Ultrasounds During Pregnancy – Your Guide To What, When, And How Many

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Ultrasounds are an amazing part of pregnancy. It’s incredible to see your unborn baby moving around on the screen. But ultrasounds during pregnancy can also leave an expectant mom with a lot of questions.

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Each pregnancy is different. You should always discuss your specific care with your medical provider. However, we’ve broken down what you need to know about the ultrasounds you’ll have during pregnancy.

How many ultrasounds will I have during my pregnancy?

This really depends on your provider and your personal medical history. The American College of Obstetrics & Gynecology recommends at least one standard ultrasound between 18-22 weeks. That’s typically referred to as the 20-week anatomy scan ultrasound.

But take note of the words, “at least.” It’s actually become more common for women with uncomplicated pregnancies to have two (and sometimes three) ultrasounds.

Dr. Mendiola, a practicing physician and an instructor at Harvard Medical school explains,

“The first is, ideally, in the first trimester to confirm the due date, and the second is at 18-22 weeks to confirm normal anatomy and the sex of the baby.”

The most common timeframe for the first-trimester scan is an ultrasound when you’re 12 or 13 weeks pregnant. At this point, your doctor can confirm the due date (or determine it, if mom doesn’t know when she conceived).

This scan can also check whether the baby is developing on schedule. Combined with a blood test, the ultrasound also screens for chromosomal conditions such as Trisomy 13, Trisomy 18, and Trisomy 21 (Down Syndrome).

Of course, some women may receive a first trimester ultrasound earlier to confirm pregnancy. The earliest scans (typically an ultrasound at 6-weeks pregnant), give the most accurate due date estimate.

An early ultrasound can also confirm that the pregnancy is in the uterus (where it’s supposed to be). If a patient has a history of ectopic pregnancies, or the provider has reason to believe the current pregnancy could be ectopic, they will likely order an ultrasound in the first few weeks of pregnancy. 

Where will my ultrasounds be done?

Some OBs or midwives perform some types of ultrasounds in their offices. Other ultrasounds are performed by trained sonographers at an imaging center.

A doctor may use a basic abdominal ultrasound to determine baby’s location or position. Your provider would likely perform a scan like this in their own office, assuming they have an ultrasound machine. Ultrasound machines are quite expensive, so not all providers have them.

If you have an ultrasound very early during pregnancy, it will likely be done transvaginally. Transvaginal ultrasounds use a wand that’s inserted into the vagina. This allows for imaging of an embryo in its earliest stages.

Transvaginal ultrasound machines are newer, more expensive technology than traditional ultrasounds. You may need to go to an imaging center for this type of ultrasound.

If your provider doesn’t perform ultrasounds in their office, they will refer you to an imaging center to have any scans done. Even if your provider does perform some ultrasounds, it’s common for the nuchal translucency screening (the official name of that 12-week screening ultrasound) or the 20-week anatomy scan to be done elsewhere.

Those ultrasounds require very detailed measurements of your baby. They’re almost always performed by trained sonographers. A radiologist then reads and signs off on the sonographer’s images and measurements. The radiologist will then send a full report to your provider.

ultrasounds during pregnancy

How many ultrasounds are too many?

Only you and your provider can determine the best number of ultrasound scans for you. Your doctor will advise you based on your pregnancy and medical history.

The medical community considers ultrasounds very safe procedures. Still, they should only be performed for legitimate medical reasons. Women with a history of miscarriage or experiencing a more complicated pregnancy may undergo more frequent ultrasounds. Women carrying a typical pregnancy without complications will likely only have one or two ultrasound scans during the entirety of their pregnancy.

Will my insurance cover all of my ultrasounds during pregnancy?

I can’t stress this enough: contact your insurance company early and often. Policies are often lengthy and written in complex language. They can be hard even for professionals to understand.

Ask about what ultrasounds your insurance covers during a standard pregnancy. Ask about what complicating factors, if any, allow for coverage of additional ultrasound scans.

Once you feel confident in the answers received, check all of your statements from your insurance company carefully. Compare them to your bills from your provider(s).

As ridiculous as it may seem, slight differences in the physician’s language or the way their office manager codes your visit can mean a difference of hundreds of dollars to you. Follow up and ask for details. Don’t be afraid to ask your provider to recode/rebill something.

(Here’s a real-life example: I had a provider order an early ultrasound during one pregnancy. I had a history of miscarriage AND she couldn’t be sure of the due date. Insurance covered one of those reasons; they didn’t cover the other one. You better believe I made sure they used the covered code when they billed my insurance.)

The more you know about ultrasounds, the more prepared you’ll be.

Ultrasounds during pregnancy can be fun and exciting. Knowing what to expect (and when) can add to the joy and lessen the stress involved.

If you find you have further questions about the ultrasounds you’ve had or will have during your pregnancy, the best thing you can do is contact your medical provider.

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