Elective 3D Ultrasound Businesses

What You Get With Elective 3D Ultrasound Businesses

The answer might surprise you. They sure aren’t going to tell you, so I will! This post calls out to all the expectant moms looking for early gender ultrasounds from elective 3D ultrasound, privately-owned, non-medical businesses. Regardless of what they advertise, please read this first before scheduling your visit! Moms, do your homework. You have a right to know before you go!

3D ultrasound, 3D fetal face, 33 WeeksJust look at this shot! It’s so precious, isn’t it? Who couldn’t fall in love with their little one more and more with every great sweep of the probe? Heck, I fall in love with your baby with every image like this that I take.

We, in OB/GYN healthcare, understand expectant parents’ desire for images like this or early gender determination ASAP, but the safety of you and your baby is the greatest concern for all of us in the field. And because I know your baby’s safety is of utmost importance to you, there are a few important factors to take into consideration before having your scan performed by a non-medical facility.

They are not required to meet the same standards of care as those who practice medicine. Their staff may not be properly educated, and they take your money for promises of gender guarantees WAY too early in pregnancy … when they know it may not be accurate. You have a right to understand that you may not be paying for the quality and expertise you may think you are receiving. Please read on for your own awareness, and pass the message!

Why I Cannot Endorse Most Elective, Non-Medical Ultrasound Businesses

Uneducated Staff

The biggest issue I have with these business is something that may surprise you. They are not required to employ certified staff. Anyone can buy a machine, start a business, and charge you to scan your baby, but they don’t have to be a formally-educated or certified sonographer themselves or hire them.😲😤

Scary, isn’t it??

Some years back, I was mailed a flyer from an elective 3D ultrasound business. The goal? To sell you your own entertainment ultrasound business by offering a franchise and ultrasound education in a matter of days–for anyone off the street with no prior ultrasound knowledge or training. Before this, I had no idea such a business was even legal.

As a certified OB sonographer for 25 years, I can vouch for the level of knowledge and skill we learn initially and acquire over time, through clinical experience and performing diagnostic examinations. Most importantly, our education and experience also applies to the equipment we use to scan you. Anyone performing OB ultrasound should be utilizing the ALARA principle–and any formally educated sonographer knows what this is. Basically, we learn how to optimize power settings in order to use the lowest level needed to obtain a good image. This is recommended by the medical community because long-term effects of ultrasound are still being researched. Someone who is not formally-trained likely has no knowledge of how to do this or even know it exists.

Ask about RDMS credentials (or DMS, meaning they have recently graduated).

Unrealistic Promises for Gender

Now, let’s address fetal sex. After all, most of you who are super anxious to find out if you can shop for pink or blue want to know as early as possible! Most of these places advertise 100% accuracy of fetal sex guesses from 12 or 14 Weeks. This is irresponsible and something they actually cannot do.

They can’t guarantee a gender guess is 100% accurate.
They can only guarantee you a refund if they’re wrong.

I’m sure you many of you wouldn’t consider handing over your money if you knew this is what they meant by their “guarantee.” A guess too early in pregnancy is a toss-up. You are paying good money, and in some cases, a lot of it. More on early gender determination here.

Furthermore, how qualified is the guess if the person scanning you isn’t certified with a level of OB ultrasound experience? Any obstetrician or radiologist will tell you that no ultrasound can be considered 100% accurate. As a matter of fact, even DNA blood tests for first-trimester genetics or amniocentesis cannot boast of 100% accuracy–these tests are 99+% accurate. Ultrasound cannot come close to this degree of accuracy in the first trimester.

My advice to a mom- or family-to-be is to keep an open mind regarding a sex guess too early and to wait for your anatomy screen before investing in paint! Many women talk about the guilt and loss they (and spouses and children) feel when true gender is later determined. Read what one mom had to say here!

That said, anyone can guess incorrectly! But when far enough along and with truly experienced OB sonographers who know when the circumstances are ripe for guessing (and when they’re not!), the chances for an accurate guess rise dramatically!

