To Scan or Not To Scan, that is the question

So I just got back from my routine monthly prenatal visit. I’ll be 17w tomorrow, and as I headed out the door I asked about scheduling the anatomy scan since Charlie wants to find out the sex this time around. My midwife immediately said, “Oh! Well, I don’t really like ultrasounds, but if you want one, I’ll order one. Do you want an anatomy scan or just one to determine the sex?”

Well shit. I dunno?

For reference, my insurance BLOWS and it costs us about $300-400 per ultrasound to get it done at the local hospital (because of the actual ultrasound charge + the radiologist overread). Apparently though, there is a clinic about 1h45 from here that will do a quick 10 minute scan to determine sex for $100.

Thoughts? Opinions?

Ultrasounds aren’t really necessary in healthy pregnancies, I know this. I had just been assuming we’d do the “standard” anatomy scan around 20 weeks because we did with Stella, but now I’m not so sure.

From here: The ultrasound is a noninvasive procedure that, when used properly, has not demonstrated fetal harm. The long term effects of repeated ultrasound exposures on the fetus are not fully known. It is recommended that ultrasound only be used if medically indicated.

I mean, I’m not worried about genetic abnormalities. I know that it’s possible, and because of the ALI blogging world I’ve heard of those awful stories where something terribleΒ was diagnosed at that scan… but at the same point, the chance of something being severely wrong at this point is so incredibly low, and part of me would like to just skip the anatomy scan altogether.

How did you decide? Did you even question doing it or did your provider just order it routinely for you?

Also, the clinic that does sex determination uses 3D/4D technology, which totally creeps me out. What do you know about the risks of 3D vs 2D ultrasounds/sonograms?

Help!

(PS – a pet peeve of mine is when people use the terms sex and gender interchangeably. They are different things!)

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50 comments

  1. I highly recommend the scan. Of all the scans you can get during your pregnancy, this one is generally considered the most important. It lets you know not only that all the baby’s parts are developing normally, but also it is a heads up to your doctor of any potential life threatening medical concerns that could need attention prior to or immediately following the baby’s birth (including heart abnormalities). My sister is a doula who preaches home births, no medical intervention, and Hypnobabies, and even she tells her clients to have this scan.

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    1. True, since I’ll be delivering 30 min from a hospital, maybe the peace of mind that there are no heart defects, etc would be good to have? Hm…

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      1. I totally agree with this. Given your location, you need to know that you won’t require special attention. Good thinking!!!!

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  2. I’m 22 weeks and had my anatomy scan, I just needed to know how the baby was doing and of course the sex, but with a crazy copay like that I can understand not wanting it! You might consider finding a local ultrasound school or at the hospital programs, the students need “hours” and you get free ultrasounds while they practice their technique. I’m not sure what the experience is like (may be uncomfortable if they aren’t sure of what they are doing, or they might misdiagnose something until the teacher comes in), but it’s worth a try!

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    1. If I lived in a city I totally would, but the closest teaching hospital type scenario is 6 hours from here in Denver. Not practical unfortunately!

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      1. Ugh, sorry to hear that! Maybe the $100 option would be a good compromise, but I would definitely feel better having the full scan, since you are far from the docs & it’s a smaller cost than if you were also delivering in the hospital πŸ™‚ good luck with whatever you decide!!

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  3. Brittany · · Reply

    We did the anatomy scan with our first pregnancy (but didn’t find out the sex) and my midwife (who I had with the last pregnancy) schedules them routinely so we will be having one this time around, too, on Aug. 7th. I don’t think there is anything wrong with having them done, although if you’re paying out of pocket for them, that would be different I think. My personal belief is that they are safe & give good peace of mind that everything is ok. Plus, I love seeing the little babe.

    Because of my husbands work schedule, and the fact that we were finding out this time around, we went last weekend to one of the local places to do a sex determination. My husband likely won’t be here for the anatomy scan & we wanted to find out together. See if your place will just do a regular 2D screening vs the 3D/4D scan. I think those are creepy! But it might cost a little less (it was at our place) to just do the 2D and this far along, they should have no problem finding out the sex unless baby isn’t cooperating.

