Gender Determination in an
The short answer? No, not always.
The short answer? No, not always.
Sometimes, there are just so many shades of gray between pink and blue. Determining Baby’s 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 a probe to a 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 only in our very 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! Most of my emails come from people who want a second opinion. However, most of the time, it’s one I regretfully 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 commit.
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. And anyone who has, too, can recognize when gender is obtainable and when it isn’t.
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.
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. You can read more about a breech fetus here–it’s merely one of many potential problems with fetal position that can hinder a guess. Remember, that you want an accurate guess, not just any guess. Most importantly, an experienced sonographer knows when not to guess. Neither one of us wants me to guess the wrong sex . . .
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. Poop–I hate when that happens!
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Ultrasound gender determination can be tricky! Especially too early in pregnancy. Or any time they just won’t cooperate!
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.
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.
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!
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So often, when readers send me their images for a second opinion on fetal sex, I just cannot provide a confirmatory guess. This is either due to too early gestational age, too poor an angle, or too poor an image. Sometimes, it is a combo of all three!
Ultrasound is such a different animal because it is nothing like a photograph. In a photo, you can see what’s in the distance or up close to the camera. With ultrasound, we cannot. We can only see exactly what is directly under the probe. It is a 2D (two-dimensional) image only, and we have to move the probe around to obtain different angles to create that “photograph” in our minds. And there are so many variables that go into creating a good ultrasound image.
Since ultrasound is completely subjective and observer-dependent, some sonographers take great images and some . . . well . . . don’t. It’s much like comparing a professional photograph to an out-of-focus, too dark, cell phone group portrait where everyone has red or white eyes. You know, the ones you always see posted on social media?
I am too much of a perfectionist. This wasn’t always a good thing when trying to take keepsake photos for patients because it caused me to run late on more than one occasion! And everyone knows people don’t like to wait in a medical office. It’s just a learned skill and some are simply better at it than others. Some just don’t tweak all the knobs as much as they should. Maybe they were never really taught how to do so very well from the start.
Some factors that cause a poor image are just beyond a sonographer’s control . . . like an uncooperative fetus, extra weight around a patient’s abdomen, or a gassy patient. The laws of ultrasound physics dictate that the further sound waves have to travel, the poorer the image. Also, sound does not travel well through air or gas. I’ve scanned heavier patients where I could see pretty well and thinner gassy patients where I struggled to see at all!
That said, I can tell when someone else’s image is not great or when she didn’t work with all the knobs. This can make reading an image snapped by someone else extraordinarily difficult. One image represents only one angle. Scanning real-time allows me to look from all angles possible, where I can subjectively determine my confidence in fetal sex–or whether a guess is too risky at all.
ALL that said, sometimes taking a second guess is easy-peasy! Check out the email I received from a reader about whether her baby is male. Her images didn’t leave much of a question in my mind! She was just over 20 Weeks along.
Can you tell this is a boy?
mama: Hello! I’ve been following your blog, and I was wondering if you could take a look at my baby’s scans and give me your opinion on gender. We were told it’s a boy, but I’ve read that girls can have parts that look similar to boys? I agree that it looks like a boy but wanted a second opinion. Thanks!
wwavblogger: LOL No ma’am! Little girls don’t normally look like that at 20 Weeks! I will wager my bet on a baby boy. 🙂 Congrats!
mama: Lol! I wasn’t quite sure, but I’ve had a feeling it’s a boy from the beginning of the pregnancy!
Reader mom: I forgot to mention in my reply to you that, yes, girls and boys can indeed look similar. But this is truer between the 12-16 Week range when parts are small, just developing, and when combined with other factors that come into play which result in limited view!
Did you guess boy?
If so, I agree! Compare the images I’ve edited below.
Even though it would be quite unusual for this to be a baby girl, I’m still always a bit cautious about guessing fetal sex based on someone else’s image. When I’m casting a vote for Team Blue, I like to ensure I see a scrotal sac which requires a slightly lower angle.
Sometimes, you can obtain both scrotal sac and penis in the same image, sometimes not. I get a slight impression of a scrotal sac here where I placed the circle. The sac at this age can appear quite small, and testicles are not expected to descend until about 26-28 Weeks. This is why scanning real-time helps; it allows me to see Baby at all angles possible while moving and stretching and opening his legs more.
Stay tuned! My next post will be one where a questionable and poorly technical image comes into play. Mom wrote back saying she delivered the opposite sex. Oops!
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What’s the worst position a fetus can be in if you want to determine fetal sex? You guessed it! Look no further than the image below to answer this question. The breech fetus compromises most of what both you and I want to see.
This image is really an example of just how much position plays a part in how well we see. This baby (above) is not only lying in a breech position, or butt-down, but baby is also facing Mom’s back (prone).
The wait for your ultrasound exam between Weeks 18-20 and whether you’ll be shopping for pink or blue may have you losing sleep! The LAST thing you’ll want to see is your baby looking like the image above. It spells one word . . . disappointment. If baby stays in this position throughout the examination, the possibility of seeing anything cute is essentially nada.
