*Motherhood Diaries worked with MyBaby4D in Watford (Ultrasound Image Studio Ltd) to raise awareness among pregnant couples about the importance of ultrasound scans during pregnancy to monitor the health and well-being of your baby. We were provided with the opportunity to review the Growth & Presentation Scan for the article – all opinions are 100% my own*
During your pregnancy, you should have routine scans via the NHS at around 12 weeks (nuchal translucency scan or dating scan) and 20 weeks (mid-pregnancy or anomaly scan). In this MyBaby4D Pregnancy Scan Series, I’ve talked about the importance of early scans (before 12 weeks) and wellbeing scans (from 16 weeks), which can provide that extra bit of comfort that the baby is doing OK, as there is a lot of time in between each NHS scan. Unfortunately, we don’t have a camera inside our uterus.
If necessary, you may be offered a foetal Growth scan between 28 and 40 weeks, too. We will discuss growth scans in more detail in this article.
Why are growth scans necessary?
I wasn’t aware of growth scans until my second baby measured big for dates (my bump was slightly bigger than the estimated week of pregnancy). So, I was scheduled to go for a foetal growth scan at 36 weeks to see if he was measuring slightly on the larger side and if there were any indicators of increased amniotic fluid (more on this below) and gestational diabetes. Otherwise, I would have no idea growth scans existed.
In recent years, hospitals’ focus has been on stillbirth prevention, as stillbirth rates in the UK were among the highest in Western Europe and had not changed much over the last twenty years. Most stillbirths were classed as ‘unexplained’, which meant these deaths were unavoidable. However, independent case reviews have been conducted to find that many stillbirths were associated with substandard antenatal care and, therefore, potentially avoidable. Most stillbirths showed that there was growth restriction during pregnancy, which had not been recognised during antenatal care. This meant that most women never had a growth scan, therefore there was no special attention until there was an absence of foetal movements, which was usually when it was too late.
Therefore, a better classification system came about that included categories for foetal growth restrictions (e.g., small for gestational age, which is a factor that increases stillbirth sevenfold). This report also found that recognising foetal growth restriction during antenatal care can halve the risk of stillbirth if discovered early.
The RCOG guidelines developed an algorithm that set out the recommended assessment of early pregnancy risk factors and the route of care for low-risk and high-risk pregnancies with foetal growth restriction. Those with an increased risk would require a growth scan and assessment. However, this was found by many hospitals to be too complicated, so The Journal of British Medical Ultrasound Society, Ultrasound, helped the NHS develop a simplified algorithm that identified a list of risk factors as part of the Saving Babies’ Lives Care Bundle initiative. You can find more information on these risk factors in the image below:
The growth assessment protocol (GAP) algorithm for fetal growth surveillance. Adapted from NHS England.
Growth scans in the NHS
The NHS now prescribes routine growth scans until delivery for those considered high-risk between 28 and 40 weeks.
Our growth scan at MyBaby4d Watford – 30+2 weeks
I attended a private Growth & Presentation Scan at 30+2 weeks with MyBaby4D in Watford, a 15-minute appointment to check the baby’s wellbeing, heartbeat, movement, weight and measurements. The primary objective of the third-trimester growth scan is to check the well-being of the baby, so I will go through each aspect of the foetal Growth Ultrasound scan taken by Dalson, the sonographer and break down each part below to show what happens at a Growth scan during pregnancy.
Preliminary questions
Dalson asked if I had had a growth scan before, if the NHS mentioned having one at 36 weeks, and whether I could notice a pattern in the baby’s movements. I told her this baby doesn’t really move much; she just shifts from side to side. But during the scan, she was dancing away, and I did wonder whether the ultrasound waves were too loud for her.
“Fetuses can hear ultrasound and the sound is as loud as a subway train entering a station.”
I also find that the baby moves more when I’m on my back. I often wonder whether I’m squashing her in that position and whether that’s why we are advised to lie on our left side while sleeping and napping. Lying on your right side puts pressure on your liver, so the left side is optimal.