Equipment Maintenance and Safety

They are not required to maintain safety standards for their equipment. Machines need maintenance to ensure they are performing properly and safely. Cracked probes and cords that are worn, old, and/or not properly cleaned or maintained can be an electrical hazard to their customers. Maintenance is costly, and I just have to wonder how many of these businesses elect to bypass it because they can. You may not necessarily know whether their equipment is safe.

No Physician on Site

Though not a diagnostic exam, a physician is not on site in case a problem is detected. And detecting an obvious problem is much less likely for someone not formally trained.

They Do Not Perform a Diagnostic Exam 

But sometimes they say or advertise that they do. Some of them even call themselves a diagnostic imaging center. They’ll tell you that they’ll scan a little to make sure Baby is okay. I believe this gives the expectant parent a false sense of security. No sonographer can legally tell you your baby appears normal by ultrasound.

Please be aware that no one can call an elective ultrasound scan “diagnostic” in any way! Your healthcare professional must order a diagnostic exam. You must be scanned by a certified sonographer in a medical facility where at least one physician is on site. Finally, an official report must be generated for a physician’s interpretation and signature.

No one scanning in an elective 3D ultrasound business can promise a diagnostic test!

Undisclosed Information

Finally, they don’t have to advertise any of the above! They have no requirements to inform you of any of the issues above. If you ask, they have to answer honestly. So, be sure to ask!

A Message To Those Who Are Not Qualified to Scan!

Make no mistake about it. Waiver or not, if you scan a pregnant woman for fun and miss a problem, you are still liable. You are not trained to recognize these problems or how to handle them. How would you handle seeing something you feel is abnormal or that you cannot explain? What would you say? If you cannot call yourself a formally-educated sonograper, you have no business picking up a probe. Most of us who practice OB every day only get slightly better at breaking terrible news. This unfortunate experience will inevitably be yours at some point.

Moreover, you don’t know how to use the equipment safely or optimally. It takes a bit of artistry, (again) proper training, and experience to be able to create good 2D images–also needed in order to create good 3D images. Providing sub-standard images takes advantage of the customer paying for it, especially when they assume you know what you are doing.

Anyone can set up a 60″ monitor and some comfy seating. Anyone can show you how to press a few buttons. It doesn’t mean you can call yourself a sonographer. If this is your goal, go to school and learn how to do it the right way. Also, it doesn’t mean you are providing a fair service for the money.

Parents, Please Do Your Research on These Businesses!

My best advice for all expectant parents who want to pay for an early gender ultrasound is, first and foremost, to ask yourself if you can truly remain open-minded regarding a gender guess. If you hold a strong preference for one sex over the other, you may want to wait until your diagnostic anatomy screen at 18-20 Weeks for a better chance at accuracy.

Know before you go, people! Call in advance to ask if the person scanning you is a certified sonographer with OB experience and not a former used-car salesman. Don’t assume he or she is qualified to scan you. If not, you would be better off with this elective scan at your doctor’s office instead. A sonographer there is far more likely to detect an obvious problem. And your doctor or another physician would be in-house to discuss it with you and answer your questions.

I’ve made it no secret in my past posts that I’m not a fan of these cash cows. I believe that non-medical personnel should not be scanning pregnant women or utilizing medical equipment.

For the safety of the expectant parent, ACOG, ACR, and AIUM do not recommend elective scans at these sites. 

These businesses were borne of the expectant parents’ desire to see their baby at will, to bond with their baby, and to share with their families a special event. We understand this movie theater experience isn’t something you can receive at your doctor’s office, but the first and foremost concern is the health of you and your baby. I think any parent would agree.

Even though this can be a fun experience for the family, the potential for serious issues is real. We can’t tell you not to go, but please do your homework first! If nothing else, ensure the person scanning you is qualified to do so! Educate yourself, and make an informed decision.

Best wishes for happy and healthy!

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Ultrasound Facts–What’s True vs What’s Not

General Ultrasound Facts

Patients have asked me these questions on a regular basis for years. Let’s get some ultrasound facts straight, shall we? I hope it’s helpful!

What’s the difference between ultrasound and sonogram?

Technically speaking, ultrasound is the study of the subject (the field of ultrasound) and a sonogram refers to the examination itself. Although we’re really not picky about what you call it.

