Keepsake Ultrasounds: Risk vs. Benefit

False alarms are no more troubling in keepsake ultrasound than in any legitimate medical screening exam, such as a Pap smear or mammogram. As far as missing something important—this isn't what a keepsake ultrasound is for. On the front end, a woman and her spouse need to accept that the keepsake ultrasound experience really is just entertainment and of sentimental value. It is the doctor's responsibility—not the keepsake ultrasound shop's—to assure the safety of the pregnancy. If a photographer were to take a picture of a model with big eyes, is it his or her responsibility to wonder that her eyes are big because of hyperthyroidism—and to feel responsible for referring her to an endocrinologist? Of course not. And though a pediatrician's patient cutely plays back with the doctor by in turn listening to his or her heart, it's certainly not the child's responsibility to notify the doctor of a heart murmur. Just because something is medical doesn't mean the lines of common sense need be redrawn.

So far I've been on the defensive in this article, addressing the concerns about unnecessary ultrasound. But there is an equally important aspect that needs to be addressed proactively: bonding.

My wife became pregnant with our first child after I was in private practice in Obstetrics and Gynecology in New Orleans. I was a salaried employee of an older doctor. At about ten weeks gestation, when it was likely that we might hear the fetal heart tones for the first time, I gave my excuse and prepared to punch out of work for the hour to accompany my wife to her obstetrician. My older partner scoffed at the whole idea, because after all, I've heard fetal heart tones thousands of times. What made this so special?

It was our child, that's what, you big jerk.

Such sentiment is important. An expectant couple isn't just waiting for a bus or taxi—they are waiting for their child. A little person that represents their hopes and dreams and visions of little league, Ward Cleaver advice, shopping together, graduations, awards, family dinners, and walking down the aisle. It is life. The family is the ultimate fulfillment of the social order of our species, and it's the meaning of life for our species. And the impact of meeting your child, be it by listening to the heartbeat for the first time or by the sophistication of actually visualizing your child's face, cannot be underestimated.

In medicine we often make clinical decisions by weighing the benefit against the risk. The benefits of keepsake ultrasound, although intangible, are substantial; the risks, also intangible, are only theoretical. In other words, unless some terrible trend bucks thirty years of apparent safety, the risk vs. benefit ratio of keepsake ultrasound is heavily—if not totally—shifted toward the benefit side. Everyone wants to enjoy his or her baby, and keepsake ultrasound lets an expectant parent start that much earlier. It's a good thing. It's love. It's the reason a couple decides to have a baby.

But if you still fear the theoretical, then don't use cell phones, live near power lines, have satellite TV or radio, walk through metal detectors, or stand within 93 million miles of that nuclear fusion device know as the Sun.