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    1. Ya, I had no problem doing it last time, but I also figured the u/s was covered by insurance at the time since I had maternity coverage (damn shitty insurance!).

      Good point about the 2D…maybe I’ll call and ask if that’s an option.

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  4. We did a ultrasound at 17 weeks at a baby belly spa when Ben’s parents were in town so we could share the sex reveal with them since they were unable to make the birth. Then we did the routine 20 week scan with our doctors.

    I say do what makes your sleep at night. If you need the reassurance that everything is ok then go ahead and do the 20 week scan. If you are good either way than do the sex scan. I get a little freaked out by the 3D/4D u/s. Maybe they have a cheaper 2D u/s package?

    Thanks for the sex and gender tidbit. I never knew this. Learn something new every day!

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    1. It’s a random tidbit, I know, but for some reason it drives me nuts! Kind of like when ppl talking about IVF say they “implant” the embryo instead of “transfer.” No human being can implant an embryo – that’s up to the embryo, the ute, and God!

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  5. I had millions of scans and depleted my medical aid funds, but I was a high risk pregnancy… The 20 week one they check the heart I think, isn’t that when Marwil found out about her problem and had to terminate? I found out the gender at 14 weeks.
    Funny story about sex and gender. As a kid I had to fill in a form and one of the questions was “sex”. I was filling it in with my dad and didn’t know what sex was, although I knew how babies were made. He was so embarrassed! He got my mom to deal with it! (The whole thing could have been avoided by using the word “gender”)

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    1. Ha – that’s my point though, sex IS the correct term to use there!

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  6. I am a sonographer (registered in OB/GYN) and I would highly encourage having the fetal anatomic survey in the hospital vs. the “quick 10 minute scan”. In the medical community these “clinics” are hugely controversial. A 2D ultrasound is considered safer due to less energy used.

    We do not only look at baby for possible defects. Your ovaries, uterus and surrounding pelvis will also be evaluated. I am unsure why your midwife doesn’t like ultrasounds. There are no known biological effects of ultrasound.

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    1. To clarify – if I was going to the OB clinic for the quick scan, it definitely wouldn’t be to check for any physical issues other than determining the sex. I get the benefit of having a trained radiologist read everything! I have also heard that 3D uses more energy than 2D — and that NEITHER has long term research in place determining the effects on a fetus from repeated exposure (which I’m sure is why my midwife isn’t a huge fan – I know it’s why I’ve had some IRL friends decline ultrasounds). I’m not hugely concerned about this, but it is something to think about, especially in a society where lots of tests are procedures are done just because they’re routine – not because they’re necessary!

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  7. I had my anatomy scan done as part of the genetic screening that we made the decision to have done. I would say that it is standard practice for the doc to recommend it here, but because I didn’t have insurance at the time, it was offered to me as “take it or leave it, up to you”. I was able to negotiate it down to the medicaid rate, you might see if the local place can offer you a lower rate or if you qualify for any special programming.

    As for the safety of a 3D vs 2D ultrasound goes, it seems to be the same. The way that it works (from my looking around for it online) is that multiple still 2D images are taken and the computer uses those to produce a 3D image. So essentially no extra “damage” is done with the 3D.

    As far as I can tell, the major risks of ultrasounds in early pregnancy are relative to cell destruction. It is unknown what type of damage ultrasound does to cell development in embryonic life. Again, from my research, it seems to be recommended that ultrasounds be avoided in the first trimester, but after that they are less likely to do damage.

    Also, the secondary risk is to hearing (as an audiologist it was a concern of mine), intrauterine probes have measured very high decibel levels near a fetus’ ears. The longer the time and the louder the sound any person is exposed to, the more likely there is to be hearing damage (think years of factory work and loud explosions), but even short periods of loud noise can damage the ear/hearing slightly. A full anatomy scan takes much longer than a sexing ultrasound, be it 2D or 3D. Therefore more exposure to the soundwaves=more damage.