Is ultrasound safe?

Biohazard testing over the past forty years reveals no ill effects of ultrasound on the fetus, mother, or sonographer. However, increasing levels of heat after scanning for several hours in one area can cause cavitation or the creation of bubbles. This is much longer than the time required for performing a diagnostic test. Since no one can predict the long-term effects, only the prudent and diagnostic use of the technology is recommended by ACOG, AIUM, and ACR. The benefits of the information from diagnostic exams for patient and physician currently outweigh any known risk.

Is Ultrasound radiation?

Ultrasound technology uses sound waves, NOT radio waves. I dedicate an entire post to just that subject in the link above. No radiation is emitted by ultrasound equipment or Dopplers utilized by your physician to detect Baby’s heartbeat. X-Ray emits radiation which is why, for example, your pregnant belly would be covered with a protective shield at your dentist’s office for X-Rays on your teeth.

Can my baby hear ultrasound? 

Nope, Baby cannot hear the sound waves:) Ultrasound is just that…sound waves that operate at a frequency far beyond human hearing. Human hearing ranges from 20Hz to 20,000Hz. Diagnostic ultrasound operates in the millions of Hertz. Ultrasound probes range from about 2 – 13MHz.

True story ~ I became a little distressed once when a patient asked me if ultrasound sounded like a jet to a fetus. She had just read this in a pregnancy magazine in our waiting room! I reassured her this was inaccurate. This experience marked one of the many reasons I wanted to start my blog–to get reliable info to new moms like you!

What’s the difference between 2D, 3D, and 4D?

Almost everyone has seen the gray clouds of 2D ultrasound at one time or another. 2D allows us to see through organs and inside your baby.

Most people are familiar with 3D imaging as a fun way to see the outside of their baby. Additionally, the best and cutest 3D images are obtained later in the 2nd Trimester or early in the 3rd. Baby’s skin has developed more fat at this point which makes for chubbier cheeks! Occasionally, a high-risk practice (MFM or Maternal Fetal Medicine) will usually also use 3D to assist in visualizing a fetal abnormality. We also frequently use the technology for GYN scans to attempt a better look at uterine shape and/or IUD placement.

4D can be described as 3D in motion or a live 3D image. So, where 3D is a still image, a 3D video of Baby moving is actually 4D.

ultrasound facts, 3D, 9 Weeks pregnant

3D 9-Week Embryo

Ultrasound Credentials for Sonographers

What’s your title? Are you a nurse or in X-Ray?

We’re not nurses, though some of us do cross over from RT (X-Ray) or other areas of Radiology. Sonographer, Ultrasonographer, or Ultrasound Technologist are a few of our titles. We are specifically and formally educated in the field of Ultrasound.

RDMS stands for Registered Diagnostic Medical Sonographer. A sonographer earns these credentials through ARDMS when he or she has passed a registry examination in Ultrasound Physics as well as his/her ultrasound specialty. A certified sonographer typically has at least two years of experience under his/her belt.

DMS refers to someone who has completed some sort of formal or on-the-job ultrasound training but has not yet taken/passed the registry examination.

What do you think of those 3D places?

Having posted on this often, I understand a patient’s desire to go, but I’m not a fan. Not everyone who scans an expectant mom in a 3D non-medical business is a certified OB sonographer. Some have no formal ultrasound training whatsoever! I know you may be surprised by this little-known fact, and so was I.

These businesses are not regulated like medical practices. They may not be knowledgeable of or follow guidelines for equipment maintenance. Ultrasound equipment that is not properly maintained can be an electrical hazard for mother and/or fetus! Do your research and at least ensure your sonographer possesses RDMS or, at least, DMS credentials. Please read the post in the link above!

Performing Your Exam

When can I expect to have sonograms in my pregnancy?

Every practice is different. Most physician’s order a first-trimester ultrasound examination to date the pregnancy. This is usually performed with a transvaginal probe. If no other problems necessitate another scan, you’ll receive your next exam around 18-20 Weeks. Most women know this scan as the anatomy screen where we evaluate fetal and maternal parts for abnormalities.

