When your mother was pregnant, she was just pregnant and had to go for regular check ups. But now when you are pregnant, your are not 'just' pregnant - you are pregnant in that era when getting pregnant is a very big deal. This generation will no longer have 10-12 kids trotting around them (not only for financial reasons, but biological as well). Once your grandmother could have had as many as eleven kids, all those who are now your uncles and aunts. But you might barely produce two. With the growing stress and PCODs and other various disorders amongst couples - bearing a child is quite a 'luck' thing. With all these IVFs and other practices coming to everyone's rescue as a boon, making all pregnancies extremely precious. As my physician once told me, "We value every pregnancy as if this is going to be the last one. Hence, we never recommend abortions to couple, warning them in advance that a wrong move now and they could repent for life."
And so.. Every pregnancy now is very minutely monitored. With the advancement in science, there are various investigations that one does in the pre-natal phase, to ensure that your baby is coming out healthy. Gone are those days, when you had to check after delivering if all the limbs are present or no. You can check that and a lot more now... Thanks to the various Ultrasound scans (or sonography as commonly known). Though none of them are a compulsory thing, but if you are an urbane mother-to-be, your doctor will ensure he/she gets all those done, without giving you an option to skip them. In a way, it is good - you are assured everything is fine inside - no anxiety of the unknown!
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Let me take you through what they will expect you to do in the first 5 months and what does that reveal (if your doctor didn't have the patience to explain it to you in person, read it here!)
1. Ultrasound SCANS:
a) First Scan: Done between 6 - 8 weeks. (Could cost anywhere between INR800/- to INR1500/- depending on your centre and location)
This one, first of all, confirms your pregnancy. Even after having skipped your period and having done the urine test; you will be advised to do this scan to further confirm your pregnancy and to check whether everything is normal.
Things they check:
- The gestational sac and the foetus inside it. The size they measure gives them an idea of the date of conception. And hence, confirm the age in terms of exact weeks and the due date.
- The position of the placenta - whether it is a normal pregnancy or an ectopic one. In case of the later, immediate action is needed. (This one is the most important thing they check)
- Any internal bleeding. (If so, they will advice you to take bedrest immediately and prescribe a hormonal intake to sustain the pregnancy)
- Cardiac activity begins by now and they check whether it is normal or are there any signs of worry.
- Single or multiple pregnancies?
- Check on the cervix - Initially it should become thicker to support the pregnancy and the internal os should get closed. In the later stage, closer to the delivery date, it starts to prepare so as to make way for the baby to come out. Till then its job is to hold everything inside.
(At this stage it is too soon to note for any abnormalities, for which, they have all the follow up scans)
b) NT and/or NB Scan:Done between 11-13 weeks. Could cost anywhere between INR1000/- to INR2000/- depending on your centre and location)
This one is the second one usually. Though they check all the other basic parameters as well (elaborated below); NT stands for Nuchal Translucency and NB stands for Nasal Bone - This is what they specially report.
Things they check:
- All the basic parameters - gestational sac and foetus and its age and size in cm; cardiac activity, foetal movements and their intensity, placenta position, internal os of the cervix, amniotic fluid quantity(very important for adequate fluid to be present at all times) and whether the ductus venosis is normal and shut.
- NT - Nuchal Translucency - In which they measure the liquid around the neck. This helps identify any chromosomal defects like the Down Syndrome.
- NB - Nasal Bone - It is very important that the nasal bone be present. If it is absent when you do this early around the 11th week, they may ask you to come again. If the nasal bone is absent - it is also a sign of the chromosomal defect. Hence, the test.
c) Anomaly Scan: Done between 18-22 weeks. Could cost anywhere between INR2500/- to INR3500/- depending on your centre and location)
This is one of the most detailed ones - Go there with enough time in hand (2hours), because they need to study all the various parameters and it is important that the baby co operates with them. And that is beyond anyone's control (how the baby is going to be positioned inside). Hence, go prepared for the waiting and multiple sessions to for the baby to give the right image.
Things they check:
- Needless to repeat the basics they will most definitely check to begin with - gestational sac and foetus and its age and size in cm; cardiac activity, foetal movements and their intensity, placenta position, internal os of the cervix, amniotic fluid quantity and fatal weight (Yes by now they can tell you exactly how much it is weighing inside you)
Anomaly means something that deviates from the normal or expected. As the name suggests, in this test, they check for any anomalies in each and every organ of the body - the minutest of things to rule out any doubts. Things that we, as laywomen, will not understand. And I feel we shouldn't try over analyse either. Let them (the various specialists doctors) do their job. All in all I would like to say that they check all the following:
- Head
- Spine
- Neck
- Face
- Heart
- Abdomen
- Kidney and Urinary Bladder
- Limbs
(In case any anomalies noted, they mark in bold and give it in the report for the gynaecologist to explain it to you and for you'll to together take an appropriate action for the same.
Please Note: Some elderly women in the family will advice you against the Ultrasound Scans, claiming that they cause some damage to the foetus. But it hasn't been proved yet!! Even for the side effects of X-Rays, it took them decades to figure. But over the past twenty years, they haven't found any solid proof over the side effects (if at all they exist) around the USG scans. So till then, explore and be informed about those things that matter a lot more now.
Also, I haven't mentioned one important thing up there - Usually the USG scans are done by rubbing the transducer(the light coloured joystick kind of a thing) on your tummy. But in some cases, where it is difficult to get the right image from the top, they try to look from the other side - ie. through your vagina. So don't be scared if they ask you to take your pants off and request you to allow them to check from there. It is absolutely safe and hygienic (ensure they are covering the transducer with an unused condom before they insert it in).
And last but the most important thing to be noted in India - Though all these scans are fully capable of telling you the gender of your baby - Nowhere in India, will any radiologist (the doctor who does the sonography) will reveal that to you. We, as a Nation, are obsessed with 'boys' and the discrimination has led to a lot of female foeticide. So, don't even think of asking - rather read those bold notices that they hang on the walls in the waiting areas that have details of how they penalise those who have found out the gender through scans. Wait for the gift to unwrap itself when it's time!!
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