Posted on July 5th, 2017 by

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!

Good luck on your next scan!

As always, thanks for reading and email me with your comments at!

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 March 13th, 2017 by

Deciphering fetal sex can be a very difficult job, especially when trying to read an image taken by someone else! Sometimes, it’s a piece of cake.

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 just looking at a photo of someone and recognizing that person. 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! Factors to take into consideration are maternal and fetal position, angle, magnification, depth, as well as brightness and contrast of the image. It’s 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.

And some things that cause a poor image are just beyond a sonographer’s an uncooperative fetus, extra weight around a patient’s abdomen, or a gassy patient. This has everything to do with the laws of ultrasound physics which dictate 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 an 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 a boy. Her images didn’t leave much of a question in my mind:) She was just over 20 Weeks along. Can you tell what she’s having?

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!

male fetal sex

male fetal sex

wwavblogger: LOL No ma’am! Little girls don’t normally look like that at 20wks! 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 that is more true 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 visualization!

Did you guess boy? If so, I agree! Compare the images I’ve edited below.

boy parts1-jpeg

boy parts2-jpeg

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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Posted on May 12th, 2016 by

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.

What You Don’t Want to See

breech fetus

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 20 Week sonogram 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.

20wk facial profile


Above is an example of baby flipped over and looking up. How much better do you see baby’s face?

Here’s hoping you have more luck than this patient did for her anatomy screen ultrasound exam!

Email me with your questions and comments at

wwavblogger, RDMS

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Posted on January 10th, 2016 by

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 December 15th, 2015 by

We’re now into single digits! Tonight’s post will be short and sweet. Day 9 of Baby’s First Christmas gets us one day closer to Santa’s arrival (and Baby’s) with yet another idea for storage under the tree in fancy paper and bows.

Maybe you already know whether you are expecting a son or daughter and have already begun to fill the closet with some of your favorite outfits. Perhaps spending a little too much time at your favorite children’s boutique? Nonsense, right?

Maybe instead you have a cherished christening gown passed down as a family heirloom from one generation to the next. Monogrammed bloomers and bibs, smocked floral dresses and baby blue linen overalls are all adorable gifts that tell Dad or grandparents just who will be joining the family in the coming months. Of course, in my mind, nothing beats a first trimester ultrasound image but I am attempting to supply you with a plethora of unique choices!

Only once in my career did I have a couple who came to their ultrasound appointment with their children and two boxed newborn outfits, one for each sex. Instead of enclosing the surprise in an envelope as most do, they asked me to choose the appropriate color and simply tell them which box they needed to wrap. Cute idea. Then everyone is surprised on Christmas morning!

Come back tomorrow where we’ll look to pro sports for more inventive solutions to inspire the Santa in all football-loving moms-to-be!

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Posted on December 14th, 2015 by

Ho Ho Hot chocolate! Everyone knows this holiday just isn’t without cozying up to a warm cup of liquid love..topped with melted marshmallows, of course! Chocolate is one of my most beloved things in the whole world. Solid, drinkable, intravenous..I’ll take it any way I can get it and so would most of my patients;)

Day 10 of Baby’s First Christmas countdown brings us one day closer to celebrating Santa, gift-giving and all the fun firsts of pregnancy (in keeping with the spirit of the season, we’ll exclude all the NOT-fun firsts). Here is another great idea to explore when trying to decide how you might share with family and friends whether they will be buying pink or blue for your shower.

If you’re hosting a Christmas celebration, consider serving hot chocolate with pink or blue marshmallows. They come in any number of shapes and sizes and thanks to our friend (sometimes), the Internet, your favorite shape and flavor is just a click away if you search Images. Aren’t the ones below so cute?


Day 10 Baby's First Christmas


Day 10 Baby's First Christmas


An even more creative idea, but a little more work, is using white chocolate and food coloring to tint the drinks the appropriate hue. If you’ve never used it, a little goes a long way! I recommend adding one drop at a time to the milk mixture until you reach the shade you want. Pastel looks best in my opinion with white marshmallows.

