Should I get an early pregnancy scan?
Worried about your pregnancy in the early weeks? We explain just how early you can have a pregnancy scan, what it involves, how to book one privately and how much it might cost
While most pregnant women have their first scan at around 12 weeks, some of us are asked to have an 'early' scan or choose to have one done privately (when we asked mums on our Facebook community if they'd paid for a private scan, 24% of 236 mums said they had).
According to midwife Ann Richley, your GP or midwife might suggest an early pregnancy scan if you've:
- experienced bleeding
- had certain types of fertility treatment
- had recurrent miscarriages
- previously experienced an ectopic pregnancy
These sorts of scans are usually done at an Early Pregnancy Unit on the NHS.
How early can I have an early pregnancy scan?
A pregnancy ultrasound scan will be carried out from around 6 weeks. “The earliest you can really scan to actually see anything is about 6 weeks after your last period,” explains Nigel Thomson, Professional Officer for Ultrasound at the Society and College of Radiographers. “Any sooner than this and you’ll almost certainly be asked back for a 2nd scan. If you’re able to wait until about 7 weeks then we will be able to see the heartbeat very clearly.”
As purplebabes on our forum confirms, “I had a scan at 6 weeks which showed a heartbeat. It was an internal scan but I think you would be better waiting (I know how hard that is) until 7 weeks as if you’re out on your dates by a day or two the heartbeat may not have started yet and you would have a really stressful time waiting for another scan a week later.”
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Pinkbutton had this exact experience. “I had 2 early scans, one at 6 weeks that didn't show anything, then another at 8 weeks that showed a heartbeat. So I would say leave it until 8 weeks so you know for sure. Going too early as I did just resulted in more worry.”
Can you ask for an early scan on the NHS?
Yes, you can request one if it's for medical reasons.
“If you’re worried about something, or are experiencing pain and/or bleeding, you can talk to your doctor or midwife and they will refer you for a scan," explains Nigel Thomson.
"You may also be able to self refer to your hospital’s Early Pregnancy Unit. However, in most cases if it’s reassurance you’re looking for, you’ll need to pay for a scan privately.”
What can you see at an early pregnancy scan?
Your baby is developing really quickly during these early weeks and so your baby will look very different each week in an early scan:
6 weeks - Your baby will just be visible and measure around 0.5mm. This is the earliest a heartbeat will be detected.
7 weeks (see pic above) – Your baby will be about 1cm with a heartbeat of about 160 beats per minute.
8 weeks - Your baby is growing at about 1mm a day, and will now measure around 1.6cm. You may be able to start to identify the head and body.
9 weeks - Your baby is nearly fully formed, and you may be able to make out your baby's head, body and limbs.
10 weeks – Your baby is now around 3.8cm and you should be able to see him or her bobbing about and making jerky movements.
Can you have a pregnancy scan at 5 weeks?
As mentioned above, it's going to be difficult to see anything before at least 6 weeks. However, if you are experiencing the signs of an ectopic pregnancy with severe pains in your side, you may be given a very early scan at 5 weeks. At this stage, it will be possible to see a small pregnancy sac, but if it's an ectopic pregnancy, the sac will sadly be empty and there'll be no heartbeat.
Will it be an internal or an abdominal scan?
Very early scans are likely to be internal (trans)vaginal scans, but can sometimes be an abdominal scan - like the dating scan you have around 12 weeks.
TheOriginalLea77 shares her positive early internal vaginal scan experience. “I had an internal scan at around 8 weeks and the heartbeat was visible then. I could see the tiny baby and it already had little stumps where arms and legs would be but it still had a yolk in the sac like a bird!”
“In these early stages of pregnancy the sonographer may sometimes try an abdominal scan first," says Nigel. "If they can’t see anything then the next step is to check you are happy to have an internal vaginal scan. This allows you to see things much more clearly.” Different sonographers will take different approaches, though, so be ready for different options.
Remember that there is no pressure to do this - any scan that you have is your choice.
What happens at an early internal vaginal scan?
Unlike an abdominal scan, you don't need a full bladder, so you'll be asked to go for a pee before the scan begins. We'll let fall3n-ang3l explain what happens next:
"You go into the scanning room and you'll be asked to take your trousers/skirt and pants off and put a sheet round you. You go into the corner of the room and have a sheet over you, in order to do this. You go in the corner of the room and they put a curtain round you to do this.
