What to Expect at Your 20-Week Ultrasound
It's time for the big ultrasound: Here's a play-by-play of how it goes
This is the big one, the extensive ultrasound that will help confirm your baby’s overall healthy development, that everything is on track and all organs look good. Maybe it’ll even reveal the baby’s gender. I’ve done it four times now, and while each experience was special and emotional in its own way, they all followed a similar routine. Here’s what you might expect at yours.
Around the 20-week mark, you’ll have an ultrasound scheduled. Mine were done by ultrasound technicians, not my OBGYNs, and were at a separate facility.
It’ll be a large exam room, similar to a dentist’s office with a big reclining chair. I’ve never had to undress; just laid back a bit, slid my shirt up and slipped my jeans down. They’ll dim the lights, ask you if you want photos or a CD to take home, and they’ll be very careful to confirm one thing before they start: Do you want to know the baby’s sex? (If not, there will be moments when they may ask you to close your eyes.)
They’ll squirt some warmish gel onto your baby bump, and with a hand-held wand they’ll start pushing gently on your abs to see the baby. You’ll be able to see too; there will either be a TV screen mounted on the wall in front of you or next to the computer your technician is using.
But here’s the thing, they’ll probably need to talk you through it. Other than an obvious little hand or foot (and even though you might feel embarrassed to say it) you’ll be challenged to distinguish exactly what you’re looking at most of the time. It’s a very fuzzy partial image on a black and white screen—of a baby whose body hasn’t fully developed yet. This is why you’re in the hands of experts, so don’t be afraid to ask questions.
It’s a very technical process. The technician’s aim is to find, examine and record several key parts of your baby’s body. They’re measuring the spine and the major organs, and the details might surprise you as they confirm that they see four chambers in that tiny heart, or even as they check for a cleft palate.
My first three ultrasounds were administered in Rome, Italy, where the tech spoke English as a third language. While his English was still better than my Italian, this was nerve-wracking. He kept grimacing during the exam but not saying anything until finally my husband, the one who is always the most level-headed between us, blurted out, “Is there something wrong?” There was. “Eeeet moves,” the exasperated man explained. “A lot.” And, sigh. Your tech will likely speak English very well, so this will not be an issue. But if you do see them concentrating deeply on one area, just ask if everything looks good. Chances are, they’re simply trying to get a better angle and a clearer photo to include in the write-up of your visit.
Ultimately they’ll get to the baby’s sex organs, and again it might seem like you should be able to just see it for yourself, and maybe you’ll be able to. But I couldn’t. Through four of them (including boys and girls), I’ve had to take the tech’s word for it because those pivotal body parts were totally indistinguishable to me. My husband was there for the first three so we had them tell us right then; he was at home with our three small children for this last one so I had the tech write it down and we did a reveal as a family when I got home.
The visit is a bit long, at least 30 minutes, maybe 45. At some point you may have to move around in the chair so the technician can get a better look from a different angle. When you’re done, you’ll scoop off the gel and either wait for the technician to report to a doctor somewhere in the building, or they’ll send the results to your OB-GYN. The technician will likely tell you whether everything looked great overall, in addition to the gender, but ultimately it’s the doctor who will examine the report and sign off on the results.
Even though I’ve done it several times now, I’ve been a nervous wreck for most of these visits. I’ve even cried, but in relief. The combination of worry—What if they find something wrong?—plus finally learning the baby’s sex set off a wave of emotion each time. Plus, after you see your baby and all of his or her very sweet little parts for the first time, the whole thing becomes so much more real. You are having a baby. And if this is exciting, just think of how you’ll feel after another 20 weeks goes by.
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