Why no scans done during the third term??

[zahara1]

Morning all!

I am just wondering why the NHS doesn't provide a scan in the last term of pregnancy to ensure all is going well?

I am 29 weeks now and so far all has been really well and easy and both my previous scans were normal and fine (first baby BTW). But I just worry that there is an awful lot of time to wait between the 20 week scan and the birth and don't understand why more ins't done to ensure baby is developing well. By that I mean making sure that the baby is the right size, that nothing has gone unspotted etc.

In most other European countries you have 1 scan per term (or more if you have a complicated pregnancy). What is the reason that it is not the case here?

I guess what I want to know is, is it worth paying to have a scan done privately to make sure all is ok and rest my wandering mind? If so how much do they cost?

What do you guys do? Have you gone for an extra scan or just waited until the birth?

Many thanks!
x

I did have a scan late in pregnancy (privately... I had an inkling something was wrong) and sadly there was a problem with my baby... but this is very rare (nearly everything gets picked up at 20 weeks) which I guess is why the NHS doesn't bother. If you are worried and just want to put your mind at ease I can't recommend the FMC highly enough. They have the prices on the site. I think a scan is around £150.

www.fetalmedicine.com/fmc/

I did not get one, but in some ways wish I had, as my baby was very big, and if had known I would have maybe thought differently about the birth. All was well, I hasten to add,but think would rather have known. Though they can't always tell anyway, I believe.

Because they are too cheap here. They'll say they don't have the money, the sonographers, the time, etc.

It's really because a few babies' lives aren't worth the extra expense.

Lucy 101, I am so sorry to hear that there was a problem with your baby. I do hope that it got sorted though and all is now fine.
Thanks for your recommendation!

It just seemt ome that it should be part of the basic care and I just can't get my head round to why they don't do it.

You are probably right, exptinscotland!

I was given extra scans due to baby measuring small (in 1st pregnancy). I have had a scan at 32 weeks this time round, due to an issue found on the 20 weeks scan.

If non of this was required I wouldn't have been in a position (finacially) to pay for private scans, so would have waited till birth.

I think the main reason is to save money

A third trimester scan (ina healthy pregnancy) is usually performed to check on the health of the placenta, the amount of fluid and the blood flow in the umbilical cord.

They will say that scans in the 3rd trimester are 'less accurate' - no idea of that is true.

Maybe, but it wouldn't be true, I suspect.

As I said, the reason why most european countries offer a 3rd trimester scan is to check on the "environment" the baby is in, rather than anomalies in the baby's health (unless of course anomalies have already been detected and need to be followed accurately in order to give the best postnatal treatment or intervene if they deteriorate)

I think if it was cost-effective (ie saved lives, or picked up particular problems) they would do it. I had extra scans because my baby was so small. When it was clear there was a problem no expense was spared. It was also clear that even the (very experienced) docs at the foetal medicine unit where I was scanned had no confidence that their weight estimates would be correct, so I think it's true that they are not as accurate.

I'm not sure it is that cost effective, the UK has quite a high rate of stillborns, or at least it had in the early 2000.

But doesn't the 'environment' have a direct impact on the development of the baby?

To me it sounds just as important and although no scan is 100% accurate at all levels, I still think that it should be a minimum requirement to have 1 scan per term, even if all is normal and going well.

I really think that this is a let down by the NHS and surely there are other, more reasonnable ways of saving money!

Yes, exactly Zahara. They check on the health of the "environment" as problems in the environment can affect the development of the foetus.

Just to add, the reason it isn't necessarily "cost-effective" to have third trimester scans is because many issues that might be detected couldn't be dealt with until baby is born anyway, so there isn't anything extra gained by doing these scans (and in most situations baby is better off inside than out for as long as possible). As I understand, most major issues will be spotted at the 20 week scans (at least anything that requires an early delivery) and if there are problems with the pregnancy, other signs and symptoms will usually occur, prompting extra scans. In other words, routine scans for every woman would cost a heck of a lot and achieve little more than the current way in which they only give extra scans where there is some cause for concern. There is some research that suggests that regular scans can actually CAUSE fetal growth retardation syndrome, whether this is true or not I have no idea...

As with all these things it's a balance betwen the advantages and disadvantages of doing it.

MOST developmental stuff happens by 20 weeks and after that all that is happening is that the baby is getting bigger/fatter. they can use the fundal height measurement and their hands to do the basic check on growth, size and position so a scan isn't necessary. And if they find something wrong - big or small baby etc... then they do send you for further scanning.

If they were to scan every pregnant mother again there would be a big impact on the hospital in terms of equipment, staff etc - and for what....? the marjority of time people would be told that everything is fine and would have just had a 'nice day out'...

The other impact that there would be is on employers - we're entitled to paid time off for maternity appointments - why should employers pay for more time than is strictly necessary?

