What You Need to Know About Your Mid-Pregnancy (18-22 Week) Anatomy Scan
From the time you learn you are expecting, you eagerly await the appointment for your mid-pregnancy ultrasound or anatomy scan. For many families, the opportunity to hear your baby’s heartbeat and capture images of your baby is one that is quite exciting. Mid-pregnancy scans also serve another important purpose - they allow your care provider to do a full anatomy assessment of your baby’s health and growth.
Many questions can come up before and during the scan, so let’s go over some frequently asked ones in preparation for your scan!
Am I required to have a mid-pregnancy anatomy scan?
In short, mid-pregnancy anatomy scans are not required. However, care providers typically perform mid-pregnancy anatomy scans, also known as a level 2 ultrasound, between the 18th and 22nd weeks of your pregnancy to learn more about how your baby is doing. In the event that you are having multiples or have a pregnancy that has been identified as high-risk, you may have more than one anatomy scan. When performed by qualified medical professionals (such as your obstetrician, certified professional/nurse midwife, or care provider’s technician) and for medical purposes, there is no evidence that ultrasounds can harm you or result in a pregnancy loss. In the event that your care provider has any concerns about findings during your ultrasound, they will typically recommend additional testing and screenings.
While your first-trimester ultrasound is used to determine your due date, your mid-pregnancy anatomy scan tells you quite a bit about baby’s development. Mid-pregnancy anatomy scans are helpful for diagnosing developmental problems, determining if you are having multiples, reviewing your placenta’s positioning, or estimating if your amniotic fluid levels are too low, just right, or too high. Anatomy scans further inform your care provider if your baby has a medical issue that can be resolved while your baby is in-utero.
Ultimately, it is your choice whether to have an anatomy scan. While some families want to know as much information as possible so they can prepare for the birth, others may not. If you do not feel comfortable having a mid-pregnancy anatomy scan, talk to your care provider about your feelings. Some care providers require mid-pregnancy anatomy ultrasounds in order to give birth at their facilities while others will acknowledge your right to refuse. In the event that you decline an anatomy scan, your care provider will evaluate the risks of doing so and the possible impact to newborn care if a problem is detected during labor or shortly after birth.
What is the purpose of the anatomy scan?
During your mid-pregnancy anatomy scan, you’ll learn detailed information about your baby’s body and his or her growth. For example, the scan will tell you about the development of your baby’s brain, spine, heart, kidneys, limbs (plus tiny fingers and toes!), and if any abnormalities are present. The scan will also help measure the baby’s growth to ensure it is aligning with your gestational stage. Your technician or care provider will measure your baby's body parts, such as their head circumference, abdominal circumference, and their thigh bone length. All of this will help inform you if the baby is growing as expected. Finally, the scan presents an opportunity for your doctor to review your placenta and amniotic fluid to ensure you're okay, too!
Will I learn my baby’s sex during this scan?
The anatomy scan is usually when you learn about your baby’s gender. If you want to wait to learn your baby's gender, be sure to tell your technician or your care provider early in the appointment so they do not inadvertently reveal the gender.
In some cases, your baby may not be in an optimal position to confirm their gender. While you may be disappointed if this occurs, particularly if you are trying to schedule your scan around a gender reveal, you can still learn the gender at a future appointment.
What do I need to do before the scan?
It can help to have a full bladder before the scan so your care provider may ask that you drink water (16-24 ounces) before your appointment. When you have a full bladder, this can make your uterus appear in more obvious detail during the ultrasound. By your 24th or 25th week, you should have more fluid surrounding the baby within the amniotic sac which may make a full bladder unnecessary for future ultrasounds or anatomy scans.
What should I do during the scan? How long is the scan?
During the scan, you will recline on the exam table. You will be asked to expose your abdomen by lifting your clothing so the technician or care provider can apply warm gel to your skin. The technician or care provider will then move a wand, also known as a transducer, over your abdomen where they have applied the gel. You will hear different sound waves as the transducer captures your baby. Occasionally, you will see your technician or care provider look at the monitor and freeze-frame several images. The scan can range in time from 15-40 minutes. Scans tend to be shorter in length when the baby is in a good position. If the baby is not in a good position, your technician or care provider should patiently wait until your baby moves or reschedule for a future date.
In most cases, you should be able to record the ultrasound or take photos as the ultrasound is occurring so you can share with loved ones. Check with your care provider to see if they have a policy about videos or photographs prior to the appointment.
Will my technician or care provider talk to me during the scan?
Your technician or care provider should walk you through everything they are looking at on the monitor in detail. If there is any silence, it’s okay to ask what he or she is doing. Please note that if a technician performs the scan, diagnosing you or your baby is outside of their scope of practice. Your care provider, such as your physician or midwife, however, can review your scan and discuss the findings with you.
What should you do if the ultrasound shows reason for a concern?
If your care provider has any concerns about the findings in the scan, they may request additional testing. If necessary, your can provider may provide you with specific recommendations that you can research and discuss with your partner, if applicable, before moving forward.
Some reasons why your care provider may request additional testing includes the appearance of facial abnormalities such as a cleft lip, brain abnormalities, limb abnormalities, or internal organ abnormalities.
What can I ask my care provider during and after the scan?
Consider asking your care provider the following:
What are my baby’s measurements? Can you tell me what percentile my baby appears to be in at this point and does that align with my gestational stage? This will help you get more information about how your baby is growing and if he or she is smaller, just right, or larger than expected at this stage. Care providers are usually good at providing this information to you upfront, but if not, ask.
Did you see all of my baby’s limbs? Do the limbs appear to be forming properly and measuring the right length? By this point, ideally, your care provider should be able to check for limbs, fingers, and toes. However, if the doctor is not able to count fingers and toes, please do not worry! Sometimes, the baby is in position where it is hard to see everything. In that case, the technician or your care provider may just wait until the baby moves or your care provider might request another ultrasound if your baby is in an awkward position.
Did you see all of my baby’s vital organs and are they forming properly? Ideally, your care provider should be able to see the vital organs (heart, brain, stomach, kidneys, and lungs). Ask your doctor about what he or she can see and if he or she has any concerns about the development of your baby’s organs.
Is the spine forming properly? During your scan, your care provider will learn information about your baby’s spinal or neural tube development. In some cases, your care provider may observe an abnormality, such as spina bifida, and will discuss recommendations for moving forward.
Are the placenta and amniotic fluid okay? Feel free to ask about your placenta as well as your amniotic fluid to ensure everything is progressing as expected with your pregnancy. Knowing about the placenta placement, such as if it is too low, and whether the amniotic fluid has the proper volume can give your care provider a lot of information about your health as well.
If there is an abnormality detected in the ultrasound, what are our next steps? It can be helpful to have a plan of action if there are any concerns. If your care provider detects an abnormality for which additional testing and screening is recommended, they will provide you with your options and work with you to evaluate the benefits and risks.
Bottom Line
Mid-pregnancy anatomy scans are a great way to learn more about your baby. Be sure to confirm that a medical professional, like an ultrasound technician, will perform the scan if it will not be performed by your physician or midwife. Ask as many questions as you would like during the scan and upon getting any results. In the event that your scan results require follow-up, like additional testing, your care provider will outline next steps for you to review with your partner. If you are able to take pictures or record your baby’s images during the scan, share them with loved ones! Your office may offer you printed images of the scan that you can frame or place in a memory album. Getting this first glimpse of your baby can be so precious - enjoy it!
This information is provided for educational and entertainment purposes only. We do not accept any responsibility for any liability, loss or risk, personal or otherwise, incurred as a consequence, directly or indirectly, from any information or advice contained here.