Everything you need to know about the malformation scan - also called the 20th week scan
The malformation scan is the second and last of the 2 free scan offers for pregnant women in Denmark. The first scan is the nuchal translucency scan, which you can read about. here. Both scans take place in 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 a malformation scan?
The malformation scan takes place around weeks 20 – 22 of pregnancy. During the malformation scan - also called the 20-week scan - your baby is examined from head to toe. I am often asked whether it is possible to have a malformation scan before week 20 of pregnancy. The answer is both yes and no. In private practice, it is possible to pay for a malformation scan as early as week 15 of pregnancy. However, it cannot show quite the same as a scan in weeks 20 – 22 of pregnancy, as the baby grows and develops week by week. Therefore, see a private malformation scan before week 20 of pregnancy as a supplement.
Many pregnant women and couples go for the malformation scan with the expectation of seeing their child, who has now grown significantly, and hearing its heartbeat, which in itself is a great and often touching experience! However, many are slightly surprised that the real purpose of the scan is more serious - and with even more things on the agenda.
The purpose of a malformation scan is, among other things:
- Checking if the baby's heart is beating properly
- To scan the baby for possible malformations
- To check if the umbilical cord has 3 blood vessels
- Check the amount of amniotic fluid
- Checking baby's weight
- To examine for various malformations
- To check if there are 1, 2 or more babies in the womb
- Checking where the placenta is located
Malformation scan
In other words, the baby is checked thoroughly. That said, some malformations are easier to see than others. For example, it is easy to see if an arm or a kidney is missing, whereas it may be more difficult to see smaller malformations, such as in the heart. So no scan can be seen as a guarantee.
Many people want to know the gender of their baby. This is of course perfectly fine. However, keep in mind that this is not the actual purpose of this scan, which is why it is not the primary focus of the sonographer who is scanning. It is not always possible to see the gender, as the baby may be positioned in ways that make it difficult to see. If you/I not If you want to know the gender, tell the sonographer at the beginning of the examination so that she doesn't - out of good will - break the 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 the understanding that you are going to be parents.
Answer one on your malformation scan
You will receive an answer to the scan immediately. If the sonographer is in doubt about anything during the process, she will confer with 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 different from normal in the baby, you will be offered an amniocentesis. You will be given a separate appointment for this.
An amniotic fluid sample is taken through your belly button with a long, thin needle. The baby is checked with a scanner before and after the sample is taken.
After the test, you will need to rest for 15-20 minutes in the hospital so that the staff can make sure you are comfortable. There is a tiny risk of miscarriage of less than 0.5% from having an amniocentesis. This means that less than 1 in 200 women miscarry after an amniocentesis.
You will receive an answer about 10 days after the test is taken. Here you can get the exact answer to the baby's gender, if desired. The vast majority of people who have an amniocentesis will receive an answer that is normal. At the same time, it is important to acknowledge the emotional pressure of going through a testing process, waiting for the answer and landing on the other side - even if the answer is positive. Please talk to your midwife, your doctor, friends and/or family about it. And know that many others besides you have gone through an amniocentesis. You are not alone!
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 for the malformation scan
If the answer is not normal, you will be offered a conversation. Here, information about the findings is reviewed and advice and information is given, including the possibility of choosing an abortion. If it turns out that the baby has a chromosomal abnormality, it is very normal to want to talk to parents of children with the same chromosomal abnormality, as part of the process of getting clarification. Such a conversation can be easily arranged.
What is a late-term abortion?
An abortion at this stage of pregnancy is called a late abortion, since you are on the other side of the border for free abortion. To have a late-term abortion, the abortion board must approve the abortion request. If severe malformations or serious chromosomal defects have been found that will have a major impact on the baby's survival and/or quality of life, then it is a formality to get approval for a late-term abortion.
In a late miscarriage, the baby is so large that it is actually a birth. You will give birth in a delivery room assisted by a midwife. The birth will be initiated, over hours you will have contractions ending with the baby and then the placenta being born. It varies how many hours a late miscarriage birth takes and whether the baby shows signs of life for a few minutes after birth - this also depends on how far along you are in the pregnancy.
It must be the right decision for you.
I know it can be overwhelming to read! It is also a process with big decisions, emotions and thoughts. Both in terms of making the decision that is right for you, and in terms of the further course, whether it is a late-term abortion or continuing the pregnancy and waiting to meet your child.
There may be many thoughts and feelings involved in the process of getting clarity. It may also be that one of you is clear and the other in doubt. And that may change over the coming days. I would like to encourage you to pay attention, talk thoroughly together several times and also talk to, for example, 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 would like to lovingly and honestly point out that abortions often leave traces - sometimes for many years to come. Especially if you are not taken care of lovingly and expertly afterwards. So dear, dear ones, reach out when you are ready, and I or others will be happy to help you land in the best possible way after a possible late-term abortion.
Whatever you choose, I send you loving hugs and thoughts! Know that you are welcome to contact me along the way, and that you are not the only one going through a difficult decision-making process.
Most affectionately
Siff Stephenson, HeartMidwife
Author Siff HjerteThe Midwife
Leave a comment