Below is an example of baby flipped over and looking up.
How much better do you see baby’s face? (Hint–it’s way better!) Here’s hoping you have more luck than this patient did for her anatomy screen ultrasound exam!
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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.
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.
Below are some great images of fetal sex that I’ve taken myself.
The above depicts an underside view of typical-appearing female parts from about 16 – 22 Weeks pregnant.
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!
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They sure can be, especially if you have one of each! Male and female twin gender determination equals one thing in my mind . . . fun. to. shop! The expense? Oh, let’s not dedicate too much blog time to that topic. All our kids are expensive, no matter what!
What’s the perfect twin gender scenario for many expectant parents? Unless, they’ve already got all boys or all girls, I think you’d hear most declare that to have one of each would be beyond ideal. The image below represents “beyond ideal” twin gender pics at 16+ Weeks. It was a very confident guess, especially when we could compare these babies’ butts side by side!
Obviously, Baby Boy is on the left; Baby Girl on the right.
Below, these babies are 18+ Weeks . . . and still looking the same.
This is the same view and very obviously a proud baby boy.
Below, you can see how much different this baby girl looks compared to her brother. No wee-wee here!
These are GREAT images of gender, mamas! Clear potty shots, no question, no guess work . . . just how I like to scan them!
You’ll need to look no further than the photos I have for you below–two great images of male gender! This baby was about 19 Weeks and (no pun intended), boy, was he proud!
The image above represents a bottom view. Just imagine Baby sitting on a glass table as you look up from the underside. I have all the parts labeled for you. The arrows, of course, point to the wee-wee (my very medical term). This pic is about as straightforward a potty shot as you will find. No guesswork–all boy!
Now this is a side view of Baby. You can’t see his head in this picture which would be off to the left-hand side. Again, I’ve labeled all the parts so that you, hopefully, understand what you are seeing. I realize it’s much harder to look at an image than to have someone right there, narrating it all for you in person.
This time it’s the legs which do not make an appearance here. Not to be graphic but for demonstrative purposes, imagine slicing the body in half lengthwise; this is the view we see here–right down the middle of the torso.
The penis and scrotal sac from the side resemble a turtle sticking out of his shell. So, appropriately enough, patients would always ask for a turtle shot. If you can appreciate the tiny dotted line, you will see it is drawn around the “turtle.”
You can see how parts look different from different angles. These depict super great images of baby boy stuff . . . no question, no nonsense, no guess work. Just how I like ’em. And just all boy!
Best wishes for a healthy baby on your next scan!
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Okay! So, this is a perfect example of how we can sometimes determine gender at less than 17 Weeks! The images below represent twins and their perfect images of male and female gender! It just doesn’t get better than this. You must remember, however, that not all boys and girls look exactly the same at every week of gestational age; so your baby may look a little different from what you see here. You can read more about why everyone’s images look different from one another here.
These babies dated at 16w4d and depict textbook images for boy and girl fetal sex. They make a perfect side-by-side comparison!
These were very easy potty shots. We’ve just gotta love it when not just one baby cooperates but two in the same belly. These babies hardly made me break a sweat. I’ve even labeled their parts for you. So, hopefully, they make for easy reading for you. Check them out below.
Baby girl, on the left, is showing off only her bottom. Imagine her feet pulled up over her head. Flexible little things, aren’t they?
Baby boy, on the right, is showing off his thighs and bottom.
Unfortunately, not all babies cooperate like these. Some babies don’t want to show off the goods, and there’s little we can do to make them move. I know we sure would have many more happy mamas out there if we could!
if your mother-in-law thinks she can read your images?
We all know that our family and friends can be quite nosy, opinionated, and even rude when it comes to all things pregnancy-related. After all, they’ve been there and done that, and they know better than you. This is your first rodeo, and you know absolutely nothing. Sound familiar?
In the course of conversation during a scan, especially with my weekly patients, we glide from the political correctness and appropriate medical office pleasantries to cutting up about life happenings. My patients take this opportunity sometimes to vent about just such personal offenses. One of my readers recently did the same! Read on about her dilemma . . .
irritated mama: Hello! Firstly, I would like to say what a great blog you have, and I’ve really enjoyed reading it. Secondly, I’m wondering if you can take a look at my scan pic from my 20 Week scan. I’m now 25 Weeks. We didn’t find out the gender as my husband didn’t want to, but his family is convinced it’s a boy from the scan pic. They are even calling it a “he” which is quite annoying. I’m just wondering if there is anything on this scan pic that confirms the gender? Obviously, we didn’t get a potty shot. I hope you can help. Thanks!
wwavb: This email cracks me up! You are not the first to be annoyed by in-laws who think they are ultrasound aficionados! Everyone is suddenly an expert. You’ll be happy to know gender is nowhere to be found on this image! It’s a great side shot of Baby, but when you get down to baby’s bottom, part of the hip/leg is pictured. So, it’s not a side shot between the legs. Now you can tell your in-laws to mind their own biz!
irritated mama: Brilliant, thank you. That settles it, and I will tell them just that. Haha!
