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Why I’m skipping the 20-week ultrasound

By July 11, 2013 September 7th, 2013 Uncategorized

Oh my, I hope this won’t make you think I’m crazy.

I’m pregnant with my third baby right now, but – for the first time – I won’t be getting a 20-week ultrasound (“u/s”).

Here’s some of the info that went into my decision.

Why I'm skipping the 20 week ultrasound

What’s a 20-week u/s anyway?

If you’ve never been pregnant before, the 20-week ultrasound is the one where they check the baby’s size, spine, and major organs. The ultrasound tech also looks at the placenta, umbilical cord, and amniotic fluid.  This is the appointment when many people find out their baby’s sex.

Benefits of getting a 20-week u/s

People feel very differently about ultrasounds.  Here are some potential benefits:

  • Opportunity to see and bond with your baby
  • Chance to rule out potential problems (like birth defects)
  • Peace of mind (if all measurements and scans are within the “normal” range)

Problems that can be detected

Overall, 3% of babies born in the US have a major malformation at birth (source).

Here are some potential problems and birth defects can be detected during the 20-week u/s:

  • Low birth weight
  • Increased risk for Down’s Syndrome and other chromosomal abnormalities
  • Low-lying placenta that’s covering your cervix
  • Serious birth defects (like problems with the baby’s heart, brain, and spine)
  • Cleft lip

Some conditions are easier to detect than others.  It’s possible for the baby to have a problem that goes undetected.  It’s also possible for a problem to be detected, but after more testing (or the baby’s actual birth) to find out that the baby is perfectly healthy.  (This is known as a “false-positive.”)

What to do if an anomaly is detected

If the u/s reveals an increased risk for a problem, your doctor or midwife will present you with options for more tests and counseling.

If a serious problem is detected with your baby, you may have the option to abort the pregnancy or prepare for treatment after birth.  Remember, this is very rare because only 3% of babies are born with a birth defect, and some will go undetected during the ultrasound.

Why I’m skipping the 20-week u/s

I’m working with a group of midwives who do not require a 20-week u/s unless there is a cause for concern with the baby or pregnancy.

Everything seems to be fine with my baby and me right now, but I was planning to have an ultrasound anyway…until I heard the first cost estimate from the hospital where I was going to have it done ($823).

Having to pay a large sum out of pocket raised a red flag to me, especially since the u/s was considered “optional.”

I polled the ladies who follow my New Leaf Wellness Facebook Page to see if I should suck it up or skip it:

“I would get the ultrasound just because of all the things they can catch now a days, I’d rather know ahead of time if there was something potentially wrong.” – Amy

“We had the same thing, totally worth the $$ just to know everything is ok.” – Andrea

“Skip.” – Heather

After more phone calls between my insurance, the hospital, and the midwives (and an endless amount of frustration), the final number that I would pay out of pocket looked more like $290.

(I should add that I’m only temporarily on a health insurance plan with a high deductible because my husband’s new work insurance will kick in until the end of this month.  If I can avoid paying the deductible until then, I won’t ever have to pay it.)

So I talked to my husband and one of my midwives again and we decided to skip the ultrasound.

I trust that my midwives will request an ultrasound later down the road if there’s any cause for concern (and I will gladly have an ultrasound done if that’s the case.)

To me, it’s not worth it to pay $200+ if the likelihood of detecting a problem is very, very small.  (I wouldn’t do anything if a problem was detected anyway.)

I’m also a pretty relaxed, non-anxious, and optimistic person.  So the whole “paying for peach of mind” thing doesn’t apply to me.  I already feel confident that all is well with me and my baby.

I’ll just have to bide my time and wait until my baby is born to see his/her sweet face.

So what do you think: Does my decision make sense to you or do you think I’m nuts?  What was your 20-week ultrasound experience like?  

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Madeline @ Food Fitness and Family
Guest

More power to you. It's not something I could personally skip. I had a friend who very recently went through a huge scare with their baby and a trisomy (lucky false alarm since it would have been fatal to baby). It made me think though about my plan of action. The hospital I'm delivering at doesn't have a NICU. I know that not everything can be caught early but if something were to be I would deliver elsewhere to have a team in place. I'm pretty loosey-goosey about pregnancy but type a when it comes to medical care. I don't… Read more »

Dawn
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Dawn

I worked for an ob for many years. Another reason some women choose to skip the u/s is exactly what you stated – the high incidence of FALSE scares. I can’t tell you how many women were sent into a panic only to end up with a healthy baby in the end. One of our patients was told by at least two doctors that she should abort her baby due to some sort of chromosomal abnormality. She ended up in our office because our doc was the first to tell her if she wanted to carry the baby to term… Read more »

Amanda
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Amanda

Hi Dawn,

Is there someway I can get in contact with you?
Please let me know.
Thank you.