During the scan, Dalson checked the following:
The head
We saw a bird’s-eye view of the baby’s head, and Dalson measured the head circumference. Dalson confirmed that the baby’s head was down, but she did state that the baby could still move at this stage. Until 34 weeks, they can still turn, but generally, babies may settle in a head-down position around 32 to 36 weeks. The baby’s head measured within the normal range.
Legs and Feet
We saw the baby’s legs stretched out, and the feet, too. Dalson struggled to measure the thigh bone as the baby’s hands on her bottom caused shadowing. I was asked to move to the side as our girl was kicking and munching away on amniotic fluid.
Amniotic Fluid Index
Dalson measured the single deepest pocket of fluid for the Amniotic Fluid Index, which should be between 2 and 8cm. Too little fluid means oligohydramnios (which is what I saw in my third ultrasound scan during my second-trimester miscarriage when I broke my waters at 15 weeks) or polyhydramnios. I was measuring at 7.7cm at the top of the normal range. Dalson mentioned that at MyBaby4D (and Watford General Hospital, where we plan to give birth), they measure one of the four pockets of the amniotic fluid volume, but some hospitals will measure all pockets. As I was measuring on top of the normal range, I was advised to control the sugar in my diet, as above 8cm could be an indicator of gestational diabetes. I have been so good with sugar until the last trimester, but now I have to get myself off it again. But to hear I was 7.7cm was a good trigger to watch my diet for the next ten weeks.
Waist and tummy
Dalson moved on to measuring our girl’s waist (Abdominal Circumference), and I was asked to turn to the other side as the baby was dancing away. We saw a bird’s-eye view of the tummy.
Spine and kidneys
They check the kidneys to assess for normality and also exclude renal pelvis dilation (RPD)—excess fluid inside the foetal kidneys. The fluid measured within the normal range.
Stomach and bladder
Dalson checked the stomach and bladder to ensure the baby was drinking well and the stomach was below the diaphragm. Pregnant women can still catch late-onset Congenital Diaphragmatic Hernia, where the baby’s stomach migrates into the chest. Thankfully, the stomach was where it should be, below the diaphragm.
Heart
We saw the beating heart, which was so relieving to see.
Gender check
It was confirmed again that we were having a girl, and this time I saw the three lines!
Placenta
My placenta was on the back wall, which is good. Dalson checked the blood flow in the umbilical cord to assess fetoplacental circulation, as I had mentioned to her my baby’s reduced movements. There was a normal flow pattern, and the pulsatility index (PI) reading was within the normal range, which was relieving. Indicators for performing umbilical artery Doppler may depend on individual hospital protocols. Some hospitals will check blood flow throughout the Growth scans,, and others will only check if indicated.
Weight
Once Dalson performed all three measurements, the baby weighed 1.5kg/3lbs and 5oz at 31 weeks.
We were provided with a report showing the baby’s measurements and developments, as well as the health and state of my placenta and amniotic fluid. The femur length was showing a little under, but thankfully, the estimated foetal weight (EFW) was plotting within the normal range.
EFW = Estimated Foetal Weight, HC = Head Circumference, AC = Abdominal Circumference and FL = Femur Length
Placenta posterior not low means that the placenta is situated high in the uterus and has attached itself to the back of the uterus. The foetal position is Cephalic which means her head is down and feet is up (which is great!). The Amniotic Fluid Index that I mentioned above is showing at 7.7cm which is at the top of the normal range. Umbilical Artery Doppler; positive EDF (speed of the blood through the cord) indicates a normal trace and it was within the normal range.
Your questions
When do you have growth scans in pregnancy?
A growth scan is a third-trimester scan to measure whether the baby is growing normally.
How accurate are growth scans?
“They’re not [technically] measuring growth. We don’t measure growth and there is no system by which we can accurately assess the growth – growth is speed, yeah? These are assessment scans or wellbeing scans as we call them.”
Many readers’ questions revolved around the accuracy of growth scans in the third trimester and whether they were routine or required.
Here were more of your questions:
How accurate are growth scans?
Are growth scans common?
Are growth scans routine?
Are growth scans safe?
Are growth scans necessary?
Are growth scans normal in pregnancy?
Are growth scans reliable?
Why would you have growth scans?
When should growth scans start?
Does everyone get growth scans?
Why are growth scans needed?
