Posts

Ultrasound Gender Determination

Ultrasound Gender Determination ~
Pink or Blue?

Ultrasound gender determination can be tricky! Especially too early in pregnancy. Or any time they just won’t cooperate!

gender determination

Female Gender 16 Weeks

male gender, 16 Weeks pregnant

Male Gender 16 Weeks

How many times have all you moms out there, young and old, heard the story that goes, “They told her it was a ‘this,’ and they decorated an entire nursery, and it came out a ‘that’! Those ultrasounds are wrong sometimes, ya know!”

A dollar for every one of those comments would buy me my dream cottage on the Amalfi coast! However, I understand why this happens, and sonographers everywhere need to apply more discretion. First of all, you may already know that it’s not the machine that’s wrong. The sonographer or observer scanning you evaluates what she (or he) sees and determines Baby’s sex. The whole process is entirely subjective! And inexperience sometimes causes sonographers to excitedly guess or, otherwise, cave to the pressure from anxious parents. Unfortunately, sometimes guess incorrectly.

Advice Regarding Gender Determination for the New Sonographer

First rule of thumb for any newbie sonographer out there . . . don’t guess! Don’t put a percentage on your guess, and don’t say “I think.” Also, don’t say “It kinda looks like ‘this,’ but let’s wait until next time.” Parents may want you to guess, but they also want you to be right! Just a word of caution here–some patients may become upset with you if you don’t guess. But if you’ve exhausted your bag of tricks and you still are not sure of what you are seeing, you owe it to the patient to explain this. It’s something you have no control to change, and you would rather they not become attached to the wrong sex. Hopefully, they will understand!

Psychologically and emotionally speaking, most parents start to really become attached to one sex or the other. They begin to envision the first dance recital or baseball game by the time the next ultrasound exam rolls around. On more than a few occasions in my career, someone else guessed incorrectly (usually, too early!), and I had to be the bearer of bad news. After witnessing the affects of “mistaken identity” (shock, anger, tears, sadness, guilt), I adopted a personal policy long ago to only offer a guess when parts were obvious. In other words, Baby had to be in a great position to easily see a penis and scrotum or labia/clitoris. Even though my policy upset a number of my patients in the past, I truly believe refraining from tossing out any old guess is in their best interest and can save them some heartache later.

True Story!

One grandmother, so excited by the doctor’s early guess, flew right out and bought thirty-two dresses! Yep, 32. She did so despite the doc’s warning about his level of confidence and told her to wait for the sonogram with me. Fortunately, he got lucky with his baby girl guess, and grandma was a very happy woman (and a little less rich)! However, you can imagine the disappointment in returning all those frilly frocks if doc was wrong. I always hated giving such news!

Please, all you excited moms-to-be, remember your sonographer doesn’t withhold information about fetal sex just because! We’d actually really rather all our babies cooperate quickly and easily! It’s such a bummer for us both when they won’t. You can’t plan all the fun things you imagined you could. Shopping, party planning… And believe me, I always preferred when my patients left my room hugging me instead of cursing my existence. A magic trick to make Baby flip on command? It’s too bad we aren’t bestowed with super powers upon certification!

Subscribe for more great images of gender determination!

Be sure to check out My Shop for custom Gender Reveal gifts and pregnancy announcements!

 

The Gender Scan–Confirming Your Guess

Why Confirming Your Gender Scan Is Tough

I think most of you reading probably would believe that most of the emails I receive have to do with parents wanting me to confirm fetal sex . . . sometimes desperately so. But sometimes determining fetal sex based on someone else’s image in a gender scan I didn’t perform is an impossible task.

I try to explain in my replies that my guess is only as good as the images they send me. Some people take great images; some don’t. And sometimes, no matter how experienced a sonographer, good images are just not possible! When I explain that ultrasound is entirely subjective, this means the person performing the gender scan has total control over the images obtained. The sonographer creates these images utilizing a number of controls to optimize the image. She also uses her own discretion to determine whether she can see well enough and whether what she is seeing looks more like Team Pink versus Team Blue.

All Images Are Not Equal

Yes, there is a standard here, but I have to brutally honest. Just as people excel in some areas of life and/or profession, some are also not very good at what they do. There are good docs and bad, good nurses and bad, good cashiers and bad. This is a painfully obvious fact regarding ultrasound when I open some of these image attachments! It’s also possible these operators are not formally-educated sonographers at all! Yep, it’s true, and you can read more on the subject of elective 3D businesses here.

