When Your Pregnancy Ultrasound Does Not Go As Planned

Our first pregnancy ultrasound experience was easy + enjoyable, but our second experience was polar opposite.

I’m sharing this personal story with you for educational purposes. It’s simply meant to say that you have options, sometimes even the most well-intentioned scans have inconclusive results that cause unnecessary stress (like my story) + if you’re feeling like you might be walking into that, then it’s completely OK to go without — contrary to the judgments of traditional care*.

[*Disclaimer: The contents of this blog post are not meant to diagnose, treat, or give concrete medical advice to any reader. Please consult with a secondary practitioner if you’re feeling uneasy about your current provider.]

Our baby is healthy + thriving in-utero + we ultimately had a happy ending to the experience.

But, this post might still be a little uncomfortable or alarming, as the experience was for me + my husband and I don’t want to sugarcoat details. There’s a lot to learn from an eye-opening experience like this one we’re recalling, so it’s worth the read!

I’m also not a swearer by nature, but full disclosure: I was thinking with some swears during this experience + I translate those into this post. 🤭

When I had my first ultrasound, I was 18 weeks pregnant with my daughter. We intentionally chose to only have a single scan.

Note: I’m not against imaging, but my reasons for only having a single scan are partly because I don’t believe baby should be exposed to an ultrasound for long lengths of time. There’s just not sufficient evidence to prove their safety, so when it comes to Mother Nature, I err on the side of leaving well enough alone. You can tell that babies move away from the ultrasound in utero and it’s not because they are trying to be funny or problematic, they don’t have the capacity for that yet… They simply move away from things that disturb them.

I remember laying there saying silent prayers that our baby was healthy. It’s all a parent ever wants to hear.

We were in and out of the ultrasound appointment within 20 minutes. Baby was healthy + agreeable + passed the evaluations with flying colors.

Since our first + only ultrasound appointment had gone so seamlessly for that first pregnancy, we followed our same plan in pursuit of a healthy second pregnancy.

So, at 18 weeks, we went for our general anatomy scan.

The baby measured beautifully across nearly every measurement — except for one tiny connection in the brain they couldn’t seem to grab clearly.

I knew that successful ultrasound readings were partially dependent upon baby’s positioning, so I wasn’t concerned that baby wasn’t in the best position.

Since it was this imaging practice’s policy to perform double scans within the same visit (so that nothing gets missed), I thought nothing of the Maternal Fetal Medicine doctor coming in to do the secondary scan. She still wasn’t able to get the view she wanted and went on to explain that I needed a transvaginal ultrasound.

I felt like the need to do a transvaginal ultrasound might not be urgent. We had already been scanning baby for 2 hours between those double scans. I could see baby actively moving away from the ultrasound — understandably annoyed about being pushed around for so long!

It sounded like everything else had appeared perfectly + that this one partially blurry image might not be something to panic about. Baby still had some growing to do. So I asked what the urgency was.

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The doctor told me that if she’s able to see it + check it off her list today, then I don’t need to come back. If she can’t see it, then I need to come back at 20 weeks so her checklist is complete.

She seemed more concerned about her checklist than explaining to me why this was necessary for baby’s health.

So I asked again.

She added “oh and the baby’s head seems a little big compared to the rest of its body”. Then explained this particular part of the brain she had been searching for doesn’t often form until around the 20 week mark.

So, to me, that was all the more reason to not feel urgency. We were 2 weeks ahead of “average”.

I rationalized that since gestational age is just a guess (mine especially, since my cycles are off) and since our first baby had measured smaller body-to-head at this time (big heads also run in the family!), wouldn’t it make sense to assume all is fine for now, and then wait a little longer than 20 weeks for a follow-up scan so that we could improve the odds of her seeing what she needs to see?

This is where things got upsetting for me.

The doctor blurts out that 75% of people born with this partial part of the brain end up being “socially acceptable”, but, otherwise, they have Down syndrome, learning disabilities or something similar.

WAIT, WHAT THE F*CK!?

She said “I’m not familiar with how you people birth at home. I know you’re not often keen on genetic screening, but there’s value in it.”

[At this point, I was trying to keep my jaw from hitting the floor + was telling myself she’s just a socially awkward doctor with no bedside manner…]

She continued that she advises re-scanning at 20 weeks or earlier because if I wanted to “exercise a reproductive choice” aka have an abortion, I would need time to get that done before 24 weeks gestation per Massachusetts law. Or I could always consider going across state borders or to another country.

It wasn’t so much what she was saying, it was how she was saying it.

I was f*cking mortified. How did we just arrive here?! It felt like this train ride had gone from 0 to 60 and ended with me feeling completely lost at a station I had never been to before.

I bit my tongue until she was finished, but went on to politely say,

“Well, when you talk about reproductive options, I really respect that. Options and information are everything. I went to school to become a doctor + I worked in neurobiology for 5 years, specifically. I understand what you’re looking for. I understand the limits of those reproductive options + know there is value in genetic screening, but I also know the value of interpreting that screening + making those reproductive decisions cautiously because development is SO unique + those screenings are not precise…
I‘ve also seen that there’s a hard stigma associated with home birthing — as if it’s an uneducated decision — when our choice couldn’t have been further from that. We did our research + made this decision intentionally. I’ll move forward with scans + screening when I can make that decision intentionally, too. Not that you’re the type of doctor to make those assumptions about us, of course.”

