Posted on July 5th, 2017 by wombwithaviewblog.com

Determining fetal sex 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 boy vs girl determination requires far more expertise than just sticking probe to 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 if there was one magical button to push, there’s not one sonographer on earth who would hesitate for a second. Why struggle to give you the information you want if we could simply and magically flip Baby? Ugh, a girl a dream, but I think this technology lies in our 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..when I’m the one scanning, that is! Most of my emails come from people who want a second opinion. However, most of the time, it’s one I 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 comment on what I can’t see.

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. Anyone who has scanned as much can recognize when this information is obtainable and when it isn’t.

Tips For Your Next Ultrasound

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.

•Keep an open mind! Understand that not seeing the sex is definitely a real possibility!

•Don’t shoot the messenger! In other words, your sonographer would never intentionally withhold this info! …Unless, of course, it’s a policy of the facility to not guess sex.

Believe me! We would love 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.

Great Pics of Fetal Sex

I’ve posted these before, but below are a couple of really great images of external genitalia, first boy then girl.

male fetal sex, around 27 Weeks

Male Gender

female fetal sex, mid-second trimester

Female Gender

Also, if you send an email asking for a second opinion earlier than 18 Weeks, you may receive the links below to other posts containing very easy, no-mistake pics of boys and girls!

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/

http://wombwithaviewblog.com/boy-girl/

http://wombwithaviewblog.com/boy-vs-girl/

http://wombwithaviewblog.com/twin-gender-update/

http://wombwithaviewblog.com/third-trimester-male-gender/

Good luck on your next scan!

As always, thanks for reading and email me with your comments at wombviewerblog@gmail.com!

You can also subscribe for automatic posts in the right margin! >> You’ll receive a little something special (and free!) when my book on first-trimester ultrasound is published!

Here’s to happy and healthy!

wwavblogger, RDMS
wwavblogger, RDMS

Comments: 2 Comments »

Posted on June 7th, 2017 by wombwithaviewblog.com

As a sonographer of many years, I know that ultrasound is subjective, but expectant moms seem to continue to be surprised by very early incorrect guesses. And I seem to be receiving more and more emails about this ever-growing problem. Nothing makes me angrier than when another sonographer tries too early to hand out a sex guess! I get angrier still when some businesses make this promise as a marketing ploy.

It just isn’t fair to the patient or customer. I feel these facilities take advantage of pregnant anxious moms who have a desire to know the sex of their baby as soon as possible. After all, it is one of the most anticipated events in pregnancy! However, these mothers-to-be wouldn’t spend their money on an ultrasound if 3D non-medical businesses didn’t exploit that desire. They advertise a promise or guarantee for sex determination at 12+ Weeks! So, what is the public to believe except that they can deliver on that promise? The truth is they know it’s only a guess. If they guess right, they got lucky. If they guess wrong..oh, well. Here’s some of your money back.

I think developments in the technology have yielded a little too much ambitious guessing in the fetal sex department. Resolution has improved so greatly over the years that we see better than ever with the most modern equipment. But just because we can see “a little something” sticking out, in no way or shape or form, means you’ll be investing in blue paint.

I want to educate every fertile, human-growing woman or parent-to-be out there that even the best ultrasound equipment on the planet cannot differentiate a boy from a girl. To this day, determination of sex is still dependent on the experience and skill of the person holding that probe to your belly. But also know that a sonographer’s skill doesn’t mean squat when external genitalia has just begun to grow. It’s anyone’s guess!

We have all heard a similar story. A customer pays for an early scan and is told one sex. “Congratulations! I’m 100% sure!” Lo and behold! At the mid-pregnancy anatomy screen (or later), the penis has magically fallen off and now all the sailboat motif and cute suspenders have to go back. Or vice versa. The question I always get is, “How did this happen???”

 

Loads of Room for Error

So, just how DID this happen?

Easy. It’s the scanning observer’s opinion, but it’s still just a guess. You assume he or she is experienced in making this determination…maybe, maybe not. Especially when this person displays such confidence in his/her guess, you feel sure that they must be correct in their guess. But it doesn’t mean they are; they can still be very confidently and entirely…wrong.

This is why!

External genitalia is just starting to develop later in the first trimester, and it will continue to morph and change in appearance over the next several weeks. All babies have a little something sticking out at 12 Weeks. But if Baby is a girl, that tissue will shrink and become recognized as a clitoris later on, with labia seen on each side. If a boy, this part grows a little larger and becomes a penis. The scrotal sac develops over the next few weeks but is still quite small. And we cannot see testicles until somewhere around 28 Weeks (or maybe slightly earlier).

 

The Nub Theory?

