Natural Childbirth IIb: Ultrasound Not as Safe as Commonly Thought | Chris Kresser
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Natural Childbirth IIb: Ultrasound Not as Safe as Commonly Thought

by Chris Kresser

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In the last article in this series on natural childbirth, I reviewed evidence suggesting that routine prenatal ultrasound does not improve birth outcomes for mothers or babies, and that organizations like the American College of Obstetricians & Gynecologists recommend ultrasound scans only for specific reasons.

In this article I’m going to review evidence on the safety of routine ultrasound and Doppler scanning, and make recommendations based on that research.

The potential adverse effects of ultrasound

According to Australian family physician Dr. Sarah Buckley, MD in her book Gentle Birth, Gentle Mothering, ultrasound adversely affects body tissues in three primary ways:

  • Heat
  • Cavitation
  • Acoustic streaming

Heat

The sonar beam can cause heating in the tissues beings scanned. During normal pregnancy, increases in whole-body temperature of up to 4.5 degrees F (2.5 C) are presumed to be safe, and research suggests that elevations of tissue temperature up to 1.8 – 2.7 degrees F (1.0 to 1.5 C) caused by ultrasound are also safe.

The degree to which ultrasound machines raise temperatures in the tissues depend on which tissues are scanned. Bone heats more than soft tissue, which in turn heats more than fluid. Heating is also dependent upon exposure time, the intensity of the machine, and whether the transducer is held stationary or moved frequently.

Doppler ultrasound, which uses continuous rather than pulsed waves, has been shown to cause significant heating – especially in the baby’s developing brain. A recent study suggests that heating in late-pregnancy fetal tissues exposed to normal pulsed and continuous Doppler ultrasound may be higher than what is regarded as safe: 2.5 to 10.4 degrees F (1.4 – 5.8 C) respectively.

A 1997 study found that significant temperature increases can occur at or near to bone in the fetus starting in the second trimester, if the beam is held stationary for more than 30 seconds in some pulsed Doppler applications. This in turn can lead to heating of sensory organs incased in bone.

Though both animal and human studies have shown that temperature elevations can cause abnormal development and birth defects, so far human studies have not shown a direct causal relationship between diagnostic ultrasound exposure during pregnancy and adverse effects to the developing baby.

However, it must be pointed out that all human epidemiological studies were conducted with commercially available devices predating 1992, with acoustic outputs not exceeding an intensity of 94 mW/cm2.

Current limits in the U.S. have risen dramatically, and now allow intensities of up to 720 mW/cm2 – more than 7 times the limit in 1992. This means we have no large, population-based studies examining the effects of ultrasound at the much higher intensities commonly used today.

This is highly problematic, because, according to a 2001 review called “Guidelines and Recommendations for Safe Use of Doppler Ultrasound in Perinatal Applications“:

When modern sophisticated equipment is used at maximum operating settings for Doppler examinations, the acoustic outputs are sufficient to produce obvious biological effects, e.g. significant temperature increase in tissue or visible motion of particles due to radiation pressure streaming effects. The risk of inducing thermal effects is greater in the second and third trimesters, when fetal bone is intercepted by the ultrasound beam and significant temperature increase can occur in the fetal brain.

A 2007 study reached a similar conclusion:

(1) thermal rather than nonthermal mechanisms are more likely to induce adverse effects in utero, and (2) while the probability of an adverse thermal event is usually small, under some conditions it can be disturbingly high.

Cavitation

Cavitation occurs in tissues with significant pockets of gas (such as the lung and the intestine) after birth. There is no consensus on the significance of cavitation effects in human fetal tissue, but some evidence suggests that mammalian tissue may contain microbubbles that are susceptible to cavitation effects.

Acoustic streaming

Acoustic streaming involves a jet of fluid created by the ultrasound wave, which causes a mechanical shearing force at the cell surface. While the effect of this force is not fully understood, research suggests that it may change cell permeability and have adverse effects on both early and late prenatal and postnatal development.

Animal studies suggest diagnostic levels of ultrasound may cause harm

One study found brain hemorrhages in mouse pups exposed in the womb to pulsed ultrasound at doses similar to those used on human babies.

Another study found exposing adult mice to dosages typical of obstetric ultrasound caused a 22 percent reduction in rate of cell division and a doubling of the rate of apoptosis of cells in small intestine.