    Still, I’d do the full anatomy scan again even with the risks, the benefits of knowing of a major medical problem in advance, especially with a home birth, can’t be overstated.

    All food for though, hope my input helps πŸ™‚

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    1. Thanks, Michele! I totally appreciate the input. I might tell the hospital I no longer have insurance and see what negotiated rate they can give me. Good call! I know we give 35% off office visits for self-pay patients at the clinic I work at.

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  8. Absuetly EVERYTHING the first commenter said. They check and measure everything (including all internal organs). There were no genetic abnormalities wrong with Jacob but everything wrong on the inside of her body. A quick gender scan never would have caught any of that.

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    1. *cough…scan!

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      1. πŸ™‚ I knew that would be your opinion! We probably will – I hadn’t thought about ruling out internal issues because of the home birth aspect, but it’s a good point.

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        1. I tried not to use caps in the comment lol.

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  9. I’d definitely recommend the scan since you’re planning a home birth. If there were anything wrong with the baby, I’d want to know to plan for delivery, and even change birth plans if necessary.

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    1. Yeah, I’m just realizing the benefit of that particular part of it! Worth the $400 to know that there is no pre-determined physical reason the baby would need medical attention immediately.

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  10. Our doc did it routinely and we didn’t really question it. We were kind of desperate to find out our baby was fine any chance we got, especially since we found out that we had miscarried at our 20 week scan with our first baby. But if we get pregnant again, I think I’ll be much more easy-going about it and I could see myself skipping the scans. The above points are really good though, especially the thought that you’d want to know if there were risks or problems, considering you’re doing a home birth.

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  11. Agreed with everyone. You will want to know that everything is fine with the baby, as well as you. I had a blood clot on my uterus and I was told that I had to deliver in the hospital in case it burst during L&D. They were worried that I would lose too much blood. Just a thought!

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    1. Side note: I was planning on delivering in the hospital do it didn’t mean anything to me, but it made me worry more about going into labor!~

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  12. The 3D/4D images have always freaked me out. I remember when they first started doing them and watching a news story about them! That was a long, long time ago but they still freak me out.

    I agree with pretty much everyone who has commented already. This is one scan I’d 1000% do. Even with a hospital birth, I want to know if I need to (potentially) be prepared for something once the baby is born. That’s basically my reasoning for doing the NT screening. I know it’s not super accurate, but I’d rather be as prepared as I can be just in case. I just want to know that everything looks good; finding out whether the baby is a boy or a girl is just a bonus to me.

    I have heard that hospitals are pretty good at offering a discount if you are self pay and you ask about it. I’ve also heard that they should be able to arrange a payment plan.

    FYI, if you decide to just do the gender scan, it may be cheaper if you wait until your 3rd trimester. I looked into one of these boutique places for the heck of it a couple weeks ago and if I wait until closer to my due date the cost of a 10 minute scan dropped to $50. And they give you the option of 2D, 3D or 4D. So, that’s something else you could ask about πŸ™‚

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  13. Runningfrmcrazy · · Reply

    I would do the full anatomy scan. Although there is a super low chance anything is wrong. I think it’s good to be prepared. So many heart defects now can be treated right after delivery with surgery, if they know about them beforehand.

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  14. I would get the anatomy scan since you’re having a homebirth. I would want to know about any defects that could potentially be a problem for your midwife to handle at home (heart defects, gastrochisis, etc). I think it was Shelley who shared the story of a woman who had no ultrasounds her entire pregnancy, planned a homebirth, and then gave birth to a baby with gastrochisis (I’m probably not spelling that right). It was a complete shock and the baby ended up losing parts of its intestines because they didn’t get to the hospital quick enough. It’s rare, but things like that can happen. I would want it for the peace of mind it would bring.

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  15. Im all about the scan and finding out the gender if thats the way you are leaning. I just like the reassurance that everything is ok.

