Anyone else chosen NOT to have 20 week scan?

[QueenOfFlamingEverything]

I am 19 weeks and the hospital have 20 week scan booked for next week, but am not sure whether I actually want to go along or not.

We don't want to know the sex, and I don't particularly want to know about any abnormalities as tbh we do not want to be faced with the knowledge and subsequent decision making.

I did have a dating scan at 12 weeks where I was redated (?) to 14 weeks. We deliberated over going for that but decided we would in the end - mainly for reassurance tbh as I had been having (presumably anxiety related) dreams about there being something wrong.

But the 20 week one just doesn't seem important to me somehow. If I went, the main reason would be just to see the baby, which IMO (and that of the WHO) isn't a good enough reason. I can feel it moving, so I don't feel I need the reassurance of seeing it again.

Has anyone else ever made the decision not to have a routine scan? How did it go down with the professionals if you refused?

But QofFEverything, you don't know if you have a baby at risk of a problem until you have your 20wk scan so it's something of a cavalier attitude to take IMO.
It's nothing to do with you saying you can't see a reason why you should have the scan - you can't possibly know that your baby's kdneys or heart is perfectly fine without a scan!
It would be terribly sad finding out after your baby is born that actually there is a problem and if only you had had the scan at 20wks you could have prevented it from developing further?.

We thought our pregnancy was 'low risk' too until our 20 week scan when it turned out we had a potentially very poorly little boy in there. We have no family history of any medical conditions, Im healthy, so is my husband, I'd taken my folic acid pre-conception and during the first trimester but they still found problems that there is no way they would have found out about had I not had the 20 week scan.

We are being closely monitored now and I'm thankful we had the opportunity to detect the problems in utero so he can be treated immediately after birth.

They do say it is highly unlikely that they pick anything up at the 20 week scan but even still, surely it is better to accept the offer of a scan just to be on the safe side.

Do you really think the NHS goes to the huge expense of giving every pregnant woman a 20 week scan just so that they can see their baby and feel reassured.

Have you not heard of NHS cuts and underfunding.

Believe me, you are offered it for a reason.

No, ottersonice, I don't think that.

But if you do not want to know about any abnormalities, and are otherwise low risk, then the only reason to have the scan would be for reassurance and a look at the baby.

I do not want to know about any abnormalities. Thats my choice, people may or may not understand it but I have the right to make that choice. The majority of people make a different choice, but I don't criticise them for it. Thats for them to decide.

So I can't see any good reason for going to the scan, especially as there seems to be no evidence that it actually does improve outcomes anyway.

"So I can't see any good reason for going to the scan, especially as there seems to be no evidence that it actually does improve outcomes anyway."

I think you're just trying to get a rise out of people now because you've been given several examples of how the 20wk scan did improve outcomes for newborn babies, my own child included. If I hadn't had the 20wk scan it is likely that I would only have 2 DCs instead of the 3 beautiful DCs that I do in fact have, thanks to prompt medical attention.

Part of being a parent is that it is your responsibility to look out for the welfare of your child and that care starts when your baby is in the womb.

Well OttersOnIce that's not 100% true, although it may be in a few months time. The NHS has never offered me a 20 week scan. I am currently pregnant with DC3 and have only ever had dating scans, apart from with my first when I was offered a nuchal as well. The hospital changed their policy after that and only offer dating scans.

If I had been offered a 20 week scan routinely I would have probably gone for it, much in the same way that I had all the routine bloods and dating scan I was offered. You do kind of sleepwalk in to these things if they are being offered. But I thought I would offer my perspective as some one who has heard all the health professionals arguments from the other side; ie consultants and midwives repeatedly telling me why the 20 week scan is NOT necessary.

This time round I tried to argue for a scan as I knew they are being introduced here soon and the sonographers are being trained. I kind of hoped they needed people to practice on . But the consultant I saw (who was probably fed up with women bending his ear about not getting 20 week scans) was very forthright in his dismissal. He said the scan often provides false reassurance, or identifies supposed abnormalities which turn out to be nothing, or suggest problems which would be identified anyway later in pregnancy. He strongly believed the money would be better spent on other aspects of antenatal care. My midwife agreed.

To give an example, I am going for a scan this afternoon, as I did at the same stage with DC1, as the head is not engaging and they want to check for placenta praevia. So not having a 20 week scan has not caused me a disadvantage in that regard.

As I say, had I been offered a 20 week scan I would have loved to have one. But really just to see the baby. And if it had been routine in all of my pregnancies I probably would have felt as strongly as you ladies do about the importance of having it. But that hasn't been my experience.

Reading this thread, I am having real trouble getting my head around your reasoning. Quite a few people have said that their 20wk scan highlighted a problem which needed to be treated immediately after bith (or even in utero), so yes, it did improve the outcome. I totally do understand about not wanting to know about abnormalities which cannot be treated, but TBH not finding out about something that could have a potentially fatal result for your child once it's born is really quite selfish, not to mention strange, IMO.