Other research has found that ultrasound induces bleeding in the lungs among other mammals, including newborns and young animals.

The American Institute of Ultrasound in Medicine concluded:

There exists abundant peer-reviewed published scientific research that clearly and convincingly documents that ultrasound at commercial diagnostic levels can produce lung damage and focal haemorrhage in a variety of mammalian species…. The degree to which this is a clinically significant problem in humans is not known.

I want to be clear: we can’t extrapolate the results of these animal studies to humans, and so far, many longer-term human studies have not shown harm to the fetus from diagnostic ultrasound exposure. However, when the stakes are this high (i.e. the health of our children), I believe the animal study results warrant caution and further study before plowing ahead with ultrasound technology.

Some human studies also suggest harm…

Single or small studies on humans exposed to ultrasound have shown that possible adverse effects include premature ovulation, preterm labor or miscarriage, low birth weight, poorer condition at birth, perinatal death, dyslexia, delayed speech development, and less right-handedness.1

This is especially true for Doppler ultrasound, which is used in specialized scans, fetal monitors and handheld fetal stethoscopes (sonicaids). Ordinary scans use pulses of ultrasound that last only a fraction of a second. The machine uses the interval between pulses to interpret the echo returns. Doppler, on the other hand, uses continuous waves – leading to much higher levels of exposure than with pulsed ultrasound.

A large UK study found that healthy mothers and babies that received two or more Doppler scans to check the placenta had more than 2 times the risk of perinatal death compared to babies unexposed to Doppler.

An Australian study found babies that received more than 5 Dopplers were 30% more likely than babies that received routine (pulsed) ultrasound to develop intrauterine growth retardation (IUGR). This is ironic because Doppler is often used specifically to detect IUGR.

A randomized clinical trial published in 1996 split 2,743 women into two groups: one that received a single doppler at 18 weeks and further scans only when clinically indicated, and another that received 5 Doppler readings during pregnancy. When compared with the regular group, and after adjusting for other confounding variables, babies in the intensive group tended to be shorter when measured at birth and at 2-3  days of age. There were also reductions in the circumferences of the chest, abdomen and mid-arm, and in the skin-fold thicknesses of the triceps, parascapular and subscapular regions – although these differences weren’t statistically significant.

A later study in Lancet found a similar effect on fetal growth in women receiving repeated ultrasound exams, although measures of growth and development later in childhood (up to age eight) were similar in both groups.

A case control study of 72 children who had undergone a formal language evaluation found that children with delayed speech had a higher rate of ultrasound exposure in utero than normal controls. Their findings suggested that a child with delayed speech was twice as likely to have been exposed to prenatal ultrasound. (Note that this is a correlation and doesn’t prove causation.)

…while other studies suggest ultrasound is safe

On the other hand, a recent World Health Organization (WHO) review of the literature in 2009 concluded that “exposure to diagnostic ultrasonography appears to be safe.”

However, even in this review they did express some concern about the association between left-handedness in males and exposure to Doppler ultrasound. Non-righthandedness is sometimes a marker of damage or disruption to the developing brain. 2

Another review in 2008 concluded:

At this time, there is no specific reason to suspect that there is any significant health risk to the fetus or mother from exposure to diagnostic ultrasound in obstetrics. This assurance of safety supports the prudent use of diagnostic ultrasound in obstetrics by trained professionals for any medically indicated examination.

What are we to make of these conflicting results?

One of the reasons it’s difficult to make any clear determinations from the research is that the methodology of many of the trials is faulty. For example, in a randomized controlled trial in Sweden in the late 70s that found no differences in hearing, vision, growth or learning at age 9 in kids exposed and unexposed to ultrasound, 35% of the supposedly unexposed group actually had a scan. This means there was no true control group.

In fact, there are very few studies at all comparing outcomes between women who have received no ultrasounds at all and women who have received ultrasound during pregnancy. This is the kind of research we need to make an accurate determination of the effects of ultrasound on mothers and developing babies.

Another problem which I mentioned earlier in the article that casts doubt on current safety assessments is that scanning intensities used today are up to 6-8 times higher than they were in the 1990s, when all of the large population-based studies assessing ultrasound safety were done. This means we have no data on the large population level indicating whether ultrasound scanning at the frequency and intensity commonly practiced today is safe.

