Posted on July 6th, 2017 by

Gender Determination in an Ultrasound Report?

I’ve received questions lately regarding where to find fetal sex or gender determination in an ultrasound report. Can you always find this information in a report?
The short answer? No, not always.
Actually, we mostly do not record fetal sex, and it’s mostly not important to your doc. Typically, fetal sex is not pertinent information to the examination. Though parents may desire it, physicians don’t need the gender determination to manage your care and that of your baby if both are healthy. The above is true for most general OB practitioners in the US. However, every physician practices a little differently, and one can certainly dictate if he or she wants this info on all patient reports (if possible to determine). The case may be different if you are seeing a high-risk OB doc, aka a perinatologist. Their reports consist of much greater detail and may possibly include a fetal sex/gender guess.

Example of a Blank Report

gender determination
In the images of a sample report taken from a monitor, you’ll notice there is a whole host of blanks to fill, but fetal sex is not one of them. On the first page where you see Sex: Other, this refers to the patient. Patient demographics were not entered here, so the Sex option defaulted to Other. We always include your LMP or EDC/EDD – aka baby due date. The larger blue space would be filled with fetal measurements, estimates of gestational age, and fetal weight as they are obtained.

OB ultrasound report

OB ultrasound report
In the pages above, you’ll note the list of fetal organs and structures we attempt to document on a mid-pregnancy anatomy screen. We only fill out the section called BPP in the third trimester when your doc orders this particular examination. And the CVP is usually only filled out when performing a Fetal Echo or detailed heart examination.

Exception to the Gender Determination Rule

There always seems to be at least one exception to every rule. Because the responsibility of a sonographer is to search out structural malformations, we also have to report suspicions of abnormal external genitalia. In other circumstances, we may see particular abnormalities that we might group together, as in the case of certain syndromes. Sometimes, knowing fetal sex helps physicians either support or rule out a particular chromosomal or structural problem. Some of these are gender specific. In the pic below, we have a designated space on a Comments page to expound on our findings. We can add fetal sex here if we feel it is pertinent information to the findings.
OB ultrasound report
In some countries, fetal sex is neither reported nor discussed with parents due to the cultural preference of one sex over another. And some facilities are beginning to incorporate policies against providing parents with this news due to litigious reasons. Unfortunately, such is life in the good ol’ US. Facilities want to limit their liability for guessing incorrectly by simply not allowing their sonographers to guess at all.
So, if you don’t want to know your baby’s sex (or even if you do!), don’t expect your ultrasound report to disclose that information. Your sonographer creates the images and report. We only include what is needed and leave out what is not!
Best wishes for happy and healthy! As always, you can email me with your comments and questions at

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Posted on July 5th, 2017 by

Baby Gender, How Do We Know?

Determining baby gender by ultrasound is not as easy a task as most think. Actually, gender misconceptions pertaining to ultrasound are so common that I thought it worthy of yet another post.

Making a male vs female determination requires far more expertise than just sticking probe to belly. And babies do not just automatically cooperate! Baby’s legs need to be wide open and other parts cannot be covering over external genitalia. If so, the chances of holding that “reveal” party are slim to none.

Another common misconception is that we can force Baby to move. I promise you that every sonographer on earth would use a magical “make Baby flip” button. A girl can a dream, but I think this technology lies in our distant future. Unfortunately, babies get comfy and only move into another position if they get the urge. And not a moment sooner!

Determining sex accurately is all about angles. Being far enough along with Baby in the right position is only part of the task..when I’m the one scanning, that is! Most of my emails come from people who want a second opinion. However, most of the time, it’s one I cannot give! Either Baby is too early or the image is just plain, well..terrible. In these scenarios, the truth is I just can’t comment on what I can’t see.

Most sonographers don’t mind telling you your baby’s sex, by the way! The problem for us comes when we can’t see what our patients want to know.  Even if we explain all the reasons, patients sometimes become upset or angry. I have scanned tens of thousands of babies. Anyone who has scanned as much can recognize when this information is obtainable and when it isn’t.