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    1. Totally just realized i said gender…and i never use that word anyway! Weird!

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      1. Haha, funny girl. πŸ™‚

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  16. We had the anatomy scan with our first three and will again this time. Insurance has covered it each time. I’m sorry yours stinks right now! 😦 I had 2 losses before baby #3 so I don’t mind another scan, especially looking at the brain, heart, placenta position etc. That’s just me!

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    1. Ya, it’s easy to “just get the scan” when you’re not facing yet another $400 medical bill. πŸ˜› I’m definitely leaning towards getting it done now though based on the whole home birth thing!

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  17. mcmissis · · Reply

    Because my cousin found out her daughter has half a heart at her 20-week ultrasound and is now, three open-heart surgeries later, a happy, healthy, 3-year-old girl, I say do the scan. I opt out of the other screening tests (to find out about Down’s syndrome and stuff like that) because I wouldn’t change anything, even if I knew. The kinds if things they can find in that 20-week ultrasound can be reason to love your pregnant life differently. OTOH, I just read an article last week about the possibility of ultrasounds leading to autism. The author said they generally roll their eyes at studies like this (me, too!) but that this one said the researchers hesitated publishing the results because they didn’t want to scare women who needed ultrasounds for medical reasons away from getting them, but that the link was strong enough to publish anyway. Just to make you second guess yourself even more! I’ll look for the link right now, but again, I still FAR AND AWAY so do the ultrasound.

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      1. Thanks S – I’ll have to look more into this!

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  18. Hey Mama, If you decide you just want to learn the sex there are two new blood tests that you can take that can determine the sex. One is the Harmony and the other is called MaterniT21. My understanding is that they are able to extract genetic material that you share with the baby in your blood stream. They can determine Down Syndrome, and other genetic issues. As well as locating the xx or xy chromosomes.

    I believe insurance coverage is iffy (especially if you’re under 35), but it might just be cheaper than the ultra sound in the long run… Something to think about!

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  19. I agree with those above-I would do the scan to ensure there’s nothing that needs to be addressed at birth.

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  20. So many good comments here, I don’t have too much else to add. I would get the anatomy scan but then again my sister was born with severe heart and internal abnormalities that eventually led to her death so I love to know that my babies don’t have any of those issues. Also, I echo what others have said about knowing something before having a home birth, since you’re not super close to a hospital. Good luck!

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  21. What reason is there NOT to get the scan besides money (I’m not downplaying money – I just didn’t see any other reasons in your post)? I would think of the money you’re saving by having a home birth, and take $400 of that to invest in the scan to make sure that there are no identifiable risks going into that home birth!

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    1. Simply b/c there are no long term studies done that can prove there is NOT long term risk associated with ultrasounds (see the link in McMissis’ comment above – I’ve seen stuff like this before) – plus just questioning why something is ordered routinely if there are no previous indications of anything to worry about. Remember, I live in a pretty crunchy area where quite a few of my friends have actually opted out of the 20wk anatomy scan now that I think about it, and it just got me thinking!

      — and, until everyone mentioned it, I hadn’t thought about ruling out identifiable risks prior to home birth πŸ™‚ I do agree that it’s a good idea though!

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  22. I say do it for my peace of mind, ok. ha ha.