So just know, all you pregnant moms out there with in-laws who are driving you to drink . . . first, I can’t condone escaping your in-laws with wine in your delicate condition. Second, you have to stick up for yourself! There are nice ways to say anything. So, next time your mother-in-law (who doesn’t know what a femur is) attempts to read into your ultrasound image, kindly thank her for her oh-so-professional interpretation, and ask her if she’d like to deliver her grandchild while she’s at it, too. 🤣
Yes, I am a smartass at times, but I blame my brother–the ultimate King of Smartassness, one-liners, and wisecracks. It’s a crown he wears proudly.
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Early gender pics can be deceiving. Many of you who want to know your Baby’s sex as early as possible with ultrasound may desperately wish to believe the tempting promises of your street corner 3D ultrasound business. Before you pay your money to one of these places, I encourage you to first read the above link! Some of their employees are not real sonographers–please do your homework first and ask the right questions before you go.
The early fetal parts of external genitalia can look different than they do later on–just as an embryo looks different from a baby or an embryonic chick looks different from a chicken! This is also the reason we do not perform the screening of anatomy until 18 Weeks. Structures like the brain are ever-changing until about that time. Even at
17 Weeks, the brain looks a little different. The same applies to external genitalia–later is most always better.
Yes and no. Because these parts are just starting to develop at 12 Weeks, both boys and girls have little parts that stick out. Over the next month, your baby’s external genitalia are still developing and changing in appearance. That is to say, boy tissue starts to get bigger and girl parts shrink. Eventually, the scrotal sac and penis take a more recognizable shape, and the labia and clitoris take on the appearance of three tiny white dots or lines. Fetal boy parts can appear different from other boys, just as girls can appear different from other girls. We’re all different!
Please take my word for it. Any guess at 12 – 14 Weeks is simply a guess based on appearance, but that appearance can change. At 15 – 16 Weeks, the parts may be slightly more developed, but it’s still a guess. And SO many factors effect how well we can see those parts. Now, have I guessed gender at 16 Weeks? Definitely! But it had to be someone I was scanning personally, baby had to be lying butt-up in a perfect position with legs wide open, and I had to have a clear image otherwise. It just all has to be textbook perfect and not every patient/fetus is a textbook scan. I might feel confident enough to provide a second opinion of your baby’s gender if you are 17 Weeks with a perfect potty shot!
Even if the parts appear very straight-forward based on the nub theory, it’s only a theory and only about 73% accurate. That’s a lot of room for error. So, just because a girl might look like a girl based on the nub, don’t be surprised to find a penis at your anatomy screen! Only genetic tests like first-trimester blood tests for DNA or amniocentesis are 99+% accurate for fetal sex.
Great! I’d love to share them.
You are welcome to email me with questions at any time in your pregnancy. I’ll do my best to answer them!
Please know, a request for gender confirmation should be at least 17 Weeks and later!
Reading an image I didn’t take can be a challenge, and I can never be more confident than the person who scanned you. Especially if your sonographer said she couldn’t get a great shot, I likely won’t be able to tell, either. (Aw,💩 — I hate when this happens!)
First, I’d like to extend a huge congratulations to a reader who recently delivered! 👶 I love answering your ultrasound questions. I love it more when I actually help a reader. This is what she had to say…
|Hi! I hope you had a lovely time on your holidays. Just had to say I had a little boy at 38+5, and he was a MASSIVE 8lb 7oz! Not half as bad as I imagined. Many thanks for your help to me!|
I’m always excited to get your feedback! The whole point of my blog is to answer questions you have about ultrasound accurately. Considering the vast forums on pregnancy where everyone chimes in on their personal experiences, taking to heart unreliable information has the potential to do harm to you or your baby. Everyone is an expert; everyone has an opinion. Though I believe most genuinely care and try to help, I have found much about ultrasound to be misleading or incorrect in some way.
I have loved breaking the news to expectant parents about whether they would be shopping for pink or blue!
And I’m happy to try to decipher someone else’s images for my readers (as long as you’re 17 Weeks and further–just click on the link, leave your email address, and email me!). In my effort to bring to you factual and truthful information about your ultrasound examinations, part of that truth is doing my best to help you understand your exam and info about results.
Ultrasound will always be, first and foremost, a medical examination of mother and child. Your sonographer needs enough quiet and concentration to ensure your baby appears healthy! Afterwards, break out the party hats, and let’s have some fun! 🎉 Of course, the level of fun completely depends on how photogenic your new addition is feeling that day. You can read more about that here. Poo, sometimes, it just isn’t what you expected, even when you lost sleep in anticipation. 😫 I hate when that happens!
That said, the highlight of many workdays revolved around very happy couples who were mindful of why they were there–so happy to be expecting and loaded with ultrasound questions! I love to impart ultrasound knowledge to anyone willing to learn it. If I could also deliver a few awesome keepsake images of the precious little bundle and enjoy a few laughs in the process, all the better. I still feel honored to have been a third objective party who was privileged to orchestrate it all!
