This post about 12 Procedures to Decline During Pregnancy will walk you through routine procedures you can decline. 

Congratulations! If you are reading this, you are likely pregnant. It’s supposed to be this extremely joyous moment in your life, yet you may often be surprised how many procedures are done during a short period of time in your life. For most women, pregnancy is not a serious medical condition. For those women, it’s important that they know they have a right to decline many unnecessary procedures.

Let’s Discuss WHY you would want to decline procedures during pregnancy

If you have a normal pregnancy – that means no at-risk signs, no prior complications in other pregnancies, no significant risk factors – then there are many things that you are subjected too simply because maternal care is treated as a one-size fits all method.  Especially in the United States, if you choose obstetric care, you are being molded into cookie cutter pregnancy care, with many procedures being absolutely unnecessary. Do you really feel like being poked and prodded for 40+ consecutive weeks? I know I didn’t. For most pregnancies, there are no risk factors, meaning you can decline procedures.

What Procedures to Decline During Pregnancy 

1- Nuchal Translucency Screening (Genetic Testing)

This is an ultrasound performed during weeks 11 and 13. It tells you the likelihood your baby may have certain medical conditions, such as Down’s syndrome.   Why Decline? This test is typically only 70-75% accurate. Additionally, ultrasounds heat tissue and it’s advised to be avoided during the first 13 weeks of pregnancy.  Also, if you feel like having a baby with a condition such as Down’s syndrome would not affect your decision to continue your pregnancy, then it’s even more unnecessary.

2- Glucose Testing

Let me start by prefacing that you aren’t all out declining to take a glucose test. Looking at your glucose levels during pregnancy is actually very important.  What you would be declining is the bottled drink they offer to all pregnancies.  Why Decline? There are many other healthier alternatives to the bottled drink. The bottled glucola drink has a high amount of chemicals and an unrealistic amount of sugar that the normal human body would consume. Because of that, many women have false positives during the one hour test, and have to repeat, adding more chemical and more sugar. Learn about your glucose alternatives here. 

3- Third Trimester Ultrasounds

A late-term ultrasound refers to any ultrasounds after week 24. The excitement of wanting to see your baby before birth is why most women will accept this type of ultrasound. Why Decline? Studies show that late term ultrasounds have been linked to an increase in caesarean section. Additionally, when used to determine size or dating of baby. Late term ultrasounds are highly likely to be off in dating up to 2 weeks and as much as 2 pounds. Studies have shown that late term ultrasounds are off as much as 20-30%.

4- Internal Exams

This is one of the most common procedures done during the third trimester, especially in the last 4 weeks; however, it’s also one of the most unnecessary. It’s also done throughout labor if you labor in a hospital, but you can decline all of these. Why Decline? For one, they can be extremely painful. They also increase the risk for infection. But more importantly, the information obtained during an external exam can change so rapidly, it makes the results obtained void. Also, if done during the last 6 weeks, it is linked to a higher increase in caesarean section. Simply put – Doctors are typically trying to see how effaced and dilated you are; however, you can go from 1cm to 10cm in 60 minutes or it may take 4 weeks, so there’s no need to have any of these done.

5- Early Induction

Also known as an elective birth.  This is where you decide to speed up the birth of the child, typically before or around 38 weeks.  Why Decline? For starters, babies truly need to be born on their own schedule.  Some babies come “early”; however, most births happen at 40 weeks or later, especially during a first pregnancy. When babies are forced to come earlier, they can suffer from a variety of medical conditions, such as breathing problems and jaundice, as well as being more likely to end up in the NICU (neonatal intensive care unit).

6- Unnecessary Induction

You’ve made it to 40 weeks! YAY! That doesn’t mean that you automatically need to schedule an induction. In fact, you should wait. One case where you shouldn’t wait is pre-eclampsia. However, many women are induced for convenience, to either the parents or doctor. This type of induction is unnecessary and even dangerous. Why Decline? In fact, up to 60% of mothers who induce unnecessarily end up having an emergency caesarean. Inductions speed up a more painful labor, leading to an epidural which slows down pregnancy and the downward spiral continues. One study found babies born from an induction were almost 65% more likely to end up in neonatal intensive care unit.

7- Epidurals

An epidural during labor is a needle that places anesthesia into a women’s spinal canal. It allows a mother to be awake but feel little to no pain below the point it’s placed. Why Decline? For starters, epidurals slow down labor. The longer you are in labor in a hospital, the higher your risk of caesarean. Also, depending on the length of your labor, an epidural placed early on in your labor may deliver too much medication and hinder your ability to push. An alternative is learning breathing techniques and considering a water birth.

8- Continuous Fetal Monitoring

Ever been sick and forced to lay in bed all day? IT SUCKS! Now, imagine having painful contractions and not being able to move around. During continuous fetal monitoring and electronic band is hooked around your stomach and records your baby’s heartbeat. Why Decline? Being restricted in your movement has an increased risk of caesarean.  Additionally, it’s best for a mother to be able to move around, listen to her own body, and get into a labor position that is ideal for her body and baby.  Ask if your hospital has wireless monitoring or can do intermittent monitoring (monitoring for 10 minutes on, 50 minutes off).

9- Routine IV Hook-up

For many women, continuous monitoring and IV-hook up go hand in hand.  But the truth is that it doesn’t have too. Why Decline? Once you are hooked up to a monitor, you are tethered to a pole, reducing the ability to really move in the desired position your body wants too. Instead, ask for the option of a saline lock (or Hep-Lock). It’s a IV catheter put into your vain. Then it is flushed with saline and capped off. This allows you to move freely while also allowing medical teams to quickly hook up an IV if it’s truly necessary.

10- Breaking Your Water

Sometimes an obstetrician will tel you this is routine or can shorten labor time.  Why Decline? Studies, however, have shown that this can strengthen contractions leading to breathing complications and reduced heart rate for babies. Once a baby’s heart rate drops, your risk for caesarean section greatly increases. For many mothers, their water will break naturally during labor and in some cases, babies will be born in caul. Neither of these warrant medical intervention.

11- Episiotomy 

An episiotomy is when a cut is made to the opening of the vagina to enlarge the space for the baby’s head to come out. In very, very rare cases this may be needed. Specifically, to use forceps in order to quickly get a baby out and avoid a caesarean. Why Decline? However, if your doctor wants to just do an episiotomy because they see you may tear, it’s unnecessary. They actually take longer to heal than a natural tear, the risk for infection is increases, and complications from sewing the cut afterwards are likely. This is something you should ask your care provider about before labor.

12-Automatic Repeat Caesarean

A Vaginal Birth After Caesarean (VBAC) is highly, highly possible for most women. More than 75% of women who go for a VBAC are successful. Some doctors will try to say a VBAC is not an option, but there are always options for different care providers. Why Decline? Caesareans are major surgery and the more often a caesarean is preformed, the great the risks are to the mother. Recovery time is also reduced for vaginal deliveries.  Check out ICANN for more information on VBACs.

Final Thoughts on Procedures to Decline During Pregnancy

The overall idea is to decline unnecessary procedures that force you into a cookie cutter mold of pregnancy. With the rising rates of American maternal and infant mortality, it’s important to look at why this is happening. One reason is that with normal pregnancies that don’t need these procedures, the risk of caesarean rises. If we can continue to speak for our rights as women, we will hopefully start to see those numbers decline.

These resources may help you delve deeper into this topic: