ask you again. It works.
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Honeybee Reply:
August 17th, 2010 at 3:39 pm (Quote)
I saw one with hand prints on it that said “Don’t touch the belly.” I love the “No touching” shirts for pregnant women. I’ve had a few friends complain that strangers have touched their stomachs and started cooing and asking questions and they feel super uncomfy about it. One of them filed an assault charge.
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EVERY time I had to have an ultrasound (more with the second b/c of suspected heart valve problems – there were none, and b/c of breech presentation) before the tech could even get my belly uncovered I very loudly & clearly state, “I DO NOT KNOW THE GENDER AND I DO NOT WISH TO KNOW THE GENDER.”
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With my second child we had an u/s at around 17 weeks. The technician was pissed (“we don’t usually do these until after 20 weeks, the baby is still too small to see anything!”) and I angered her even more when I mistakenly called the u/s results an “opinion”. I had told her up front that we didn’t want to know the sex of our baby. Right off the bat she brought up baby’s genitals on the screen and said, pointing, “Look! Can you see that?!”
We pretended we didn’t know throughout the entire pregnancy. Lie? Sure. But I didn’t want those “oh, another boy?” comments.
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There has to be an easier way for doctors to remember not to tell. Like … oh, I don’t know, a big ass post it note on her chart that says “Patient doesn’t want to know sex” or something.
This is how my midwives do it… they put a sticker over the part of the report that tells the sex and then at your appointment it is your choice whether you want to remove the sticker or not. It was cute
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This happened to me with my first. The midwife (medwife is more like it) I was seeing came in and said, “So, you’re having a boy?” I said, “We didn’t want to know!” She then scrambled to cover herself and said, “Oh, I don’t know why I thought that! I promise it’s not in your records.” And she showed me where it said something like no genitalia visualized. But I had several ultrasounds, and I know the techs knew what I was having, so I’m sure it was in there somewhere and she was just trying to make me feel better. In any case, I believed her at the time and it was still a surprise, but it was a boy.
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Not as serious, but this reminds me of a doc’s appt about a year ago (I was not pregnant). I’m in recovery for an eating disorder, and it’s not a great thing for me to hear my weight (the number matters so little anyway). I felt a little uncomfortable asking the tech not to weigh me (didn’t feel confrontational that day), but I said, “I’m just going to turn the other way if it’s okay with you.” I got on the scale, facing away from the numbers. Got off and the tech said “XYZ pounds!” Uhhhhh… DUH. WHY DID YOU THINK I WAS FACING THE OTHER WAY AND SPECIFICALLY ASKED TO DO SO?
Granted I could have been clearer, and have ever since, but really.
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This is kind of like the story about the couple who said they didn’t want to know the baby’s gender, and no one told them, but then as an aside, they were asked if they wanted circumcision. Fail.
This is why I don’t do unnecessary prenatal testing – from where we stand, it doesn’t matter what an ultrasound might reveal. The information is useless to us because 1, we’re not going to abort regardless of the deficiency, and 2, whatever we find, it’s very unlikely we can do anything about it anyway. So why stress over it?
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What an idiot.
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