Best wishes for a beautiful experience!
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I’m working on one! (Though your baby might be three by the time it comes out . . . )
It’s a Boy!
Male fetal gender on ultrasound is pretty obvious here, wouldn’t you say? This grandma wrote in to update me on the questionable sex at a 12 Week scan. If you’ve read many of my posts on attempts for early gender guesses, you know there’s no hugely reliable method for determining sex at that age. It’s all theory (the Nub Theory) and hypotheticals and not enough accuracy to start planning your Gender Reveal Party.
Little boys are an easy guess when they pose like this! Not much question here, right? I love it when your babies cooperate!
This baby was about 20 Weeks here in the above image. He obviously positioned himself perfectly to obtain a great underside view with part of his thighs in the pic. This is exactly what I like to capture when I type “oh, boy!” on the monitor.
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(The short answer is no.)
I LOVE IT! What a breath of fresh air I received from a reader–someone who actually wants to avoid fetal sex determination! Now, don’t get me wrong. Though I held off on the potty shot for my first child, I was a full-time certified sonographer working several years by the time my second came along. I personally couldn’t wait to see for myself. I even scanned myself in the process (we all do this, by the way)!
This post comes from someone who definitely fits into Club Minority. She wanted to wait for The Stork, but that was just not good enough for everyone else in her family–especially her sister.
wwavblogger: I LOVE IT!! First things first. Absolutely, positively NO genitalia in that shot whatsoever! The black oval in the pelvis is Baby’s bladder, and I’m guessing she thinks she sees something just above that which is a very small section of umbilical cord at abdominal insertion. Either way, you are totally correct in that if I can’t see parts, neither can anyone else! Tell your fam they have a 50/50 shot at guessing! 😉
Everyone the expert, right? And, yes, the desire is overwhelming for patients to know gender as soon as the pee stick shows the little plus sign. However, sometimes the desire comes more from the family than the patient!
Read below for some props (thanks!) and a question about 14-Weeks gender from a new reader and subscriber:
reader: Hi! I’m expecting my third little one in October. Before I ask my question, I just wanted to say that I’ve been reading your blog for the past three hours while my kids are down for a nap. I love it! I went for a private 3D ultrasound on Monday, and he said it was a girl! We are so excited because we have two little boys already. I’ve heard so many horror stories since I had it done, and I’m terrified he was wrong. I clearly see “three lines,” but I’m no ultrasound technologist. What do you think? Thanks in advance! I’ve already subscribed, and I’m excited for more!
wwavb: Hi! First, let me say thanks so much for reading and subscribing. I’m so happy you are enjoying my (sometimes) sense of humor. I really am very honored that you spent three hours of your own personal quality time reading my stuff! Very cool.
So, I am going to guess that you are maybe 14 Weeks? 15? Please write back, and let me know. Maybe you have already come across some of my posts. You may also already be familiar with my opinion of these ultrasound drive-thrus! Baby looks a bit small in these images, like you may be a little early to determine gender.
If you are less than 18-20 Weeks, wait to paint! This is really the best time (and later) to determine gender, and those images are not proof enough to me to paint pink just yet. Please know I am not telling you he’s wrong, I just cannot concur based on these images.
reader: You’ve guessed correctly! I was 14 Weeks in this ultrasound and did, in fact, read your posts about the drive-thrus. I must say, if I’d had know your opinion before, I probably would’ve waited. He told me he was 75% sure it was a girl and to come back in two weeks for another look for free. I’m definitely not convinced that it is a girl, nor have I bought anything pink. I do hope that it is, though! Thanks for your input!
wwavb: I hope so, too! Pink is so much fun to buy, and you could use some estrogen in your family! Feel free to email me again when you go back and then again when you go for your diagnostic anatomy screen at 18-20 Weeks. 😉 I’d love to tell you pink, too. Thanks again for reading.
It’s possible. We’ve all heard a story or two, right? A guess too early in gestational age is one way to ensure mistaken fetal gender guesses. When Baby won’t move from a difficult position, that doesn’t help, either. The message of this post is simple. What I really want expectant moms and sonographers alike to take away from this message is there’s more at stake here than just being “wrong.”
Parents start to identify with being a mom or dad to a new baby girl as soon as you speak the words. Thoughts jumpstart to dance recitals and her wedding day. Dads immediately daydream of the fishing partner they always wanted, or they run out to buy his first tiny baseball glove.
These are strong emotional ties that often get broken when someone casually throws out the gender card on ultrasound. Beyond the need to return some beloved items often comes with associated feelings of guilt or loss when the true gender is identified.
reader: This is my second pregnancy, and I am 18 Weeks. At my 20 Week ultrasound with my first pregnancy, I was told by the head ultrasound doctor (radiologist?) that it was definitely a girl, and I picked out a girl’s name. I ended up going into labor early at 30 Weeks.