12 Week Nub Theory

12 Week Fetus

Most readers ask if this test has any validity. The answer is “some.” If (and, again, subjectivity comes into play here), if an observer knows what fetal angle to obtain and how to read the angle of the nub, you might have a 70% accurate guess. But that’s a few IFs. The observer also has to know when the angle is equivocal, meaning the protruding part is not one way or the other but somewhere in-between. In these cases, a guess cannot be made. Keep in mind here that even if the angle is perfect, there is still a ~30% chance of an incorrect guess! In other words, it’s not a hugely reliable predictor.

 

So, What’s the Best Advice?

Later is better! Wait for your mid-pregnancy anatomy screen at 18 – 20 Weeks. Below are great images of typical and normal-appearing external genitalia of each sex at this age:

male gender, 2nd Trimester

Male Fetus

female gender, 2nd Trimester

Female Fetus

 

 

If Baby isn’t cooperating, don’t put the heat on your sonographer to guess anyway. Part of a good sonographer’s job is also to know when NOT to guess.

The truth is that no one should be providing a guess for sex determination much earlier than this in pregnancy, especially for a fee. And certainly not with a 100% positivity attached.

Just because someone says she is 100% sure, doesn’t mean she is right.

Business is business. As long as parents will pay for it, someone will take your money and offer a guess. This is the unfortunate bottom line in the non-medical ultrasound business. I’m not saying you shouldn’t go to one of these places. Maybe you just want to see a heartbeat and bond. This is understandable. But I caution you to pay for sex determination earlier than 18 Weeks.

Advice Regarding Early Fetal Sex Determination

All you moms who are thinking about paying for an early scan at a strip mall near you (or anywhere!), please first consider the above info. It might just save you a few bucks and some disappointment later. Alternatively, if you are the kind of person who can remain entirely neutral about any sex guess and just want to have some fun watching Baby move, go for it. Have a blast.

The biggest issue here is our own nagging, relentless, compelling need to know as soon as possible. But more of the same will keep happening. Businesses won’t quit selling as long as pregnant moms are buying. Let’s pass the word around, ladies. Just don’t buy what they’re selling!

Thanks for reading, and please email me at wombviewerblog@gmail.com with questions or comments!

wwavblogger, RDMS
wwavblogger, RDMS

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Posted on April 11th, 2017 by wombwithaviewblog.com

Yep, it happens..the mistaken fetal sex guess. It can happen to anyone and sometimes does! We all have heard the story somewhere. A friend. Family member. Someone’s friend’s cousin’s sister-in-law.. The truth is that the right conditions can make anyone susceptible to an incorrect guess.  Consequently, discovery of the opposite sex inevitably leads to a roller coaster of emotions!

I have certainly been on the giving end of that conversation. Most of the time, it’s not pretty. The result usually accompanies shock and wonder at how this could have happened, especially with today’s technology. This is the typical feeling. However, still get the feeling that the general public thinks it’s the machine doing the guessing and not the observer. It always has been and always will be the observer who guesses, very experienced sonographers versus new to the field. Other healthcare professionals are more experienced and better than others at scanning. And some observers, unfortunately and unbeknownst to you, are not formally trained in ultrasound at all! Some (in the 3D business) are taking a crack at your baby’s sex don’t even come from the medical field. Scary, right?

That said, a whole world of other issues can interfere with the guess of someone more than qualified to make it. Factors like fetal position and patient size can both make visualization limited. This last statement is not an opinion..it’s a long-known fact within the field and has everything to do with the laws of ultrasound Physics. The more tissue the sound waves have to penetrate, the more limited the image will be once traveled back to the monitor. That said, I could see very well in a few of my heavier patients over the years and definitely struggled in some thinner ones. This is also because air and gas are not our friends in ultrasound. If your intestines are full, it can get in the way of what we need to see..even in the thinnest of people!

Readers from all over the world email me with their images for a second opinion on fetal sex. This can be very difficult when the image isn’t great to begin with. I always like to play it cautious..with my patients and readers. You’ll find one reader’s story below who wanted my opinion, but I was clueless. This baby didn’t look like a boy or girl to me, either!

She wrote initially expressing her confusion. She was 20 Weeks but couldn’t make out typical girl or boy parts. This was the image below.

Honestly, it looked a lot a like a girl to me but not a 20 Week fetus..maybe 25 Weeks or so. And it certainly didn’t look like a boy.

I wrote her back saying this:

Hi, this is not a very clear image but does seem to be a good angle. I don’t see anything sticking out so I would have to guess girl based on that alone. Maybe a future ultrasound may be more clear? I’m sorry I couldn’t help more!

Best,
wwavblogger 

She wrote me back a couple of weeks later:

Everyone said it’s a girl again. I was a little disappointed, but now he is here. Blessed with a baby boy. The family is complete now. Wanted to share this happiness with you. Thank you.

