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

Because the NHS has been fucked by the tories

Oh, it was scans galore under labour, was it?

The most important thing regarding reduced movements is that women go in straightaway and keep going in straightaway. Do not listen to people telling you that it is normal or a midwife who tells you that you are being over anxious.

Scans are a medical intervention and so should only be used when indicated. The benefit has to outweigh the risk. We don't know if scans are definitely 100% safe and we don't know if they improve outcomes in low risk pregnancy.

I know people find them reassuring, but why? They only are a snaphot in time and don't tell you what will happen next.

People saying "oh it's all the tories" are just missing the point.

No government has handled the NHS well. The massive rises in complexity and cost of treatments; people living longer; rapidly increasing population; people taking the piss because we take it for granted - no party has prepared for all this. Look at the cost of some of Blair and brown's PFI contracts, or all the middle management roles that they created for just a couple of examples.

You'd have to live in a wonderful world of bubbles and rainbows and unicorns to think that any other party would change it magically now. Especially corbyn - how is he going to fund billions for the NHS all at the same time as tuition fees and privatising the railways?!

As has been said on the NHS thread running alongside this one, it should be taken out of politics and given a thorough overhaul.

Money.

I went private for my pregnancy, so had extra scans. At 32 weeks a scan picked up that my DD's growth was tailing off. From then on I was monitored closely, and eventually my CS was brought forward, due to IUGR, as the risk of stillbirth became quite high.

Had I been treated by the NHS, nobody would have been any the wiser until the birth, as throughout this time my bump was measuring fine. Maybe we would have been lucky and DD would have survived till 40 weeks (though unlikely, given the state of the placenta at 37 weeks). However, the alternative doesn't bear thinking about.

It seems positively medieval to be relying on measuring a bump for information on growth. Given the UK's appalling record on stillbirth, I am amazed a late scan is not routinely offered.

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.

Just wanted to point out that stillbirth charities advise against the 'device' (a home Doppler) because it can give false reassurance: www.kickscount.org.uk/want-ban-home-dopplers/ . I take your point about the NHS not having 'nice to have' money, but a home Doppler is definitely not a substitute for a scan if there are indications (like reduced movements) that something may be wrong.

My eldest is 17, but standard practice in my area for scans was a dating scan and that was that unless you were considered high risk. Same with my 2nd pregnancy and with everyone else I knew. So, one scan at around 10-12 weeks.

Yes those home dopplers should never be used as an indication that the baby is ok.

I know trials are underway to see if the introduction of a routine scan at 36 weeks might reduce the high number stillbirths/ maternal deaths that we currently experience compared to the rest of the developed world. I had an unscheduled scan at 36 weeks because of my asthma where it was spotted that baby was breech- this had been completely missed by 2 midwives and a consultant feeling my bump, and potentially prevented a difficult labour and /or emergency section.

I know people find them reassuring, but why? They only are a snaphot in time and don't tell you what will happen next

But they do tell you what's happened so far - which if you've had a missed miscarriage is incredibly important to you. It was important to me that I didn't walk around for weeks not knowing that I had a dead embryo in me, as I had before. Of course that's reassuring.

No one can tell you what will happen in an individual pregnancy, but your odds of success go up massively once you've seen a good heartbeat at 8+ weeks, so of course people find that reassuring.

Also agree that although it's hard to hear, more early scanning isn't going to do anything to stop you miscarrying if that's the way the pregnancy is going to develop. All it can do is let you know there's a problem at an earlier staeg.

ShovingLeopard that's exactly my point I'm sorry you went through that

I had scans at 6w 8w 9w and 10w. Still had a mc at 14w. It doesn't mean "something" will be noticed. So little is really understood or able to be done that scans are merely a record and observation. Only in the later stages of pregnancy can they be used to support a medical decision to DO anything.

I think there is a case for later routine scans actually.

Both my babies were born via c section after a late scan picked up a problem. I had the late scans due to gestational diabetes, but the problems were unrelated to that- one baby was breech (my midwife had thought the baby was head down) and the other had very little amniotic fluid left. I had gone to hospital with reduced movement the week before but baby's heartbeat was fine so I was sent home. Thankfully I had a growth scan for my diabetes and the lack of fluid was noticed then.

A friend of mine also had a breech baby that was not picked up (her midwife thought baby was head down and as she wasn't diabetic she didn't get a late scan)- it was only spotted in labour after baby got stuck and her foot popped out!

This article first appeared in Midwifery Today in 1999. As far as I know, there has been no research further significant research repute these opinions. It makes for interesting reading.

midwiferytoday.com/mt-articles/ultrasound-harm-good/

If you honestly want to know then look up the NICE guidelines.

Apparently missed breech babies is relatively common in petite or fit (muscular) ladies. The midwife feels to see if the top of baby 'wobbles'- if it does it's a head and baby is definitely breech. If it doesn't it's probably baby's bum and baby is head down. But a baby can get wedged by the ribs or held in place by muscles and the head doesn't wobble, leading midwife to declare its baby's bum she can feel. At least, that's the explanation my midwife gave when I told her baby was breech not head down as she thought.

Like any medical test/intervention they have to be evidence based. At the moment there isn't the evidence but as people have said that may change.

There is also thought that they may be damaging to the growing baby's brain www.nhs.uk/news/pregnancy-and-child/warning-over-souvenir-baby-scans/
This was a while back but I knew some of the team that studied it and they were convinced enough.

As with everything in health it's a balancing act of prevention, cure and not doing any harm/ making things worse.

In most pregnancies it's utterly pointless to have more scans - and this is why they drum into women to seek help if there's any change in movement or any other issues.

I was having twins so had scans every 4 weeks from 20 weeks. Didn't make any difference though, at 32 weeks they were happy with everything despite ones growth slowing. At 35 weeks my mw convinced me to go in as I didn't feel right - one had stopped moving, they were born my emcs a few hours later and he was severely growth restricted, if I'd waited a few more hours he wouldn't be here, let alone the 10 days until my next scan.

I think it could be helpful nearer the end. My sister had a 10lb 7oz baby and they didn't know he was so big and she had a difficult birth and the cord was round his neck. Dangerous for him and resulted in surgery for her. For my my first son was breech and they only found that out by a scan on my due date at the hospital and he had been beech for weeks so I was whipped in for a c section. I know it must be hard to see a lot on the scan at the end as the baby is so big but just seems to be a lot that can happen after 20 weeks x

because they aren't needed. People can easily get them privately if they want to.

My eldest is 17 and I had a 12 week and a 20 week scan. My youngest I had abroad privately and had regular scans (at every appt with my obgyn so first every 4 weeks, then every 2 weeks then weekly at the end) I did find them reassuring but I also don't think some of them were necessary. In my opinion one more scan at 36 weeks to check position, growth and placenta would be ideal but the NHS just can't afford it. If we have another I will probably pay for a scan at 8 weeks and one at 36 weeks in addition to the NHS scans but that's it.

Thanks Sarah

I was offered more than I had! Four NHS, two private seemed more than enough.

There is also thought that they may be damaging to the growing baby's brain www.nhs.uk/news/pregnancy-and-child/warning-over-souvenir-baby-scans/
This was a while back but I knew some of the team that studied it and they were convinced enough.

I think you're going to worry people there so - the concern was specifically over the 3D scans you can have done privately, because they keep the scanner in one place for much longer than a standard one, and a lot of doctors disagreed with that study anyway. It isn't about having multiple standard scans, which doesn't carry any known risks (and it's worth noting that a lot of countries - the US and Singapore, to give two examples - have more scans as standard, so there's nothing magically low-risk about having two; it's about cost, not about more scans being dangerous)