Appointments and ultrasounds

[sweetpea508]

I had to go in to the office to get my blood drawn and for a urine sample before my first appointment with my midwife. So I was talking to the nurse and she mentioned that they might not even do an u/s or listen to the heartbeat on the first visit. She went on to say that they don't really do ultrasounds very often. At 18 weeks would be my first? And then she gave me a handout of a private firm that does like an ultrasound package, that I assume is expensive, and that will give me one 2D ultrasound for the sex and one 4D moving someshit or whatever when I am further along. I fully expected to have a few ultrasounds at least, one for the nuchal scan for Downs, and one for the sex obviously, and then more when I was further along. I'm trying to give them the benefit of the doubt before I jump ship. I mean why the hell would I not at least get to hear the heart beat. I would at least like to know it has a healthy heartbeat. So end rant, how many ultrasounds did you ladies have? And is this normal or am I being a noob? I'm so not looking forward to my first appointment next week now

[joolz]

It depends when your first appointment is for the heart. If it's really early, they may not want to try to find it because of how early it is.

Do they do the first trimester screening or do you go elsewhere? I had to go to another facility to get the ultrasound and bloodwork done for the screening. If you're planning on doing that testing, you should have an ultrasound then.

Beyond the NT scan and the anatomy scan , that's usually it for ultrasounds unless there's an issue (like last time I had placenta previa, so I had another ultrasound at 28 weeks or so).

My dr does listen to the heart at every appointment from 10 weeks on, though.

[sleepyheads]

I felt the same way! At my first appt. at 8 weeks, they only did a pregnancy test to make sure I was pregnant. At this upcoming appt. (12 weeks) they will only be listening to the heartbeat. I think I'll only get an ultrasound for the NT test and the A/S.

I think how many ultrasounds you receive just depends on your doctor and your past history. If you're fairly healthy, it seems they don't do ultrasounds too often.

[baconlettucetomato]

My OB only does the 20W Anatomy Scan. I ended up getting an ultrasound after I started bleeding at 6W. At my first OB appt at 10W she couldn't find the heartbeat so I had another. We elected to do the NT scan but it was done through a separate office because my OB doesn't do them, she gave me a referral. Our 20W will most likely be our last one. So, that said, it's totally normal. My OB just doesn't like to do them if not needed and she only thinks the 20W is needed.

[osulori]

How far along are you? I had my prenatal education appt (bloodwork, urine test, and medical history stuff) at 7 weeks, ultrasound (where we could see but not hear the hb) at 8 weeks, doppler/handheld u/s to hear the hb only at 12 weeks, and then my NT scan this past Monday at 13.5 weeks. The NT scan may be something the NP bring up with you-it was discussed at my education appt and I was given the option then of scheduling it or not. Plus, not all insurance plans cover it. I'd be really suprised if you didn't even hear the hb before 18 weeks.

[candreco]

Depending on how far a long you are, there wouldn't really be anything to see on an u/s, and way too early to pick up the heartbeat (around 10 weeks, but no guarantee then even).  Not every practice does a dating u/s, particularly if your cycles are pretty regular, and the NT scan isn't necessarily standard, most places will do it if you request it, but unless there are specific risk factors present your OB might not recommend it for you.  Later u/s are generally done only if there's an issue, like placenta previa, gestational diabetes, or some other complication.  Growth u/s to check the baby's size are sometimes done, but they're often pretty inaccurate anyway, so a lot of practices don't bother.

The anatomy scan (it's not really to determine sex, that's just a bonus) at around 18-20 weeks is the only u/s that is really standard.

[HoneySpider]

I didn't get one at my first appt either, I got one when we went for the NT scan, and since they found problems then, I now see a specialist and get one every single time (I guess that's the upside to seeing a specialist). My ob just does the heartbeat when we go see her. 

[blindyswife]

What you're describing is very standard. If your first appointment is sooner than 10 weeks, they may not try to find the heartbeat with Doppler because it can be difficult to find that early on. My office only does u/s at around 20 weeks, unless there are issues that would make another u/s necessary. A lot of insurance plans won't cover more than one unless there is a medical reason.

[housegeek]

Mine does one ultrasound at 20 weeks. I'm big on low intervention pregnancies/labors when at all possible, so I'm good with it.

I think they generally check the heartbeat every appt though, but that's not an U/S.

[dragonfly08]

It's totally normal to not get an u/s or hear the heartbeat on the doppler at a first visit.  Those are usually at 8-10 weeks, and most OBs won't even try with the doppler until closer to 12 because it's hard to pick anything up before then.  And an u/s often isn't covered by insurance in that case.  In my experience, the only people who typically get one at the initial visit are those who 1) go to an OB who owns a machine in-office (so it's billed to insurance as part of the global prenatal care and not a separate u/s), or 2) have medical necessity (seeing an RE, lack of accurate dating due to irregular cycles, etc.).  

