Part 12 - The Twelve-Week Scan
For many the twelve-week scan is the first time that they get to see their growing baby on a screen. We’d already had a number of scans by this stage, albeit internal vaginal ones, so we were very aware how exciting it is to see your baby in utero. I shall never forget the mind blowing nature of our first scan at 6-weeks gestation, which showed a simple beating heart reminding me that we are all about the heart essentially. Then two weeks later to determine the number of babies I was carrying and seeing little arm and leg buds, equally amazing.
The twelve-week scans tend to be carried out by specially trained staff called sonographers and conducted in a dimly lit room so the sonographer can get good images of the baby. At the scan itself you’re asked to lie on a couch and to lower your skirt or trousers to your hips and lift your top to your chest so your abdomen is uncovered. The sonographer or their assistant should tuck tissue paper around your clothing to protect it from the gel, which will be put on your tummy.
The sonographer then passes a handheld probe over your skin to be able to examine the baby's body. The gel makes sure that there is good contact between the probe and your skin and in theory a black and white image of the baby will appear on the ultrasound screen. Having the scan doesn’t hurt as such, but the sonographer may need to apply slight pressure to get the best views of the baby and this can be a little uncomfortable with a full bladder.
The sonographer needs to keep the screen in a position that gives them a good view of the baby so the screen may be directly facing them, or at an angle, but you may have another screen ahead of you so you can see what s/he is doing. Sometimes the sonographer will need to be quiet while they concentrate on checking the baby; it’s good to know this so you’re not worrying about what they may have found. They’ll be able to talk to you about the pictures once they've completed the check and if you’re lucky you also get to take some images home with you – here on Guernsey you pay for the privilege.
This first scan at twelve-weeks is sometimes called the dating scan because the sonographer estimates when the baby is due (the estimated date of delivery) based on the baby’s measurements. I already had an idea of my due date because we had an exact date of ‘conception’ from the clinic, so I wasn’t sure how a machine could better that really, and it can’t, it just provides an estimation. However, a lot can hinge on this estimated date in terms of gestation period (in the case of premature babies this has quite some implication) and a date which may determine whether you are ‘overdue’ and require induction (and therefore intervention).
I’ve never been entirely comfortable with the idea of the estimated date. I appreciate that you need to have one, and I appreciate that many women don’t know when they actually conceived and therefore need an indication of where they are in their pregnancy, but I’m just not convinced we should get too hung up on the date in terms of delivery.
From my experience babies arrive when they’re ready to arrive and psychologically I’ve seen many women get themselves all worked up when the baby doesn’t arrive on the ‘due date’. They then have induction and intervention hanging over their heads, which can create unnecessary stress.
Furthermore, other people, be that family, friends and/or work colleagues can become very fixated on a date and add additional pressure to the anticipation of the eagerly awaited birth. Lots of judgments can also arise in terms of the size of bump in relation to the stage of pregnancy, which of course brings with it anxieties as people – often innocently - comment on how big the baby may be, or how big you are getting carrying the baby – none of this is helpful, especially if you are already anxious about the potential vaginal delivery!
Still here we were at the dating scan, so it was of course to be expected that we would be given a date and yes, it turned out to be a few days short of the date we had expected based on the information provided to us by Wessex. The dating machine determined that our little bean would be expected for delivery on 21 November 2013, 9 days short of E’s 47th birthday. I decided however not to place too much emphasis on this date, the baby would arrive when s/he wanted to arrive, and often first babies can be notoriously late.
The 12-week scan can also include a nuchal translucency (NT) scan, which is part of the combined screening test for Down’s syndrome and involves a blood test and an ultrasound scan. We decided to take the screening test which basically looks at the risk in the pregnancy of the baby being born with Down’s syndrome. It doesn’t give a definite ‘yes’ or ‘no’ answer - if the screening test shows a higher risk that the baby has Down’s syndrome then you are offered a diagnostic test to see if the baby actually does have Down’s syndrome or not.
The screening involves the scan, where the sonographer measures the fluid collection under the skin at the back of the baby’s neck (the nuchal translucency). Apparently all babies have a collection of fluid here but babies with Down’s syndrome tend to have more fluid in this area. The fluid measurement, your age, the size of the baby and other details such as your weight, ethnicity and smoking status are then put into a computer program to give the risk of the baby having Down’s syndrome. Sometimes it can be difficult to obtain an accurate measurement of the nuchal translucency due to the position of the baby or because the pregnant lady is overweight.