*Your doc does not order this exam to determine fetal sex!* However, most sonographers will happily provide the info if at all possible (as long as policy allows)! Also, important to note here is that determining sex is never a guarantee nor should it be an expectation. Sometimes, those Little Sweet Peas just won’t cooperate! You can read more here about those limitations. Note of advice for moms: Don’t pre-plan your Gender Reveal party for the same day as your ultrasound! The health of your pregnancy determines whether you will receive more ultrasound scans later in your pregnancy.

Can you predict how much my baby will weigh at birth?

While we can measure your baby’s head, belly, and femur for an educated (called EFW or Estimated Fetal Weight) guess for weight at the time of your scan, a large discrepancy for weight determination exists due to fetal position and sonographer skill. We can typically track a trend for large or small babies. We know the average gained weight in the last few weeks is about 1/2 lb per week. However, every baby is different!

Ultrasound Facts About Fetal Sex

Most expectant moms today already know this little fact. The ultrasound machine is never “wrong” in determining fetal sex. Actually, it is the observer who is incorrect!

Guessing the wrong sex can be due to one or a combination of many factors. It is possible your baby was in a difficult position to see well. Maybe you were too early in your pregnancy for an accurate guess. In addition, an overall poor view can also limit fetal sex determination!

Facts About Your Results

Yes, the sonographer can read your examination. However, your OB/GYN physician or radiologist must ultimately interpret the images and report we create. Consequently, only your physician can legally give you results! Read more about why here.

However, most of us are more than happy to educate you about what you see on the monitor (minus a diagnosis!). I loved sharing how we measure and pointing out all your Baby’s parts for any inquisitive parents or family.


Feel free to email me at with your comments or questions!

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3D Ultrasound Images

The 3D Ultrasound Images All Parents Want

These were such great fetal 3D ultrasound images that I felt they should be posted again. They are representative of the best of the best!

You’ll see from the captions that this baby was 33 Weeks at the time of the scan. Just know this isn’t the norm! Most babies at this gestational age pose some difficulty because the head is typically pretty low at this point, and fluid begins to diminish a bit. However, this mom had polyhydramnios (or extra amniotic fluid), and baby had his own Olympic-sized pool! The additional fluid allowed better visualization of baby’s face which yielded these most beautiful pics!

In other words, Moms-to-be, the images you see below are an exception to the rule. The best time remains about 25-30 Weeks for most women.

Important Tip When Purchasing Fetal 3D Ultrasound Images

I’m super-focused on safety and educating you expectant Moms right now! I understand the popularity of elective ultrasound today, but be sure to do your research!

Because you don’t want just any images, at least ensure your sonographer is formally trained (that’s right – not all of these places employ real sonographers!). Look for certifying credentials like RDMS behind someone’s name. It doesn’t mean he or she has spent a career in OB or is registered in OB, but at least this person has received proper ultrasound training. DMS means that someone completed a formal ultrasound program, but has not yet passed a registry examination. Only trained sonographers know best how to construct an image, to optimize it with all our fancy knobs, and (most importantly!) to utilize the lowest power settings while scanning your precious little one!

You can read an important message from the AIUM (American Institute of Ultrasound in Medicine) on the subject.

Enjoy! His mom and I sure had a fun time taking them. 🙂

Email me with your great 3D images at!

No paparazzi, please!

3D Ultrasound Images


Pucker up!

fetal 3D images 33 Weeks


Sleepy baby 😉 So sweet!

fetal 3D images 33 Weeks

3D Scan Images

Factors That Will Hinder Your 3D Scan Images

Not everyone makes a great candidate for a 3D scan. Firstly, a great pocket of amniotic fluid in front of Baby’s face and Baby facing up toward mom’s belly are two very important variables. Ultrasound is full of limitations. Some factors that will hinder 3D images are maternal, some fetal as described below:

  • A fetus facing mom’s back (we can’t scan through mom’s back!) Like this:

breech fetus, prone fetus, ultrasound pictures

  • A fetus with the face buried into the placenta or uterine wall (we need fluid there to see well) This won’t work:

ultrasound pictures, fetal profile

  • An anterior placenta (if Baby is looking up, a front-side placenta gets in the way) Again, like the images above and below.