Can growth scans be wrong?
Can growth scans prevent stillbirth?
Can I refuse growth scans?
I’ll answer all these together. As mentioned above, growth scans are not routine,, but your consultant, doctor or midwife may book a baby Growth scan if you are measuring big or small for dates. The scanning of a baby can show up indicators of too much or too little amniotic fluid and check for other developmental issues, therefore it is important to attend your growth scan if it has been suggested for you to do so. Depending on your issues, you can have a 28 week Growth scan (often when the bump is small) or a 32 week Growth scan (or at 34 and 36 weeks when baby could be measuring too big or too small). I had my initial NHS Growth scan at 36 weeks, so it depends on when your hospital books the appointment.
Growth scans are safe, but as with anything, they are not 100% accurate, as they are based on estimates. Specific issues can be missed at your scan,, so it’s essential to track your baby’s movements and attend all midwife and consultant appointments for optimum antenatal care.
Reasons why you will be offered a growth scan
If your fundal height (vertical measurement of your belly) is smaller or larger than expected for your baby’s gestational age
If you have any maternal diseases like diabetes or gestational diabetes
If your placenta is looking low at the 20-week scan
If you have a history of pre-eclampsia (high blood pressure and swollen hands, face and feet)
If you have a history of premature births
If you are very overweight and you have a BMI of 40 or over
If there is a large difference in your and your partner’s height, although experts dispute this so it may be assessed on a case-by-case basis
You have concerns about your baby’s pattern of movement or reduced movements
You have any vaginal bleeding
You experience any abdominal pain
Are growth scans 3D or 4D?
At MyBaby4D, you can request a 3D or 4D preview, but the NHS does not offer them. Remember, the growth scan is to check the baby’s well-being and development—all other perks are added bonuses but may not be offered if they disrupt the baby’s well-being check during the appointment.
Can partners attend growth scans?
At MyBaby4D, you are allowed to bring one partner with you, but they advise you to keep children away. The NHS scans I have attended so far do not allow a partner to attend the scan appointment, but this may soon change as restrictions lift in the coming months. Check with your local hospital and stay updated on current COVID rules at MyBaby4D’s website here.
Growth scan cost at MyBaby4D
To book your growth scan at MyBaby4D, please visit here for more details. At the time of this published article,, the price is currently £65.00, but may be subject to change.
* I was offered a Growth & Presentation Scan for the review article but all words and opinions are 100% my own
*MyBaby4D Watford is a trading name of Ultrasound Image Studio Ltd
What is a wellbeing scan and why is it important?
*Motherhood Diaries is working with MyBaby4D in Watford to raise awareness among pregnant couples about the importance of ultrasound scans during pregnancy to monitor the health and well-being of your baby. We were provided with the opportunity to review the Wellbeing Scan for the article – all opinions are 100% my own*
Under the NHS, you are offered two pregnancy scans (a third scan may be advised later). These are:
12-week scan (around 10 to 14 weeks) – This is a dating scan where the sonographer estimates your baby’s due date based on their measurements. The dating scan can also include a nuchal translucency scan, which is part of the combined screening test for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome (this is optional).
20-week scan (around 18 to 20+6 weeks) – This is called a mid-pregnancy or anomaly scan and is also part of the screening test. The sonographer checks for 11 physical conditions in your baby.
36-week growth scan (this is optional). Depending on your health and pregnancy, this scan may be offered and can also be called a foetal growth and well-being scan. The scan also checks whether the baby is in an ideal position for birth.
You can also opt for an early reassurance scan or viability scan as early as 6 weeks if you are experiencing any complications like bleeding/spotting or tummy pain. I bled throughout my first trimester, so I booked an early reassurance scan with Hey Baby 4D Watford. You can learn more about the importance of an early reassurance scan here.
There is quite a bit of waiting time between these scans, so it’s common to spend the interim worrying about whether your baby is doing ok. An ultrasound foetal wellbeing scan can bridge the gap and spot for any anomalies before you attend your 20-week scan (which is still advised as part of your complete antenatal care package).
So, what is a wellbeing scan from 16 weeks?
