The prenatal ultrasound has become part of routine care for pregnant women, so ubiquitous that doctors rarely explain its risks. Expecting parents happily share these first “pictures” of their babies. With October designated as “Medical Ultrasound Awareness Month” by the joint effort of the American Institute of Ultrasound in Medicine (AIUM) and several other organizations, it’s time to revisit this technology.  A prenatal ultrasound, also called a sonogram, uses high-frequency sound waves to create an image of the developing fetus and the mother’s reproductive organs. In allopathic (western, medical) prenatal care, ultrasounds monitor fetal development and screen for any potential problems. The average number of ultrasounds may vary, depending on the doctor or midwife’s concerns for each pregnancy.

How Do Ultrasounds Work?

Ultrasounds work by emitting high-frequency sound waves, higher than humans can hear, beginning at 20,000 hertz. A handheld device, called a transducer, sends and receives the ultrasound waves. The sound waves bounce off the structures in the body and produce echoes received by the transducer. The ultrasound machine processes the time it took for the echoes to return and calculates the distance traveled. All of these signals are calculated to form a “picture.” The most familiar ultrasound is the traditional machine with a monitor. However, there are several devices that use ultrasound technology for prenatal care, including:

• Transvaginal ultrasound – A small ultrasound probe that’s inserted into the vagina used in the earlier stages of pregnancy to get a clearer picture.
• 3-D ultrasound – An in-depth ultrasound that displays the width, height, and depth of the fetus and mom’s organs, for diagnosing any suspected problems.
• 4-D ultrasound – A moving video of the fetus. It creates a clearer image of the baby’s face and movements for an even more detailed look at any potential problems. However, the main benefit of 4-D ultrasounds is the keepsake video.
• Fetal echocardiography – An ultrasound that captures an in-depth image of the fetus’ heart, for diagnosing suspected congenital heart defects.
• Doppler – A handheld device for listening to the fetus’s heartbeat at checkups and during labor to confirm it’s in the normal range. Although a picture isn’t formed with the handheld Doppler, it also emits ultrasound frequencies.
• Electronic fetal monitoring belt – An ultrasound device strapped to the mother during labor to continuously record the fetal heartbeat and contractions.

To make informed decisions about ultrasounds during prenatal care, it’s essential to understand not only which devices use ultrasounds but also what they detect during pregnancy.

The Many Uses Of Prenatal Ultrasounds

Under standard allopathic prenatal care, ultrasounds are given for many reasons depending on each pregnancy. Generally, ultrasound devices are used to:

• Confirm a viable pregnancy (that the fetus is living)
• Check the fetal heartbeat
• Estimate a due date
• Check for more than one fetus
• Examine the mother’s reproductive organs
• Check for an ectopic pregnancy (when the embryo attaches outside the uterus) or miscarriage
• Monitor fetal growth and position
• Determine the baby’s sex
• Check for placenta previa (when the placenta covers the cervix) and placental abruption (when the placenta detaches from the uterus)
• Check for signs of Down syndrome
• Look for congenital disabilities
• Check for structural abnormalities or blood flow problems
• Monitor amniotic fluid levels
• Check fetal oxygen flow
• Scan for possible issues with the reproductive organs
• Measure cervix length Guide tests such as amniocentesis, where a needle is inserted into the womb to collect amniotic fluid
• Confirm fetal demise

This exhaustive list might give the impression that there’s a lot to worry about and constantly monitor during pregnancy. If that is the case, ultrasounds certainly can put minds at ease. But, do the benefits of having more information outweigh the risks of continually exposing a developing baby to high-frequency sound waves?

The Known Risks Of Prenatal Ultrasounds On Fetal Health

Ask your doctor if prenatal ultrasounds have risks, and you might hear, “The data’s clear; they’re unquestionably safe.” Yet, an abundance of scientific literature clearly shows that ultrasounds present enough risks to a developing fetus to question the current standard of practice. Some of the health risks of prenatal exposure to ultrasounds that current science shows are:

• Slowed fetal growth
• Increase in delayed speech
• Autism
• Doppler scans doubling the risk of perinatal death
• Increased risk of autism, ADHD (Attention Deficit Hyperactivity Disorder), DNA damage, jaundice, cancers, and allergies demonstrated in over 50 studies from China
• Increased risk of delivering via c-section based solely on fetal size, as assessed by an ultrasound test and based on continuous fetal heart rate monitoring during labor

Do We Know Enough About Prenatal Ultrasound Risks?

The FDA states, “Ultrasounds can heat tissues and in some cases, produce very small bubbles or cavitation in some tissues.” They issued a warning that ultrasounds should be reserved only for medical needs. Additionally, the Doppler for hearing the fetal heartbeat proves to be no better. The handheld Doppler device has been shown to heat tissue higher than safe levels. Another problem is that current-day ultrasound intensity and fetal exposure have yet to be adequately studied. Douglas L. Miller, Ph.D., in his report entitled Safety Assurance in Obstetrical Ultrasound, states:

The present use of diagnostic ultrasound in obstetrics is expected to be essentially free of risk of ultrasound-induced bioeffects. However, it is not possible to prove this expectation […] Scientifically, only the opposite can be shown; that is, continuing research could elucidate a significant harmful effect.”

