20 week scan….no more scans?!

[Waitandsee86]

I had my 20 week scan (well over 2 scans as baby wasn’t on right place), it was all fine and nothing untoward, which is fantastic. However, I was shocked when the sonographer said I’ll next see him when I’ve popped him out!! I thought there would be more growth scans? I mean how do they decide if someone needs a caesarean etc?!
Obviously this is normal and he wasn’t making it up but I really thought there was a scan towards the end? Any input welcomed 🤣🤣🤣

after 20 weeks though you start to feel the baby move, and the midwife will be able to check the heartbeat. Having said that my local hospital also scans at 36 weeks, and I’m considered a high risk pregnancy and will be having cervical scans and a neurologist and obstetricians input as well as midwives and being seen more often.

Midwives can feel a lot by palpation, after all it's our absolute bread and butter. It's the most basic part of our job so we get rather good at it. However, we're not perfect and sometimes it's really hard to tell. In those situations, if we have any doubts over baby's position whatsoever at 36 weeks, we refer for a presentation scan to check.

In a lot of countries a third trimester scan is part of the standard treatment so it's not a black and white clinically necessary/unnecessary.

A third trimester scan would have picked up the problem that has a significantly higher risk of stillbirth or brain injury. We were incredibly lucky and DS1 was fine, but he could just as easily not have been. In other countries, many cord problems are routinely picked up at third trimester scans. The NHS considers the relatively low risk of these catastrophic outcomes acceptable, that's not the case everywhere where the risk tolerance is lower.

I paid for a scan at 33w with DS2 to be on the safe side.

Also to add that scans in later pregnancy aren't accurate when judging size anyway. They measure babies thigh length, head and belly size .... I was told at 36 weeks with DD1 she was 'big' and spent the rest of my pregnancy worries however she was born at 41 weeks weighing 7lb 15oz, she just had a slightly large head and really long legs so it threw off the measurements 🤷 x

My trust does a 36 week presentation scan for everyone. Helps to pick up undetected breech (like my DS, midwives said cephalic, scan said the opposite) and SGA/IUGR babies. I hope it gets rolled out NHS wide one day.

I hope your anxiety lessens as baby gets bigger and you can feel lots of reassuring movement. If your midwife had any concerns or doubts about size and/or position, you'll be sent for a scan, so you might get to see baby again anyway.

My daughter was measuring correctly at 28 wks at her midwife appointment and sent home thinking everything was fine.

A week later she had a private 3D scan and found out that her baby had a serious condition, was very small (less than 3rd percentile, eventually born 0.4th percentile) and she had polyhydramnios - this was the reason she was measuring correctly for that gestation - the midwife didn't think the baby was small at that appointment.

Wonder how long it would've gone unnoticed?

There are conditions that can only be detected after 28 wks.

My DD was breech, 5 mins before my section (and all through my pregnancy) the midwives were sure she was normal presentation… cut me open to be greeted by a bum! Good job it was a planned section!

I had all my kids abroad following the US guidelines (not actually in US). Had regular scans each time I met my obstetrician (midwives only present for birth and aftercare). I felt very safe and well-monitored, and actually pretty relieved I wasn't in the U.K. I also had two planned sections by my choice, which removed a lot of anxiety too.

I would love to see a properly funded NHS give women more choice and certainty in pregnancy.

@JassyRadlett totally agree with you!

Probably because I have a high BMI and they can’t possibly believe I can grow a normal size baby

This is incorrect. Growth scans are booked for those with a high BMI as the Midwives measurements of the symphysis fundal height are inaccurate.

I had growth scans In both pregnancies. And definitely think a 36 week scan as standard would be a good idea. My midwife was sure DS2 was head down from feeling him. 36w scan showed transverse. Triage midwife at 37 weeks when discussing admission said from feeling she reckoned he'd turned back head down. Scan to confirm 10 mins later showed breech. After I was admitted there were a couple more instances of not being totally sure if they could feel a bum or a head and a scan was needed to check position. Just feeling isn't always accurate. They can think baby feels head down and be completely wrong. If I hadn't had the growth scans I'm not sure if or when we'd have known, since I did phone triage once for increased movements and was told only to worry about decreased. Turns out I'd felt him completely flip!