Hospitals and their resources shold be for the sick and for making sick people better IMO - i'd rather they did save their money for the necessities rather than just spending it on the 'nice to have's'. I'm extremely grateful for the care I have received through all three of my pregnancies - all of which was free and lovely. I had a hospital delivery for my first, emergency surgery to remove a ruptured ectopic for my second and an ERPC to remove the MMC of my third.

we're lucky to get scans at all - for the majority of history women have just had to trust their bodies and their developing baby and wait until the birth - I feel so lucky to have 'seen' my babies before they were born at all - even the one that i then miscarried.

I do understand that you want to know your baby is developing beautifully - it's a sign that you're going to be a lovely mum.

I'm in Italy and we get a 3rd trimester scan free on our ASL (equivalent of the nhs, more or less).
3rd trimester scan is considered very important, as problems with the placenta/fluids etc can arise in the healthiest of pregnancies.

A 3rd trimester scan is not offered to please the parents with new pics of their baby.

I do see where you are coming from Knitternottwitter and I do agree that we are living in blessed times. To be able to see your baby before the birth is amazing and of course, the monumental progress that have been acheived towards mother and baby care has to be cherished.

And I agree that the care I have received so far has been great. I am only questioning the last term scan and wondering if it really isn't worth it. I may be a little paranoid and I think this is prompted by the fact that back home in France or my husband's home in Spain, it is compulsory to have a scan at every term. I chose to have my baby in this country because I always felt that the level of healthcare was very good and there was no reason why I shouldn't give birth in the country that I live in.

There may be no need to worry at all, but I just wanted to have your views, lovely ladies, and see how you felt about it.

I had a scan last week at 35 weeks. It was a 4D scan, and she said that they couldn't guarantee any great images at this stage - I explained that I wasn't bothered about images, I just wanted to know that everything was OK. Actually we got some amazing images, which was a bonus, but really it was just a relief to know that things were progressing well. I am fortunate to be able to afford a private scan, but I still don't see it as a "nice day out". Going for a scan is a nerve-wracking experience, whether you pay for it or not.

I don't know statistically how many babies might be saved if they scanned during the third term. However, I am sure the money could be found if necessary (I am convinced that if men were to have babies instead then the money would be found, but that is a highly controversial view!).

Some conditions only become apparent after 20 weeks, so IMO a third trimester scan is a necessity. I agree that an US is a medical procedure and its main purpose is not to get nice pics of the baby, and I personnally prefer to err on the side of caution and not have too many. But an additional scan around 32 weeks would be welcome, be it only, as other posters said, to check on the amount of fluid, size of the baby, etc.

I see where you're coming from Knitter but the argument that most women would get good news is not justified, IMO, as the same is true for the 20 week scan.

I am not complaining about the level of care the NHS offers, but because I know things can come up after 20 weeks I'll pay for a private 3rd trimester anomaly scan.

I don't think many people are aware of this but the NHS does provide a free scan at 32 weeks for all pregnant women in Northern Ireland, it's a shame the rest of the UK can't be treated the same.

My consultant is quite anti-scans and only does them if she has definate need. She feels they distress the baby. Certainly this baby and dd2 got particularly active at scans & dopplers.

My friend under another consultant got scans every 4 weeks because of her age.

So its obviously not a hospital policy

I've ended up with lots of scans in both pregnancies, for various reasons. It is really reassuring to see that things are going well with the baby.

I've never been aware that they have particularly checked the placenta etc, which sounds like a really good reason for scanning. They generally check size, and here I'm much more sceptical. DD1 was supposed to be very large. She was supposed to be 7 lbs 11oz at 36 weeks, and was predicted 9lbs 11 at term. But she was born at 40 on the dot weighing 8.2. My current baby has very similar measurements to my DD, and so they are also prediciting him to be very large. The last time nobody seemed to be worried, this time I have GD and so they are taking the scans more seriously. My problem is that I find it hard to trust them because they were so wrong the last time.

So I'd sort of say, for size they are a bit pointless. But it is only one experience (at least for another couple of weeks before DS1 is born!).

Not to do with cost, but because routine scans do not offer any extra information unless there are suspicions of something untoward.

To try to confirm this, all first time mothers in Cambridge were invited to take part in a study which involved a couple of extra scans ad some blood tests. We weren't given any results, except whether the baby was breech or not at the 36 week scans. They will then look at the outcomes of all the pregnancies and the results and see if anything (scan, blood test etc) could have predicted things going wrong.

www.obgyn.cam.ac.uk/pops.html

The other thing to remember is that often private care in the US or Europe means that people get extra blood tests or scans that we wouldn't consider necessary here but that acts as increasing revenue for private practice there.

More isn't necessarily better.

Yes, blood tests every month and I've lost count of the number of scans I've had. That's German private health care for you. The thinking with a lot of tests seems to be that if the health insurer will pay, then why not do it.
During the last couple of scans the doctor has concentrated on checking heart beat and blood flow in the umbilical cord rather than looking for nice pictures of the baby. She also gives an estimate of the weight which is nice to have.

No, 3 scans, monthly blood test and swab to check on group b strep are totally free here in Italy.

Italy has the lowest rate of maternal and infant death at birth.