Ultrasounds..

http://birthinternational.com.au/articles/wagner02.html ( a lot more info at the site)

In the United States, for example, a consensus conference on diagnostic ultrasound imaging in pregnancy concluded that "the data on clinical effectiveness and safety do not allow recommendation for routine screening at this time; there is a need for multidisciplinary randomized controlled clinical trials for an adequate assessment".

Denmark, Sweden, and the United Kingdom have made similar statements against routine screening. The World Health Organisation (WHO), in an attemmpt to stimulate governments to develop policy on this issue, published the following statement:

"The World Health Organisation stresses that health technologies should be thoroughly evaluated prior to their widespread use. Ultrasound screening during pregnancy is now in widespread use without sufficient evaluation. Research has demonstrated its effectiveness for certain complications of pregnancy, but the published material does not justify the routine use of ultrasound in pregnant women. There is also insufficient information with regard to the safety of ultrasound use during pregnancy. There is as yet no comprehensive, mulitdisciplinary assessment of ultrasound use during pregnancy, including: clinical effectiveness, psychosocial effects, ethical considerations, legal implications, cost benefit, and safety.

"WHO strongly endorses the principle of informed choice with regard to technology use. The health-care providers have the moral responsibility: fully to inform the public about what is known and not known about ultrasound scanning during pregnancy; and fully to inform each woman prior to an ultrasound examination as to the clinical indication for ultrasound, its hoped-for benefit, its potential risk, and alternative available, if any."

This statement, sadly, is as relevant today. During the 1980s and early 1990s, a number of us were raising questions about both the effectiveness and safety of fetal scanning. Our voice of caution, however, was like a cry in the wilderness as the technology proliferated. Then, during the course of one month in late 1993, two landmark scientific papers were published.

The first paper, a largely randomized trial of the effectiveness of routine prenatal ultrasound screening, studied the outcome of more than 15,000 pregnant women who either received two routine scans at 15 to 22 weeks and 31 to 35 weeks, or were scanned only for medical indications. Results showed that the mean number of sonograms in the ultrasound group was 2.2 and in the control group (for indication only) was 0.6. The rate of adverse outcome (fetal death, neonatal death, neonatal morbidity), as well as the rate of preterm delivery and distribution of birth weights, was the same for both groups. In addition, in the author's words: "The ultrasonic detection of congenital abnormalities has no effect on perinatal outcome". At last we have a randomized clinical trial of sufficient size to conclude that there is no value to routine scanning during pregnancy.

The second landmark paper, also a randomized controlled trial, looked at the safety of repeated prenatal ultrasound imaging. While the original purpose of the trial was hopefully to demonstrate the safety of repeated scanning, the results were the opposite. From 2,834 pregnant women, 1,415 received ultrasound imaging at 18,24, 28, 34 and 38 weeks gestation (intensive group) while the other 1,419 received single ultrasound imaging at 18 weeks (regular group). The only difference between the two groups was significantly higher (one-third more) intrauterine growth retardation in the intensive group. This important and serious finding prompted the authors to state: "It would seem prudent to limit ultrasound examinations of the fetus to those cases in which the information is likely to be of clinical importance". Ironically, it is now likely that ultrasound may lead to the very condition, IUGR, that it has for so long claimed to be effective in detecting.

So.. I quit. (long, long, long)

I hope to continue to post pictures, but my Project 365 enthusiasm was derailed by colds, pukey children, and my continued fun with wisdom teeth. Yes, I know most people don't keep theirs.. but hey, I'm not most people and all the literature I find says if you can make it to 30 without issues then you're almost gold. My issues only happen every few months. I did call the dental insurance and find out all of the particulars just in case I find some courage somewhere to have them removed.

(you can her Julia say.. "Gracie, do you have any AA batteries?" I think most of us have been there!)

Last co-op we tie-dyed shirts. Unfortunately, Julia's camera was without batteries and my phone doesn't like to take great pictures. I think we'll supply some more dye/salt and maybe have a go at it again! I need to get some more shirts from Michael's while they are on sale. The shirts turned out great and the children enjoyed it a lot. The older girls tried batik and enjoyed that as well. I *love* the quilts made from batik fabrics so perhaps I'll get them working on that.. assuming I get time to quilt.. I still need to get to Anna's house to finish Jo's quilt (hi Jo!) and bring my frame home. My mom gave me a quilt that she hand-pieced decades ago. It is a Grandmother's Flower Garden style and full of bright yellows, oranges, and other happy colors. I will get a picture of it when I get it in the frame. My poor Dear Jane is on hold... I'm hoping to spend my birthday (2/28, I have a while!) getting some of my applique things together so I can have a few good hand projects. They might be nice to take with me during births if the Mom is resting.

Speaking of births... I have three doula clients so far and it has been fun getting to know them. With good timing, my doula certification will be done by mid-March. Each has such a different birthing history. I'm SO thrilled that I get to be part of this and it makes my midwifery studies all the more fun. I'm literally surrounded by books here at my desk and have notebooks full of various things as well. There are envelopes, pencils, pens, sticky-notes stuck to the rolltop desk, and so on. I organize it often, but it generally falls back into comfortable disarray.

For the locals.. I am teaching a HypnoBirthing class at Covenant Birth Center in March (and again in April, after Easter) and there are spots still open. If you, or someone you know, is expecting, please pass along the info. The max is 5 couples per class. I also teach privately for those not interested in a group class.

On the children (kid) front..

James wants to know what we're naming the next baby. I told him Gertrude or Harry.. he accepted that.