When we scan you real-time, we are trying to see from many angles. However, only one angle can be depicted in one image at a time. I wasn’t there during your gender scan, so I don’t know anything about the variables that could have made imaging difficult.

I just know a technically bad image when I see one. Sometimes, I can tell an operator did not take measures to improve the image. In those cases, I can only assume that someone did not know how to use them correctly. If the person scanning you is new to ultrasound or not a real sonographer, the image may not appear optimal to someone who is experienced in sonography.

Great Images for Determining Fetal Sex!

Below are some great images of fetal sex that I’ve taken myself.

female fetal sex, 18 Weeks, gender scan

The above depicts an underside view of typical-appearing female parts from about 16 – 22 Weeks pregnant.

male fetal sex, 28 Weeks, gender scan

Male genitalia, late 2nd Trimester

So, all that said, if the image you send is not an optimal one, I may not be able to take a guess on fetal sex. Even if your sonographer felt sure of her guess during the gender scan, I may not feel I can agree based on limitations of the image. That doesn’t mean your sonographer got it wrong, just that I cannot concur with the former guess because the image quality is not there. If I didn’t observe the scan myself, I am unable to see your baby’s parts from many different angles!

Want more great images of fetal sex?
Any questions about the images here?

Just subscribe here for to see updates first.

Just go to Ask Me with your questions!

 

As always–thanks for reading!

 

 

Fetal Gender Determination

Sometimes, it’s just Mission Impossible!

Fetal gender determination is not always a walk in the park for us sonographers. Ultrasound, like many technologies, has its limitations. There exist many factors which can make fetal gender determination mission impossible! Your OB docs understand there are a number of variables that prevent good visualization in every ultrasound we perform. Unfortunately, many patients do not.

So, if you’ve been losing sleep in anticipation of this long-awaited news, read this first! My goal is to inform expectant moms so that you go into your ultrasound exams with realistic expectations. I sincerely hope that through understanding these limitations, you’re able to leave your experience feeling happy. If all you can see is Baby’s heartbeat, it’s an opportunity to bond with your new addition that doesn’t come everyday.

Is Fetal Gender Determination a Requirement?

Definitely not. Fetal gender determination is not a routine part of a diagnostic examination. It may be information you desire, but it’s not typically information your physician needs. The anatomy screen at about 18-20 Weeks or so is ordered to rule out structural fetal malformations. Most U.S. practices do not mind providing a fetal gender determination as a courtesy IF the sonographer feels she can see well. And we LOVE to give you this information, if we can!

What Factors Impair Fetal Gender Determination?

Some of these factors that can get in our way of how well we see are listed below. They are very common! Actually, some of them confront us on a daily basis.

  • A breech fetus
  • A fetus with the rear against the uterine wall
  • A foot or feet in the genital region or crossed feet
  • Closed legs
  • The umbilical cord between the legs or against the fetal body
  • Body habitus or too much weight around a patient’s middle
  • Uterine fibroids or contraction
  • A decrease in amniotic fluid
  • Genital malformations
  • Early gestational age

Even one of the above factors can prevent even the most experienced sonographer from determining fetal sex. A good sonographer knows when the views are good enough to provide you with a guess. A good sonographer also knows when not to guess! What you don’t want is someone who is inexperienced but willing to guess anyway. Many times, it’s not just one but several of the above variables that limit what we see. Unfortunately, we can’t change any of them.

Can you appreciate the difference between the first two images and the third?

female gender, 2nd Trimester female gender, fetal gender determination

Great image of female gender!

female gender, 2nd trimester female gender, fetal gender determination

Great image of female fetus!

fetal gender determination

Um, not so much . . .

Another little fact I’ll add here is that a non-arguable truth of the modality is Ultrasound’s laws of physics. The further sound has to travel, the weaker the returned signal. The more tissue the sound waves have to penetrate, the worse the image. In other words, the more tissue there is around a patient’s middle, the more fuzzy the picture. The more fuzzy our picture is, the less we can see Baby’s parts. Any not just fetal gender, any parts. All it takes is one of the above factors to ruin the party. More often than not, a combo of factors will cause a little unwanted rain on your parade.

What Can We Do to Help?

We can try a couple of variables in an attempt to see better. Jiggling your belly or turning you to each side sometimes helps. We do this in the hopes that your change in position will also change Baby’s. Alas, it doesn’t always work. For some tips on how you can try to ensure Baby is a little more active during your exam, click on this link!

