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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to think early pregnancy scans should not be offered on the NHS

258 replies

nancydrewrocked · 11/11/2010 10:17

OK I am prepared to be flamed but I couldn't help thinking this when I spoke to a friend recently. So tell me why I ABU.

Friend has just started ttc. No difficulties, no previous history. 2nd month of trying she gets a +ve the day her period is due. Two weeks later another scan no HB. Friend understandably very upset.

But I can't help thinking this would have been easier on her if the GP had gently told her to go home take it easy and then done a blood/pregnancy test in 2 weeks. It also strikes me as a enormous and unecessary cost, especially when many areas no longer offer routine 12 week or nuchal scans.

OP posts:
dockate · 11/11/2010 20:39

MumNWLondon you are absolutely right. Testing (of any sort really) should only be done where there is a clinical need (IE where it may change the management of the patient) and not 'on request'. Routine early scans are not offered through the NHS. Early scans are performed only under specific circumstances. The main ones are (and this might not be an exhaustive list):

-routinely in IVF pregnancy

-routinely for SOME women who have a history of recurrent early pregnancy loss (but it is NOT done for the majority as it is unlikely to be helpful for most)

-For any women who have bleeding and/or pain in early pregnancy, to exclude ectopic/ other abnormal pregnancy

The problems arise when scans are done TOO early - under 6-7 weeks the scan may well not give a useful result (it CAN, but if, for example, it shows no foetal pole or HB, you are no further forward - you don't know whether you have miscarried or if the foetus is still too early & small to detect). Thus women bleeding before 6-7 weeks are in an awful limbo situation where there is NO totally reliable way of knowing what is happening. Serial blood tests (serum Bhcg) can SOMETIMES help (a one-off test is next to useless), but the decision to take a woman at this stage to theatre to look for an ectopic pregnancy is still largely made on clinical grounds and not based on scan findings.

The final issue is that even if an early scan shows a healthy-looking pregnancy, there is absolutely no guarantee that it will continue like this. The vast majority of miscarriages occur before 12 weeks. Some missed miscarriages happen to women who have had a fine early scan, and no more warning signs after it.

I guess what I'm saying is that early pregnancy is a very uncertain time for everyone. If there is a clinical need (bleeding, pain etc), then a scan is mandatory. But they should not be offered 'for reassurance' in the absence of clinical need. They may make a woman feel more confident about her pregnancy, but they do not guarantee that everything will be just fine.

RoxieP · 11/11/2010 20:52

Yes when i had mine they stressed the point that it was in the right place and the heart was beating NOW, but that there was still no guarantee that i wouldn't miscarry in the future. Just served to rule out an ectopic pg/incomplete abortion.

daimbardiva · 11/11/2010 22:47

I miscarried last week. I had an early scan last Friday, which confirmed it, and allowed me to deal with it and try to move on.

If I hadn't had the scan (I was 6 weeks) I'd still be wondering if I had/hadn't miscarried.

So yes, I think you're being VERY unreasonable.

Mammie81 · 11/11/2010 23:01

I had an early scan to confirm whether I was having a miscarriage/ectopic pregnancy at 10 weeks. All was fine, but without that resource I would have waited 2 weeks to know the result at my 12 week scan.

Is a two week wait to know the outcome really reasonable, OP?

midori1999 · 12/11/2010 00:08

"The final issue is that even if an early scan shows a healthy-looking pregnancy, there is absolutely no guarantee that it will continue like this. The vast majority of miscarriages occur before 12 weeks. Some missed miscarriages happen to women who have had a fine early scan, and no more warning signs after it."

This is true, but depending on the gestation at which the heartbeat is seen, the chances of a miscarriage go down significantly.

If a hearbeat is seen at 6 weeks, there is a 78% chance of the pregnancy continuing. At 8 weeks a 98% chance and at 10 weeks a 99.4% chance. I can see why this would reassure a lot of women.

BoffinMum · 12/11/2010 08:58

Sounds to me like this isn't really about scans. This is about very hormonal women desperate for reassurance being told to fuck off and develop a stiff upper lip. Perhaps a more holistic approach looking after this group of patients might be in order, with a bit more basic human kindness and hand holding.

looneytune · 12/11/2010 09:54

I think YABU. I had some light spotting and was just put on bed rest, what a joke!!! I was off work, nothing to occupy my mind, no scan or anything and I can't tell you how scared I was. Waiting was AWFUL and just made me more stressed. I'll never know whether everything was ok but the sheer stress of not knowing made me mc or whether I was slowly mc anyway but I could really have done without all that time worrying. In the end I woke up one day and then I just knew (VV heavy). That was on a Friday and we phoned the GP who just said that yes, I was mcing and there was nothing they could do and to wait until next week. It was horrible. I wanted to do something and not just sit there bleeding so much. In the end (the following week) I had to go in as was so weak and could hardly walk and it turned out I needed an ERPC - could have done with that being sorted sooner thanks!

Then when pg with ds2 I had bleeding and was terrified. I told them I wanted a scan. I had the same thing as your friend - no heartbeat but too early so come back and MAY be ok. It WAS a horrible wait yes but I felt I'd done all I could to find out and the wait would have been horrible at home too. At least with the scan I knew it wasn't Eptopic, that was reassuring so I was glad I went. Luckily for me after 2 weeks of being sure I'd lost him, I went for the scan all prepared for the bad news again but they said all was fine (I burst into tears as didn't expect that).