In a 2002 review of the safety of ultrasound in the prestigious journal Epidemiology, the authors concluded:

Until long-term effects can be evaluated across generations, caution should be exercised when using this modality during pregnancy.

Weighing the risks and benefits of routine ultrasound

The evidence I’ve reviewed here does not prove that a single ultrasound scan at relatively low intensity performed by a skilled operator will cause harm to a developing baby.

However, there is sufficient evidence that multiple pulsed ultrasound scans, or as few as two continuous wave Doppler scans, or any ultrasound scan performed by an unskilled operator may cause harm. There is also a pressing need for large epidemiological studies to be performed using the higher ultrasound intensities commonly used today.

When making a decision to perform any medical diagnostic test or procedure, benefits must always be weighed against risks. It’s rarely a black or white issue. Clearly, if ultrasound was 100% safe with no potential for harm, there would be little medical reason not to perform routine ultrasound during pregnancy.

But the evidence indicates that ultrasound is not risk-free, so we are forced to weigh whatever benefits routine ultrasound might provide against the potential harm it could cause. That harm could be physiological – including the effects we’ve covered in this article – and it could also be psychological. And of course psychological effects like stress and anxiety very quickly produce real physiological changes in both the mother and the baby.

The authors of the 2010 Cochrane review on ultrasound remind us that:

Subjecting a large group of low-risk patients to a screening test with a relatively high false positive rate is likely to cause anxiety and lead to inappropriate intervention and subsequent risk of iatrogenic morbidity and mortality.

Translation: giving all women ultrasounds may end up introducing unnecessary stress and anxiety, which in turn can produce real complications that would not have otherwise occurred. The screening for potential abnormalities can become a self-fulfilling prophecy.

Routine ultrasound also increases the likelihood that more tests will be performed, which could also increase the risk of complications. In a trial of Doppler in 4,187 low-risk pregnancies in France, the only significant result of using doppler was an increase in the number of ultrasound and doppler examinations subsequently conducted. There were no other effects on the management of pregnancy.

And then there is the new trend of non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound), which is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. This practice involves long exposures using 3-D and 4-D ultrasound techniques, which have not been studied adequately, and do not provide the patient with medically appropriate data.

For this reason, major organizations like the American College of Obstetricians and Gynecologists, AIUM and the FDA do not support keepsake ultrasound.

Recommendations and personal experience

Based on the evidence we’ve reviewed in this article, I recommend minimizing exposure to ultrasound during pregnancy in the following three ways:

  1. Using ultrasound only when medically indicated, i.e. only when a problem is suspected, rather than as a routine screening to determine the sex of the baby or check on its development.
  2. Minimize total exposure time (by choosing a skilled and knowledgeable operator).
  3. Minimize exposure intensity (i.e. avoiding Doppler during the first trimester especially).

Steps 2 and 3 are especially important in light of the lax regulation of ultrasound and the incredibly high variability of skill of ultrasound operators. In the USA, UK & Australia, ultrasonography training is voluntary – even for obstetricians – and the skill and experience of operators varies tremendously. Most operators don’t follow the scientific literature and aren’t aware of the safety issues involved with repeated and high intensity exposure.

In cases where abnormalities are suspected, a woman may wish to have an ultrasound to determine whether an early termination is warranted. The moral, ethical, economic and social issues involved in that decision are far beyond the scope of this article, and cannot be answered through research alone.

I support the right of a woman and her partner to choose what is best for them in this regard; after all, it is they who have to live with the results of their decision.

My wife Elanne and I chose not to have any ultrasound scanning done during her pregnancy, even though she was 39 when she conceived and thus at higher risk for certain genetic abnormalities.

We discussed it at length. In the end, we decided that what we might lose in getting the scans was greater than what we might gain. We felt the stress that a minor or uncertain problem on the scan could produce, and the worry and concern we’d feel waiting for the next scan, and the next one… would interfere with our relationship with our growing baby.

We also decided that we would carry the pregnancy through to full term, regardless of whether an early scan (had we had one) turned up a risk for an abnormality. It took us 2 years of off-and-on attempts to get pregnant, and because of the relatively high risk of false positives and the uncertain results of those genetic tests, we were willing to live without the information a scan might have given us. If it hadn’t taken us so long to get pregnant, or if Elanne had been younger when she did get pregnant, perhaps we would have made a different decision. Perhaps not.

