Blessings

Dot writes: there’s a shocking story in the news here about a woman who at an early scan was wrongly told her baby had died and was booked in for a D & C. Fortunately she got a second opinion, or she would have lost a perfectly healthy baby. Since this story broke several other women have reported similar experiences, including one who underwent the D & C and then found she was still carrying a living child, so presumably had been expecting twins. The problem is being blamed on faulty scanning equipment in the first instance. The true horror in the story is the realisation that there were probably other living babies who were aborted because of faulty scanners and a lack of checks.

What this underlines for me is the danger of trusting machines to the exclusion of less quantifiable, more subjective assessments of maternal well-being. The woman in the original story still felt pregnant and trusted her own senses enough to do something about it; but so often in modern medical and maternity care the authority of technology is allowed to silence completely the unscientific instincts of the person. (My use of ‘unscientific’ is deliberate there: the Latin scientia refers to any kind of knowledge, but we use its English descendent only for particular kinds of knowledge gained through formally defined methods of testing and analysis carried out by a select class of people.)

The other lesson I draw – not a new one, but one it’s good to be reminded of – is to be grateful for my own beautiful babies, whose hearts were always happily audible and visible when medical science required them to be.

Advertisements

5 thoughts on “Blessings

  1. ken

    I completely concur with the remarks about the privileging of scientific knowledge over women’s intuition, though because I am a science totalitarian I would want to spin it in the following way: Medical knowledge is based on science and so is sound, but even as such, it is shades-of-grey style knowledge. It is probabilistic and fallible, which means it should be applied to particular cases cautiously and with sensitivity. I think medical practitioners (I won’t say ‘doctors’ because they don’t have PhDs) don’t really understand the limits of what they know. For instance, there are two mutually antagonistic measures of the goodness of any test. A test can be sensitive, which means it will find the condition if it is there. Or, a test can be specific, which means it won’t find anything except the condition. At the extremes, a maximally sensitive test would always report a positive finding. It would always say the condition is present (even when it isn’t) and in that way guarantee that it never failed to spot the condition. A maximally specific test would always give a negative finding, and in so doing it would never false represent something else as an instance of the condition. We try to design tests that are both sensitive and specific, but the fact is that no test is ever perfect in either respect. False positive reports of miscarriages must be expected, just as there will be false positives for tests for aids or cancer or variant CJD. There most definitely will have been healthy babies mistaken for miscarriages in other countries too only we haven’t been told about it. The point is that the scientific tests sometimes get it wrong, so there cannot be a culture that insists that they always get it right and rides rough-shod over the testimony of a patient’s awareness of their own body.

    1. Dot

      I think you’re a little unfair to doctors here but on the whole I concur.

      Of course, there are cases where the patient’s own awareness doesn’t add anything much (in pregnancy and in other conditions); also, one’s feelings are interdependent with the information coming from medical sources – so, for example, if I know I’m pregnant I’m likely to pay attention to nausea and interpret it as morning sickness, whereas if I didn’t know I might try to ignore it. The implication of this for the false diagnosis of miscarriage is more that results have to be checked, and that shiny exciting technology such as ultrasound needs to go hand-in-hand with old-fashioned midwifery caution and know-how.

  2. oh that’s such a horrible thing! How can this happen? I got a second opinion as a matter of procedure when I miscarried, after the initial scan (11 weeks, no heartbeat and baby measuring 6 weeks, so pretty obvious that there was no chance of a pregnancy) I HAD to wait for a week for another scan to make sure this was indeed a miscarriage. It’s normal practice to scan twice to make sure and exclude mistakes.
    And that was on the NHS who are keen to save money where they can.

    I also find that D&Cs in general, like other medical procedures, are offered too readily. Miscarriage usually take their own time, even if it can take a while and the wait can be distressing. However, things are moving, a generation ago you had to have a D&C after a miscarriage, now it’s optional/done only if indicated and when reducing a significant risk and patient choice is taken seriously.

    1. kenanddot

      It’s good to hear that they routinely check these results in NHS hospitals. I think we’ll soon see something similar in Ireland. Ironically, the problem wouldn’t have arisen if there had been no ultrasound in the first place – in the really old days I guess you either miscarried or not.

      I’m interested in your point about D & Cs being offered too readily. Because they are very gungho about doing these invasive procedures and not letting nature take its course. On the one hand, if the option is there and the alternative is a distressing wait of course medical staff want to offer the procedure; but people tend to accept procedures and maybe don’t realise they also have the option to say no if they don’t feel comfortable with it.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s