Add your favorite “It’s a Boy or Girl” napkin for service. If you’re going all out, I’m sure some company out there would print your kid’s adorable mug on them! Hopefully, you were one of the lucky ones who’s fetus cooperated with position.


20wk facial profile


3D fetal face 33wks

I’m such a sucker for a cute face;)

Come back tomorrow if you need more Christmas ideas for Baby!


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Posted on November 19th, 2015 by

“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:

Best wishes for a happy healthy baby!

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Posted on October 20th, 2015 by

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. And sometimes determining fetal sex is an impossible task.

I try to explain in my replies that my guess is only as good as the images they send me. I don’t believe it is quite understood what I mean when I say that ultrasound is entirely subjective but the person scanning has total control over the images obtained. The sonographer creates these images utilizing a number of controls to optimize the image and uses her own discretion to determine a good angle with the probe she is holding. 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 bad. There are good docs and bad, good nurses and bad, good cashiers and bad. That being said, there are sonographers who just do not do it well. This is a painfully obvious fact when I open these image attachments.

In addition, I sometimes use many angles, holding the probe in different places to obtain a different angle of the same area in order to determine sex. At times, just one angle is not enough to see well but only one angle can be depicted in one image at one time. I wasn’t there during your scan so I don’t know anything about the variables that could have made imaging difficult. One of my last posts on this subject can be read by clicking the links below:

I just know a technically bad image when I see one. Sometimes, I can tell there are measures that could have been taken to improve the image. In those cases, I can only assume your sonographer did not know how to use them or even that they existed. If the person scanning you is new to ultrasound or is a physician who isn’t trained on how to use the equipment fully (which they typically are not) 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 16-22wks. The side arrows point to labia, the middle to the clitoris.


Female labia in the 3rd trimester


Male genitalia, late 2nd trimester


Fetal male genitalia 3rd Tri

The above demonstrates a side view of typical appearing male parts from about 27wks on.


So, all that being 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 she was sure of her guess, I may not be able to 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 and I didn’t observe the scan myself so I was unable to see from many different angles.

Below are the links I typically email on my posts regarding fetal sex:

I hope this helps you understand a little more insight from the sound perspective!

Ta-Ta for now! Until next time, feel free to reply, comment or email with your questions on the Ask Me tab up top or at! You can also subscribe to the right:)


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Posted on October 5th, 2015 by

I hope anyone who is searching intently about what is required to see fetal sex will take a minute to read this post and behave accordingly at her future ultrasound appointment. Sonographers the world over will thank me if it results in even one less patient who leaves her department foaming at the mouth.

Firstly, determining fetal sex is not part of a diagnostic examination. Period. It may be information the patient desires but nowhere in any ACOG publication is it written as a requirement. This examination is ordered to rule out structural fetal malformations only. It’s a courtesy most practices provide their patients IF it can be seen but is wholly left to the discrimination of the sonographer. This is because we see fetal sex with ultrasound way more often than your physician does and most docs will tell you we are far better at this guess. Also, OB docs are well aware there are a number of variables that prevent good visualization for each and every ultrasound we perform for them. Some of these factors are as follows:

a breech fetus
a fetus with the rear against the uterine wall
a foot or feet in the genital region or crossed feet
closed legs
the umbilical cord between the legs or against the fetal body
body habitus or an overweight patient
uterine fibroids or contraction
a decrease in amniotic fluid
genital malformations
early gestational age

Even one of the above factors can prevent even the most experienced sonographer from determining fetal sex. This is what you want. What you DON’T want is someone who is inexperienced guessing anyway. Many times, it’s not just one but several of the above variables that limit what we see and we can’t change any of them. We can push around a little or turn a patient on her side but that is it. And, no, jumping jacks won’t help.