  • Limbs or cord directly in front of the face (again, anything but fluid obscures the view)
  • Too much weight around Mom’s middle (the laws of Physics tell us the image will be fuzzy)
  • Decreased amniotic fluid (fluid helps sound waves travel)
  • Late gestational age (a bigger baby takes up more space, less room for fluid)
  • A very low or engaged fetal head in the pelvis (little room for fluid in front of the face)

What We Can Try to Obtain Better 3D Scan Images

If the limitations are positional, we can roll mom to one side or push around a little. Sometimes, this does help! However, many times Baby is quite comfortable and has no desire to change position, even if it’s just an arm over the face. The farther along you are, the less likely baby will make big rolling moves. This is why 26-28 Weeks is the best time for 3D scan. A much earlier scan makes Baby look too skeletal because he or she doesn’t yet have enough body fat!

All the other factors are some we cannot alter. An anterior placenta and/or more weight around Mom’s middle means the sound has to travel further. The resulting image can look grainy or with an out-of-focus appearance. And too little fluid limits visualization overall. Even if baby has lots of fluid by his or her butt, very little in front of the face will still yield a limited 3D image.

The above are just a few tidbits of useful info to keep in mind before going for your 3D elective or entertainment scan. The link is a warning from AIUM (American Institute of Ultrasound in Medicine) about these types of scans. Be sure to make sure your sonographer has been formally educated! Look for RDMS or DMS after your sonographer’s name.

We cannot ever predict whether your baby will work with us on the big day, so do inquire as to the facility’s policies in advance in case of a stubborn fetus! In the meantime, enjoy these below from a very cooperative little one indeed:)

3D ultrasound images, third trimester


3d scan image

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How Ultrasound Works

How Ultrasound Works

Let’s explain ultrasound, how ultrasound works, and why we call this technology ultrasound!

What is Ultrasound?

Ultrasound is just that…ULTRAsound, or sound waves that operate at a frequency far beyond human hearing.

*Human hearing ranges from about 20Hz (Hertz) to 20,000Hz (or 20kHz)*
*Ultrasound operates in the megahertz (MHz) or millions of Hertz!*

Fetal ultrasound probes operate at a frequency range of about 2-13MHz. Also, the use of Doppler technology is another form of ultrasound. Your healthcare provider may use a hand-held Doppler transducer to detect your baby’s heartbeat starting at about 10 Weeks. The frequency of these dopplers range from 2-5MHz. These dopplers require special training. Only those educated on how to distinguish maternal blood flow from fetal heart tones should use them.

Additionally, Doppler technology can also play a role in conjunction with an ultrasound machine, but only formally-educated sonographers should utilize it. This feature emits a higher energy, therefore, power settings should be set very low. An example of this type of Doppler is when your sonographer is scanning your baby and uses doppler to hear the heartbeat while it’s also shown on a graph below the image. We like to use this very sparingly early in the first trimester!

Most importantly, Ultrasound is not radiation!

X-Ray is ionizing radiation; ultrasound is like sonar or a fish-finder!

What It Does

Sound waves penetrate skin and the tissues below it with the help of gel which aids in conducting the waves. Remember the goopy stuff we squirt on your belly? Once the sound waves hit the target of interest, they bounce back and result as an image on the monitor. It’s up to the operator to efficiently and properly adjust many settings to optimize for the best image. Credentialed sonographers know how to do this best! After all, Knobs and Buttons 101 is a large part of our training and education:)

The image produced is a 2D image (the gray-scale image) which allows us to see in two planes only at one time. An example of a 2D image is seen below. Baby is shown upside down here!

9 Weeks pregnant, ultrasound, 9 Week Embryo

9 Week Embryo in 2D

Because a 3D image is made when the sonographer makes a sweeping motion with the probe, several 2D images are saved all at once. We then have a “box” of information to work with that allows us to see the outside of Baby instead of “through” Baby. Below is a 3D image at 9 Weeks:

how ultrasound works

9 Week Embryo in 3D

Hopefully, this post helps you understand ultrasound a little better when you go for your next scan. I wish you all uneventful pregnancies and happy, healthy babies!

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