Everything you need to know about the anomaly scan - also known as the 20-week scan
The anomaly scan is the second and final of the two free scans available to pregnant women in Denmark. The first scan is the nuchal translucency scan, which you can read about here. Both scans take place at the hospital and are performed by a sonographer, who is either a nurse or a midwife with special training in scanning pregnant women.
When and why should I have an anomaly scan?
The anomaly scan takes place around weeks 20–22 of pregnancy. During the anomaly scan -also known as the 20-week scan- your baby is examined from head to toe. I am often asked whether it is possible to have an anomaly scan before week 20 of pregnancy. The answer is both yes and no. Privately, it is possible to pay for an anomaly scan as early as week 15 of pregnancy. However, it cannot show quite the same as a scan in weeks 20–22, as the baby grows and develops week by week. Therefore, a private anomaly scan before week 20 should be seen as a supplement.
Many pregnant women and couples go to the anomaly scan expecting to see their baby, which has now grown significantly, and to hear its heartbeat, which in itself is a big and often moving experience! However, many are slightly surprised to find that the real purpose of the scan is more serious -and that there is even more on the agenda.
The purpose of an anomaly scan includes:
- Checking that the baby's heart is beating properly
- Scanning the baby for possible anomalies
- Checking that the umbilical cord has 3 blood vessels
- Checking the amount of amniotic fluid
- Checking the baby's weight
- Checking for various anomalies
- Checking whether there is 1, 2 or more babies in the womb
- Checking where the placenta is located
Anomaly scan
In other words, the baby is checked thoroughly. That being said, some anomalies are easier to see than others. For example, it is easy to see if an arm or kidney is missing, whereas smaller anomalies, such as those in the heart, can be harder to see. No scan can therefore be seen as a guarantee.
Many people want to know the baby's sex. Of course, that is completely fine. However, remember that this is not the real purpose of this scan, which is why it is not the sonographer's primary focus. It is not always possible to see the sex, as the baby may be positioned in a way that makes it difficult to see. If you/you do not want to know the sex, tell the sonographer at the beginning of the examination, so she does not -in good faith- end up revealing that news to you.
And yes, after the scan, it is possible to take a few scan images home. Images that in themselves support bonding with the baby and understanding that you/you are going to be parents.
The answer to your anomaly scan
You/you will get the results of the scan immediately. If the sonographer has any doubts during the scan, she will consult a sonographer/doctor colleague immediately.
Not all diseases can be detected by a scan. If further tests are needed, you will be offered an amniocentesis.
Is the baby okay?
If there is a suspicion that something is not normal with the baby, you will be offered an amniocentesis. You will be given a separate appointment for this.
An amniocentesis is performed through your abdominal wall with a long, thin needle. The baby is scanned before and after the sample is taken.
After the procedure, you must rest at the hospital for 15–20 minutes so that the staff can make sure you are okay. There is a very small risk of miscarriage of less than 0.5% when having an amniocentesis. This means that fewer than 1 in 200 women will miscarry after an amniocentesis.
You/you will get the results approximately 10 days after the procedure. Here you can get the exact answer about the baby's sex, if you wish. The vast majority of people who have an amniocentesis will receive a normal result. At the same time, it is important to acknowledge the emotional pressure of going through a testing process, waiting for the result, and landing on the other side - even if the result is positive. Talk to your midwife, your own doctor, friends and/or family about it. And know that many others besides you/you have had an amniocentesis. You are not alone!
You/you can read more about amniocentesis and watch a short animation here https://www.sundhed.dk/borger/patienthaandbogen/graviditet/undersoegelser/fostervandsproeve/
If something is wrong at the anomaly scan
If the result is not normal, you/you will be offered a consultation. Here, you will receive information about the findings and be advised and given information about the option of choosing an abortion. If it turns out that the baby has a chromosomal abnormality, it is very common to want to speak with parents of children with the same chromosomal abnormality as part of the process of getting clarity. Such a conversation can easily be arranged.
What is a late-term abortion?
An abortion at this stage of pregnancy is called a late-term abortion, as you are on the other side of the limit for abortion on demand. To have a late-term abortion, the abortion board must approve the request for an abortion. If severe anomalies or serious chromosomal defects have been found that will have a major impact on the baby's survival and/or quality of life, approval for a late-term abortion is usually granted.
In a late-term abortion, the baby is so large that it is effectively a birth. You will give birth in a delivery room assisted by a midwife. The birth will be induced, and over several hours, you will have contractions, ending with the birth of the baby and then the placenta. The number of hours a late-term abortion birth takes and whether the baby shows signs of life in a few minutes after birth varies - this also depends on how far along you are in your pregnancy.
It must be the right decision for you
I know that this can be a lot to read! It is also a process involving big decisions, emotions, and thoughts. Both in terms of making the decision that is right for you and in terms of what happens next, regardless of whether it is a late-term abortion or carrying the pregnancy to term and waiting to meet your baby.
There can be many thoughts and emotions involved in the process of getting clarity. It can also be that one of you has come to terms with it, while the other is unsure. And that can change over the coming days. I would most lovingly encourage you to feel out what you want, talk thoroughly with each other on several occasions, and also very much talk to a midwife or other relevant (professional) people. The final decision is yours, which in itself can feel like a burden.
If you choose a late-term abortion, I will lovingly and honestly put into words that abortions often leave a mark - sometimes for many years to come. Especially if you/you are not cared for lovingly and expertly afterwards. So dear you, dear you, reach out when you are ready, and I or others will gladly help you land as best as possible after a possible late-term abortion.
Whatever you choose, I send you loving hugs and thoughts! Know that you are welcome to contact me during the process, and that you are not the only ones who have gone through a difficult decision-making process.
Warmly
Siff Stephenson, HjerteJordemoderen
Author Siff Stephenson HjerteJordemoderen