She was obviously much farther along than the image she sent, but I was a bit shocked that she had a boy (I have to admit)! However, I was so happy for her that she got what she wanted. My reply to her:

Oh, congratulations!! This is precisely why I don’t like to try to confirm sex with other sonographer’s images! Sometimes they just aren’t very good and depend on angle and experience. A lack of something in one shot is not a definite girl! Many blessings to you!

Now, obviously, we all look differently from one another and abnormally developing parts can cause confusion on sonography. I surely can’t say her baby didn’t have normal genitalia, but I’m still perplexed to this day. I feel very sure I could show that image to any of my former co-workers in ultrasound or docs, and I would bet my left arm they’d all guess girl!

I’d rather play it safe any day!

 

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Posted on January 10th, 2016 by wombwithaviewblog.com

Hi, all! Tonight’s post serves as just a reminder when you go in for your 18-20wk diagnostic scan.

Remember that, at the end of the day, we all get what we need. Boy or girl, sometimes it’s your child-to-be that needs you or you that needs this child for whatever reason which you may not understand entirely right now. Maybe you’ll never really know while living this life; maybe you have instinctively always known. Regardless, I do believe that most people at the time of delivery do not ultimately care about fetal sex, no matter the preference previously. We take one look at that face and stare into those eyes and most women fall in love instantly. This is the child whom you nurtured all along. You’ve finally met!

So, as I’ve said a million times, it’s OKAY to have a preference of one sex over the other so long as one remembers that healthy is more important than anything else. Just ask someone who lost a baby or who experienced a difficult pregnancy. Moreover, ask a couple who could never become pregnant or suffered infertility many years. Oh, they may choose to still find out with subsequent pregnancies but it’s not top priority on their list. Typically, when asked if they want a boy or girl, they are usually pretty quick to respond “Healthy!” It’s all about perspective.

As with anything in life, keeping an open mind about such things allows us to keep our priorities in line and provides us freedom from sweating the small stuff! (And most of it, like fetal sex, is small stuff..)

Best wishes for a happy and HEALTHY pregnancy!

Comments: 3 Comments »

Posted on November 19th, 2015 by wombwithaviewblog.com

“How sure are you?” I’ve heard this question probably more than any other in my career.

Every sonographer is different. One person’s sure is another’s iffy. I’ve seen images where a person was told one sex and the sonographer had “no doubts” only for me to scan later to confirm how very wrong she was. The fact here is that as long as people keep wanting to see fetal sex by ultrasound, there will always be challenges surrounding the guessing fetal sex.

As long as ultrasound-for-entertainment businesses are allowed to remain open, they will continue to take money from any person who wants to pay them. They will guess at sex because you are a paying customer. You paid for a guess; they’ll give you just that. But is it right? Who knows?

From my end, as long as new graduates and people with little experience are guessing sex, there will be incorrect guesses. Since we all practice differently, there will always be some sonographers, even experienced ones, who jump the gun and guess too early or despite suboptimal visualization. Others are more cautious, examining from every angle but still hesitant to commit.

I’m more of the latter persuasion. I want to be VERY sure, superduper sure, sure-as-white-is-on-rice sure. I need perfect views in more than one angle and textbook imaging. In other words, baby parts have to be ultra obvious for me to feel comfortable making a guess. There will be none of this 70% stuff on my watch. What does a percentage mean anyway except that someone is just really not sure! Does anyone really feel comfortable with buying pink or blue based on that? ..Or painting a nursery based on that supremely expert opinion?

What needs to happen is bipartisan cooperation (is that really a thing in the U.S.?????). People who cannot scan well should just put down the probe and walk away. Those who are new to ultrasound should not attempt to guess sex without first consulting someone else more experienced. Patients should not push to find out sex at the first positive sign on a pee stick nor should they pressure sonographers to guess NOR should they throw a fit when we refuse. And, last but most certainly not least, non-medical, non-necessary, thorn-in-my-side, bane-of-my-existence, menace-to-society-and-medical-communities-alike 3D cash cow businesses need a cease and desist from scamming the general public into believing they can actually provide a 100% guarantee on sex at 14wks. SO! If all the above happened, we would never have another incorrect fetal sex determination by ultrasound again. Unfortunately, there’s about as much chance as my waking up to a million bucks in my driveway. I think I’ll be going in to work tomorrow after all:/

And for those of you who have not yet seen them, check out the links below for my images of fetal sex which are textbook, classic, no-guesswork-needed images of both male and female sex:

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/
http://wombwithaviewblog.com/boy-girl/
http://wombwithaviewblog.com/boy-vs-girl/
http://wombwithaviewblog.com/twin-gender-update/
http://wombwithaviewblog.com/third-trimester-male-gender/

Best wishes for a happy healthy baby!

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