And finally, the American Congress of Obstetricians and Gynecologists states: “No links have been found between ultrasound and birth defects, childhood cancer, or developmental problems later in life. However, it is possible that effects could be identified in the future. ” Does any of the above medical literature alleviate any public concerns about ultrasound safety? Quite the opposite. So, now that the risks are disclosed, the question remains, how necessary are prenatal ultrasounds?

The Shocking Data About Prenatal Ultrasounds And Birth Outcomes

Yes, any doctor and expectant parent would prefer to confirm if any problems can be prepared for, or prevented, with advance knowledge, and ultrasounds can be helpful in providing this information. Yet, research shows that routine prenatal ultrasound use results in ZERO improvements in infant mortality. This alarming fact was revealed in a vast study of over 15,000 pregnant women in the U.S. The study showed that the use of routine ultrasounds showed no improvement in infant mortality compared to women that didn’t receive ultrasounds during pregnancy.

Ultrasounds Lead To Zero Improvements To Critical Conditions

According to a thorough report by Judy Slome Cohain in Midwifery Today Magazine, prenatal ultrasounds also resulted in zero improvements in these other critical perinatal outcomes: Amniotic Fluid Check – Studies show there was no difference in stillbirth, miscarriage, newborn health, or neonatal NICU (newborn intensive care unit) admissions among women who had an amniotic fluid check. Umbilical Artery Check – Existing research does not provide conclusive evidence that the use of routine umbilical artery check with the Doppler benefits either mother or baby. Placenta Check – There are no placental defects that can confirm intrauterine growth restriction, and ultrasound is unable to diagnose them if there were. Therefore, ultrasound scanning of the placenta before birth provides no benefit. Twenty-week Anatomy Scan – The ability of ultrasound to find fetal growth anomalies varies from 13 percent to 85 percent. Also, there are cases of ultrasounds diagnosing defects even though the babies were born without any sign of them. Pregnancy beyond 42 weeks – There’s no effective screening test that clearly shows a reduction in stillbirth rates in the general population associated with post-term pregnancy. Judy Slome Cohain also reports that recent studies have found that ultrasounds are largely inaccurate when assessing prenatal risks and diagnosing possible problems.  Additionally, Peter Brocklehurst, Professor of women’s health at Birmingham Clinical Trials Unit states that continuous, electronic fetal monitoring during labor not only increases the risk of delivering by c-section, but electronic fetal monitoring resulted in no difference in perinatal mortality in a review of data for over 37,000 women. Given that research shows routine prenatal ultrasounds carry definite risk, but little to no guaranteed benefit, it’s rational to consider alternatives to ultrasounds during your prenatal care.

The No-Risk Alternatives To Prenatal Ultrasounds

Contrary to what conventional medical professionals believe, there are risk-free alternatives to prenatal ultrasounds. If you wish to reduce ultrasound exposure during pregnancy or forgo it entirely, here are some of your options. Choose The Best Maternity Care Provider For You Whether you prefer an obstetrician, a hospital midwife, a free-standing home-birth midwife, or midwife at an independent birth center, be sure they listen to your concerns with care and understanding. They should offer alternatives for any procedures you’re uncomfortable with or be content with, “No, thank you.” Check Your Baby’s Heartbeat In Another Way You can opt for a fetoscope, which is a type of stethoscope for listening to a fetal heartbeat. A skilled midwife or doctor can usually hear the fetal heartbeat beginning from 16 to 20 weeks gestation and throughout the rest of the pregnancy. Screen For Genetic Disorders, Including Down Syndrome Safely You may request a non-invasive DNA blood test. All that’s required is a simple blood draw from Mom any time from nine weeks gestation on, and DNA test results are shown to be 97 to 99 percent accurate. Bonus, you can also find out your baby’s gender this way. The 20-Week Anatomy Scan  If you’re uncomfortable with ultrasounds, you may opt for only the 20-week scan. You may also request the sonographer perform the scan as efficiently and quickly as possible to reduce exposure to ultrasound. Fetal Growth/Position And Placenta Position  As the pregnancy progresses, a skilled obstetrician or midwife can generally feel the positions of the baby and the placenta. Plus, they can accurately track fetal growth by measuring the fundal (uterus) length externally with a tape measure. Keepsake Ultrasounds Due to the risks, avoid 3-D and 4-D ultrasounds, home monitoring devices, and others done solely for the comfort or as keepsakes. Fetal Heart Rate Monitoring During Labor  A skilled midwife or obstetrician can use auscultation with a fetoscope by listening to the fetal heartbeat at regular intervals. Though fetoscope use during labor can sometimes be challenging, it can successfully be accomplished. Finding a practitioner that’s comfortable using a fetoscope for labor is key to avoiding the continuous ultrasound monitoring or Doppler use throughout labor. If your practitioner insists on using a Doppler during labor, you may request that it’s used as briefly as possible. Fifteen second periods are enough to establish a fetal heart rate.

Getting Informed Consent For Prenatal Ultrasounds

Ultrasounds, as with all medical care, should come with informed consent. Though checking for possible problems during pregnancy is a worthy intention, it’s critical to be aware of the risks and the alternatives to make an informed decision. While in certain situations this advanced medical technology is certainly helpful, for prenatal care in low-risk cases, routine ultrasounds may do more harm than good.  Dina Robison is a yoga instructor, freelance writer, life coach, and mom. She’s taught yoga since 2004 in New York City and Silicon Valley and has helped women attract their soulmates with her coaching and online courses. Submit your story or essay to Buzzworthy Blogs.