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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… inside the uterus as they are outside of it. Male gender on ultrasound can be difficult to discern if other parts are in the way. And there’s just not much room in there for the plastic Hefty superman cape of the garbage can variety.
I know my patients over the years would have been thrilled to decipher baby parts on the monitor all by themselves. If they could only read that fuzzy gray and white image, they’d feel much more assured of the whole boy or girl thing. How many times has a sonographer pointed out gender to all you moms during your sonogram and you respond back with a “Uh, where?” Well, you’re not alone in that boat. Check out this email from a mom who had the same problem:
confused mama: Hello! I just recently paid for a gender ultrasound which I was so excited to finally get. But I had an uncomfortable experience with the ultrasound technician. The second she saw the baby she said I am 100% it is a boy. She didn’t show me, my mom, or my mother in law the penis or scrotum, and she didn’t explain at all.
I was 19 weeks and 2 days at the time of this ultrasound. I might be in denial it is a boy, but I’m honestly confused by the photo she gave that shows the penis and scrotum. There are two lines underneath it. But in all the boy ultrasounds I have seen, the penis and scrotum look more defined. It might be the butt, I’m thinking, but I don’t know. Can you please give your professional opinion? I had a friend who is also a RDMS, and she said she could not tell the gender. I am debating if I should do another gender ultrasound. Please help!
wwavb: Okay, so check out the image below.￼
You are seeing an underside view of Baby. Encircled in yellow is the cord which lies between Baby’s legs and obscuring parts somewhat. His parts in all their glory should stand out a little better with my annotations. I wouldn’t go for another, especially if it’s one of those non-medical ultrasound drive-thru’s.
Does your friend not do OB/GYN? I felt it was pretty easy to tell, but I would have either not given this image to a patient or otherwise explained the parts.
I think some sonographers forget that not everyone can figure this stuff out as easily as we can. Even if a sonographer can boast of experience and certification but specializes in aspects of sonography which are not OB, a guess can still be quite a challenge for them, too. After all, experience is the teacher, right? ANY sonographer who is brave enough (or stupid enough) to call anything between the legs 100% will one day learn this the hard way. Anyone experienced in medicine, or sonography, can attest to the fact that nothing is 100% in any testing arena … even DNA and amniocentesis are only 99+% accurate for gender. As flawed as we humans are, it’s for this reason and the nature of this technology that will never guarantee better accuracy than genetic blood and amnio results.
As sonographers, if we’re going to state how sure we are about gender determination, we should always narrate for our patients when Baby is feeling a little shy that day. And patients, if you can’t tell a penis from a big toe, speak up! Most of us are more than happy to show you around.
And especially when you pay for a 3D elective scan (I’m not a fan of some of these–please read why in the link above!), you have the right to see the monitor with full explanations. After all, you paid for it!
If you have questions for me, just email them here.
And if you’d like me to review your images, just click here!
Thanks for reading, and I hope you’re enjoying the new site!
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!
As always, thank you for reading!
And you can email me with your questions at firstname.lastname@example.org.
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.
You can email me at email@example.com with any ultrasound questions you have!
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Thanks for reading!
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.
And the winner in this nub theory update is . . . PINK!
Mom sent me the image below at about 12 Weeks. Of course, I had to tell her all about how the Nub Theory is a guess, but not one you can base decorating the nursery off of! It can be hit or miss, for sure.
We can tell our families at Thanksgiving. Yay!! Go TEAM Pink! Thank you!
wwavb: Congrats!! Yes, I hope you will enjoy all those dance recitals as much as I did! 🙂
wwavb: Sounds like what you are describing matches what we look for in girl parts. By 20 Weeks, external genitalia is very easily seen, providing baby is in a great position! And, yes, a small scrotal sac and penis should be easily seen in boys. The labia and clitoris (we can’t see the vagina!) usually look like 3 white dots or lines at that gestational age. Baby has very little fat in her skin right now. So, her labia will plump up, and she will have much more recognizable girl-stuff later!
mom: It’s been such a blessing to have crossed paths. I truly LOVE reading your blog, and I would have to agree you capture a reader’s attention just like Carrie Bradshaw. Lord knows, most girls/women love some good ol’ Sex and the City!
*(I have to add here that my younger daughter who LOVES SATC referred
to me as the Carrie Bradshaw for pregnant women! Hilarious!)*
wwavb: So sweet of you to say, and I’m SO happy to help! And, yes, the image you sent could not look any more girly than it does!! Congrats again!!!!!!!!
