Prenatal Ultrasound and Autism: Multiple Voices

I previously blogged (also here) about Carolyn Rodgers’s idea that prenatal ultrasound may cause autism. It turns out that she isn’t the only person with this idea; researchers at the University of Louisville recently published the same idea.

I learned about the Louisville study from Anne Weiss, who said the connection has been plausible for a long time.

Ultrasound was introduced into obstetrics in the 1970′s and was generally restricted to high-risk pregnancies. By the 1980′s policy statements were issued by ACOG, the NIH and equivalent bodies in Europe and Canada stating that its use should remain limited to high-risk cases. Despite these recommendations, ultrasound technology became common in hospitals and doctors’ offices and routinely applied to low-risk populations. Within a short time the majority of pregnant woman were being exposed at prenatal visits, during multiple scans in hospitals, and during continuous monitoring during labour (which could mean 12 to 14 hours during childbirth alone). Skills and techniques used to monitor the fetus prior to the introduction of ultrasound (in utero and during the birth process) were slowly undermined by the technology and often underutilized. Iatrogenic effects from false positive readings, – unnecessary C- sections, inductions, instrumental deliveries etc. caused harm to moms and babies, especially in the early 1980′s.

Three important names in the 1980s were (1) Robin Mole, who presented a paper “Possible Hazards of Imaging and Doppler Ultrasound in Obstetrics” to the Royal Society of Medicine Forum on Maternity and the Newborn: Ultrasonagraphy in Obstetrics, April 1985. She was former director of the Medical Research Council Radiobiology Unit, England. Also the work of (2) M.E. Stratmeyer – Research in ultrasound. A public health view. Birth and Family Journal 1980 and (3) Doreen Liebeskind – still at Albert Enstein and a prof of radiology- presented at a symposium at Columbia in 1983.  She was concerned that ultrasound may be producing subtle changes in the fetal brain perhaps affecting behavioral mechanisms, possible changes in reflexes, IQ, attention span or some of the more subtle psychological, psychiatric or neurological phenomena. Referred to animal and lab studies that showed ultrasound may cause chromosomal damage, breakdown of DNA, etc. There are others who sounded the warning that this was not a benign technology but these voices were crowded out for varied reasons like threats of litigation, loss of the traditions skills of birthing etc.

There were also Japanese studies that raised concerns about ultrasound. Weiss continued:

Unfortunately the use of ultrasound in obstetrics has not declined, despite safety concerns and the lack of research to rule out serious neurological effects. It’s so entrenched in modern obstetrical practice.  Doctors use the machines to protect themselves from litigation – in the case of fetal abnormalities, undetected multiples, placenta previa, neurological or physical damage to the fetus during childbirth, stillbirth etc. It has almost become a form of entertainment – you can get photos and videos of baby’s ultrasound. It’s disturbing how benign it appears.

Within the context of the work I do, ultrasound is just one of many concerns I have with the over-management and medicalization of childbirth. My clients come to me to find ways to subvert this within the hospital setting or to prepare for a home birth with a midwife.  I also get referrals from doctors whose patients are dealing with difficult issues while pregnant.