January 20, 2019

'Keepsake' Ultrasounds: Just Say No

by Keng Lam, MD

“See your unborn baby in live 4D motion!”

“Bond with [your] unborn child in our private, soothing and spa-like atmosphere.”

“Actually see how your child is going to look before he or she is born.”

These are a few of the claims you’ll find on websites advertising fetal "keepsake" ultrasounds—elective ultrasounds that are performed outside medical settings and done for the sole purpose of seeing the fetus and creating keepsake images or videos. (Some companies even offer viewing parties and live streaming video of the scan, so friends and relatives can watch remotely.) Also known as recreational ultrasounds or commercial ultrasounds, they aren’t covered by insurance because they aren’t medically necessary. And they’re becoming increasingly controversial.

In December 2014, the FDA warned consumers to avoid commercial ultrasounds for the purpose of seeing the fetus. While the agency acknowledged that there currently is no evidence of negative health effects from ultrasounds, the scans do expose body tissues to heat and in some cases can produce very small bubbles, called cavitation, in tissues. Since the long-term effects of tissue heating and cavitation are not known, and since fetal keepsake videos provide no medical benefit to the fetus, the FDA advises steering clear.

Professional medical associations agree. The American Congress of Obstetricians and Gynecologists (ACOG) in 2012 reaffirmed a 2004 ethics committee opinion that discouraged the use of ultrasound for nonmedical purposes, in part because there may be biological risks to the mother or fetus that simply haven’t been identified yet. ACOG also warned that having an ultrasound in a nonmedical setting may falsely reassure pregnant women that their unborn baby is free of abnormalities, or, on the flip side, reveal a possible abnormality without a qualified health professional on hand to interpret and discuss the findings.

The American Institute of Ultrasound in Medicine has similarly warned that obstetric ultrasounds should be performed only when medically indicated, and not for entertainment purposes. The group in the past has supported legislation prohibiting the administration of an ultrasound on a pregnant woman unless ordered by a licensed physician, nurse practitioner, or midwife.

Bottom line: I see an ultrasound as basically an expensive photograph, albeit one that uses sound waves instead of light. Even though we don’t have evidence right now that having extra ones can cause physical harm, it could become a problem if you or an unqualified technician try to interpret the photo or video yourselves, as ACOG pointed out, or use it to justify skipping routine prenatal appointments or tests.

Even if the commercial ultrasound provider is a great photographer, the most prudent move is to save your money and settle for those grainy images you get at a real medical ultrasound. You can spring for professional pictures once the baby is out of the womb.

By the way, Berkeley Wellness has written in the past about the pitfalls of other types of elective ultrasounds, such as those for the heart and bones. See what we recommended.