At the hospital while an ultrasound was being done, I kept asking if she was ok. The poor tech said, “Why do you keep saying she? Were you told it was a girl?” We said yes. She said, “Well, I see a scrotum. I’m going to get the Dr.” So, it turns out we were the first time this head doctor ever got it wrong, and now we are legend at his hospital.
We were already calling the baby by the girl’s name we picked, and I had a really hard time with the news. The only way I can describe it is like I had to grieve this little girl I had in my head that was suddenly gone. I wouldn’t change a thing about the amazing toddler boy I have now. But at the time, I was a wreck. Needless to say, I don’t want to go through that again. I was told today that the baby is a girl (again), and it is hard for me to believe. So, I just want to see what you think!
wwavblogger: Wow! Your story is EXACTLY the reason I implore sonographers to give careful and cautious consideration when determining gender!
I learned many years ago that even if I say I am not sure but give a “possibly,” parents are already thinking ballet slippers and pink tutus or sailboats and whales! It’s so true. It’s just an emotional attachment you begin to develop as soon as someone even mentions the slightest inkling of pink or blue.
Look no further!
Here, I’ll clarify what constitutes REALLY GOOD male and female ultrasound images. If you guys read my blog on a regular basis, you already know how many emails I receive from parents wanting a second opinion on gender images only to get a “I’m really sorry, but I just can’t see well” instead of the confirmation they anticipated.
Most of the time, their sonographer gave the nod for male or female followed by handing them an ultrasound image which looked like a snowstorm. I’m afraid it’s just not quite the validation I can support! I’ve posted other great male and female ultrasound images and gender shots throughout the site, but let me add a couple more.
Hello! Any guesses? I’ll give you only one, but I think you won’t need more than that. THIS is the boy shot patients want to see. This is the holy-cow-look-at-that-wee-wee or he-is-so-proud! shot we always try to obtain.
I’ve labeled the parts, but I realize you probably don’t need that assistance, either. Is there REALLY any question in anyone’s mind here? I didn’t think so. This baby boy is about 20 Weeks in the photo you see here.
Anybody not see three lines here? There’s a little dotted circle around the labia and clitoris in the middle depicting the three lines you hear most about. So. Girly. Enough said.
This little Sweet Pea is 22 Weeks here. She really didn’t want to move her legs for us initially, but I could still see well enough to reconfirm Team Pink for this couple!
And this one I’ve posted before! The female labia are much more plump closer to that due date! This baby girl was about 38 Weeks here and probably represents THE most clear female gender image I’ve ever obtained.
See the difference? I never like to guess gender, and these images leave no room for guessing. I love it!
Even the most ultrasound-challenged won’t argue with these textbook images of fetal genitalia. Everyone who desires to find out fetal sex wants a great photo of those parts, but second to that is a sonographer who knows when the view isn’t good enough for a guess!
Do you have great images of male and female gender you’d like to share?
Email them to me at firstname.lastname@example.org!
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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! And these 15-Week Gender Pics make the perfect example.
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 receive such big commitments on 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!
The first reason lies with my own image for comparison. Both sexes at Week 15 might look like this:
What do you think? I know what I think. No sonographer with any level of adequate experience, especially those who specialize in OB, would ever label these first two images a girl OR a boy, much less to seal it with a “100%.” We all know that a lack of seeing anything which 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.
Better known to many as “the scan where I can tell the gender!” Many of you moms out there may already know determining boy or girl is not the purpose of the scan but rather a sometimes side-perk. This post is dedicated to the routine or Level 1 anatomy screen and what we look to document on it.
The anatomy scan is routinely ordered by your doctor to be performed between approximately 18 – 20 Weeks of pregnancy. We can perform this scan a little later as long as your doc gives the okay but, typically, not earlier. Those who are antsy to find out their baby’s gender will usually ask to have the anatomy screen earlier, but your doc will likely not sign off on that one. The reason for waiting is that Baby and his/her organs need to be large enough to be able to evaluate them well. We already prepare ourselves to battle Baby’s position. Along with the other limitations of ultrasound, scanning too early just adds another and defeats the purpose. And if Mom has extra weight around the middle, the screen will sometimes be pushed back a little further. We can see a little better with a little bigger baby.
This exam is ordered to rule out structural malformations on Baby. We want to ensure that all Baby’s parts exist where we expect them and are functioning properly. Diagnosing serious problems in advance is the real purpose of ultrasound. Physicians can then prepare a plan for management for mother and baby and assist in providing the parents and family all the education and counseling needed.
Even if you elected to have genetic testing early on, it can’t detect some abnormalities, like a heart problem, for example. Additionally, some chromosomal problems are not obvious on ultrasound. Unfortunately, no test can detect every problem which is why you are offered different types of testing.
If your pregnancy is high-risk to start or if a problem is detected, your doctor may elect to send you to MFM (Maternal Fetal Medicine) for a Level II anatomy screen. This just means the sonographer evaluates a few more structures and takes a few extra measurements. The perinatologist, or high-risk OB doc, reads the scan and forwards a report to your general OB doc.