Believe me! We moms who are also sonographers know how important your sonogram visitors are to you. You have counted down the days and lost sleep just waiting to see your baby and to find out the gender. Your family is excited, too, and maybe even flew in from another city or state. Visitors during your sonogram are typically allowed. But realize that your uterus may not be the only crowded womb in the house! Your entourage of friends and family may crowd the ultrasound room, too. As a result, they may not be welcomed at the start of your exam depending on the policies where your scan will be performed. Here’s what to do and what not to do on your Big Movie Day.
The most important piece of information I’d like to impart here includes the most important aspect of our job … to make sure your baby looks okay. I would always feel just a tinge of anxiety before setting the probe down on any mom’s belly. A looming fear exists in every sonographer that we’ll discover your worst nightmare. As I casually smear the gel around your belly, you don’t realize that I’m first confirming a heartbeat. All I need is a half-second pass over your baby’s heart to appreciate the flutter. I breathe a sigh of relief and move on with the exam.
We require lots of concentration to make sure we aren’t missing a thing. We have many measurements to take and images to document, especially on an anatomy screen examination. Sure, we can make small talk and usually I do. As a matter of fact, I always enjoyed the “teaching” aspect of my career. Most parents are enthralled and appreciative when I point out all Baby’s organs as I document them, one by one.
Even though we perform this examination every day, it is one of the most comprehensive and detailed examinations in our repertoire. Distractions create a bit of anxiety that we’ll forget something on our very extensive check list.
Most places have limits on how many sonogram visitors you can take into the room for your exam. So you are not disappointed on your big day, call your doctor’s office or facility where the exam will be performed and ask about their policies.
I have found that the best way to approach any entourage is to simply have all other sonogram visitors remain in the waiting room except for one support person, usually a spouse. After the initial diagnostic portion of the exam is complete, everyone else can then join in the fun. At that point, it’s play time and the real work is done. However, this approach is often met with resistance.
We don’t ask your friends and family to wait behind because we are mean people. But, in all our experience, we know that you may have never considered the possibility that this event would be anything but fun and exciting. The unfortunate reality of our jobs is that not all babies are normal, and most parents do not wish to receive terrible news at the same time as grandparents, cousins, and nieces. Such an experience ranks high in the hearts of most couples as an extremely private matter, one they would rather not share with an audience. Ask any couple who has endured this misfortune. Moreover, receiving such devastating news is accompanied oftentimes by shock and sadness, as one might expect. Many couples want time to grieve before breaking this news to family or their other children.
Most of us moms know how to tune out our kids when the need arises. However, any distraction in the ultrasound room makes a thorough evaluation of your baby more of a challenge. Circumstances that create a poor environment for providing you with the most optimal exam possible are usually caused by visitors. Chatting family members, a fussy or crying child, and family crowding behind the sonographer or touching the monitor all wreak havoc on our concentration.
Additionally, even though most patients understand this concept, your ultrasound exam room is not the place for cell phone conversations. You name it, I’ve seen it! I’ve had visitors on their phones talking gossip, ironing out bills, conducting business, discussing court cases, and ranting about dysfunctional family. I’ve had to ask them to end their calls or to please step outside.
Finally, patients frequently show up for their exams with a small child or children and no one else to take them outside if they become upset. We do understand this is one sonogram visitor you can’t leave outside if you have no help whatsoever. But a screaming child in an 8×10′ room is no small distraction. I’ve found children pulling images out of my machine, opening drawers where needles were stored, and digging in biohazard trash cans which contain the blood or body fluids of other patients. Yuck! I’ve literally stopped my exam so I could wash Little Bit’s hands.
Unbelievable? Maybe, but I can pretty much guarantee every sonographer has similar stories!
So, all you moms with your big sonogram coming up, I hope you enjoy your experience! I hope your baby is cooperative and you have a sonographer who is engaging. I hope she narrates all your baby’s parts for you and is able to give you some great pics.
Most importantly, I wish you a healthy new addition to your family. If you can oblige your sonographer just a few minutes of pin-dropping silence, she will love you for it! And if you bring another adult with you who actually takes the screaming baby outside, she’ll love you forever.
Email firstname.lastname@example.org with your questions, pics, or stories!