A well-being scan can allow you to check if your baby is growing well. This includes:
Checking the measurements of the foetal head, abdomen, and thigh bone
Calculating and estimating foetal weight.
Examining the movements of the foetus
Evaluating the position of the placenta and its appearance.
Checking the amount of amniotic fluid present in the womb
Our experience having a wellbeing scan at My Baby 4D Watford
MyBaby 4D Watford kindly gifted us a wellbeing scan during week 17 of our pregnancy so we could check how our baby was growing and whether there were any other issues which needed to be flagged before our 20-week NHS scan. I had been spotting until 13 weeks, so I was very eager to check how my membranes were doing and whether my baby was ok because I hadn’t felt her move yet. I was so glad to see that she was jumping around enjoying herself in my tummy! The heartbeat was clear and the image on the TV was so crisp that we could immediately spot that she was a girl. We could even see the umbilical cord and her drinking!
We weren’t able to get a 3D preview because she wasn’t in the right position, but Saad, the owner of Hey Baby 4d Watford, said that it’s too early for a 4D scan, as babies can look a bit alien-like at 17 weeks, anyway. The best time to have a 4D preview would be at a well-being scan at around 27 or 28 weeks.
Dalson, the licensed sonographer and wife of Saad, managed to get a lovely picture of the baby’s feet and legs, which was beautiful to see. She explained in great detail where each of the organs and limbs was. The membranes outside looked good too, which I was relieved about, as my membranes rupturing was my biggest fear.
The scans were also in sepia rather than the grey you see at the hospital. I found that sepia made it easier to see the baby in detail, and the two printed scans we were provided with showed the clarity of our new baby.
We were also provided a foetal wellbeing scan report, which showed that the baby’s measurements were all in the normal range. The report showed:
Foetal growth and measurements
The head circumference
Femur length
Abdominal circumference
Estimated foetal weight based on the circumference
Position of the placenta
Limbs and organs were seen in the scan
You can also check the gender of your baby – if you want to!
The primary objective of the wellbeing and gender ultrasound scan is to check the well-being of your baby, but if the baby allows, you can determine the gender too from 16 weeks of pregnancy and with a free 3D preview—again, if the baby allows! Normally, you would need to wait for your 20-week scan via the NHS, so the private wellbeing and gender scan suits impatient parents who want to find out the gender ASAP, like me!
The exclusive Hey Baby Gender Reveal Lighting will turn the whole room pink if you’re having a girl and blue if you’re having a boy. You can also video the experience to share with your loved ones.
What’s included in the Wellbeing and Gender Scan?
15-minute appointment
Baby’s gender reveal
Exclusive gender reveal lighting
Free 4D preview – If the baby is not in a good position, a re-scan will not be offered for this purpose only. Best to request a 4D preview from 27 to 28 weeks
Wellbeing check and report
2 prints of scan photos
You can also ask for digital download images for £10 (An additional £5 for video too)
You can purchase a Gender Reveal Balloon for £10.00 to reveal to the family.
You can also purchase Gender Reveal Confetti Cannons for £10.00
During COVID times, you can bring one person to the scan, but you must be from the same household.
You can book a Well-Being and gender Scan from 16 weeks and a Well-Being and 4D Baby Scan from 24 to 32 weeks. MyBaby 4D also performs Growth and Presentation Scans from 28 weeks to term. You get a full written Obstetric report that comes with graphs showing how your baby’s measurements are plotting, as well as an estimated weight.
Ensure you are properly hydrated an hour before your scan. If you have questions, contact MyBaby 4D or find a nearby clinic.
Mybaby 4D Watford is the trading name of Ultrasound Image Studio Ltd.
*Motherhood Diaries was gifted the Wellbeing and Gender Scan for the purposes of a review, but all opinions are 100% our own.*
The importance of having an early reassurance scan in pregnancy
*Motherhood Diaries is working with MyBaby4D in Watford to raise awareness among pregnant couples about the importance of ultrasound scans during pregnancy to monitor the health and well-being of your baby. We were provided with the opportunity to review the early pregnancy scan for the article – all opinions are 100% my own*
Just before my second-trimester miscarriage, I had experienced spotting from week 6 to week 12 of my pregnancy, which was the first time I had experienced any bleeding. I booked a 7-week first pregnancy scan at my local hospital because I was worried about the spotting. However, I had to chase this appointment via my GP. When I got to my appointment, the hospital was so busy that the appointment itself seemed rushed and quite clinical.
