From the moment you meet your midwife she’ll talk about scans and tests. The main thing to remember is that every test you’re offered is optional, and you won’t have to pay for any of them, as they’re all available on the NHS.
Don’t be afraid to ask your midwife questions – it’s important that you fully understand what the tests are and what the results could be. That way you can make an informed decision about whether or not they’re right for you.
Delayed motherhood linked to increase in Down’s pregnancies
In your diary… between 6 to 10 weeks
Women who’ve experienced bleeding, some types of fertility treatment, previous ectopic pregnancy or recurrent miscarriages will be offered an early scan to check their pregnancy’s proceeding properly. If the pregnancy’s very early the scan may be done through your vagina, but usually it’s just done on the outside of your tummy as you’d expect.
“My first pregnancy was ectopic with quite a few complications so when I got pregnant a second time I was quite tense. My midwife suggested an early vaginal scan, which I wasn’t sure about, but she reassured me it was fine. I’m glad I had it done because it showed that everything was OK so I could relax,” said Caroline Mathers, 29, from Leeds, mum to Rosie, 3 months.
Nuchal Translucency scan
In your diary at… 11 to 13 weeks
The nuchal translucency scan measures the amount of fluid under the skin at the back of your baby’s neck. Babies with Down’s syndrome often have an increased amount, so the results of this scan are used (along with the stage of pregnancy and your age and weight) to estimate the likelihood of having a baby with Down’s syndrome. If you like, you can have a blood test as well as your nuchal scan (known as combined screening) to give a more accurate result.
“My sister didn’t have the nuchal scan as she said she wouldn’t have terminated a pregnancy under any circumstances. I honestly don’t know what I would have done if the tests had shown a problem, but I knew that either way I wanted to know what I was dealing with. What’s right for one person isn’t necessarily right for another, as I don’t think any of the decisions are easy ones,” said Nisha Hossain, 21, from West Yorkshire, 8 months pregnant.
In your diary… between 10 to 12 weeks
If you decide not to opt for the nuchal scan, or if it isn’t available in your area, you’ll be offered a dating scan, which will be done at the hospital. This scan will confirm your due date and how many babies you’re expecting. You can usually ask for a photo of your scan to take home, though there may be a small charge. Many women are unsure about their dates and it might be too early to see the baby clearly, so you could be asked to return for another scan a couple of weeks later.
If you have a nuchal scan and it shows you’re considered high risk for having a baby with Down’s syndrome, or your past or family history shows there may be a risk of your baby having a genetic chromosomal condition such as cystic fibrosis or sickle cell, you’ll be offered either CVS or amniocentesis.
Chorionic villus sampling (CVS)
In your diary… from 11 weeks
During CVS, a doctor will pass a fine needle through your abdomen and into the womb, or into the vagina and through the cervix, to sample a tiny bit of the placental tissue. Either of these procedures can feel uncomfy but they shouldn’t be painful: the midwife or doctor will advise you to take things easy for a couple of days after you have the test. The results can take anything from 48 hours to three weeks. In two per cent of cases there are no clear results, so the procedure will need to be repeated.
Jasmine received her transfusions in a delicate procedure while she was still in the womb
In your diary… from 15 weeks
Also testing for Down’s and other conditions, this is where the doctor passes a fine needle through your abdomen and into the womb. It withdraws some amniotic fluid from around the baby, which contains cells that can be tested. The results can take anything from 48 hours to three weeks. In one per cent of cases there’s no result as the cells don’t grow, so a second amniocentesis will be needed.
“Waiting for the result of the amniocentesis was the longest two weeks of our life. I just wanted to fast-forward the days. Thankfully we were told it was OK, but I must admit I didn’t completely relax until Louis was born and the doctor had given him the all-clear,” said Nadia Hawes, 34, from Wednesbury , mum to Louis, 6 weeks, and Imogen, 2 years.
In your diary… from 20 weeks
This is also known as an anomaly scan, as its main purpose is to look for any abnormalities with your baby. He’ll be checked from head to toe, and his spine will be checked for neural tube defects such as spina bifida. Remember, though, that not every abnormality can be picked up on a scan, and occasionally things can be missed.
Sometimes it can be difficult to check your baby properly as he might be lying in a position that hides the essential bits, in which case you’ll be told to go for a walk and return later, to give him a chance to move.
The position of your placenta will be recorded and if it’s low, you’ll be asked to come back for another scan near the end of your pregnancy to check that it’s moved up into the ideal place ready for the birth.
If you want to know the sex of your baby, you can find that out at this scan, too.
Later in your pregnancy
After 20 weeks, you may have 1 or several ‘growth’ or ‘wellbeing’ scans to monitor your baby’s health inside the womb or check they’re around the right size for your pregnancy week.
It tends to be your midwife, at one one your regular antenatal check-ups, who would decide if a growth scan is needed – perhaps, for example, is the ‘tape measure’ midwives use to measure your bump is showing you’re small or big ‘for dates’.
Usually, it’s just a precaution, so don’t worry too much if you’re told you need a growth scan. Those tape measures aren’t brilliantly accurate – and everyone concerned with your care would rather be safe than sorry.
Researchers at the University of Cambridge have recently (April 2019) recommended that all pregnancy women should also be offered a ‘breech scan’ at 36 weeks. The NHS hasn’t acted on these recommendations yet but we’ll update you if they do.