Another little fact I’ll add here is that a non-arguable truth of the modality is the principle of physics that refers to the attenuation of sound. The farther sound has to travel, the weaker the returned signal. The more tissue the sound waves have to penetrate, the worse the image. In other words, the more a patient weighs, the less we can see a fetus. And the worse our visualization of a fetus, the less we can see of important structures much less very small ones like external genitalia. Combine that with some of the other variables listed above and the possibility that fetal sex will be determined for some people at 18-20wks is quite unlikely.

What we cannot do is scan a patient indefinitely in an effort to gain this information. We are on a timed schedule and we work like hell to stick to it. The next patient deserves to have her ultrasound as close to her appointment time as possible, barring an unforeseen medical complication. We are required to scan a patient for only as long as it takes to determine what anatomy we can or cannot document. We also require time prior to a scan to examine a chart for an order and indication for the exam. After the exam we need time to write the report. Most of us are nice enough to take more time with a patient if the schedule allows.

An entirely repulsive action disgruntled patients take these days is to post their rants on social media. This is never okay whether it be a personal beef or not. I would advise against this method of revenge only if one would not want to find a new physician or appear grossly ignorant. If you are unhappy, you have the right to discuss it with the administrative manager but keep in mind that negative press will cost the practice future patients and you run the very real risk of being fired by your doctor. Yes, a patient can be fired. A practice does not have to tolerate any behavior deemed irrational or unreasonable. Just like one can fire an attorney, a plumber or your doctor, a patient can find herself in the same situation.

Being a healthcare provider can be the most rewarding but also the most infuriating of experiences. Our patients who are thankful and appreciative remind us why we chose this profession to begin with while others make us want to throw down the vinyl gloves in submission of a different a Whole Foods stock girl. Artisan cheese doesn’t talk back or complain when fetal sex can’t be determined.

Unfortunately, our society has become one of immediate gratification, even demanding it in the face unreasonable and ridiculous circumstances like the spoiled brat, Veruca Salt, of Willy Wonka fame. It’s comical to me that these people expect better behavior from their children but, themselves, scream and cry in a public setting, ranting and raving like a lunatic. Or it rather reminds me of the kid who throws a tantrum and holds her breath until she faints because she wants the candy in the grocery store cashier line. In my professional and motherly opinion, both behaviors are well deserving of a spanking and time-out…or a good firing.

I hope patients who have shown their immature side in the past over this same scenario might read this and reevaluate the series of events that led them to exhibit such embarrassing, high school-like behaviors. We cannot walk on water, we cannot move mountains and we cannot see fetal sex on a patient who fits into the above categories. It’s not because we’re mean or didn’t scan long enough, try hard enough, didn’t care or are incompetent. I treat all my patients the same and I try to determine sex for all those who want to know. It’s just that I cannot change the laws of physics.

On more than a few occasions, some patients mistakenly assumed that if we cannot tell them fetal sex, we must not be able to skillfully perform an ultrasound examination otherwise. It’s usually these people who are guilty of the aforementioned bad behavior. I suppose it’s too good to be true that those same people who didn’t see anything wrong with their actions to begin with might also read this and figure out my post is all about them.

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Posted on May 1st, 2014 by

I am always absolutely astounded..flabbergasted..when people ask me my opinion about gender and then don’t believe it.  They keep asking. And asking. And asking. They continue to ask the same question over and over but in a different way.  It. makes. me. CRAZY!

This is especially true when it’s just too darned early!  Consider this..does a fetus at 8wks look like a baby?  No.  Does a baby chick embryo curled up in an eggshell look like a chicken?  No.  The same applies to external genitalia on a fetus!  It’s not completely developed yet so one just cannot discern boy or girl very early in the pregnancy.  In fact, TOO early in the pregnancy they both have itty bitty parts that stick out and can all look the same.