Blood tests may be done to measure levels of various hormones and proteins in your blood – these hormones and proteins are produced by the placenta or the developing baby. If the baby has Down’s syndrome, the levels of these substances can be affected. Again a computer programme is used to give the risk of the baby having Down’s syndrome, based on the blood test results, your age, the stage in your pregnancy, your weight, ethnicity and smoking status. This blood test is sometimes called serum screening.
During our scan the sonographer managed to measure the nuchal translucency and the result indicated we were low risk. However, we also needed to do the blood test so, following the scan, we walked up to the maternity unit so I could have bloods taken. The choice to undertake this test is very personal to each parent and should be discussed prior to the scan so that you know where you both stand.
I’ve known parents elect not to carry out the screening test and they have been perfectly contented with their decision. I’ve also known other parents who have chosen not to take the scan but have then spent the latter part of the pregnancy fretting about whether their child may have Down’s syndrome and considering their ability to cope if that happened to be the case. And of course there are other parents like us, who felt that we wanted to know, so at least we could try to prepare ourselves mentally if nothing else.
The scan was excellent. I know there are some who believe that the scans adversely affect the baby, but for us, having already had a number of essential scans with the IVF, we were happy to go with the flow of things. It was actually really exciting and indeed emotional to see a real life baby with a head and arms and legs and organs on the screen. I know that may sound silly because of course we already knew that I was carrying a baby inside me, but it becomes all the more real – we really were having a baby!
However, there was an edge to our scan simply because the sonographer noted that my placenta was lying low. She told me it was highly likely that it would move upwards as the pregnancy progressed but there was something about the way she said it, or perhaps the way I heard it, that made me think that I couldn’t be so sure.
I didn’t know an awful lot about placentas at that point but I made a mental note to find out all I could when I returned home. Other than that the scan seemed fine and we left with the classical scan prints, which don’t really mean an awful lot to anyone else but provide you with a memento all the same!
By the time we attended this scan, I had officially signed up with Anita, my doula, and was on the list to join her pregnancy yoga classes as they were known at the time. I contacted her following my scan and she – like the sonographer – reassured me that it was highly likely that the placenta would move as the uterus expanded and not to worry too much about a low lying placenta. I decided that I would try to forget about it, I am very aware that we attract that to which we give attention, so better not to give it too much attention!
I had already met with a midwife for an initial consultation, in which I relayed my intention to have a home birth. At that time home birthing was only just becoming a more acceptable option so there was some mention of the need to check that the cottage was appropriate and some muttering that if the ward were short staffed then they would expect me to come in to the hospital to birth and access to the birthing pool would be dependant on how busy they were in the delivery rooms.
I was still busily reading any book I could get my hands on about home birth, natural approaches to birth and birthing without fear. I found it all fascinating and with my interest in natural approaches to healing and life generally, let alone the whole law of attraction perspective on things, I was struggling to understand the reason anyone would birth in a hospital or lay themselves at the mercy of unnecessary medical intervention and the whole medicalised and often fearful birthing experience.
Still what I was also beginning to recognise was that the pregnancy world is rife with fear, even I was feeling it in terms of the concern about miscarrying, let alone any of the other anxieties that pregnancy brings. At times it was almost reassuring to feel sick, just to know that I was still pregnant! It’s crazy really as I’m not usually someone who experiences anxiety, so it was a bit of a shock how much this showed up during the pregnancy.
I have to say that those online pregnancy forums don’t help matters and I would strongly encourage others to avoid them as much as they can. Perhaps sometimes they may be helpful, but on the whole I think they just serve to further promote anxiety and prevent you checking in with your own wisdom and trusting in this.
I believe that we already know everything we need to know and as mothers or mothers to be, our intuition is even stronger, certainly in respect of our children be that Earth-side or in utero – I truly believe we know deep down if there’s something wrong or not.
However, I found signing up to babycentre.co.uk was positively insightful as you receive a weekly email explaining the stage of development of the growing foetus based on your estimated due date (see it does have some positives I guess!). I found this helped me to connect more fully with the bean and also helped me to learn a little more about foetal development and the changes experienced by women at various stages of gestation.
I supplemented this with a “week by week” yoga in pregnancy book where the authoress also details the developmental stages but compliments this with yoga poses to support that particular gestation period.
Life continued much as usual over the coming weeks with the sickness finally easing – thank the Goddess of the Moon - and by sixteen weeks it stopped all together. Phew. It was like a switch being switched off, all of a sudden it just went. Furthermore, I started to have more energy and felt like a normal human being again albeit with an expanding waist line – it was such a relief! I think the trouble with morning sickness is you have no idea, especially that first time, when it will ease, and you can’t help feeling a little bit anxious that it may continue the whole of the pregnancy – thankfully not in my case!