I’m in no way suggesting this is the right choice for everyone. I strongly recommend that you educate yourselves about the risks and benefits of ultrasound first, and then consider your own personality, circumstances and values before making a decision. No one – not me, your doctor, or any other authority – can make this choice for you.

Articles in this series:

  1. Buckley S. Gentle Birth, Gentle Mothering. Celestial Arts, 2009. pp. 88
  2. Odent M. Where does handedness come from? Handedness from a primal health research perspective. Primal Health Research 1998;6(1):1-6.)

102 Comments

Join the conversation

  1. Thank you for this very detailed and well documented explanation!

    I read the full explanation after my wife did an ultrasound scan at 11 weeks (she had spotting and she was worried), without knowing that there is the NT scan scheduled at 12-13 weeks. Our GP said there was no scan planned at 12-13 weeks. How could she be so wrong ? (plus this GP is a mom herself). This caused my wife to be very upset about all this, and it ended in tears. Our intuition told us from the beginning that we want to minimize ultrasound scans. Your very good explanation confirmed this.

    This experience taught me (once again) that the doctor cannot be blindly trusted, and that the patient should do some research on his own.

    Some further research told me that an NIPT scan, for women >35, would be a better choice than the typical FTS scan. My wife falls into this at-risk category, so we will skip the NT scan and go ahead with the NIPT scan for which we will have the result at week 13.

    The NT scan can only ASSESS risks, it is not a diagnostic. And the NIPT test gives more accurate results for women >35.

    This said, you should obviously contact your obstetrician if you have concerns.

  2. I do often wonder about those that propose a more natural approach to health and their thoughts on abortion. It wasn’t entirely clear here. I would hope though that with such a scientific foundation and respect for human life that they would reject abortion. Human life clearly starts at the moment of fertilization (once it occurs, there is a completely unique human being growing rapidly) and “termination” has to forcibly end the life of the new child that is the most vulnerable human being. We need to protect human beings in every stage, not “terminate” (re: euthanasia/abortion) when they are inconvenient, sick, the timing is not good etc.

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  4. I have read the article, thank you. I found this article after feeling concerned yesterday at a scan at Kings College Hospital fetal research center in London which I might add has some of the leading researchers in the world for fetal medicine. I was concerned when the doctor mentioned two more scans at 32 and 36 weeks to be added which were not offered in my previous pregnancies, the last one being in 2012. I note that the doctor informed me that they were to monitor growth and to check if the baby had turned and it’s head was down and engaged. Now, the midwives seemed to have no problem monitoring growth from traditional non invasive methods in my three previous pregnancies, so I found alarm bells ringing. I actually read an article on this subject around ten years ago and because my first pregnancy was with twins and I did have extra scans because of this, it interested me. I note that the extra scans have only recently been introduced, to my knowledge in the UK. I already find it extremely disturbing that routine vaccines in pregnancy were introduced in the UK in 2013 which I have researched quite deeply after nearly losing one of my twins after an adverse reaction 11 years ago; which leads me to wonder if these extra scans in later pregnancy have actually been introduced to monitor whether the administration of vaccines shortly before these scans interfere with fetal growth and defects. I am not stating this as fact, just speculation in my own mind, but thought it’s worth mentioning as it’s something to think about. The thing is, what mother would sign up to a study to check whether vaccines in pregnancy affect fetal growth, so it seems to me that this is the only way to check and my inner conscious and intuition tells me that there is a deception or something amiss going on here.

  5. This paragraph is a direct quote from Sarah Buckley and should be cited as such:
    “This is especially true for Doppler ultrasound, which is used in specialized scans, fetal monitors and handheld fetal stethoscopes (sonicaids). Ordinary scans use pulses of ultrasound that last only a fraction of a second. The machine uses the interval between pulses to interpret the echo returns. Doppler, on the other hand, uses continuous waves – leading to much higher levels of exposure than with pulsed ultrasound.”

  6. I’m concerned because my OB wants me to do the non-stress test 2 times per week starting at 36 weeks. If NSTs are done with a doppler that’s 30 minutes of constant exposure… I understand they want to make sure my placenta is functioning well (due to “advanced maternal age” they’ve labeled me as having a “geriatric pregnancy”), but I do not feel good about this amount of doppler expose. My baby is active (I’m 35 weeks now) and feels fine!

