When I was pregnant with my second child, I had one and only one ultrasound, early in the pregnancy, in an attempt to establish a due date. I couldn’t bring myself to schedule another. You could blame crunchiness (I birthed both of my kids at home) or craziness (where to begin?). I blame fear.
I pace my kitchen with the phone cradled between my ear and my shoulder. My eyes are red from crying and staying up googling “echogenic bowel.” I know I’m going to cry when the doctor answers. I’m going to ask him for more information about the ultrasound but what I really need to know is whether I’m carrying a baby who is healthy or a baby who won’t survive a day outside my body. I cry because no one can tell me the one thing I need to know: what to do next.
Up until now, my pregnancy has been normal. I’d left my 18-week ultrasound knowing the baby had all its vital organs, ten fingers, ten toes, and that the femur measured relatively long. On that cloudless summer day, I’d wondered aloud to my husband whether our little miracle would be a talented cyclist with my scrappiness and his natural athleticism. I stuck the black and white image to the fridge, not knowing that at our next prenatal appointment we’d learn our perfect bean was maybe not perfect after all.
The radiologist’s report reads, "Echogenic bowel is identified, which is frequently a benign finding in the second trimester. However, there is an association with increased risk of chromosomal abnormalities, trisomy 21, cystic fibrosis, IUGR (intrauterine growth restriction) and other abnormalities."
I’m sitting on my couch, my legs tucked underneath me, a glass of water on my left, and my husband on my right, when the midwife’s apprentice presents our options.
“You could get genetic testing. There’s a great clinic we can refer you to. Another option is to get an amniocentesis. You could do a follow-up ultrasound in a few weeks. Or you could do nothing.”
I don’t feel like crying. I’m not scared or overwhelmed. That will come later. “What do you recommend?” I ask.
“My job is just to educate you and let you make the best decision for you.”
“I know, but what would you do?” I press her.
“Like I said, the midwifery model of care is about educating you and letting you choose for yourself.”
But I want someone to choose for me. I turn to Google, which confirms that in most cases, this is a benign situation. But Dr. Google also says a follow-up ultrasound could appear normal when the baby is not actually normal.
Google has also informed me that certain ultrasound operating frequencies are more likely to produce false positives. I am obsessed with finding out the operating frequency my ultrasound technician used, which is why I’m tolerating the interminable hold music, waiting for the radiologist to answer.
When he finally does, I can’t speak without crying. I breathe in through my nose and out through my mouth, the way my mom told me to whenever she tended to a skinned knee or a splinter. It occurs to me that she must have learned that when she was pregnant with us in the ‘70’s.
When I regain my composure, I ask about the operating frequency. He tells me which one they use. It’s the one with a higher rate of false positives.
“What should I do?” I don’t care if he can hear the desperation in my voice.
“Schedule a follow-up ultrasound at the high-risk clinic in about two weeks. It will be normal, and you can relax.” His voice sounds like kindness and confidence.
“But what if it doesn’t? I’ll be at least 21 weeks along by then.”
“Just come into the high-risk clinic. You’ll get another ultrasound, it’ll be clear. You’ll see.”
“If you’re so sure it will be clear, what’s the point of even doing it?”
“It will ease your mind.”
When there’s nothing left to say, I thank the doctor for his time and hit End. Questions flood my mind. What would my options be if the ultrasound were abnormal at 21 weeks? Would I have any options?
I return to Google, re-reading the same articles, literature reviews, and blog posts I’ve already devoured. I cling to the hope that an answer is buried somewhere online. If I just use slightly different search terms or wildly different search terms, or perhaps if I dig deeper into the discussion forums, someone will tell me what to do. But no one does.
On my lunch break, I step out of earshot of my co-workers, call my mom, and vomit up the whole story.
“Slow down,” she says.
“Mom—“
She cuts me off. “When you were about six weeks old, we had to take you to the hospital because you were turning blue. All the doctors could come up with was you were constipated. But maybe it was echogenic bowel. Maybe it resolved on its own. We didn’t have all this imaging back then. We never would have known. But you were fine.”
Whether she meant to or not, my mom gave me permission to stop worrying. There would be no genetic testing, amnio, or high-risk evaluation. My husband was on board for waiting and hoping for the best. It would be weeks until I’d find out he’d cried his own private tears.
By the time our baby was born, beautiful, pink, and perfect, the intensity of my worries had faded to the point where I hardly remembered worrying about her vitality.
Pregnant again less than two years later, I’d forgotten nearly everything I knew about babies. I (mistakenly) remembered babies being easy, that all they do is sleep. Yet, I remembered the anguish my husband and I experienced in the aftermath of that ultrasound with painful accuracy. The anxiety of skipping the ultrasound and letting our second baby remain a mystery until the day of her birth was nothing compared to that.
Pam Moore
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