To wonder why pregnant women don't get more routine scans

[Sarahh2014]

I had a difficult pregnancy with scans at 8w 10 12 20 24 28 32.All was fine in the end but I often think that 2 scans might be enough to measure growth but a lot of people get anxious before their first and even second scans as a lot can happen in that time.Does anyone know why this doesn't happen? Is it because of cost? Genuinely wondering

In a healthy pregnancy there is no need for more scans really. You have the dating scan and the anomaly scan. It wouldn't be worth the cost in most cases and actually could be a pain to go to if there is no particular need. The midwives, along with the women themselves can monitor other signs and other scans can be done as needed.

Because early scans are unreliable and can give false hope and later scans aren't necessary.

I've had 5 per 12 week miscarriages and because of this I'm going for a scan today at 6 weeks. I have to keep telling myself that at 6 weeks they cant always see a heartbeat. I also need to tell myself I had a heartbeat at 8 weeks before and still lost the baby so not to get my hopes up.

Early scans should only be for those that need them

Money money money, I think.

Other countries you get at least 1 scan between 20w and labour.

I'm having a private scan at 28 weeks and maybe again at 36 or so, just to check growth and placenta etc (I'm paranoid and old, so want the extra reassurance!). But most people seem to get on just fine without them.

@Namechangedtoscream Sorry for your losses best of luck for today

Probably cost partially. And also partially because extra scans don't necessarily improve outcomes routinely in a straight forward pregnancy. At least I'm pretty sure that's what I've read. They will scan if there's a clinical need - for example I'm getting 2 extra scans after 20 weeks because of pre eclampsia in a previous pregnancy. My friend also had one because of reduced movement.

During my pregnancy I had so many scans because it was a multiple pregnancy and one of the babies wasn't growing at the correct rate. He was healthy and happy, but they decided to go for scans every 4 weeks, then every 2 weeks, then twice a week - at first it was great to see the babies so often, but then it became very tedious hauling my massive pregnant self to the hospital constantly, walking what felt like miles to get there because the parking was crap. If I have another pregnancy I'll be grateful for only a couple of routine scans (if I don't have twins again that is!)

Have you considered the negative effects of overinvestigation? Because the thing is, once you open the hood and start looking around, you will eventually find something "wrong". More scans would do the opposite of reassure many women - they'd lead to far more people being referred for unnecessary further screening and potentially for unnecessary treatment and procedures.

One of the GOOD things about the NHS is that it provides diagnostic screening where there is actual evidence that it improves outcomes, and not just because people want it and are willing to pay. Unnecessary screening can have serious consequences.

The cost and ordinary scans are not very reliable. You would need very frequent scans late in pregnancy to pick something up. I had a scan ( not doppler) at 32 weeks due to lack of movement and all appeared fine but baby was stillborn at 34 weeks with severe iugr.

It's just not necessary. And expensive.

I am in an area where they do a 36 week (32 for multiples) scans as part of a study - I guess depending what the study shows re effectiveness and cost it might roll out wider.

Of course it’s the cost - stop voting Tory and our nhs might get the funding it desperately needs!

Rules about what sorts of scans you get change all the time. First time round I didn't get a dating scan at 12 weeks ish as I was sure of my dates. Third time 10 years ago my area of Scotland wasn't offering anomaly scans on the NHS so we had to pay for a private one.

It's about clinical NEED. Yes scans are expensive but if you are having a difficult pregnancy or if there are concerns, you get what you require. If you are having a straightforward pregnancy, then there is no need to get you in every couple of weeks to tell you that everything is fine. Hugely expensive, disruptive to employers, pointless.

During the subsequent pregnancy I had 3 times a week doppler scans from 30 weeks but they can't do this for every pregnancy.

Thanks I suppose my view was from a paranoid perspective I was convinced that something would go wrong (prob being silly) but the extra scans gave me peace of mind.I think maybe one extra like the pp said would be ideal but like others have said it's unlikely as seen as not necessary

Of course, it's about money!

It’s not just the cost though. I’m sure extra scans wouldn’t be anywhere near top of the list if the NHS magically had a lot more money. It’s not necessary and I don’t think it would actually do much to relieve anxiety. If you’re an anxious sort of person, would three scans rather than two really make that much difference?

I also think a lot of the "evil Tories ruining the NHS" brigade aren't understanding what scans are for.

They are a clinical tool to check on the health of the baby. They are used when the mother or the doctors have concerns, or at set points in the pregnancy to check things are as they should be. A mother presenting with bleeding at 20 weeks, or who is worried about reduced movements later in pregnancy will get scanned.

Scans are not about finding out the sex of your baby, or reassuring an anxious mother, or to have a wee peek at the baby. A scan isn't something you can have just because you want one. 2 is plenty for most mothers. If you want more - pay privately.

Because they are trying to achieve a balance between spotting potential problems and not over medicalising a natural process which most women go on to achieve healthily with minimal investigation and intervention.

I had 12 week and 20 week scan, and then had a EFW scan at 32 weeks as was getting bigger and bigger for dates, this was arranged in less than 48 hours, so can't fault the NHS on that.

I know I am an old dinosaur but women like me went through pregnancy back in the day without scans at all.
I realise medical advances mean better outcomes and greater reassurance that problems will be picked up but the NHS cannot afford to do everything for everybody if it is not critically (and medically) needed.

Of course it’s the cost - stop voting Tory and our nhs might get the funding it desperately needs!

I've never voted Tory in my life, but it's a lot more complicated than that, and we wouldn't get more unnecessary scans in an NHS system period. Only if we went to a private on-demand system like the US's, which I don't want even slightly - there are all sorts of negative effects on health.

If studies find that a further scan at, say, 30 weeks leads to better mother and baby outcomes, it will likely be introduced. We don't have more routine scans because no responsible centralised health system would spend the money for no benefit and clear downsides.

The uk has one of the highest rates of still birth in the developed world - clearly the balance isn’t that well adjusted and like other people have said at least another scan at very late pregnancy would be helpful (eg 36 weeks). The trouble is at thr moment it relies on the mother to push for and access extra services if she is concerned about movements etc and that doesn’t always work

The thing about early scans is, while they can be a great thing for some women who have justifiable increased anxiety (I'm very grateful I got NHS scans at 7 and 9 weeks in my current pregnancy because I have had three previous miscarriages and no live births), they can't actually do anything - if they see a problem, no one can do anything to intervene or save the pregnancy. So it's hard to justify the cost for no improvement in outcomes.

That said, I have wondered whether we'll switch over time to earlier dating scans - in the US, these are standardly done at 8-10 weeks, not 12. It depends on whether blood testing rather than nuchal translucency becomes the standard test for chromosomal disorders - at the moment it's way too expensive, but if the costs could decrease then it's a superior test. It is really noticeable how many women pay for early scans, it's this huge private industry (which I have also used, I'm not judging). Now that so many people find out about their pregnancies at 4 weeks or even earlier, I think there's a growing sense that 8 weeks is too long to wait to find out if there's a viable pregnancy, when you can get an almost equally reliable answer at 9/10 weeks. But I can only ever imagine the NHS moving the dating scan forward - they're not going to add the extra 'viability' scan that's common in the US, as it would just cost far too much.

The NHS is a medical service that needs to balance costs vs need. Why would it spend it's limited budget on something that is not necessary just because it's nice and reassuring for mums? Many companies offer private scans and you can buy a device to hear your baby heartbeat after a certain stage of gestation. You are free to use your money to benefit from these services.

www.telegraph.co.uk/news/nhs/12199712/New-NHS-advice-to-tackle-high-stillbirth-rates.html