I was also told that the bleeding was normal and that I shouldn’t worry, except to abstain from any physical exercise. Pregnancy can usually continue as usual, and the bleeding will eventually stop. But later, I found out that bleeding in early pregnancy is like sandpaper to your cervix. A potential UTI (although this was never confirmed) around week 16 of my pregnancy caused my waters to break prematurely, and I lost my baby.
This time around, I didn’t want to take any chances after I started spotting again at week 6. I learned about MyBaby4D online, a private ultrasound boutique in Watford that provides high-quality private pregnancy scans in a relaxed and comfortable atmosphere with a team of professionally qualified sonographers. I knew instantly that this was the right option to take.
MyBaby4D Early Reassurance Scan
I contacted the owner, Saad, and his wife, Dalson, who is also the chief sonographer at MyBaby4D, and they were so lovely and welcoming.
When I arrived at the clinic, I was immediately taken aback not just by the cleanliness but also by the homely and luxurious feeling of what a hospital should feel like—a spacious waiting area that felt very inviting, with cute little memorable baby gifts decorating the wall cabinets.
The scanning room was a large open space equipped with a flat-screen TV so couples could watch their baby in HD in front of them and a couch area for the partner to rest and enjoy the experience.
I was invited to undress from the waist down behind a screen and empty my bladder before we started, as I was only 6 weeks and 4 days, so a transvaginal scan had to be completed. (You would have an abdominal scan after 8 weeks and would need a full bladder, and a gender scan is from 16 weeks.) Hubby sat on the couch, and Dalson waited by the computer and bed.
As soon as I was ready, I laid down and Dalson got to work. I was asked about the date of my last period to ensure the dating scan measured up to when ovulation took place, plus or minus a few days. I was also asked about the spotting, i.e. how long it had gone on for and whether I was feeling any pain. I said that I had felt some cramping, but this had disappeared.
Dalson advised that there was a small haematoma of less than 1cm, which may have been caused by implantation. I was advised not to do any heavy lifting or physical exercise of any kind until the bleeding had stopped completely. The whole experience felt private, informal and relaxed, unlike my last early scan at the local NHS hospital. At the end of the appointment, I was invited to sit down while Saad printed our baby scans, which he emailed over too. I was grateful for the high-res imagery because it made sharing the scan pictures with my family so much easier.
Dalson and Saad from HeyBaby4D have kindly answered the top 10 most asked questions from Motherhood Diaries readers and social media followers about early reassurance scans. Thank you to those who sent in your questions and to Dalson and Saad for answering them!
1. What can an early reassurance scan tell me about my baby?
The purpose of an early reassurance scan is to determine whether the pregnancy is implanted in the correct place, and to check how many babies you are having.
Various measurements are taken depending on how far along in the pregnancy you are, and the scan will identify whether there is a visible heartbeat on the day of the scan or not. Some fetal poles may be too small to determine cardiac activity on the day of your scan, and you may be advised to have another scan in about two weeks to check if the pregnancy is viable.
The scan includes an assessment of the surrounding pelvic area around your uterus.
Referral advice will be given on the day of your scan, depending on the scan findings.
2. Why is an early reassurance scan important?
An early reassurance scan is essential for expectant mums/parents who are anxious and would like to find out if everything is ok.
3. Why can I not have a scan before six weeks?
A 6-week scan may not always provide the information you require, as the fetal pole may be too small for ultrasound to pick up.
At any stage of pregnancy, if you have had a positive pregnancy test and are having symptoms like bleeding or severe pain and/or shoulder tip pain, then you are advised to attend your nearest A&E Department.
4. When is the best time to have an early reassurance scan?
At most clinics, early reassurance scans can be performed at 6 weeks; however, if the patient is asymptomatic, 8 weeks is more suitable.
5. What will I expect to see and what will be measured in my early reassurance scan?
What you expect to see on the day of your scan will depend on how far along your pregnancy you are.