  7. I found a good link with graphs that help you visualize the intensity and frequency of pulsed versus Doppler ultrasound. It seems that Doppler fetal heart monitors aren’t much cause for concern since their intensities are low -even if the frequency of Doppler heart rate monitors are high. The intensity on a typical heart rate monitor isn’t enough to cause heating of tissues. But what really is a concern is the Spectral Doppler with waves that are both frequent and intense which produce images for a screen. The Spectral Doppler scan is often used to check the flow of blood via the placenta into the baby’s major arteries. This is the type of ultrasound that has caused retarded growth in fetuses in the studies cited. That particular article seems to recommend keeping pulsed scans under 30 minutes and Spectral Doppler scans under a minute. But who knows if the intensities of the scans measured are the same used in machines today – so I’d personally halve those recommendations. Anyway, after having a missed miscarriage, I think it’s good to know whether the baby is still alive at 12 weeks. Otherwise it could die and cause pelvic infection and sepsis, hurting the mother’s chances of having another baby. I would opt for a quick monitoring of a heartbeat during that time. I’d also do a quick pulsed ultrasound which checks for placenta previa and spina bifida and pair it with a blood test to check for chromosomal abnormalities. Here is the link with the ultrasound graphs: http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=3278&Type=FREE&TYP=TOP&IN=_eJournals/images/JPLOGO.gif&IID=252&isPDF=YES

  8. Hi, I did not have ultrasound with my first baby and now I’m pregnant with my second. I don’t know how far along I am because my cycle has been anywhere from 25 to 70 days for the last year and a half, plus i think i might have forgot to record my last period. I started a cycle on July 8, but can’t remember if i had one in August (I know it’s terrible I can’t remember this). I know I did not have one in Sept or Oct., therefore I could be due anytime between the end of April and beginning of July which is a big range. My midwife would prefer that i do an ultrasound to get a better due date. If i got a 2d and ask that it’s under one minute, would that probably be ok, or should i maybe not get one? Is there a way to go about finding a technician that uses older equipment with the lower frequency?

    • Reevaluate the risks by discussing with professionals, the recently discovered human studies. Those indicate extreme risk. Improper focus on due date can bring unnecessary worries and false diagnostics. In 1984 the NIH refused to endorse routine ultrasound, for many reasons which have still not been refuted. Since then, the FDA-allowed machine intensities have risen 8-fold! Increase your knowledge of your body’s ability to birth a child, and increase your environmental knowledge. See http://harvoa.org

  9. So do pulse instead of doppler and keep level and time low. Don’t sit there and stare and have unnecessary pictures taken. Don’t get an excessive amount unless it is absolutely necessary. We had a doctor recommend 9. That was a little crazy. We stopped at 2. I guess every case is different. Sometimes we make a deal with the devil with medical tests in general. We find some information we are looking for but have to pay later, sometimes with something much worse.

    • It is difficult with modern machines to use ultrasound at low intensity. Most operators are deficient in skills according to several polls.

      Reevaluate risk: Human exposure studies are presented in my unprecedented bibliography, studies that examined 2,700 women, their abortive matter after ultrasound exposure.. See http://harvoa.org/chs/pr

    • There exists abundant peer-reviewed published scientific research that clearly and convincingly documents that ultrasound at commercial diagnostic levels can produce lung damage and focal haemorrhage in a variety of mammalian species…. The degree to which this is a clinically significant problem in humans is not known.

  10. Well to put it politely this is rubbish. As a trainee Sonographer, who is currently back at university to complete the required course that all Sonographers have to in order to practice in the UK, you have a done a very good job at manipulating fact. There is very little known facts about safety of ultrasound in humans because it is classed as unethical to conduct the same research in humans as we do in animals. Animals that have shown adverse effects have had ultrasound applied for long periods of time, at high frequency, in one area … something that would not be done in real life, these are extreme exposures. Doppler dose use higher frequencies and should be kept to a minimal (which it is) and is not used in the 1st trimester due to the rapid fetal development. There are no legal laws at exposure as it is such a complex system that is individual to the patient, but there are guidelines which me and the Sonographers work to. Technology has improved vastly, but every time an exam is selected it starts with the lowest acoustic power possible and the improvement in technology has allowed for the use of image manipulation first before increasing power. I have never increased power – which in THEORY is believed to cause thermal effects – nor have I seen anyone else do so. It pains me that I can not write a better response as I am currently writing an assignment, hence why I stumbled across your blog (I will not call it article). I just hope that no one bases their refusal of an ultrasound on this bias manipulation of facts. To everyone else blaming ultrasound on varies problems, please read up on your fact from peer reviewed articles. Last of all to the lady who is 26 please don’t despair for our generation (I am 23) as I find it embarrassing that you yourself know little if not nothing.