Read the emails from the grandma-to-be below who just didn’t want to take “It’s too early” for an answer.

g-ma:  Hi, I subscribed to your blog. I love it. These are my grand baby at 12 weeks 2 days. Any guesses?  The baby’s legs were crossed at the 16 week ultrasound.

12 Week Fetus

12 Week Fetus

Too early for sex guess!

12 Week Fetus


wwavb:  Hi! And thanks for reading and subscribing! So glad you are enjoying the info!

Okay, so if you’ve read any of my posts on the subject, you know that guessing at 12wks is like flipping a coin. Just too early. An accurate guess can be made at 18 wks IF baby is cooperating!
Any guess any earlier is simply a guess and I just wouldn’t invest in paint.

Best wishes for a healthy grandbaby!

g-ma:  Thank you for your response!  It’s just driving me crazy wondering what those two white ovals are in between the legs.  Doesn’t look girl or boy. Could it be fingers or an umbilical cord?

wwavb:  No, haha. It’s definitely external genitalia but boys and girls look the same at that age! Over the next several weeks, girl stuff shrinks to form labia and all her girly parts; boy parts get bigger to form the scrotal sac and penis. It’s all still developing on the outside even though chromosomally it’s already determined on the inside.

g-ma:  Thanks for being so helpful. I would think it’s a boy for sure if it’s genitalia!  But, not if they look alike at 12 weeks.

 wwavb:  Sounds like you’re not too far off from finding out. Happy shopping!
g-ma:  Really… No guesses? I know it would be a guess. I thought the pics looked pretty clear. Everyone thought boy.

wwavb:  Wow.  You’ve earned a spot in a post for your persistence.  But it doesn’t change the facts.  You can either believe what you and your fam think you see in the images OR you can believe someone who has seen tens of THOUSANDS of fetuses at this age.  Up to you!

The professional verdict is that it’s simply TOO EARLY to determine gender on any baby at that age.  It’s just not all formed yet!!!
Let me know what you end up having!

People have a tendency to believe only what they can see or understand.  As long as sonographers guess too early and continue to be wrong, I will have to persistently defend my determination until the cows come home.  My advice when it comes to gender is that you have to entrust the word of an experienced sonographer..or just buy neutral!

Comments: 3 Comments »

Posted on October 27th, 2012 by

When fetal gender determination turns into the likes of a Willie Wonka movie..

I love it.  Not really.  I’m scanning a patient for the anatomy screen, the exam performed between 18 – 20wks to evaluate fetal anatomy among other things or sometimes referred to as “the scan where we found out the sex”.  Every time I hear this I have to find some politically correct way of telling a patient that we could care less about gender determination and include it NOwhere in the report.  Nonetheless, most refer to it in this way.  God forbid if baby is not cooperating to determine gender.  Then I hear things like the following:

“I can’t wait a whole month to find out”  or

“Well, this is what we came here for today!”  or

“Come on, open those legs, open up!” (as mom or grandma or dad jiggles and pokes on mom’s belly like they’re trying to wake the dead) or

“Can I jump up and down in the hall a little and try again?”  or  “Should I go and get something to eat and come back?” Uh, no.  Like I have time for that because I have no other patients waiting for an exam.  And my favorite..

“I’m not getting off this table until you tell me what it is.”

I have to smile very nicely and try to refrain from hitting the eject button. Not really..I don’t actually have one of those but sometimes..I would like one.  We know patients are excited to find out what they are having.  It IS a very exciting time but in this Veruca Salt generation of “I need it now”, the idea that we cannot determine the gender when patients have waited SO long to find out is incomprehensible to them.

And then I get the “But can you guess?” question.  Not no, but heck no will I try to guess.  No good can come of guessing!  Do you want me to guess or do you want me to be right?  I never want to go back and tell a patient she is having the opposite gender of what they have previously been told!  So, I will not guess but I do promise each patient a thorough and excellent examination.

At the end of it, I hope I can write in all my little report boxes..normal, normal, normal..

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