For example, a measurement of your baby’s length will give you an Estimated Due Date (EDD).
This question may also be linked to Question 1.
6. I have had some bleeding/spotting during pregnancy. Should I have an early reassurance scan?
If bleeding/spotting occurs during pregnancy, you should visit your nearest A&E.
Having an early reassurance scan is essential to determine why you are bleeding. However, it is not always possible to determine the cause of bleeding with ultrasound in pregnancy. It may provide some relief from maternal anxiety.
7. Why is it not compulsory to have an early reassurance scan before 12 weeks?
The NHS routinely only offers two scans: your Dating Scan and your Anomaly Scan.
Exceptions are made in circumstances where you are bleeding, if there is a suspected ectopic pregnancy, a threatened miscarriage or miscarriage.
Women with assisted conception or previous pregnancy history/complications may also be offered an early reassurance scan.
8. Can too many scans harm the baby?
There are no known risks in ultrasound. Evidence suggests that ultrasound performed during conception to 10 weeks’ gestation is safe, provided there is a clinical reason. The benefits of the scan outweigh any theoretical risks. (Kirk, 2017)
9. What can a private early reassurance scan offer me that an NHS scan can’t?
Sadly, not all scans will have a positive outcome or a conclusive result.
A private scan is easily accessible and you can attend your appointment with your partner/or one person within your bubble (Terms and conditions are susceptible to change with current guidelines).
10. How do I book an early reassurance scan?
You can book your early reassurance scan via the MyBaby4D Watford website or call us on 01923 943 501 if you have any questions.
Are private early reassurance scans worth it?
If you have got your positive pregnancy test at four weeks, then that’s two months before you get to see your baby via an NHS scan (unless there are complications) – and that is a long time! If you have any doubts or you feel like something is not quite right, i.e. you have pain or you’re spotting, then don’t waste any time and book yourself in for a private early reassurance scan now.
For the experience you get, the cost is worth it because you book an appointment with the clinic and you’ll get a slot straight away. You are also treated as if you are the only ones in the room and I found this to be the most significant difference between NHS early pregnancy scans and private scans. It’s not to negate the NHS in any way – my mum works for the NHS – but because the NHS is so massively overrun and understaffed, medical staff have no choice but to treat us like numbers in a queue, which they need to get through quickly to see everyone in their allotted time, with waiting times sometimes spanning to over an hour. However, I have never had a bad experience at my local Watford Hospital or had to wait that long. The difference comes with the service you get and the extra bit of comfort in private settings.
When you book an anomaly early scan with the NHS, they have to fit you in. The baby scan is not scheduled into an automated system like the standard Week 12 and Week 20 scans, and if you have any complications, you may have to wait upwards of four weeks to be seen, which may be too late by then.
Through this magazine, I have found that many women are not armed with enough information before 8 weeks, when the NHS gets involved in the pregnancy care process. So MyBaby4D Watford has teamed up with a private midwife from Bushey called Hannah, who hosts antenatal classes to help women in the dark gain the knowledge they need to feel empowered and informed during pregnancy.
Saad and Dalson are invested in your pregnancy—it’s so nice to see how much they care about your mum and your unborn baby’s health and the pregnancy journey.
You get a lot for the price
Early pregnancy scan cost = £85*, which includes:
15-minute appointment
Visualise baby’s heartbeat
Dating your pregnancy
Includes 2 colour printed scan photos 6×4
Assessment of pelvic area/ovaries
Full obstetric Report
Internal scan available for accuracy
Peace of mind and a high standard of care = priceless
You also have the option to purchase extra download images and video, too, if you want the extras.
MyBaby4D are there to help
Saad told me that many women come from abroad, and MyBaby4D is their first port of call because they are not registered and don’t know how to start the process. Luckily, as both Saad and Dalson are health professionals and work in the NHS, they have that little bit extra to offer regarding information during the pregnancy journey compared to other private clinics.
Early Pregnancy Ultrasound: A Practical Guide. (2017). In E. Kirk (Ed.), Early Pregnancy Ultrasound: A Practical Guide (pp. 1). Cambridge: Cambridge University Press.
*Price is correct at the time of publication and may vary in the future