I didn’t have a scan after 20 weeks with my son. My uterus was measuring ok but at 36 weeks I had a scan because of lack of movement. I actually had polyhydramnious and my son was literally swimming in all the fluid and was an unstable lye !!
So yes I do think that there should be a scan around the 36 week mark !!

I completely disagree with MW lead care.

I'd book a private scan.

If there are concerns about anything, make sure your MW is listening to you.

I'm convinced lots of DD problems could have been noted had my midwife been with it.

I didn't know any better on my first.

I was with the same team of 4 MW and always feared the dopey one would be available on the day, sure enough she was.

I told her multiple times DD never moved or kicked her muscle tone was so low she couldn't push out.

My 2nd DC born in Ireland was consultant lead throughout.

Much safer option.

Another couple of weeks you'll have plenty of movement.

It's really tough going that long without seeing them - I'm nearly at 40 weeks now and haven't had any scans since 20 weeks, and even midwife appointments are still just every other week so not even regularly hearing the heartbeat. I can see why there is no need for extra scans just for the sake of it, but it would be nice to have that extra bit of reassurance just in the run up to labour if nothing else.

Book a private scan if you want but I’d seriously recommend you spend some of the money you’d want to spend on scans on a decent therapist to work through your anxiety before the baby is born.

I felt a similar surprise that 20 weeks was to be my last scan. It feels so long!

But by 21 weeks I felt regular movement and from there on out you are getting constant reassurance the baby is OK because they are booting your insides.

My baby moved a lot until really late (well D day) and I reached a point where I could tell what position she was in, which midwife confirmed with palpitations. Their fundal estimates were also spot on for me.

I did actually end up with extra scans and everything was also absolutely perfect and no concerns in each one. Didn't stop the baby moving just before delivery and getting cord wrapped around her neck. She's fine but with hindsight I can see why relying on scans could be a waste of money and misleading.

@EmeraldShamrock1 people are people. Whether consultant or midwife.

In my last pregnancy the consultant was shit! He ignored me, dismissed concerns, patronised me and his student and was no help at all. I was so glad to be sent back to midwife led care. At least they listened and had some bedside manner.

The NHS doesn't have unlimited money. If there's a reason for an extra scan, you'll get it.

If it's because you're worried, I think it would be a good idea to talk to your midwife. They probably can't offer you a reassurance scan, but they might be able to offer you other help. And that other help might actually be more useful to you - a reassurance scan just shows you that everything is ok at that moment so you can wake up the next morning and start worrying again.

A scan is a snapshot in time, I never found them reassuring beyond the snapshot. Kicks and movements are reassuring, wait for those.

The early pregnancy clinic is really good in my area and I’ve had 6 scans up until now, which has really put my mind at rest so I was just a bit like ‘Woahhhh no more’ 😨

The excessive evening then creates a reliance as a coping mechsmism.

It is anxiety-inducing, I get it, I didn't ever trust I'd bring a baby home and it was an awful feeling. I also knew it was my anxiety though and no amount of scans or heartbeat monitors would guarantee a positive outcome and I recognised that would only feed my anxiety.

The midwife appointments are there for a reason. They will refer of there is reason to.

That's interesting, what hands on checks did you feel you missed from the UK? I also had a baby in Germany and did appreciate the additional scans, but perhaps that has more to do with it having been my first pregnancy. It also seems standard here to do a quick scan when you arrive in hospital to give birth, to make sure baby is in the correct position - this seems like a good idea to me. Unfortunately I was in so much pain I cried and refused the poor obstetrician who tried to do this so it didn't happen in my case!

Same as my experience. Consultant was vile, really patronising and acted like I was wasting her time. Whereas my community midwife was really good.

That's interesting @BertieBotts . I'm consultant led with a lot of scans this time (in the UK), and rather to my surprise I've only seen my community midwife once - I'm 31 weeks now. I'm not sure whether this is a clinical decision that I don't need to see her or if they're just really busy and know I'm seeing someone anyway so I'm not top of the list.

Very common in other countries to have more scans. My SIL had one per month in a EU country. I had 4 in UK because of high risk pregnancies, I also think it’s madness you don’t get scanned after 20 weeks.
in some countries you get scanned when you arrive in labour which helps detect issues much earlier.