James also got a hair cut: he gave me a five limit time limit, a no-brush rule, and sang during most of it. He looks like.. well.. a boy that got a five minute haircut by a mom that doesn't cut hair well. hehe BUT!! He loves it and that's all that matters. It's his head, his hair, his likes.. he likes non-fuss and one day I am sure that will come in handy! Summer is coming and he'll need some new clothes. I seriously think we're doing the two-outfits idea. Well, three outfits.. one for church. I sometimes wonder if folks think we don't have enough clothes for him. I should take pictures of his drawers and closet.. he's just NOT into clothes. Well, none of them are.. I'm really not either. We dress and go about our day. We are running low on shoes! Kuza has been a fantastic puppy - no jumping, no biting, and he's so gentle/sweet with even the littlest of kids. He adores the cats and constantly keeps watch if we're outside.. but he's got a shoe-habit. :)

Thankfully, sandals are coming into the stores so we'll be buying those and skipping the rest. Nobody wants to do sports this year (and I'm not complaining!) so we don't need tennis shoes. I know there's a birkenstock outlet near the place where we camp in WV in July, I think I'm going to make a stop there this year. I'd love a pair of birkenstocks again! My last ones I wore until they absolutely fell apart beyond repair. When people ask me about the challenges of a big family I usually reply, "Socks." Others with more than one child usually nod their head in agreement. (Except for my friend Di, she's got it all licked when it comes to organization! She should rent out her services for seasonal clothes changes.)

For those still mulling over the "next baby" comment I made above.. I'm not pregnant. Breathe. ;)

Noah cut his own hair, his bangs are VERY short and he left the rest alone. Silly monkey. Joseph doesn't want his hair cut ever again. He told me yesterday that he had one already. Silly Mommy. Why would he need more than one? I know that lots of large-family Christian folks pride themselves on their boys always having those short buzz cuts and such. I've officially dropped out of those ranks. (Not like I was ever -in- those ranks, but y'know.. this is my official dropping out).

My main goals: Make sure my children have a really nice childhood (they only get to do this once) and be a genuine person of integrity... and never forget that what we do is important, unless we're doing things for show or because others think we should. Then it is just a crappy waste of time.

Project 365 - Day 3

Day 3. Still going strong on the pictures. Not doing so great on the germ-avoidance. I managed to catch Bethany's sore throat which means today's picture was almost a cheat.

This is the view off of the front porch. On the right is the end of the white van with the red truck parked behind. The skinny "what in the world are those scrawny thing" trees are called Loblolly Pines. I don't know if they grow in other places, but they're pretty common in the south-east. You'd never mistake one of those trees for a Christmas tree.. but they do make really nice telephone poles! See the oak tree with the red leaves still hanging on? Look down a bit.. the kitten sitting there is Black Cat. Noah named him. I'm happy to announce that Noah now knows his colors. ;) But the name Black Cat has stuck, just like he has. Oh, I'm also happy to announce that Black Cat -is- a boy. Charli managed to grab him up long enough to check. Whew. He's the feral kitty that adopted us a while back. He likes sleeping on the porch and Kuza dotes upon him. I'm not sure if all great pyrenese like cats.. but ours surely does!

Off I go for another cup of hot tea... I hope everyone is having a great 2009 so far. Bethany is trying to decide what she wants to do with her birthday. She has twelve days left to decide!

Project 365 - Day 2 & Christmas Pic

"Oh, no!" says the cat. "It can't be the end of holiday vacation already!" Actually, the cat hasn't said that, but the kids might as we jump back into a normal routine next week. This picture is a good sign that we're not in our normal routine.. because the cat is snoozing in my clean laundry. (Which, I'm guilty of not folding. Charlotte fills the washer and moves things to the dryer. I fold. Everyone puts away. It's a good system when Mommy doesn't get distracted!)


We have two siamese cats because having just one might be normal. How scary if we did something normal! :) So, we have two siamese cats and the cheat is to look at their feet. Artoo (Joseph's kitty) has grey feet and Taliesin (my kitty) has white. They're brothers. I'll let the visitors figure out which cat it is. I think I've given enough hints!

This picture makes me happy because it's like a "Where's Waldo" image for me. We have the sword on the table, don't worry it is rubber, and then the hodge podge of Christmas paper littering the floor. Bethany, always the helper type, is attempting to open up the basket of Naomi's plastic foods. Naomi, always the Queen, is wearing her new backpack and the footed PJs that have been passed down through all three of her brothers.

I remember when James wore all pink blanket sleepers because that is what we had to hand down. Then, slowly, they wore out and we bought boy ones.. used by Joseph and then Noah.. We have two blanket sleepers currently and I think it's about time to replace them. They'll definitely be pink!! There's something fantastic about snuggling someone in a sleeper, I'm surprised more adults don't wear them to bed. One of Naomi's has legs a little too long so her feet tend to slip out of them. She walks around with the footed part flipping all over.

The other part of the picture is the realization that Noah is wearing shorts with a sweater. We don't take fashion seriously in this house, but .. really.. for Christmas next year I am going to have assigned clothes for -everyone-! :)

Project 365 - Day 1

Yep! Trying this again.. This is a shelf in our schoolroom. I wanted to make sure I didn't miss the first day! :) However, I admit, this picture is uninspired. Project 365 is where you take a pic every day for a year. I might not post one every day.. but I do plan to take one every day. I'll label all of the posts appropriately!

The quote does match the schoolroom theme.

“The United States is the outlier — it’s the place that is strange. All of the Western European countries and Canada have school choice. They don’t always call it vouchers but they have it. If you lived in Winnipeg you could go to any private, public or parochial school and the province pays. They have choice. They have choice in Sweden — socialist Sweden has choice: vouchers for going to religious schools, private schools, public schools. Only the United States has this system where all the money just goes to the government-owned schools. It’s unusual. It’s weird. It’s not sustainable in the long run. Eventually choice will catch on.” – John O. Norquist, Former mayor of Milwaukee