"Then you shuffle on the bed and they get this stick and put on what looks like a condom (LOL) on the stick then they put some jelly on. Then they ask you to put your knees up and open your legs, like you're having a smear.
"They have a good look with the probe and then turn the monitor to you and show you."
annebop had a similar experience. "They showed me the screen straight away. They said they were checking to see how many were in there, there was only one. They checked for a heartbeat and you could see a flutter and he put the volume on so we could hear it too."
So does an internal scan hurt?
Not according to MFMers on our forum. "It's not painful but might feel bit weird," shares berly153. "They will use what looks like a plastic dildo. It's quite long but they don't put it all the way in. They cover it with a condom and put some lube on the end."
Is it embarrassing to have your partner there?
"It's not overly embarrassing," says betsygrub. "They put a sheet to cover you and my hubby said he would not have known what they were doing if he had not been sat watching from the start."
"My OH is a bit squeamish," continues annebop, "and he said that he had to look away from my bottom half as he was inserting the probe, even though he couldn't see anything because of the towel! Still he found it an equally amazing experience and it certainly has made it feel more real."
Do you get a photo afterwards?
This appears to vary according by hospital, and obviously very much on your circumstances.
"On both my early scans I was given a picture afterwards," explains fall3n-ang3l whereas cdsmiler81 had a different experience. "We weren't allowed a pictures with our early scan because we were told 'some ladies have bad news at this stage'."
If you go privately you should be be given a picture. “With a viable pregnancy we would give you a photo of your baby and a heart trace as standard,” confirms Jan Steward, sonographer Jan Steward who is director of Ultrasound Direct and Babybond.
How do you book a private early scan?
What if you’re not experiencing any medical issues but are just feeling anxious that your pregnancy may not be progressing well?
Firstly be reassured you’re not alone. Many of us in the early stages of pregnancy feel like this! Waiting for the standard NHS dating scan at around 12 weeks can seem like an age.
“I found out last week that I am pregnant and at first I was over the moon," explains Mrs CC on our forum. "However as the week goes on I find myself feeling more and more worried about what could go wrong. It feels as though life has stopped and all I can think about is the pregnancy, seeing the midwife and having a scan! I don't know how anyone waits until the 12 weeks scan. Is it just me that worries this much?"
The answer to that is of course not. Here is Mrs_Matthews' experience of booking an early scan. "When I was expecting my son, I booked a scan for 7 weeks and it was so reassuring. We heard his little heartbeat and saw that he was growing as he should be. My advice is that a happy relaxed mummy leads to a healthy baby, so if a scan will help you achieve that, then go for it.”
But, if your only reason for wanting one is reassurance that your pregnancy is going OK, have a chat with your midwife first. And remember, you’re unlikely to be offered this scan on the NHS, and will probably need to go private.
“We see so many women in the early stages of pregnancy,” explains Jan Steward from Ultrasound Direct and Babybond. “Having a scan at this time can provide vital reassurance.”
How do you find a private scan company?
There are a number of private scan companies - you can find local ones on Google. Look for reviews and recommendations and then check for qualifications and accrediation.
“Make sure you look for a company that has qualified sonographers and CQC registration," says Jan Steward, director at Ultrasound Direct and Babybond. "For us, all of our sonographers have an NHS background and 90% still work in the NHS in some capacity.”
So, before you book your scan, ask what experience the sonographers have and whether they're able to perform vaginal scans if that is required.
How much do private early pregnancy scans cost?
The costs of these scans really varies. At Ultrasound Direct, for example, you would pay £99 for a 30 minute consultation.
What questions should you ask at your early pregnancy scan?
The questions you may have will probably vary depending on whether it is a private or an NHS scan and your reasons for having a scan, but these may help:
- What is the plan if the sonographer can't detect a heartbeat or baby? (If it's very early, you will almost certainly be asked back for a 2nd scan after a week to 10 days)
- What will happen after the scan is finished?
- What is the referral pathway if it is bad news?
Are there any risks to having an early pregnancy scan?
Jane Fisher, director of the charity Antenatal Results and Choices, is quick to reassure. “Ultrasound scans have been used in antenatal care for over 30 years and there is no evidence to suggest that they are harmful to you or your baby.”