[That last sentence wasn’t made snarkily, though it reads that way… It was made politely — as hard as it was to do!]

The doctor’s demeanor changed when I stepped up. She actually got more pleasant with me and only then went onto explain her train of thought.

But it was honestly too late. My head was spinning. I was in complete shock that I was having one of those experiences I had been cautioned about in the home birth community. I had been judged to the point of needing to validate my intelligence + had been pushed to agree to further intervention.

I couldn’t help but think of all of the moms who didn’t happen to have the knowledge that a scenario like this was wrong (although often standard) or those who didn’t have the confidence to speak up even when they did.

I couldn’t help but think of the moms that couldn’t validate their health/science related education against a physician — feeling that they’d have to qualify themselves at all to participate in a conversation about their own health + child. It made me sick.

I couldn’t help but still think to myself, “What the f*ck did you just say to me? Something that isn’t technically supposed to be developed yet on average is causing alarm enough for you to give me the heads up that I might want an abortion?! But let’s rush for an imperfect scanning timeline so that your checklist gets completed sooner?!”

I was so beyond rattled. I could barely speak.

I agreed to the transvaginal ultrasound because I was ready to never appear here again. I told myself I could deal with 2 more minutes if it’d just wrap up this visit with a bow for my sake. It’d be worth it if I could leave with peace of mind. That transvaginal ultrasound actually only really lasted 2 minutes because baby turned away + completely snubbed the doctor’s view even worse than before. That was gratifying in a different way!

She went back to doing a regular ultrasound + still didn’t find what she was hoping for. The appointment was now clocking well over 2 hours of scanning. For someone who doesn’t even like scanning to be done in the first place, I was over my limits. I just wanted to get home.

And, with the promise of our ultrasound report being sent to the midwife that afternoon, we went home.

My husband had been at this appointment with me the entire time + upon exiting the building, we just looked at each other like “what in the world just happened?” Throughout the whole appointment, he had done an incredible job of reminding me that I could say “no” and that we could leave at any time. But he still left feeling like he should’ve stepped in and just cut off the appointment for me. We felt insulted + sad + now had a seed of worry planted in our heads of “what if our baby has a developmental problem?!”

We already knew that we would never terminate a pregnancy. We took comfort in the fact that we trusted our midwife to help us through this uncomfortable + uncertain time post-appointment. We focused on laughing about how many times Kevin thought he saw a ballsack on the ultrasound (which was a lot because it was actually baby’s hands and feet!). We spent the car ride home brainstorming baby names. We pulled into Taco Bell and had no regrets emotionally eating chalupas. What a day.

When I got home, I left my midwife a voicemail asking her to call me back when she sees the ultrasound report later because I’m rattled + need her to hash it out with me logically.

We decided that re-scanning wasn’t urgent. That we would sit with the option to re-scan and talk it through all together at our next prenatal appointment in 2 weeks. And unless you hear otherwise, you can assume all is happy + healthy + fine with me and baby. Kind of a cliffhanger, I know…

But I share this with you now because I want you to know that you are the one person who has the final say in what you and your baby participate in. If you’re feeling pressured or confused in any way — however small or insignificant you might dismiss it to be in the moment — you have the 100% right to give yourself time to make an informed decision. Repeat that to yourself when that feeling of uncertainty bubbles up.

You can politely ask, “Is this a life or death emergency that I need to decide upon right this minute?” And when the answer is “no, but ____”, just take that no and say, “Okay, then I (or my partner and I) would like some time to consider this decision privately. How can I/we get back in touch with you in 20 minutes?”.

And then you do that. And if you need more than 20 minutes, you take it. And if you need more information, you ask for it. And if that information is still confusing, you tell them + ask for a refreshed explanation. Unapologetically. Rinse and repeat as many times as you need.

I am so grateful that I had a pregnancy + birth education that encouraged me to stick up for myself. I would never have known how to do that my first go-around + I can’t help but wonder what if my ultrasound experiences were reversed? What if I had this awful one first + didn’t know what to do? My pregnancy + birth outcome could have been very different.

My story also goes to show you how vastly different healthcare services can be from place to place. My first ultrasound was done in a random hospital affiliate practice in Kansas. My second ultrasound was supposedly done in the one of the best places in Massachusetts. Not all services are the same.

Ultrasounds can be a beautiful “first meeting” of your baby + a confirmation that they’re developing healthily, but it’s okay to be disappointed if those appointments don’t turn out that way. And it’s completely okay to end an appointment early or never even have an ultrasound done at all. You owe nothing to no one.

Equip yourself, in advance, with the strategies for preventing the cascade of interventions. Practice what to say + how to say it. Go into any physical appointments with a support person + know who you have available outside of those appointments for continued support. And regardless of the results, know that health is all relative.

Those measurement “standards” + “checklists” were derived from averages. If you + your baby deviate from them slightly, then that’s likely no cause for worry — just means you’re not average! I take pride in that!

You were made to make this baby + you have all that you need to birth this baby. This baby has all that it needs to grow + birth with you, too.