These days an ultrasound is one of the first and most basic investigations done in pregnancy.

Undergoing an ultrasound during pregnancy is a simple and painless process — a gel is spread on your abdomen to work as a conductor for the sound waves produced via a transducer. The sound waves bounce off bones and tissue returning back to the transducer to generate black and white images of the fetus and you walk away with a picture record for your fridge (and family!).

Due to the ease and availability, having an ultrasound during pregnancy is also being done far more frequently than what they were in recent years. Ideally they should only be done when medically indicated, but this varies according to your healthcare provider and very often due to your requests to have them more often “just to see the baby and hear the heartbeat” – it is a wonderful tool to aid in prenatal bonding with your baby. And this is where I would like to throw the cat among the pigeons, so to speak.

What about when you go in for your 20 weeks scan, bursting with excitement only to be told that your baby has a complication – maybe cleft lip and palate?

Despite all reassurance that this it can be surgically repaired, the first thing you do when you get home is do an internet search. Pictures of cleft lip are scary. It is not cute or pretty. Once you get over the shock, you will eagerly devour all information.

But will it affect the bond you have with your unborn baby? Will your feelings change? Will you look back on everything you did, ate, thought and said and wonder why this has happened? Who is to blame? Will you get mad at your husband? Will he get mad at you? Will you wonder “Why me?”, “Why my baby?”

Yes, yes and yes is probably the answer to most of those questions.

Would it have made any difference if you did not know? Would the shock have been any less on discovering it in those few precious moments after baby is born? Are the effects of oxytocin enough to see beyond the apparent “imperfection” and just love your baby because it is yours? Would the bonding be affected in any way by not knowing versus knowing and being prepared?

I think that the most important aspect to consider when we go for a routine scan is that all the technology in the world cannot and will never prevent fetal abnormalities and things going wrong.

We have to accept that certain things are beyond our control. We have to stop looking to place blame. We have to stay realistic and open minded and if the wonders of modern technology reveal a baby less than our perception of perfect, we embrace that we have been specially chosen as parents for such a special baby. We prepare.

A Guideline for Ultrasound During Pregnancy

First Trimester:

• Confirm viable pregnancy
• Confirm heartbeat
• Measure the crown-rump length or gestational age
• Confirm molar or ectopic pregnancies
• Assess abnormal gestation

Second Trimester:

• Diagnose fetal malformation
• Weeks 13-14 for characteristics of potential Down syndrome (NT Scan)
• Weeks 18-20 for congenital malformations (Anomaly scan)
• Structural abnormalities
• Confirm multiples pregnancy
• Verify dates and growth
• Confirm intrauterine death
• Identify hydramnios or oligohydramnios – excessive or reduced levels of amniotic fluid
• Evaluation of fetal well-being

Third Trimester:

• Identify placental location
• Confirm intrauterine death
• Observe fetal presentation
• Observe fetal movements
• Identify uterine and pelvic abnormalities of the mother

Noninvasive prenatal testing is another effective way to determine chromosomal abnormalities of an unborn child for as early as 10 week of pregnancy.

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About the Author

Karen Wilmot is a Midwife, Yoga Instructor, Birth and Lactation Consultant. In August 2009, she started a community based service offering birth preparation classes, home and hospital visits and support throughout pregnancy, birth and beyond.

Learn more: www.pregnantinoman.com
Email: karenwilmot@gmail.com

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