Pat
Guest

You not getting the scan is how the insurance makes money. If you get the scan, they pay what you do not. People pushing for extra scans is one of many things that make insurance premiums go up. People not getting scans they needed also makes insurance premiums go up because emergency care is more costly than planned care. If you need a scan, where you get it also impacts cost. Get them at MD offices and centers not associated with a hospital, hospitals use a different code so they up charge severely for the same tests. Like how they… Read more »

Camille
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Camille

You have a good piont but her not getting a 20 wk ultra sound does not increase the chance or emergincy care later on. If the baby has a problem that is discovered durring tge ultrasound just alerts you to it doesnt prevent it.

Deana
Guest
Deana

Hey Dawn
I’m going crazy right now my doctor informed me that I low placenta and also a bright spot was seen on my baby heart a sign for down syndrome. I am very scared have you heard or seen this before? The have done blood work and I am scheduled for a specialty ultrasound this week.

HELP ME PLEASE

Anna
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Anna

In european countries they are for free and you can have as much as yu want. I am 18 weeks pregnant and I have already had two. I would not want to skip those touching moments with my baby! Also it is great opportunity for baby daddy to bond with the bump!

lissa
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lissa

You might want to be careful of too many ultrasounds. Many doctors believe that they may be harmful in higher doses.

Musa
Guest
Musa

How harmful? It’s a sound, no other waves or radiation.

Lisa
Guest
Lisa

They use ultrasound to shrink fibroids and tumors. They are not harmless. In studies they have changed the brains of mice in the neural connections. Do the reading. They used to think Xrays were harmless and even xrayed childrens feet for shoe fitting until the cancer link was shown.

Dali
Guest
Dali

Nothing is “free”. You pay for it in healthcare taxes.

Kim colo
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Kim colo

I think its nuts. I hope her baby is okay. Look up cdh.

Nichole Plank
Guest
Nichole Plank

My friend’s son was just born with CDH. It was missed at the 20 week ultrasound. Luckily, her OB sent her for one more because she was measuring big. They picked it up at 34 weeks. We live in a small town, a 2 hour drive from the closest NICU. Had the baby been born in our small town, I don’t think he would be alive today. He is now actually at the biggest Children’s Hospital in Michigan, two weeks, just fighting away! I can’t believe it is as common as spina bifida. Prayers for all the babies who are… Read more »

Kelly
Guest
Kelly

Madeline- Thanks so much for sharing your friend's story and how it has influenced your thinking. If all goes according to plan, I'll give birth at a birthing center (not a hospital), so I don't think I'm following the same route as most women in the U.S. I very much respect each woman's choices during her pregnancy and birth though!

Amy
Guest

When I commented on your Facebook post we were waiting for results from a follow-up ultrasound, our 20 week had shown a cyst on a neural tube, which can be a soft marker for Down's Syndrome. Luckily, at 28 weeks the cyst was gone, and the baby is okay, but obviously this caused me & my husband slight anxiety. The doctor said that it was unlikely to be an issue, but they like to double check. We were trying not to worry or tell anyone at the time, but had they discovered more markers the second time around, I would… Read more »

Terry
Guest

I have to say that this post makes me glad to live in Canada and to not have to make medical decisions based on finances. If I were in your position, I would probably do the same thing, but it would be a tough call. I wouldn't abort a pregnancy based on the 20 week ultrasound, but I guess knowledge is power. I am also a positive person who was always very relaxed about things during pregnancy, so would also be assuming everything was for good.

Sarah
Guest
Sarah

Just wanted to say that you are so brave to post your story! I feel like many Moms may frown on your decision but in the end it's your decision. I commend you for your honesty and appreciate a fresh perspective on Mom issues. I too share your positive outlook and know that you will have a happy & healthy addition to your family soon!

Kelly
Guest
Kelly

Terry- Thanks so much. It makes me feel good to know you can relate on some level. The subject of differences between countries makes me wonder if/how other countries do ultrasounds.

Sarah- Your comment makes me want to keep sharing and being vulnerable. It can be scary, so I have to be very confident in myself and my decisions. Thank you for the encouragement!