I have been saying for years that traditional prenatal care is worthless. As a health professional, I always felt it was a total waste of time for me to miss time from work to pee in a cup and be asked the same three or so questions every time (did I have any questions or concerns, did I have any problems I needed to discuss, etc.). Most of the time, if I had a concern I could get it answered over the phone. And really, I could have tested my own urine and charted my weight gain myself. If something was wrong, then I should have seen a doctor.
Having a child is a natural thing; it is not like a broken bone and should not be treated as such. Thanks for this article. I thought I was alone and crazy in my views because everyone else seems to think prenatal care is sooo vital.
-- Yvonne Lynum
It sounds like Dr. Strong is saying something that I and others have suspected for a while now. It's a curious society we live in, where birth has become so medicalized. I do believe in peace of mind for expectant families. But I can't help wondering to what degree our system has created that need. Research indicates that ultrasound has not improved fetal outcomes one bit. In fact, it's not all that accurate and no one can say definitively that there is no harm, however subtle. Plenty of parents have found peace of mind from an ultrasound only to learn postpartum that their baby has a serious health condition. Others have carried a heavy heart all through pregnancy awaiting the birth of a "seriously defected" baby due to ultrasound results that ultimately prove erroneous. When pregnancy is viewed by our society as a normal, natural, healthy occurrence, perhaps women won't need to rely on a relatively new piece of technology to give them peace of mind.
-- Chan McDermott
On one hand, I do think that the prenatal "experience" goes a bit too far in the medical field as far as the plush offices and special treatment are concerned. The money for comfy couches, extra-long question sessions and other unnecessary minutiae could be better spent elsewhere. As a woman, I am often angered by how long it takes to get an appointment with a gynecologist (six-plus months), and the impossibility of seeing an actual doctor if medically necessary as they are always too busy doing extended prenatal chats.
At the same time, I could never condone eliminating ultrasound or other prenatal tests because "most" pregnancies go smoothly. It is the 3 percent that have trouble that truly need them, and the earlier a problem is caught, the better the chance of survival. To say that nothing can be done is ridiculous. There is an entire team in the University of California at San Francisco that is dedicated to prenatal surgery. There has been great success in this field, all with children that would have died from their defects before or shortly after birth. Even when the problem is not so great as to require surgical intervention, prenatal detection allows the mother to have the warning that she needs to be in an appropriate setting when the infant is brought into the world. Just because 97 percent of pregnancies go well does not mean that the other 3 percent should be neglected!
-- Fritzi Frobozzer
The story by Annie Murphy Paul about the book "Expecting Trouble: The Myth of Prenatal Care in America" contains an unfortunate error. She states that pregnancies "proceed perfectly well 97 percent of the time." The rate of miscarriages alone is much higher than the 3 percent she suggests. In fact, after a woman discovers she is pregnant, she has a 15-20 percent chance of losing her pregnancy. Also, there are many other possible complications that can end a pregnancy or make the mother seriously ill. Pregnancy may be natural, but that doesn't mean it can't be dangerous.
-- Ellen Joyce