Scans: what to expect
Ultrasound scans offer dads the amazing opportunity of seeing the baby we’ve helped make! But there is a lot more to them than getting some exciting pictures…
What is a scan?
Ultrasound was originally developed during WWII to detect enemy submarines, and was then subsequently used in the steel industry before being adapted for use in the medical arena. Ultrasound scans use high frequency echoes from sound waves, which bounce off the baby and are translated into a computer image showing the baby’s size, position and movement.
Most scans are carried out by specially trained staff called sonographers. They are carried out in a dimly lit room and your partner will be asked to lie down and lower their skirt or trousers to the hips and raise their top so the sonographer can access their tummy.
The sonographer will put ultrasound gel on your partner’s tummy and use a handheld device called a probe over the skin. It is this probe that sends out the ultrasound waves and picks them up when they bounce back.
How many are needed?
Scans are a medical screening tests which are offered to all pregnant women, but there is a choice about whether you accept them or not – they are not a requirement. Some people want to find out if there are any problems or concerns within the pregnancy so they can be prepared and have more options; others feel that the result won’t change how they feel or their choice of actions, so they don’t need to know and therefore don’t need the test. There is no right or wrong, just what feels right for you as a family.
If you decide not to have any scans, it does not affect you receiving any other antenatal care. If you choose to have a scan, be clear about the information that you do and do not want to be told.
There are two key scans which all pregnant women are routinely offered.
- A ‘dating scan’ usually around 8 - 14 weeks.
- An ‘anomaly scan’ usually around 18-21 weeks.
Other scans may also be offered, depending on certain factors.
The Dating Scan
The first scan is used to confirm the pregnancy, so will be checking for a foetus with a heartbeat, and they are growing in the right place. It also checks for how many babies there are! The sonographer will also measure the baby to estimate when your baby is due. Some abnormalities may also be detected at this scan, such as neural tube defects.
The dating scan can include a nuchal translucency (NT) scan if it is done before 14 weeks. The NT scan is a separate test, and it is possible to have the dating scan but decline the NT scan. Find out more about the NT scan here. Tests and checks
The Anomaly Scan
The second scan checks for structural abnormalities (anomalies) in the baby. The scan looks in detail at the baby's bones, heart, brain, spinal cord, face, kidneys and abdomen. It allows the sonographer to look specifically for 11 conditions, some of which are very rare.
The sonographer will also be looking at what is around baby - the amount of amniotic fluid, the cord flow and where the placenta is positioned.
Girl or a boy?
It is possible to tell whether you are expecting a girl or a boy from around 16-17 weeks of pregnancy, but whether it can be discovered will depend on the position that your baby is in. Be aware, though, that it's not always possible for the sonographer to be 100% certain about your baby's sex, and because it is an interpretation, sometimes mistakes can be made.
However, the aim of the anomaly scan is to not to find out the sex of the baby, so whether your hospital will tell you the sex of baby depends on their individual policy. If their policy is not to tell you, you can either wait for a surprise, or pay for a private scan to find out.
Are there any risks?
There are no known risks to ultrasound scans in pregnancy. However, this is different from saying they are proven to be safe – the reality is that they have been used widely in medical practice for 50 years, with no conclusive evidence of adverse side effects.
The small amount of waves that the baby is exposed to during a routine scan is not thought to be big enough to cause any damage and the diagnostic opportunity to identify any problems is thought to vastly outweigh the very small potential risk. However, this still ultimately remains your choice to weigh up.
There is more uncertainly in the use of ultrasounds for non-diagnostic reasons, such as for 3D photos or videos. These tend to require much longer scans, which too have not been proven to be either safe or unsafe, and again are your choice to weigh up.
The other risk around scans is the risk itself of finding a concern (conclusive or not) which may cause distress and anxiety. Further tests may be offered as a result, such as amniocentesis, which can carry their own risks including miscarriage. In some cases, it may transpire that there is nothing wrong with the baby and the distress caused was unnecessary. However, this is a very personal decision to make, and it is worth discussing with your partner what you want to know and when, and, if anything, what you don’t want to know.
Are they accurate?
While routine scans can be reassuring, it is also important to balance them with the understanding that they cannot diagnose everything. Many heart defects cannot be seen until after birth, regardless of the skill of the sonographer, because they are not present until after birth following the physiological changes of the heart and lungs. A study from Brisbane showed that ultrasound at a major women’s hospital missed around 40 percent of abnormalities, with most of these being difficult or impossible to detect.
Why might more than two scans be recommended?
An additional scan or scans can be recommended in certain circumstances:
- there are twins (or more)
- if there is concern about your baby’s growth
- if the placenta is covering or close to the cervix
- there’s too much or too little amniotic fluid
- your partner has diabetes or hypertension
- your partner is bleeding
- there’s a risk of premature labour
Problems in pregnancy: what can happen?
Should fathers attend the scans?
It’s a wonderfully exciting way to connect with your baby – by seeing them in action inside the womb. Some dads say it’s the first time they felt a real bond with their baby – so remember to bring some money to buy a keepsake scan photograph. Dads and bonding. What can a dad expect from a good maternity service?
It’s also a way of supporting your partner – scans are most often amazing experiences, but they are diagnostic tests, and on occasion will find something suspected to be wrong with the baby. If this happens it can be distressing and supporting each other is so important.
Can fathers take time off to be at the scans?
Since October 2014, Fathers and partners have the right to take unpaid time off work to accompany expectant mothers to up to 2 antenatal appointments, which include scans.
If you wish to attend more than 2 antenatal appointments then you still have other choices. Talk to your employer about taking additional unpaid leave, or even consider using annual leave where necessary.
‘I knew we were pregnant, but it didn’t really compute until that first scan. Then it became very real for me. It was pretty amazing actually, which I hadn’t expected. Seeing our baby on the screen and getting that scan photo meant it was really happening, and gave me something to focus on. I couldn’t wait for the next scan!’ – Matt