    • I’m curious… If it’s been determined that Doppler is either questionably safe or unsafe during the first trimester how has it been proven that it IS safe in the second or third trimester? It seems to me if there is a risk of damaging developing cells that risk would extend beyond the first trimester, just perhaps to a lesser degree. If you could point me to any literature or studies on this I’d greatly appreciate it!

  11. Well now I’m freaking out. I used a friends Doppler (Bistos) at 11 weeks for 30 minutes and never found a heartbeat, but now I am second guessing myself for using it for too long and for using it at all.

  12. I found some of the observations in this article to be both informative and thought provoking. I have wondered for years about the increased incidence of Autism in our children, and even asked my son (a physician) if there was any known link to ultrasound. My reasons for asking were based on my perception that the numbers of cases of Autism are much higher now than when he was born (early 80s), and I don’t recall that the use of ultrasound at that point was nearly as pervasive as it is now. Was Autism there and we just didn’t know what it was? Or is there really more children affected now than there was 30, 40 or 50 years ago?
    I had not considered the more powerful machines in use now, let alone the fact that heat might be generated, but it all make me wonder. Do we really just assume that subjecting a developing fetus to repeated ultrasound waves will have no adverse effects?
    The use of ultrasound is more prevalent in certain cultures and even in certain demographic groups. Does the incidence of Autism or other developmental conditions also appear in these same groups at a much higher level?
    I am a veterinarian that strongly believes in the use of US for diagnostic purposes given medical reasons. The young women that I employed in my practice that are pregnant seem to get a lot of ultrasounds, certainly a lot more than what I recall being done 30 years ago, and to my knowledge there are no issues with the fetus to explain the need.
    The “standard of care” is constantly changing as we learn more and develop more sophisticated diagnostic tests and equipment. When do we consider the adage “above all do no harm” and whether we inadvertently might be doing that without even knowing it?

    • I had my ultrasound today. The lady spent about 8 to 10 min in the baby’s heart. I came home and I felt pain in that specific area. I start Google if there some evidence about the harm of ultrasound, because I did not feel this before. I feel very angry and scary. Never let the person who is doing your ultrasound stay an one area for more than 15 seconds. I feel angry with this lady because she should know better.

  13. Nobody does ultrasounds for fun. For everything you do put it in the risk vs reward context.
    Driving can be risky too will that make you stay at home and abandon everything ?

    High risk pregnancies with placenta issues, single umbilical cord fetuses, IUGR and many many more warrant a frequent monitoring.

    if it is being prescribed without a strong reason or for a fun Saturday night activity then risk outweighs the reward.

  14. The current usage of ultrasound during pregnancy has the capacity to reveal significant, life-threatening abnormalities which can affect both mother and/or baby. Ultrasound is not only safe, it’s use is considered the standard of care. Suggesting anything else to pregnant women who are understandably concerned with their baby’s health is both irresponsible and dangerous.

    • Could you please expand; In discovering life-threatening abnormalities through ultrasound how will the health outcome of mother and baby be improved? (i.e. what kind of treatments will be done and at which stage of pregnancy)

      • A routine ultrasound can diagnose dangerous conditions such as an incompetent cervix which can lead to premature labor (sometimes before the fetus is viable). If this is discovered, doctors will either put in a cerclage or recommend bed rest for the rest of the pregnancy. It can also detect fibroids and abnormalities of the uterus and placenta which could require medical intervention. I think for those reasons it’s important to get at least the detailed ultrasound!

  15. Thank you, Chris, for sharing your knowledge and beliefs. And thank you, too — Tarek and others — who generously shared your knowledge and understanding of ultrasounds etc. And I so appreciate the kind and respectful tone used to share the information as well!

    I don’t have anything to add – at this point anyway – as I am just researching information in order to decide how to proceed with my own pregnancy. But I did want to say thank you, very much, to all those who shared.