I can understand about not wanting to know about abnormalities that can't be treated too - I chose not to have any tests for Down's for example. But what if there's something wrong that can be treated, or even needs to be treated before birth?

Queen, may I ask what it is about the scan that makes you feel uncomfortable or unwilling to have it?

Tbh I haven't ever considered not having a 20wks scan (in fact, I get scanned by my gynae at every antenatal appointment).

Queen I completely agree that this is your choice, I refused the triple test because we decided that we wouldn't do an amnio anyway, my midwife said I was an irresponsible mother...

But what you need to think about is the worst case scenario. Bad things happen, there is no reason to think that it will/won't happen to you.

You said 'I do not want to know about any abnormalities. Thats my choice, people may or may not understand it but I have the right to make that choice' and I agree but you have to ask yourself if you will be able to live with yourself if you choose not to have the scan (and any appropriate treatment/measures that may come as a consequence) and the very worst happens. If you find yourself in a SCBU unit with a doctor saying 'if only we'd known about this earlier we could have saved your baby'.
If you think you can cope with that, then go with your gut instinct and don't have the scan. If you have an doubt, have the scan.

There's a world of difference between having a test for something like Downs, when you can do nothing about that and don't plan to take any action, and an anomaly scan which can spot things that may need immediate attention at birth. Would you really rather not know if your baby has a condition that would require action at birth? Of course things will probably be fine, but you don't know that.

Your call though, of course.

QueenOfFlamingEverything I am really struggling to understand your logic. Would you really not want to know about any abnormalities, even if it meant the difference between your baby living and dying? Really?

I dont understand the reason for not wanting it though? I am not being argumentative - generally interested.

I am also confused about how you know you are low risk? All my friends and myself who have had problems were low risk until the scan. I would guess at least three of my friends babies and I only know around fifteen maybe (babies not friends) would either not be here now or would have had a very traumatic birth if it wasnt for the 20 week scan.

I am not 'trying to get a rise' out of people, and I don't want to dismiss the stories posters tell of how problems were detected and treated in their babies.

When I say 'low risk', I mean otherwise low risk. I appreciate that a scan could show something that would make us 'high risk', but when looking at studies and WHO statements, the message is that for women who are otherwise low risk, routine scanning is not associated with a statistically significant improvement in outcomes.

There is no Big Reason that I don't want the scan, I just don't. I feel uneasy about it, I have no desire at all to see the baby on screen, I don't feel any need for it. Evidence that it would offer a significant benefit to me or the baby might make me feel differently, but I can't find any.

Its odd though, that when something becomes routine in the way ultrasound has, anyone who simply doesn't want it is placed in the position of needing a justification for that. Somehow, the burden of proof seems to be on the woman who chooses not to have a scan, rather than on those offering it as routine and important.

I was simply wondering if anyone else had chosen not to have the scan, I wasn't asking to be called 'cavalier' and told I am risking my baby's health.

Queen I think the point is that having a baby is risky to both yourself and the baby. Yes, things normally go well for most women but there is always a risk.
These days women choose to reduce that risk by having scans that are available to them. So when you say you are being told that you are risking the babies health, you are (in comparison to a woman having the scan).

I, of course, don't mean that having the scan itself reduces the risk of a problem - just that the overall outcome has a better chance of being positive in lots of cases if the problem is picked up early and both yourselves and the medics are prepared.

The problem is that most women can't relate to the feelings you are having (I can't) and when you can't relate it makes you feel that someone is being unreasonable.
I think the scan is for the baby not you and you should do something you don't want to do because it just might end up being important for the baby. But hey, you've already decided not to have it, and you had decided that before you posted on here otherwise your responses would be different.

personally i'd think you were a bit mad. its non invasive and there are things it could pick up that could be life threatening to your or your baby - eg low lying placenta.

if there is a low lying placenta its not about abnormalities, more about making sure you don't die in childbirth.

i know you have said you don't want to make choices, but i know of someone whose baby had a kidney condition - no choices but it might not have been picked up at birth and this way it was carefully managed.

they are unlikely to tell you sex unless you specifically ask.

IMO if you are going to pass up on a scan its the 12 one thats less essential - because essential unless you have the nuchal fold measured there is nothing really you get from that scan that you wouldn't get from the 20 week one.

Queen,I think your use of the statistics arguement is somewhat displaced.
If you find a lump in your breast, statistically speaking, it's likely( something like 98%)to be totally benign. So I guess you would not have it checked out?
So, statistically blah blah, but really, after reading all these stories from the other posters, who themselves it seems were considered low risk and whose babies by having the routine scan were saved or whose care was managed much more efficiently, can you really dismiss them and say, oh it's not going to happen to me and if it does than having the scan wouldn't improve the outcome anyway?
Because you can see from these posts that they can save the babies or allow the professionals plan their treatment better.
And you don't have to look at the screen if you don't want to.
Frankly, if your reason for not going is 'there's no big reason', then imo you might need to rethink your priories here.
It's not the same as not screening for Down's Syndrome, where there's nothing you can do about it.
You could be in this statistical minority of women with undetected problem and further in the statistical minority ( if you say so) for whom the scan can possibly save the baby's life. But, hey, if it's not statistically significant, who cares

*priorities

You say you don't want to have to make choices yet in your other thread you say you want to have this, your second child, at home. How can you possibly make that decision without knowing for a fact that this baby is ok and won't need immediate hospital attention once born? You are making a choice for a homebirth without knowing if it's actually safe to have a homebirth?
If you don't attend the scan, will your MW still support your decision for a home birth?