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  23. I had a homebirth with my daughter and opted to not do any ultrasounds or scans. For me it wasn’t based on money, just didn’t seem necessary and it was a healthy pregnancy so nobody pushed the idea on me. Although I do live in an area with a lot of Mennonites that all do homebirths and doing those sorts of things aren’t all too common in my area unless you go the hospital route. For some people it gives them peace of mind, but for me I’ve always been the whatever happens happens type of person. Although there were 12 kids in my dad’s family all born at home back in the 30s/40s and almost all of his siblings also opted for homebirths, none ever doing any ultrasounds/scans, so guess its something that runs in my family. But I do think the thought process on this does depend on where you live, how you were raised, and what relatives did. I do know a few people who have done homebirths that have gone in for the regular ultrasounds/scans/tests and every prenatal appointment, so guess its personal preference. So I say you just gotta do what your gut tells you to do. I think it also depends on if you already have had a homebirth. From what I have noticed a lot of women who have had 1 or more homebirths usually skip a lot of the ultrasounds/scans/tests compared to those that are new to the idea of a homebirth. But good luck with whatever you decide! And also on the money issue, have you looked into your states insurance options when Obamacare goes into effect in October (or at least goes into effect in my state in October). I know right now through my hubby’s job insurance costs him a fortune for my daughter and me, he gets his paid for through his job. But with options my state has, it would only cost us around $150-200 a month for the insurance then for all 3 of us and it covers almost all prenatal visits and birth but other medical issues have a higher out-of-pocket rate. Something to look into as an option, although I know all states are way different on what they plan to offer and the cost of it.

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  24. I really needed the reassurance that all was well of the anatomy scan, but that’s me and mine didn’t come with a hefty bill! I like some of the other girls’ thinking though, since it will be a home birth, it would be great to have that reassurance that all is perfectly well (which i am sure it is!)

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  25. While I appreciate your conscientiously considering decision such as these, I have to be honest and say that personally I don’t put too much stock in the theory that ultrasounds may be dangerous. You are absolutely right that there are no studies proving there are no long-term risks. However, if I’m not mistaken, neither are there studies proving that there ARE long-term risks. So, why the big fuss? The same argument could be made for cell phone use – we’re always hearing theories that there will someday be an explosion of brain cancers because of people always having the phone up near their head. Perhaps it’s true. But there are no studies proving that, nor are their studies disproving it. And, yet, few (any?) people choose not to use cell phones, “just in case.”

    I understand that it’s not necessarily an apples-to-apples comparison here, and in the one example of course your making a decision about your own health (cells) and not your unborn child, but I do think it’s a valid argument regardless. Honestly, I refuse to live my life thinking about the “what ifs” with regards to all the potential harmful elements in our environment, especially when, for the time being, there are only theories and conjectures.

    Getting back to the topic specifically at hand – as someone else said above, you absolutely HAVE to do what your heart tells you, and go with the decision about which you will have no regrets. Previous comments that it’s important to know ahead of time of any conditions that would need immediate attention make a really good point and not one I’d thought of. But, of course, as you’ve said you’re low risk. So, really it’s up to you!! And I’m sure everything is just perfect in there! πŸ™‚

    P.S. I also think the suggestion of the maternit21 bloodtest to know the sex is a good one, although I don’t think it’s cheap. A friend of mine had it done and her insurance ended up covering it, but IIRC it was going to be around $230.

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    1. Yeppers, I agree with everything you’ve said. πŸ™‚

      $230 for a blood test is cheaper than $400 for an ultrasound, but at that point, I selfishly think I’d rather pay the extra $170 and get to SEE my baby!

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    2. theurbanjunglegym · · Reply

      I’m totally in-line with all of this. Also, you know the one thing my doctor told me I absolutely had to do to be safe during pregnancy? Wear a seat belt every time I ride in a car. That was it–she didn’t care if I ate sushi or had an occasional glass of wine. Car accidents are far more deadly and dangerous to both mothers and children. Far more dangerous than ultrasounds! And yet, I’m sure you don’t second-guess yourself every time you drive somewhere. Which is good– because if you did you’d be a neurotic freak like me πŸ˜‰

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  26. My sibling had a cleft palate that was discovered on an anatomy ultrasound, so I’m a fan of them. It actually was almost totally healed at birth but had some hefty long-term consequences and it was good to know ahead of time. A cleft palate isn’t super huge but with any anatomy problems, it’s so much easier to prepare if you know what to expect.

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  27. I vote for taking the drive for the quick scan to see if it’s a baby sista or a baby brotha πŸ™‚

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  28. […] wrote about this a few months ago, as I was torn about what to do. Ultimately, we decided that since I’m […]

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