But the Royal College of Obstetricians and Gynaecologists is a little more cautious; “Ultrasound is a very valuable resource to detect possible problems in early pregnancy, for example miscarriage and ectopic pregnancy.
"Whilst there is no evidence to suggest that ultrasound is unsafe, during the first 10 weeks of pregnancy the embryo is its most vulnerable because it is incredibly small and cell division at this point is rapid. As a precautionary approach, the RCOG recommends that women should only have a scan at this stage of pregnancy for clinical reasons.”
Recommendations aside, ultimately it’s still your choice. But it's a good idea to have a chat with your midwife or GP before making any final decisions.
What if my baby measures small for dates at the scan? Can the dates be wrong?
This is exactly what happened to Future Mrs Graham on our forum. “I had a scan at 6 weeks because I'd had 2 miscarriages in the past. They could hardly see anything and said that either I was earlier than I thought, about 4 weeks, or the baby had stopped growing.
"I had to go back 2 weeks later so they could have another look. I was a nervous wreck for 2 weeks and didn't sleep the night before. Anyway, I got there and the first thing the doctor said was 'I can see the heartbeat'.
"I cried, I was so happy. It turned out I was 8 + 3 and my dates had been right all along. I'm now 26 weeks, massive and my baby kicks constantly, which is very reassuring.”
Nigel Thomson from the Society and College of Radiographers explains, “The usual time to find out about the dates is at the standard 12-week dating scan. But you will of course be given measurements and dates at your earlier scans too.
"If the dates given are significantly greater or less than you expect, then do discuss with your sonographer or midwife if you are concerned.”
dipndazzle adds her friend's experience. “Try not to worry. A friend of mine went for an early scan and thought she was 6 weeks. But they put her at 4 weeks and said to go back 2 weeks later. She has just been back and everything is fine, She was just earlier than she thought.”
OK, the hard question. What if the sonographer can only see an empty sac or no heartbeat?
Firstly this may mean that your pregnancy is not quite as far along as you think. In this case you will be invited back for a 2nd scan after a week to 10 days. Of course this wait can be an agonising time.
“But as difficult as it is, be reassured that you are in the right place and the experts will support you,” says Jane Fisher from ARC.
If you’re having a private scan, Jan Steward says to be sure you have established what the next steps will be before you have the scan. “It's important that the information is passed on to your midwife and doctor so they're aware of what's happened and discuss with you what happens next."
And remember, no heartbeat doesn't have to mean bad news. "I had to have an internal scan and they said they could see the sac but no heartbeat," says jessicadervin.
"I had to wait 2 agonising weeks for another scan. I was sure I had lost the baby as all my pregnancy symptoms had disappeared...
"I was proven completely wrong though. My dates were so haywire and we now have a gorgeous 10-week-old baby girl. Sometimes the scans just aren't that clear."
What if you're scared about having an early scan
It’s completely natural to feel worried at this early time in your pregnancy. So think about whether having a scan will make you feel better or just add to your worries.
“The point of an early scan is to try and relieve anxiety and not cause it,” says Jan Steward. “That is why where possible we encourage women to try and wait until they think they're at least 7 weeks so we can be more definitive about what we see.”
But there is a warning here from Jane Fisher from ARC; “We appreciate that some women can be incredibly anxious in these early stages so having a scan is what you opt for. It can be a double edged sword though because often the sonographer will not be able to see as much as you might like. You need to go in with the understanding that you might be recalled for a scan at a later date.”
Essentially you need to go into the process with your eyes open.
While we want to be positive in these early weeks, some MFM mums have shared a few difficult experiences with us. This includes a story of how one mum-to-be had two early scans, one at 6 and one at 8 weeks, due to her worries over a previous miscarriage and a bit of early bleeding. The scans went well, but sadly the mum went on to miscarry at 10 weeks.
"Obviously for most people this is not the case," explains the mum, "and an early positive scan is good news and the pregnancy continues... However for me it made the shock and pain of my 2nd miscarriage worse as I had let my guard down.”
While we don’t want to be negative, we feel it’s important to be realistic and for you to have all the facts.
So the choice is yours...
Think carefully, weigh up the pros and cons, and decide for yourself - especially if you're looking for reassurance. And remember. have a look out for other signs that you're still pregnant. We've got lots of them here.
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