You may not be someone who likes to be seen to conform but putting your head in the sand isn't going to magically make any health problems in your baby go away so you might as well find out what's what before (and obviously I hope this doesn't happen) you find out a bit too late that there was a problem and that it has developed into something serious but could have been prevented had you had the scan.

I think winnybella summed it up really well

Queen - stick to your guns and do what you feel is right for you.

Last time I looked (about a year ago) there were no long term studies on the safety of ultrasound to the foetus. No one has thoroughly assessed potential risks.

There are a lot of personal stories on this thread about the benefits of scans. I will share one of a friend who had an amnio due to the presence of 'soft markers' on her scan. The baby was fine but she miscarried after the amnio. Really sad.

I know lots of people who have worried themselves sick for weeks about 'soft markers' on the 20 week scan.

That said, I had one as I felt it would decrease my anxiety. Also, as I was planning a homebirth and had had some bleeding I felt it was justified.

OP - are you sure that you are not:

a) reacting against the tendency towards complacency and seeing a 20 week scan as "meeting the baby" and "finding out the sex" when it is in fact a serious medical procedure, or

b) actually really scared of what the scan might find so convincing yourself you don't want/need to know?

I was really really scared of the 20 week scan (particularly this time, my second time around - even though, or perhaps because, everything was fine the first time). I wasn't at all complacent, I spent the entire scan shaking and in tears, convinced the next words would be that something was wrong. But I had to face my fear and I would never have refused the scan - it's just too important.

I refused nuchal and triple tests but I had an anomaly scan (that's actually what a 20 week scan is). I wouldn't have had a termination unless I had a foetus with a condition that was incompatible with life.

One of my friends decided to terminate after the 20 week scan showed her baby's brain was not connected to its spinal cord. Absolutely horrible and heart-breaking but much more traumatic IMO to have continued with the pregnancy to term and then discover it. Of course it may be that you feel (judging by your post of 13.02) that you would want to continue to pregnancy to term. I don't know if you've considered abnormalities that are so severe though - forgive me if you have been through that thought process.

As someone who works in antenatal screening and is currently leading a research project that's looking at better ways of putting together info on screening/scans for distribution to pregnant women and their families, I'd like to add some support for QUEEN. Of course there are very sadly problems that can be diagnosed in utereo that can (most of the time) be seen on the scan (such as spina bifida). However, we shouldn't lose sight of the fact that the 20 week scan is actually part of the screening process for chromosomal and other abnormailities (only part of, as it's pretty imperfect at identifiying things such as ds). Ie, it will suggest that there may be problems, but can only talk (most of the time) of greater or lesser risk, usually combined with other background factors such as age etc. In other words, it can't often say there is is problem, and for this reason we give out leaflets that detail the actual rates of abnormailities that can be seen on an scan (pretty low actually - 25-35%), the fact that in the majoroity of cases 'soft' markers are simply 'variations on the norm', and that, for this reason we ask for consent from the pregnant woman as would be the case for any screening test, recognising that the majority of soft markers are in fact 'false positives'. It's also true that there is research that points to the fact that the 20 weeks scan doesn;t actually result in better outcomes for the baby, as the majority of abnormalities will be detected at birth. Please don't think I'm downplaying the very tragic cases of when a life limited condition is identified at 20 weeks. I understand this is a very real consideration for many people, and a valid reason for choosing to have a scan. On the other hand some lethal conditions are missed. What I'm trying to say (not very well)is that we need to step back a little and remember that, as with all screens, the 20 week scan simply identifiies possible problems (or that things are possibly 100% perfect) and for that reason QUEEN is entirely correct in the reasons she gives for declining.

Thank you Diege, it is interesting to hear the perspective from someone who works in the field.

I can see this is a far more controversial and emotive decision than I had any idea it would be, and tbh I feel pretty jumped on now. But the more I research the more certain I am that routine scanning is not something I want to have. I can see why people are questioning my decision to have a dating scan but I had my own reasons for wanting that scan. They are no longer an issue - I am making my decision about the 20 week scan on its own merits.

The NHS's own Health Technology Assessment concludes that perinatal mortality is only reduced if the majority of women accept termination for serious abnormalities, which I would not do.

The consensus from the studies done seem to be that ultrasound should only be carried out for diagnostic purposes, and I don't want diagnosing. Maybe not a decision anyone else would make, but I am clear on it. So what reason is there, if I have chosen not to have antenatal screening, to go for a screening test?