Tips For Your Baby Gender Ultrasound

So, here are a few recommendations for you to follow before your next ultrasound. No guarantees! But if you are busting at the seams to find out what you’re having, these tips just might work!

  • Try eating or drinking something about 30 minutes prior to the exam. Baby typically becomes more active after eating. Now, I’m not condoning a double espresso and Snickers combo (yummy, yes; smart, no). We don’t want your fetus launching into orbit. Instead, try enjoying a hearty and healthy lunch or breakfast prior to your scan.
  • Keep an open mind! Understand that not seeing the sex is definitely a real possibility. Whatever you do, not planning a gender reveal party for the same day is a smart idea.
  • Don’t shoot the messenger! In other words, your sonographer can only tell you what she sees. If that is an uncooperative fetus or if visualization is poor, she may not want to risk a guess. Remember, that you want an accurate guess, not just any guess. Most importantly, an experienced sonographer knows when not to guess. I so hate it for parents when they get excited about one sex, only to discover differently on a future scan!

Believe me! We would love to do our part to help you plan your party, shop for baby clothes, or decorate a nursery. It’s the most fun when we can! And when we cannot, it’s a real bummer – for you, because you leave disappointed and for us, because we’re (sometimes) blamed as the party poopers.

Textbook Baby Gender Images

I’ve posted these before, but below are a couple of really great images of external genitalia, first boy then girl.

male baby gender determination ultrasound

male fetal sex, around 28 Weeks

female baby gender determination ultrasound

female fetal sex, mid-second trimester

Also, if you send an email asking for a second opinion earlier than 18 Weeks, you may receive the links below to other posts containing very easy, no-mistake pics of boys and girls!

Female Gender Scan

16 Week Ultrasound

Boy vs Girl Ultrasound

Twin Gender Ultrasound

3rd Trimester Ultrasound – Male

Thanks for reading! You can email me with your comments at!

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Posted on April 8th, 2014 by

Terrible images of fetal sex like these kill me. First, I know they could be as easily wrong as right. In other words, the best rate for accuracy for this particular guess is 50% – as good as a coin flip but cheaper! Second, these moms get so excited for what they’re told. It’s just not right!

I still can’t believe some of the emails I receive from expectant parents who’ve been promised the gender-equivalent of the moon and stars based on crappy images…and I don’t mean a little crappy. Who taught these people to scan? Hmm, maybe they weren’t taught? Read more on elective ultrasound businesses here; they’re not required to hire real sonographers. Moreover, most moms are WAY too early in their pregnancies to make such big commitments regarding Baby’s sex.

Read below an email from a reader who has experienced this very situation:

reader:  Hi! I just found your site, and I love it! I was hoping that you could just reassure me that what we are having is a little girl? My ultrasound tech said that he was 100% sure it’s a girl because there were definitely no boy parts. But I just wanted a second opinion! Thank you so much!

15 Week gender 15 week gender


All the Reasons Why This 15 Week Gender Guess is Just Bad

No sonographer with any level of adequate experience, especially those who specialize in OB, would ever dare to label this a girl OR a boy, much less to seal it with a “100%.” We all know that a lack of seeing anything that looks like a penis can hardly be declared a girl. Furthermore, with a bit of a projection between the legs here, wouldn’t you think he would err on the side of male? Regardless, of all the images I would dare tack a label of 100% to, these fall super short.

All I could advise is that she not paint a nursery based on these images! And I would be leery of any sonographer who calls anything 100%. The first cardinal rule of ultrasound is that nothing in medicine is ever 100%. It makes me crazy when patients are given images like this and told it’s a definite. This is precisely how mistakes with gender determination are made.

 I didn’t want to burst her bubble, and I couldn’t guarantee that her baby wasn’t a girl. Simply put, I wanted her to know that determining girl by those images alone was impossible. I did not see  her scan live, however, these images are not textbook images for girly parts at any age.
I can’t teach the world to scan. But maybe I can nip some mistakes in the bud…one crappy disheartening image at a time. Once again, my goal is to educate and inform!
You can email me with your stories here!