My OB routinely offers the 20 week anatomy scan and that's it.  If you choose to have the NT scan, you'll get an u/s earlier as part of that (and will have to pay OOP for it if your insurance doesn't cover the genetic testing).  They do not do an u/s in-office so there needs to be medical necessity for writing you a lab order for the radiology center.

SO obviously I didn't have an u/s at my initial visit, nor did my doc use the doppler as I was only about 8 weeks along.  And it was my second kid, to boot.  Still found it pretty exciting to have the pregnancy confirmed by the doc, talk about the due date, rehash all the do's and don'ts.  From my second appointment on, she did use the dopper each time so there's that to look forward, too.  Congratulations!  

[jssymom14]

I will say that it was awesome to see heartbeat and little baby at 8 weeks or so for dating u/s but we had to pay oop for it. Have heard heartbeat at ever appt so far and we opted out if nt scan. At the 20 week appt they will do the anatomy scan and if you are like me and get soft markers for things, I had to see a specialists for another u/s which turned out fine. I will not get another u/s of baby unless dr wants to measure for size as I get closer to delivery due to GD.

[countthestars]

My OB only does ultrasound at the 20W anatomy scan unless you elect to do the NT scan. They tried the Doppler at my 12week appt but had trouble finding the HB but it was fine at the 16week appt. We had a dating ultrasound and NT ultrasound so I had already seen the baby.

[KKD]

My first OB appointments have always been around 8 weeks and always include a dating ultrasound. (They don't start using the doppler until 12 weeks.) I know one of their three offices does not have ultrasound equipment, so I purposefully avoid scheduling my first appointments there. My last pregnancy ended in a missed miscarriage, and I had no sign of it until that first ultrasound; my bloodwork and symptoms were in line with what they should have been at 8 weeks.

If you do opt for the first trimester screening (and my OB's office gives the paperwork to schedule it at the first 8 week appointment), you will have an ultrasound then, between 11-14 weeks.

I was spoiled with ultrasounds during my first pregnancy; I had weekly ultrasounds with my RE until 8 weeks, then I switched to my OB and had the first trimester screening, the anatomy scan, a growth ultrasound at 38 weeks (only because I was measuring small), and an NST at 41 weeks (which is standard when you go so far overdue). My second pregnancy, I had four: the dating ultrasound, the first trimester screening, the anatomy scan, and another NST at 41 weeks.

[sweetpea508]

Thanks for all your responses! I think I've been seeing too many u/s pics in my Facebook feed and its driving me a little crazy. I'm 8 weeks now, 9 weeks for appointment. I was just surprised that the u/s weren't as standard as most people make them out to be. I truly thought that that's something that everybody got on their first visit. I really wanted to have one to tell the age of my baby since my periods were so off and I spotted for 3 days a few weeks before I tested positive. Also, I didn't really think the NT scan would be elective, it's something I definitely would want to test for. I'm going to check with my insurance to see what they cover so I am informed before I go in next Thursday. I'm glad their practices aren't totally off base. I was just taken aback when they handed me all this third party u/s info. My midwives have really great reviews and the hospital they work out of is top notch so I think I made the right decision to go with them. I think I'm just a little nervous about the type/ quality of care I am going to receive. I knew you ladies would know if this was right or not. Thanks for settling my mind. Off to relax and eat more pickles.

[halfpint]

I got one at my first visit, then I have one at 12 weeks because I requested the integrated scan, 20-ish weeks for a/s, and I think that's it. Maybe one more toward the end just to measure growth?

With my last pregnancy, I started with a midwife. They didn't do a first visit until 10-12 weeks, and didn't do an u/s until the a/s. I had to request because my RE recommended getting one right away, so I ended up getting one at 6.5 weeks. I never had another after that as I lost that pregnancy.

Bottom line, I think it's totally dependent on the practice. If you want something, ask for it - I'm sure there's a way to accommodate.

[SallySparrow]

My first appt. was yesterday, and they did a "dating" ultrasound. Everything there is in house though (lab, ultrasound machine, etc), so I don't know if that makes a difference? We won't have another one until the 20 week anatomy scan unless we decide to do the NT scan in a couple weeks.

They didn't do a doppler to hear the heartbeat yet, but we did see it really easily on the ultrasound. They said they'll start listening to it at every appt. around week 12.

[imoan]

I had 4 ultrasounds technically... but the first one I only got because I thought I was further along than I actually was so that was SUPPOSED to be my dating ultrasound. Instead my OB marked it as a "missed period appointment" and I went back for my REAL first OB appointment 2 weeks later (at 8 weeks). Then I had the NT scan at 12 weeks. Then the AS ultrasound at 21 weeks. And from what I gather, that'll be it ultrasound-wise.