Welcome to motherhood. You took an at-home test. You know, the one with the stick? And you wait anxiously for the double lines to show up. Finally, you let out a squeal (or maybe you cry happy tears) as the test tells you: Congratulations, you’re pregnant. Now, what’s next? 

Call your doctor 

First, you may want to go to your PCP (primary care physician) and get a blood test to confirm you are pregnant. False positives do happen, but very rarely. You have some blood drawn at the doctor’s office.  This blood test measures a hormone in your blood system called hCG (human chorionic gonadotropin) that shows up when you become pregnant. But enough of that, let’s get back to you officially being a mom. 

Next step is to call your OB, if you have one. If not, that is OK. Ask your friends, your mom, your aunt, sister, even your coworkers. Your PCP can also refer you to a credible OB/GYN. Feel free to ask for advice on which local OB to pick. Chances are, after you’ve done your research, you will be able to find the right one for you. (See Choosing the Right OB or Midwife for You). You will get your first appointment scheduled around the 8-week mark, and they will likely inform you that there will be an ultrasound. 

What is an ultrasound?

Fear not, momma. Ultrasounds, first and foremost, are safe and noninvasive. An ultrasound is defined in Webster’s dictionary as follows:

“the diagnostic or therapeutic use of ultrasound and especially a noninvasive technique involving the formation of a two-dimensional image used for the examination and measurement of internal body structures and the detection of bodily abnormalities” 1                                                  

You might be asking, I still don’t get it. What does that mean?

To sum it up, it is the use of noninvasive sound waves to create a 2D image (called a sonogram) of your little one. This way, medical professionals can check to make sure that everything is growing correctly, and nothing seems unusual. 

Alright, with that out of the way, let’s talk more about what they are, how they are performed, and when they will be done.  

The idea of ultrasounds might seem scary. In truth though, it is one of the least invasive medical procedures out there. Ultrasounds (sometimes referred to as ultrasonography) are done for all kinds of procedures. There are bladder ultrasounds post-surgery to see if there is urine in your bladder, and even an ultrasound of the kidneys to make sure they are functioning properly if you are having an endocrine issue. These are all fantastic measures, but our focus here is solely on Obstetric (OB) ultrasounds. 

Ultrasound technicians are specially trained to handle OB ultrasounds. These experts must go through rigorous schooling and testing in order to become specialized in obstetric ultrasonography. Part of OB techs being specialists in their field is that they have special interest and training in the development of fetuses. When they conduct the procedure, the soundwave is keyed to the lowest setting possible. This helps ensure that the ultrasound is as safe as possible for you and for baby.

What Types of Ultrasounds Are There?

With a normal ultrasound procedure there is just one type. Obstetrics is a specialty, so there are few types of ultrasounds performed during pregnancy:

• Transvaginal (Endovaginal)

• Standard Ultrasound (Abdominal)
• Advanced Ultrasound
• 3-D
• 4-D

Transvaginal Ultrasound

This is the first ultrasound that will be done. It’s the one that you scheduled for your 8-week appointment. This is exactly how it sounds -- they place a plastic sleeve over a wand, apply a gel to it, and insert into your vagina to scan for the implanted egg sac.  The wand itself is small, just a little larger than a tampon.2 

Standard Abdominal Ultrasound

A standard ultrasound is performed by an ultrasound tech. As mentioned, they have special training in order to be able to execute it. During these ultrasounds, they will again use gel on the tip of the wand and run it all around your belly.  But instead of just hearing the heartbeat, you will be able to see images of your baby on the screen. This also gives the technicians the ability to see any abnormalities that may be present.

Advanced Ultrasound

An advanced ultrasound is like a standard ultrasound, but even more in depth. They look at the baby’s skeletal system, internal organs, and overall size. They can also check the fluid levels (also known as AFI), blood flow, placenta, and gestational age. All this information gives the OB an extensive ultrasound report. 

3-D Ultrasound

With a 3-D image you get a full view of your baby. You can even see the definitive features on your baby’s face. These are only done as needed. They are not medically necessary unless the baby has a definite irregularity, or at the discretion of a physician.

4-D Ultrasound

This is also a 3-D image, but with movement (time is considered the fourth dimension in the scan). These also are only done on a case to case basis. They are not deemed medically necessary unless the baby has a definite anomaly, or if the physician feels the need to do so as a precaution. 

How Many Ultrasounds Will I Have During My Pregnancy?

Each pregnancy has a generic outline of when ultrasounds should be completed. Your first ultrasound will be between 6-8 weeks, an anatomy scan at 18-22 weeks, and you could get an ultrasound if there is a growth discrepancy between your due date and your belly size. A 12-week noninvasive prenatal testing (NIPT) is also an option. It is a blood draw which screens for Down Syndrome, Trisomy 13 and other genetic defects. The results are compared to your first trimester scan. You may end up needing an ultrasound or another procedure to confirm the results.

Look at the Bigger Picture

Except for a fetal echocardiogram or a follow-up ultrasound after your NIPT, all ultrasounds are routine. There is absolutely nothing to be afraid of. These noninvasive and painless procedures are a way that your OB can keep an eye on your baby’s growth and development. Trust that the ultrasound techs know what they are doing, and just enjoy being able to hear your baby’s heartbeat and to see your baby on a screen. Your baby will be here soon enough!