It’s true that we may detect findings which require follow-up and end up resulting in no problem. Thank goodness! You may feel like you ended up worrying for nothing. However, if a serious problem was found, you’d probably be happy you knew about it in advance. Special circumstances require life-saving surgery for Baby immediately after birth or require special NICU accommodations that your local hospital may not offer.
My co-worker and partner in crime in ultrasound (of all people!) discovered her child had a heart condition, a very rare one at that. Instead of four chambers, he had two. She had innumerable tests prior to delivery by MFM and a perinatal cardiologist. They needed to make every effort to determine the extent of his problem before he was born. Even though one of our local hospitals had a NICU, it wasn’t equipped to manage his severe heart defect. Moreover, she could not deliver him vaginally because it put too much stress on his heart. She had to deliver him out of state, and he required surgery immediately after birth. He did great! Thanks to the incredible and extensive knowledge of some very dedicated neonatal cardiologists!
Absolutely not. As a patient, you have the right to decline any test. I’ll advise, however, that you discuss this option with your healthcare provider first. You need to communicate with your physician the reasons for your decision so that she/he can counsel you on what declining means for you and Baby. Your doc will also want the opportunity to clear up any misconceptions you might have about the technology.
If one of your reasons is because you believe ultrasound is radiation, you’re in luck!
You can click on the link above to read more details about this factual bit of ultrasound info. In fact, please do!
We have a long list of structures to document on your anatomy screen. Some of the things we look for on this scan are as follows:
Cervical length–we measure the length of your cervix.
Placenta–we evaluate its shape and features and tell your doctor where it is located.
Amniotic fluid–we tell your doctor if the general amount of your fluid is normal.
We measure your baby as shown below. However, please note the images were all taken at different gestational ages!
The head from side to side (BPD or biparietal diameter) and around (the HC or head circumference):
We measure around the belly (the AC or abdominal circumference):
Another image of the fetal abdomen is seen below without the measurement:
And the femur length (FL):
These measurements estimate a weight which is usually about 8 ozs. at about 18 Weeks.
We document internal organs and other structures:
Parts of the brain, orbital lenses, facial structures like a nasal bone, upper and lower extremities, heart (very basic views), spine, stomach, kidneys, bladder, umbilical cord insertion, and umbilical vessels.
After we take all these images, we formulate a report for your doctor in great detail regarding the above parts. We also document what structures could not be well seen. Usually, if your baby doesn’t cooperate to allow us to see everything we’d like, your doctor may or may not send you back for a follow-up scan at some point to attempt a recheck.
Only your doctor (or MFM doc) can give you results! Never, never, never the sonographer. For those of you who have had the terrible experience of a problem on your anatomy screen, you have a hundred questions and your doctor is the only one who can answer them for you properly. Your doctor is the one with whom you have the important relationship. He/she manages your pregnancy, not your sonographer. You can read more about your results here.
Most facilities, as a side perk, will allow your sonographer to give you this information if she determines that it’s possible. Unless we see a problem where gender plays a role, boy or girl is not important to the health of your fetus, and your doctor doesn’t really need this information. We know, however, that it is important to those of you who want to know. And there is nothing wrong with wanting to know! There is also nothing wrong with waiting to find out, and that decision is as personal as picking out a name. Believe me, I couldn’t wait to find out myself. Yes! I scanned myself! A perk of the career;)
A little side note here … many facilities are beginning to put restrictions on gender determination. As more and more legal cases pop up over wrong gender guesses, facilities will take more precautions to limit their liability. And if you decide to visit a non-medical ultrasound facility for a fun scan, please read more about them in the link provided and ensure your sonographer is properly educated! (No, they don’t have to hire real sonographer!)
We love a fun family! And we can’t deliver your little sweat pea, but this is one priceless piece of info we SO enjoy delivering when we can! It’s a big job which requires time, focus, and concentration. For some guidelines on how many to include in your entourage for this exam, click this link for a little insight into a sonographer’s recommendations!
It’s okay to want to know gender, to keep it a mystery, or to even have a preference. It’s just not okay when that’s all that matters.
Questions? Great! Email me, and I’ll answer what I can!
Are male sonogram images always easier to read than girls? Not when they aren’t great images to start. And especially not for some moms who have always dreamed of buying pink! Here’s an email from a reader who was really hoping for some estrogen in the family after two boys. Sometimes, wishful thinking prevents us from seeing what is really there.
kb: At my 17-Week ultrasound, the tech took a photo saying the baby was a boy pointing to what is clearly the foot between the legs. She also said the umbilical cord was between the legs.
At my 21-Week ultrasound, the baby was breech with cord between the legs. When asked what we thought, we saw two lines and nothing else . . . so, we guessed girl. In the next view, she said boy.
