His measurements were still smaller than expected, but his heart rate and movements were reassuring. The doctor sent us home confused.
That night on the phone, my mother listened as I talked through hormone-fueled tears about amniotic fluid levels and growth percentiles. And as usual, she struggled to relate. “We never had this much information,” she said.
We were in the depths of pregnancy paranoia. What once seemed a magical transformation from embryo to newborn has become a nine-month research expedition, thanks to advances in ultrasound screening, prenatal testing and an explosion of Internet sites where expectant parents can explore every nuance of fetal development and every thing that can go wrong.
The information overload is being eagerly consumed by parents with 47-point birth plans who have learned that knowledge is power and who want to be active participants in their care, said Penny Simkin, a Seattle-based childbirth educator who has been helping parents navigate pregnancy and birth since 1968. “Having all that access can be troubling,” though, she said. It’s so hard to “sift through all the information that you get.”
For me, and for many friends approaching parenthood for the first time, the experience often felt more stressful than joyous.
New tools, new fears
Obstetricians are trained to use every available tool to identify potential problems early on and alleviate risk, and new technologies continue to churn out new tools.
Financial incentives for doctors and a fear of litigation help fuel an abundantly cautious approach, experts say. And for many women, there is little disincentive to splurge for more tests when many insurance plans pick up most of the tab, said Katy Backes Kozhimannil, a University of Minnesota professor who studies health-care costs.
Then there’s the added circumspection that comes from making health-care decisions for two.
A large majority of new mothers — 70 percent — reported having had at least three ultrasounds during their pregnancy, according to a national survey released by Childbirth Connection, a nonprofit group. The survey included 2,400 women who gave birth to single babies between July 2011 and June 2012. Nearly a quarter of the women had six or more ultrasounds. And about two-thirds of the respondents said they believe more tests mean better care.
Yet, increased testing can exact an emotional toll, said Aaron Caughey, chair of the Department of Obstetrics and Gynecology at Oregon Health and Science University School of Medicine. Obstetricians rely frequently on noninvasive screening tests with uncertain and sometimes false-positive results, which they feel compelled to affirm or discount through more testing, he said.