Eptopic pgs need to be found asap so I think anyone with worries like that should be able to have a scan. You don't need to have family or previous history to have one!!! My sister could have died if it wasn't for my knowledge of this (thanks to MN). She was 'done' because didn't want any more children and not that long after and I can't remember the series of events but I remember she was feeling unwell and paranoid that she was pg. GP and hospital said don't be silly. Neck/shoulder pain got worse, I nagged and nagged (on the phone, she lives couple of hours away) her to go back to the hospital, she did contact them and they made her feel silly and she went home. She just got worse and worse and I BEGGED her to be rushed to hospital NOW and I'm so glad she listened. Yes, she was pg in her TIED tube and it was about to burst (or something, I don't remember but it was serious). She had no choice but to have the tubes removed for her own safety. So there you go, GP and hospital had no concerns, no history, just her sister had a bit of knowledge thanks to Mumsnet and very likely saved her life by INSISTING she got a scan.

If you still don't understand why early scans are important, I bloody give up!!

RoxieP · 12/11/2010 09:58

It's like saying reconstructive breast surgery for people who have had mastectomies shouldn't be offered on the NHS because it is not medically "necessary". Though actaully early scans often actually are.

NotShortImFunSized · 12/11/2010 10:01

MumNWLondon

"There is also the possibility that the pregnancy is less likely to proceed with lots of early scans."

Do you mean that if you have multiple early scans you are more likely to MC? Hmm

Do you have any evidence/stats that back this up?

RoxieP · 12/11/2010 10:08

There is absolutely no evidence of risk of Ultrasound. And yes ealry scans tend to be done trans-vaginally but it is no more invasive than sex! In fact the thingy is considerably smaller then your average .....!

And they don't even touch you cervix or anything, it is just in your vagina. So I really don't see how it could be risky in any way.

WhyMeWhyNot · 12/11/2010 10:24

I think Nancy is imagining life as it used to be in our grandparents days when there were no pregnancy tests, no scans and very little antenatal input medically.

You waited till you missed 3 periods and presumed you were pregnant.

Those unfortunate enough to have conceived ectopically were probably dead or left infertile and numerous others had had a partial/complete miscarriage and infections galore.

I know the saying the good old days but really..................!

KTDace · 12/11/2010 11:07

YABVU - your poor friend, I hope she finds someone better to speak to other than yourself.

midori1999 · 12/11/2010 11:45

"Those unfortunate enough to have conceived ectopically were probably dead or left infertile and numerous others had had a partial/complete miscarriage and infections galore."

This is true. My Grandmother had an ectopic not discovered until 16 weeks. She almost died and that was certainly an end to her having further children. She's never really got over it.

giveitago · 12/11/2010 12:27

Well NWLondon - I wasn't 'entitled' to an early scan. I presented myself and demanded one and I'm very glad.

I was shaking when they did it - but I don't care as I was shaking as soon as I found out I was pregnant against all odds and I didn't want to be in a blind panic for 3 months and have a repeat of having to wait so long just to find out you'd suffered a mc.

I don't regret a thing.

OnEdge · 12/11/2010 12:32

YANBU, you are being very twattish ! This is offensive to women who are experiencing problems in early pregnancy.

teal15 · 04/02/2015 11:02

Hi I am new here. I am 6 weeks pregnant but had a mmc in September. I had to endure 2 months of not knowing whilst the worked out what was going on. It is killing me not knowing if my baby is ok or I am having another MC. A early scan would help. I have rang up to arrange a mid wife appointment but it is not until 2 weeks. A early scan would really help me mentally. Plus I have bad morning sickness Sad

firstposts · 04/02/2015 12:42

Hi teal, this is an old thread so it's probably best to start a new one in the pregnancy section of mumsnet.

If you can afford to you may be able to get a scan much sooner by going private. I paid around £75 for a early scan and got it the next day. I contacted a local private hospital with a fertility clinic and had it there. All the best.

wanttosqueezeyou · 04/02/2015 12:58

Ectopics aside.

There are very many things done on the NHS that are not a 'need'.

Procedures that improve the quality of life/improve mobility/reduce pain/suffering/distress etc.

Pregnant women aren't any less deserving and I'm happy to see these principles extended to them.

wanttosqueezeyou · 04/02/2015 12:59

Sorry!!! Didn't see it was a zombie!

Nirvisna · 04/02/2015 12:59

Had I not had an early scan, I wouldn't have known my baby was growing inside my fallopian tube. I had to be rushed to theatre to have baby and tube removed, otherwise I was at high risk of dying and leaving my then 18 month old DD behind. YABU.

chasingtherainbow · 04/02/2015 13:00

You are being so massively unreasonable I can't even bring myself to list why.

I would have died if they'd not scanned me when they did.

Nirvisna · 04/02/2015 13:00

Oops sorry I didn't realise it was an old thread!!!

Murphy29 · 04/02/2015 13:12

YABVU - 1st mmc (twins) picked up at multiple early scans as the babies' heartbeats stopped weeks apart so was monitored. The next 3 mmc picked up at early scans due to history - would you prefer I had went the full 12 weeks being sick every day only for our dreams to be shattered even further along?

During successful pregnancy the early scans really helped us feel more positive and I think there's some research by Lesley Reagan to suggest that the extra TLC can have a positive impact. Which is much cheaper than yet another surgery surely?

molyholy · 04/02/2015 13:14

The same happened to my sister and she was devastated and the waiting would have increased the upset. Any more clear on why you ABU OP?

Disgruntledfarmerswife · 04/02/2015 13:21

I had an ectopic pregnancy at 16 years old. YABVVVU