What We Can’t Do

Unfortunately, we can’t scan you indefinitely! In an effort for fairness, we always try to get our next patients in as close to their appointment times as possible. Sticking to this schedule can be tough when patients arrive late or when we find abnormalities. Most patients are allotted a 30-minute appointment for their ultrasound exam. However, not all of this time is scanning time.

Before we scan you, we need to examine your chart for your history, an order from your doc, and an indication for the exam. After the exam, we need time to type up your report and send it to the physician. Most of us are nice enough to take more time with a patient if our schedule allows. I always did. Unfortunately, some of my patients (not understanding ultrasound) didn’t think I did!

What You Shouldn’t Do!

internet search of fetal abnormalities

An unreasonable action disgruntled patients take these days includes airing their rants on social media. Consider, first, that venting your frustrations reflects poorly on your physician and practice. And you could be fired. Yes, a patient can be fired! In other words, I would advise against this method of revenge. If you are unhappy, you have the right to discuss it with Administration. But just know a practice does not have to tolerate any behavior deemed irrational or unreasonable. Just like one can fire an attorney, a plumber, or doctor, a patient can find herself in the same situation.

A Modern-Day Problem

Unfortunately, our society has become one of immediate gratification, even demanding it in the face unreasonable circumstances. I’m reminded of a few former patients and a like-minded character from one of my favorite childhood movies. Anyone remember Veruca Salt of Willy Wonka fame? These patients actually got angry, yelled, cried, and ranted in a place of medical business, much like the toddlers they would have themselves in another couple of years – all because I couldn’t tell them the sex of her baby. This. Is. Unreasonable.

I realize some sonographers don’t try very hard. In most circumstances, however, most of us make a sincere attempt to obtain this information for our patients who want it. We cannot, however, change the laws of physics.

Moreover, some patients mistakenly assume that because we couldn’t make a fetal gender determination, we must not be able to skillfully perform their diagnostic examination otherwise. Please keep in mind that medical professionals never judge such as gross incompetence. Rather, ranting such on social media is reflective of the patient’s lack of understanding of how the technology works. So, please! Don’t do this. 🙂

We hate when our patients leave foaming at the mouth. Remember, this scan is about Baby’s health first! Just ask any mom who didn’t have a healthy baby.

Good luck for a great sonogram!

Subscribe for your most reliable ultrasound information!

~ * ~

Female Ultrasound–23 Weeks

Yay for Team Pink!

Confirming a female ultrasound image isn’t always difficult. Below is an email I received from a reader hoping for some “sugar and spice” confirmation:

curious mama:  Hi! Please, can you confirm that this is a little girl? Why do the girl bits look so big on this 23 Week 3 Day scan? Thank you!

female ultrasound, 23 Weeks pregnant

wwavb:  So, yep, looks pretty girly to me! Babies are just starting to develop a little fat now, so this is why labia are starting to look more like typical little girl parts. Also, keep in mind this image is HUGELY magnified!

Congrats and have fun shopping for Team Pink!

***

As you become further along in pregnancy, you may notice that the dots you once saw in earlier scans of your baby girl may turn into the image you see above. She’s just getting a little more plump! For a great image of baby girl parts later in the 3rd Trimester, click here.

 

<<< Just click Ask Me if you have questions or comments.

And if you’re ready to shop for Gender Reveal or pregnancy announcement ideas,
just shop My Shop. It’s coming soon!

Thanks for reading!

 

3rd Trimester Female Gender

A Great 3rd Trimester Female Gender Pic!

Okay, readers, if you are searching for the perfect shot of 3rd Trimester female gender, check out this photo below. This image is shouting, “Am I a girl or what?” Poor thing. We don’t even give her half a chance for modesty!

3rd Trimester female gender

This is a great image of labia as seen later in pregnancy. Baby has more fat in her skin now and looks nothing like the “3 dots or lines” you saw at halftime. Now, granted, not every baby girl looks exactly like this one. We are not all built EXACTLY the same, right? Some babies have smaller labia than others. Still others have a larger clitoris.

However, I think no one can argue that the pic above looks nothing like any little boy I’ve ever seen. This mom and dad were so excited for their second precious baby girl. Lucky for you, they were also so happy to share! 🙂 This represents a beyond-GREAT shot if I do have to say so myself!

I just LOVE a great ultrasound image. (Wow, I’m such a geek sometimes.)

If you have great shots of your baby girl (or boy), feel free to email me!