Where the tech called a penis looks like a foot to me. I have two boys already, and you could see the scotum and tip clearly. I feel different and not even pregnant. The heart rate was 170, 171, 157. I can’t shake that it’s a girl. Am I wrong and just hoping? What do you think?
wwavb: Hmm, what do I think…
Well, as far as “feeling” different goes, each pregnancy is a different universe in and of itself. The way you feel with one pregnancy has nothing to do with how you “feel” in another. People historically want to contribute that difference to gender, but there just is no relevance there. And Baby’s heart rate can vary quite a bit, just as ours does with respect to fetal activity. So, you can’t go by that, either.
It’s entirely possible that your sonographer could tell it was a boy, but it wasn’t clear to you because the cord was in the way. It’s also possible that you just want a girl so much that it’s hard for you to really “see” boy parts in the image.
(I labeled the images she sent–see below.)
The first image isn’t very clear. But see the labels for the second image. No foot here! Where I have the arrows of the legs, you are only seeing part of the thighs. The rest of the legs and feet are not in the image.
kb: I don’t see the scotum because she said the cord was between the legs.
wwavb: Holy cow, this is totally a boy! All boy! See my edited image attached below . . .
Patients have a really hard time believing their eyes in a male sonogram image if all they want to do is shop for frilly dresses! However, I do stand by my advice to her–we women have a unique opportunity to instill great character in our little boys.
Chivalry doesn’t have to be dead!
To conclude, all mamas should teach their sweet little boys to hold open doors and show respect to the next generation of women. Not only can you teach him to respect all the future women in his life–his girlfriends, his wife, and potential daughters–but one more very important woman who is arguably the most important of all.
Best wishes to all you moms out there of all boys!
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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!
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!
And the people who take them when they’re this bad just make me angry! Only those with real skill possess the ability to make great ones! In all my years of scanning, I have to say this image from a reader takes the cake for bad ultrasound images in the most epic of proportions. I’m hoping that my beloved readers at home appreciate the exquisitely limited value of this image. But, surely, any sonographer who values technicality might agree regarding all the ways in which this image sucks (for lack of a more professional descriptor). Read on from one mom!
Mama G: First off–loved reading your blog–hilarious! Seeing as you seem to be exceptionally good at your job, I thought I’d send you the image I received from my gender determination from an elective u/s. I feel like the image is really confusing because I can see what are clearly legs and feet. And then I see the “penis” that the tech referred to, but it looks like it’s in the wrong place.
It was a 15-minute scan, and that included the 3D sneak peek where my baby looked like an alien. lol (I was only anticipating the 2D images). He didn’t point out anything that we were looking at other than “100% Baby Boy Pecker.” (Yes, he did indeed use the word pecker … in front of my mom and grandma no less!). I just thought his feet were at the top of the screen and couldn’t understand why the penis looked like it was far from where his legs meet his body! lol Is this even a good image to determine gender? I wish I could’ve gotten a good ol’ between the legs shot like the ones on your blog!
wwavb: Holy cow! Probably the worst ultrasound image of gender I’ve ever seen! As I am reading this, I am laughing hysterically at your own hilarious comments, AND in total disbelief at the level of bad here. Let me count the ways. Before I go on, let me say THANK YOU for your lovely comments, thank you for reading, and thanks for subscribing to my blog! I hope you’ll continue to enjoy hours upon hours of laughter and insightful words of wisdom. 😂
Mama G: I definitely have not purchased a single boy thing due to how little confidence the tech (and his images) instilled in me. Alas, t’was a “drive-through” elective u/s place! lol I will most definitely keep you posted as to the gender of my little bean (which will hopefully happen at the anatomy scan should the baby be cooperative). You may absolutely use my email and images for a post–that’d be very cool! Thank you so much for your kind words and prompt reply!
Hmm, when is the absolute best time to plan your gender reveal party? That would be AFTER your sonographer determines your baby’s gender . . . not before! I know parents get excited and family and friends are dying to know what color to buy. However, planning the party before your ultrasound results in, well . . . not the best planning!
On more than one occasion, a patient expressed shock and dismay during her anatomy screen ultrasound exam when I stated that I couldn’t determine her baby’s sex. “But my Gender Reveal party is tonight!” Unfortunately, there are SO many factors that contribute to a poor image or an inability to determine sex.
Gender determination is totally dependent on the cooperation of the fetus. Sure, we can push around on your belly a little. Sometimes, a lot. Not everyone, but most patients I’ve had who want to know the sex of their baby wanted to know yesterday–even better, at conception! They want to schedule their ultrasounds early, as soon as possible. Our schedulers, doctors, and nurses get the question all the time, “Now, how early can we tell the sex?” and “I want my ultrasound at ‘this’ time.”
We are always happy when we can break this super fun news! But we have to see images like this:
But it’s more important for patients to go into their examination with a different type of expectation. Expect a good examination. Expect a thorough sonographer who guides you anatomically through your fetus and provides an adequate explanation of what she is going to provide for you for your visit. Your sonographer probably has thirty minutes or less before another patient is expected to show for her examination. So, if your sonographer spends a few minutes looking and she still can’t tell, believe her. She would never withhold this info intentionally.
