Wednesday, September 21, 2011

Sometimes... We Make Mistakes - Private Ultrasounds

Three years ago, when I began this doula practice with several other excited and newly trained birth doulas, I have to admit, I was very naive.  Companies contacted me offering samples, coupons, etc. for us to share with our clients.  Some of them had very significant discounts.  Realizing that having a baby is not an inexpensive undertaking, I accepted some of these offers and passed them on.  They say hindsight is 20/20, and while we have since become more aware of companies true intentions and perhaps some less than ideal family values, we still slip up on occasion.

One of the companies that we had shared with our clients was a private ultrasound service.  While we do not advocate the use of ultrasounds, other than for medical reasons (see Obstetric Ultrasound Biological Effects and Safety by SOGC, Are rural general practitioner - obstetricians performing too many prenatal ultrasound examinations? Evidence from western Labrador, Ultrasound scans may disrupt fetal brain development, and Ultrasound: More Harm than Good? by Marsden Wagner, MD Midwifery Today Issue 60, Summer 1999), we realized that some parents wished to have a second ultrasound to for a special memory, gender prediction, etc.  Therefore, we provided the discount coupons to those who mentioned they were planning to have these ultrasounds.

Recently, we have been doing much more research into baby-friendly practices such as the WHO/UNICEF Code of Marketing of Breast Milk Substitutes (World Health Organization).  Specifically, we believe we must adhere to the following:
Article 4. Information and education
4.2 Informational and educational materials, whether written, audio, or visual, dealing with the feeding of infants and intended to reach pregnant women and mothers of infants and young children, should include clear information on all the following points: (a) the benefits and superiority of breast-feeding; (b) maternal nutrition, and the preparation for and maintenance of breast-feeding; (c) the negative effect on breast-feeding of introducing partial bottle-feeding; (d) the difficulty of reversing the decision not to breast-feed; and (e) where needed, the proper use of infant formula, whether manufactured industrially or home-prepared. When such materials contain information about the use of infant formula, they should include the social and financial implications of its use; the health hazards of inappropriate foods or feeding methods; and, in particular, the health hazards of unnecessary or improper use of infant formula and other breast-milk substitutes. Such materials should not use any pictures or text which may idealize the use of breast-milk substitutes
 Article 5.  The general public and mothers
5.1 There should be no advertising or other form of promotion to the general public of products within the scope of this Code.
5.2 Manufacturers and distributors should not provide, directly or indirectly, to pregnant women, mothers or members of their families, samples of products within the scope of this Code....
5.4 Manufacturers and distributors should not distribute to pregnant women or mothers or infants and young children any gifts of articles or utensils which may promote the use of breast-milk substitutes or bottle-feeding
  
Now, to the reason for this post.  It has come to our attention that the private ultrasound company whose coupons we had mistakenly shared has a "rewards" program which includes a gift package of discounts, samples, and information which does not abide by the WHO Code.  Therefore, we will no longer provide coupons for this service.

Please know, that as doulas, our first priority is caring for the families we work with.  We support your choices and will assist you in finding evidence based information to help you make informed decisions about caring for your new baby.  We also must abide by the standards set forth by the World Health Organization and our training/certifying organizations.  We're happy to serve you in a mother-friendly and baby-friendly practice!

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