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Posted on July 27th, 2012 by

Believe me! We moms who are also sonographers know how important your sonogram visitors are to you. You have counted down the days and lost sleep just waiting to see your baby and to find out the gender. Your family is excited, too, and maybe even flew in from another city or state. Visitors during your sonogram are typically allowed. But realize your entourage of friends and family may not be welcomed depending on the policies where your scan will be performed.

First Things First!

The most important piece of information I’d like to impart here includes the most important aspect of our job…to make sure your baby looks okay. I would always feel just a tinge of anxiety before setting the probe down on any mom’s belly. A looming fear exists in every sonographer that we’ll discover your worst nightmare. As I casually smear the gel around your belly, you don’t realize that I’m first confirming a heartbeat. All I need is a half-second pass over your baby’s heart to appreciate the flutter. I breathe a sigh of relief and move on with the exam.

We require lots of concentration to make sure we aren’t missing a thing. We have many measurements to take and images to document, especially on an anatomy screen examination. Sure, we can make small talk and usually I do. As a matter of fact, I always enjoyed the “teaching” aspect of my career. Most parents are enthralled and appreciative when I point out all Baby’s organs as I document them, one by one.

Even though we perform this examination every day, it is one of the most comprehensive and detailed examinations in our repertoire. Distractions create a bit of anxiety that we’ll forget something on our very extensive check list.

My Advice Regarding Your Visitors

Most places have limits on how many sonogram visitors you can take into the room for your exam. So you are not disappointed on your big day, call your doctor’s office or facility where the exam will be performed and ask about their policies.

I have found that the best way to approach any entourage is to simply have all other sonogram visitors remain in the waiting room except for one support person, usually a spouse. After the initial diagnostic portion of the exam is complete, everyone else can then join in the fun. At that point, it’s play time and the real work is done. However, this approach is often met with resistance.

We don’t ask your friends and family to wait behind because we are mean people. But, in all our experience, we know that you may have never considered the possibility that this event would be anything but fun and exciting. The unfortunate reality of our jobs is that not all babies are normal, and most parents do not wish to receive terrible news at the same time as grandparents, cousins, and nieces. Such an experience ranks high in the hearts of most couples as an extremely private matter, one they would rather not share with an audience. Ask any couple who has endured this misfortune. Moreover, receiving such devastating news is accompanied oftentimes by shock and sadness, as one might expect. Many couples want time to grieve before breaking this news to family or their other children.

When Visitors Make Our Job Difficult

Most of us moms know how to tune out our kids when the need arises. However, any distraction in the ultrasound room makes a thorough evaluation of your baby more of a challenge. Circumstances that create a poor environment for providing you with the most optimal exam possible are usually caused by visitors. Chatting family members, a fussy or crying child, and family crowding behind the sonographer or touching the monitor all wreak havoc on our concentration.

Additionally, even though most patients understand this concept, your ultrasound exam room is not the place for cell phone conversations. You name it, I’ve seen it! I’ve had visitors on their phones talking gossip, ironing out bills, conducting business, discussing court cases, and ranting about dysfunctional family. I’ve had to ask them to end their calls or to please step outside.

Finally, patients frequently show up for their exams with a small child or children and no one else to take them outside if they become upset. We do understand this is one sonogram visitor you can’t leave outside if you have no help whatsoever. But a screaming child in an 8×10′ room is no small distraction. I’ve found children pulling images out of my machine, opening drawers where needles were stored, and digging in biohazard trash cans which contain the blood or body fluids of other patients. Yuck! I’ve literally stopped my exam so I could wash Little Bit’s hands.

biohazard trash, sonogram visitors

Unbelievable? Maybe, but I can pretty much guarantee every sonographer has similar stories!

Best Wishes for Your Next Scan!

So, all you moms with your big sonogram coming up, I hope you enjoy your experience! I hope your baby is cooperative and you have a sonographer who is engaging. I hope she narrates all your baby’s parts for you and gives you some great pics. Most importantly, I wish you a healthy new addition to your family. If you can oblige your sonographer just a few minutes of pin-dropping silence, she will love you for it! And if you bring another adult with you who actually takes the screaming baby outside, she’ll love you forever.

Email with your questions, pics, or stories!

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