Is Ultrasound necessary? Safe?

I am a big supporter of families having the information they need to have informed consent. The “myth of normal” is real. We have normalized so many practices without sufficient evidence that they support the long-term physical, mental, and emotional well-being of babies and their caregivers. So much of what we do is just culturally normalized without much question of its validity. Having an ultrasound has become a given in pregnancy but is it really needed? Is it safe?  Does its benefits outweigh the risks?

Routine prenatal ultrasound, while widely used and perceived as safe, lacks clear evidence of benefit in terms of improving birth outcomes and carries potential risks. Pregnant women should be well-informed and consider the use of ultrasound judiciously, prioritizing medical necessity and minimizing unnecessary exposure.

Ultrasound is deeply embedded in obstetrics because it seems to offer a comprehensive view inside the womb. However, many critics argue that its routine use contributes to a disconnection from ourselves, our babies, and our trust in the birth process. They believe that we don’t need to see our baby to feel connected to them. This deeper level of connection is at the heart of my conscious birth BodyTalk work.

The obstetric industry has convinced women that ultrasound is both safe and beneficial, despite the lack of objective, scientific proof supporting these claims. For low risks pregnancies the evidence goes against their use as being beneficial for better outcomes!

While ultrasound technology has been widely used in the medical field for various diagnostic and therapeutic purposes, there are growing concerns about the potential safety risks associated with its use.

1. Mechanisms of Ultrasound Effects:
   • Ultrasound can affect embryonic and fetal tissues through thermal and mechanical mechanisms.
   • Thermal effects occur due to the conversion of acoustic energy into heat as ultrasound waves pass through tissues¹².
   • These effects can lead to localized temperature increases (about 1°C above physiological levels).
2. Teratogenesis and Human Studies:
   • Animal studies have demonstrated thermally induced teratogenesis, where elevated temperatures cause developmental abnormalities.
   • However, controlled human studies have not conclusively shown a causal relationship between diagnostic ultrasound exposure during pregnancy and adverse biological effects on the fetus¹³⁴.
   • It’s important to note that human studies were conducted with older devices predating 1992, which had lower acoustic outputs.
   • We do not have sufficient evidence of the long-term implications of ultrasound and doppler use.
   • Fetal Development Considerations
3. Temperature Sensitivity: Fetal tissues are more sensitive to temperature increases, particularly during organogenesis in the first trimester. Elevated temperatures can potentially lead to developmental abnormalities. There is evidence to support increased risks of miscarriage in the first trimester.
   • Studies:
     • Study of 57 women who were supposedly “at risk” of miscarriage, half of whom were given ultrasounds, and the rest pelvic exams, showing the possible risk of ultrasound correlating to miscarriage. https://www.ajog.org/article/0002-9378(90)90926-X/abstract
     • Study by Taskinen et al. showing physiotherapists using ultrasound have higher incidents of miscarriage: https://www.ncbi.nlm.nih.gov/pubmed/2273355
4. Brain Development: The fetal brain is particularly vulnerable to thermal effects, and excessive heating can impair neurological development.
5. Current Safety Limits:
   • In the United States, current limits allow a spatial-peak temporal-average intensity (ISPTA) of 720 mW/cm² for fetal applications¹.
   • The synergistic effect of elevated body temperature (febrile status) and ultrasound exposure remains insufficiently studied.
   • The longer exposure of keepsake 3D/4D ultrasounds especially deserves scrutiny over their safety and have not been adequately studied.

Additionally, there are concerns about the non-thermal effects of ultrasound, which can include cavitation and acoustic streaming. Cavitation, the formation of gas bubbles in the body, can lead to tissue damage and even embolism, while acoustic streaming can disrupt cellular function and potentially lead to cellular damage. 

It is commonly observed that babies move away from ultrasound and Doppler waves, indicating potential discomfort and dislike of them.

Ultrasound is often inaccurate in diagnosing conditions, size of babies, fluid levels etc. leading to both false positives and missed diagnoses. Which can create stress and requirements to have even more diagnostics and invasive procedures. Once down the rabbit hole of medical intervention and diagnostics it can be hard to get out if you are seeking a natural birth experience.

So I decided to share  a few great articles that break it down for you. As well as some direct research studies so you can make your own conclusion. 

https://chriskresser.com/natural-childbirth-iia-is-ultrasoun…

https://chriskresser.com/natural-childbirth-iib-ultrasound-n…

https://www.thehealthyhomeeconomist.com/50-in-utero-human-st…

https://www.midwiferytoday.com/mt-articles/ultrasound-weighi…

Research:

The safety of obstetrical ultrasound: a review

https://pubmed.ncbi.nlm.nih.gov/19899071

Mice exposed to diagnostic ultrasound in utero are less social and more active in social situations relative to controls

https://pubmed.ncbi.nlm.nih.gov/24249575

Given the new insights and information. You may consider the following questions:

Is this in alignment with my values and beliefs?

Can I trust and connect with my baby without external imaging?

Would the information it gives you change your decisions in any way?

Do you have any medical conditions or a history of pregnancy complications that might influence your decision?

The current data shows that there is no added benefit to having a scan with a low-risk pregnancy.

1. IRIS Study:
   • The IRIS study investigated the effectiveness of routine third-trimester ultrasonography in reducing adverse perinatal outcomes in low-risk pregnancies compared to usual care.
   • Participants: 13,046 women with low-risk singleton pregnancies.
   • Intervention: Routine biometry scans at 28-30 and 34-36 weeks’ gestation in addition to usual care.
   • Primary Outcome: Composite of severe adverse perinatal outcomes (e.g., perinatal death, Apgar score <4, asphyxia).
   • Findings: Routine ultrasonography detected more cases of small for gestational age fetuses but did not reduce severe adverse perinatal outcomes significantly¹.
2. Cochrane Review:
   • Existing evidence suggests that routine late pregnancy ultrasound (after 24 weeks’ gestation) in low-risk populations does not provide benefit for mothers or babies².
   • No significant differences in perinatal mortality were observed.

In my work of connecting with baby in the womb with BodyTalk many have found they have been able to get the reassurance and information they need without a scan. In some cases where their intuition and BodyTalk tells us that everything is fine an ultrasound has led to unnecessary fears and intervention. The choice is yours.

I hope I was able to provide some info so that you can be better informed in making that choice.