Fetal ultrasound is a method of viewing a fetus while in the womb. Ultrasound technology uses
sound waves, that bounce off the baby’s mass, to produce a picture of the baby. While both the
American College of Obstetrics and Gynecology (ACOG) and the Food and Drug Administration
both agree that limiting fetal ultrasound is important, some doctors continue to insist on
frequently looking at baby in-utero without caution.
To avoid unnecessary viewing of your unborn baby, ask why an ultrasound is necessary.
Oftentimes, doctors utilize certain technology simply because it’s readily available without taking
into account the potential risks at-hand. In the case of fetal ultrasounds, it seems that
obstetricians, especially those with direct-in-office-access to ultrasound technology, like to “take
a peek” at baby in-utero far more frequently than may be clinically-indicated. Some women have
a fetal ultrasound performed at nearly each prenatal visit. Patients, trusting the doctor, don’t
always question why the ultrasounds are being conducted, and understandably so, enjoy being
able to view baby. However, if there is not a clear clinical need to have these images taken,
these ultrasounds are better off being declined.
What are the potential risks you’re even avoiding if you were to decline an ultrasound? In this
FDA article, Dr. Shahram Vaezy, an FDA biomedical engineer, states that,
“Ultrasound can heat tissues slightly, and in some cases, it can also produce very small bubbles
(cavitation) in some tissues.” Dr. Vaezy also warns that, “...prudent use of these devices by
trained health care providers is important.” Ultrasound has also been utilized recently to help
heal fractured bones and is also used to “blast” away kidney stones. Something that has the
potential to change the tissues of a developing fetus should be used with caution and operated
strictly by a trained health professional. This means that not only should the storefront
“keepsake” ultrasonography shops be completely avoided but frequent viewing of baby under
any circumstance increases risks to the fetus.
A trained ultrasound technician should be the only person performing these scans but it’s not
just the operator that holds significance. The length of time the ultrasound takes place is also of
significance. The longer the fetus is exposed to ultrasound, and the longer the fetal temperature
is altered, the higher the potential risks. The ACOG, in an October 2017 “ACOG Committee
Opinion” release note specifically that, “Ultrasound imaging should be performed efficiently and
only when clinically indicated to minimize fetal exposure risk using the keeping acoustic output
levels As Low As Reasonably Achievable (commonly known as ALARA) principle.”
Worth noting is that fetal Dopplers, often used by care providers to listen, not look, at baby in-
utero, also utilize ultrasonic sound waves to pick up baby’s heartbeat. These monitors carry a similar risk to visual ultrasound and also carry warnings as to be used only by healthcare
professionals. By purchasing this type of monitor, many mothers feel reassured by being able to
listen to baby’s heartbeat at any given time. However, Doppler monitors have not been
designed for at-home use.
The decision for frequency of ultrasound exposure during pregnancy remains with the patient.
With information regarding both risks and benefits of this medical intervention, one can make an
informed choice as to how she wishes to proceed when ultrasound is recommended by her care
provider. It is always important to have an open dialogue with your provider regarding any
concerns about recommended procedures. Only when the patient is comfortable and in
agreement, should a non-emergent procedure take place. As a patient, you have the right to
decline any or all ultrasounds recommended by your care provider. You also have the right to
question what the provider is hoping to find through the recommended imaging and how the
imaging itself would affect future medical recommendations.
While ultrasound is widely accepted in the medical community as being safe and carrying little
to no risk, it is still wise to proceed with caution. Let us not forget that several decades ago, X-
rays were used readily for a host of reasons, including fetal imaging and were considered “safe.”
Of course, now more is known and there is great caution with X-ray use. This is a good lesson
in why, for a healthy pregnancy, less medical intervention is often the best choice.