  16. Excellent article and nice references. It is true that an ultrasound can create different complications in a human body, but for the tubal reversal patients, it is a necessary element, so what the other procedure should they choose to identify their tubal ligation surgery type.

  17. The World health organisation published this warning about ultrasounds:

    “The World Health Organisation stresses that health technologies should be thoroughly evaluated prior to their widespread use. Ultrasound screening during pregnancy is now in widespread use without sufficient evaluation. Research has demonstrated its effectiveness for certain complications of pregnancy, but the published material does not justify the routine use of ultrasound in pregnant women. There is also insufficient information with regard to the safety of ultrasound use during pregnancy. There is as yet no comprehensive, multidisciplinary assessment of ultrasound use during pregnancy, including: clinical effectiveness, psychosocial effects, ethical considerations, legal implications, cost benefit, and safety.”

      • Hi Lisa,
        I was doing preliminary brief research when I found that quote and didn’t think to take note of the source.

        I have just found a similar quote for you with the source from the WHO in collaboration with other organizations:

        t]here are several frequently quoted studies that claim to show that exposure to ultrasound in utero does not cause any significant abnormalities in the offspring. …However, these studies can be criticized on several grounds, including the lack of a control population and/or inadequate sample size, and exposure after the period of major organogenesis; this invalidates their conclusions….”

        Here is the source: http://www.inchem.org/documents/ehc/ehc/ehc22.htm

  18. Tarek,

    In one of your multiple comments, reiterating the same arguement, you do “note Dr. Kresser’s point about most [studies establishing ultrasound risk] having been done with the older machines”, but then proceed to completely ignore it. I think this is the entire point of his article, and it is valid.

    Also, he doesn’t have to be an expert to choose to err on the side of caution when our technology has surpassed our knowledge of its safety. He can voice these concerns as an intelligent individual with choices to make for himself.

    I remember the silly Mr. bean shows, when Mr. Bean would exclaim, “I don’t know Mr. Hands, it doesn’t look very safe! It didn’t take a Philadelphia lawyer to agree with Mr. Bean, and it doesn’t take one to see where Chris is coming from either. It is his right to point at the potential risk and a the absence of needed information, and to share his personal choice to forgo tests based on the simple fact that gynecologists themselves warn against overuse for the exact reasons that the as-yet unquantifiable risk of may cause negative outcomes. Is he being over cautious? With no established risk ratio, your guess is as good as anyone’s, and only time will tell.

    His point is but one voice. I for one appreciate that it isn’t left out of the discussion. Yours has also been made, heard and more than sufficiently indulged.

  19. My doctor uses the handheld fetal stethoscope at every appointment. It has a little speaker on it, so that we can all hear the heartbeat out loud. I am 17 weeks, and at today’s appointment, I told her I’d prefer that it not be used.

    She then convinced me to let her go ahead by telling me her machine used the lowest frequency (that to produce an image it would need to be much higher, but not for sound only), and that she would only use it for a very short period of time (she was done very quickly – maybe one minute?) She also agreed to use her stethoscope alone in future, without the additional handheld device, once the heartbeat can be heard that way. She also scared me a little by informing me that if the baby’s heartbeat were “off” in this listen, she would need to send me to the hospital for further testing.

    So now I’m back home and wondering, what exact frequencies are used in these hand held stethoscope monitors? Also, what can the medical system do if the baby’s heartbeat is “”off”? How much of this testing actually leads to useful intervention? I had three very early miscarriage and nothing could be done to prevent those…

    I did read that the 20 week ultrasound can reveal anomolies that are operable in utero – one article discussed the better outcomes for those babies with scoliosis operated on while still in the mother’s womb than for those for whom treatment was delayed until after birth. Are there a lot of these kinds of anamolies that can be detected AND resolved or pre-treated before birth? Are there enough benefits and/or positive results to justify the risk involved with multiple high frequency doppler tests?

    • Hi Ceylon, thanks for your interesting comments. Where can I find the information about treatments in utero? I would be very interested to read those. Also, I don’t understand that if these studies suggest benefits of operating in utero, then how come the large studies mentioned by Chriss have shown no benefits to pre-diagnosis of complications…?

      And I’m also interested in hearing more about the handheld stethoscope since I believe they use them at the birth-center I’m attending. From this article it would seem to be that they are among the highest of concern along with the Doppler…

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