If with your next exam you are hoping to find out the gender of your baby, I hope your technologist can determine this for you. If she can’t, please don’t blame her, and give that baby a smack on its bum when he or she gets here!
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A lot! If I’ve heard it once, it’s been a million times. How sure am I? Or “Can you confirm my guess?” For the images below? I’d love to say it’s a definite. But there exists no way that I can feel entirely confident that these images are all boy! Below is an email from one mom and her follow-up response!
Mama K: Stumbled upon your site looking for answers of why I had “3 white dots” and was told boy when other moms I knew were told girl. Here are images taken at 15 Weeks 1 Day. I was told boy, and I believed it until I saw others with similar images who said they were having a girl. None of my other two boys looked like this, so I’m just curious! 🙂 Thank you!
wwavb: First, 15 Weeks is still a bit early. Not that I’ve never felt confident to throw out a gender guess at 15 Weeks, but sometimes parts can still look a bit equivocal. And since I didn’t scan you real-time, I just cannot confirm based on these images! Therein lies the problem with trying to guess sex too early, and this is where mistakes are made. I’ve seen the tip of a penis appear similar early on, and I’ve also seen the clitoris (middle white dot on female images) still appear a little prominent in females at this gestational age.
My best recommendation is time! Your anatomy screen which is usually performed between 18 and 20 Weeks should reveal much more information PROVIDING baby is in a great position to see between the legs. I hope this helped somewhat, and please upload images of that scan to keep me posted!
“His Pee Pee” may turn out to be “Her Hoo Hoo!” Hoo writes this stuff anyway?
Drumroll, please . . .
Wow, what a difference a few weeks makes! This is why I always recommend expectant parents wait until later! What I failed to mention in the original email was that I also couldn’t see anything that looked like a scrotal sac. And at 15 Weeks, it can be SO tiny anyway, but the angle in the first two images is just off slightly. All the right angles make all the difference in how easy or hard it is to answer the gender question.
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Expectant parents who pay for elective ultrasounds at the nearby strip mall may not get exactly what they are seeking–a definite on the fetal-gender front. Take my reader in today’s post, for example. She was 16 Weeks pregnant. Even though guessing sex proves not the impossible task on every 16-Weeker, it is difficult on most that age. My best advice comes down to waiting for the best chance at an accurate guess–the exact opposite of what any anxious mom wants to do.
Elective ultrasounds–is it really worth the money? You might say “Yes” if fun was had by all, if Baby cooperated, and if you got everything you paid for and more. But here’s one reader who probably will beg to differ.
Mom: Got this elective ultrasound done at 16w2d–sonographer said she was 80% sure girl but had a hard time finding this shot. Just felt like she was throwing something out there for us to go on. She also reminded us that it was early, and I should wait until my 20 Week scan to be sure before buying pink. Well, because of the holidays, I can’t get in until after the New Year for my scan at 22+ Weeks. And it’s driving me crazy now. I spent $100 on this for her to tell me 80%. I’ve been looking at other pictures and reading and just wondering what you think. THANK YOU SO MUCH!
wwavb: Thanks for reading my blog and for your question! First of all, and this is just my professional opinion, no one should be offering gender determination scans at 16 Weeks. She’s absolutely right … it is early, so it would have been better to explain this first and recommend you wait a couple of weeks more for the best chance of determination.
No one can guarantee gender 100% at any gestational age (NOTHING in medicine is 100%), especially not at 16 Weeks. It’s not that you can’t ever make a determination at 16 Weeks. But it’s definitely harder then than at 20 or 22 Weeks (providing Baby cooperates!) for the anatomy screen. Also, I never give percentages. Either I can tell or I can’t. No guessing! When a patient asks me to guess I always say, “Do you want me to guess, or do you want me to be right?”
I can tell you that ultrasound is tricky! Trying to determine sex from someone else’s frozen shot without scanning you real-time is only a guess. Your sonographer should not have added the annotation of girl then tell you to wait for the next scan. She probably felt it was a girl and just didn’t want to commit due to your early gestational age. What the image demonstrates where the arrow is pointed LOOKS like three little white lines. I would say this appearance resembles female genitalia. So, based solely on the image, I would have to say Team Pink may have it.
It’s just like the lady said–16 Weeks can still be a little too early. So, why are they taking money for something they can’t provide? Well, now, that’s the question of the day, isn’t it? My best advice is to simply keep the receipts and hold off on painting a nursery until you feel confident about the guess. I personally never want to cavalierly toss out an incorrect guess. Furthermore, I don’t want to cause anyone the distress moms feel when someone guesses incorrectly.
It’s too bad these guys don’t feel the same. If they did, they wouldn’t scan their customers at 12 Weeks. In the whole baby game, is it fair to charge someone any price for something they can’t guarantee? Or is it highway robbery because they advertise they can when they know it’s a toss-up? And since we’re on the subject of guessing, I think you all can guess my opinion.
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