What to Expect at Your First Ultrasound

It's one of the most exciting moments in a pregnancy: the first time you get to see your baby-to-be. If you're feeling a little nervous, read on—we'll take you step-by-step through what you can expect.

Every parent remembers their baby's first ultrasound, from that thrilling peek at their future child and confirmation of their sex to the strip of black-and-white pictures they excitedly take home. It's one of the highlights of pregnancy, for sure, yet people are often nervous about the exam and the outcome. If you've never had one before, you might wonder: When should I get an ultrasound? Will it hurt? And what is it really looking for? We spoke with the experts to answer your most pressing questions.

What is an Ultrasound?

An ultrasound is a painless diagnostic test that most people receive during pregnancy. High-frequency sound waves travel into the uterus, then bounce back off the fetus as vibrations. The echoes are translated into electrical signals that are projected as black-and-white pictures on a monitor. The images display the baby's soft tissues and organs.

What Should I Expect at My First Ultrasound?

Most people will have their ultrasound done in a practitioner's office or a local hospital, though there are also freestanding facilities that offer them. There are two types of pelvic ultrasounds that a pregnant person will typically have: a transvaginal ultrasound or a transabdominal ultrasound.

Transvaginal ultrasound: Given early in pregnancy, this type of ultrasound places a wand-shaped probe (a transducer covered with a latex sheath and lubricant) inside the vagina. It offers a very detailed look at the fetus, and helps health care providers assess how far along a pregnancy is. To get a good picture, the ultrasound technician may move the device, but any discomfort should be mild.

At this point, the fetus is very small and located deep in the pregnant person's pelvis; since sound waves can't pass through bones, a technician may approach the uterus through the cervix. This exam may also be used later in pregnancy if the person expecting develops placenta previa (a condition in which the placenta covers the cervical opening) or the provider needs to measure the cervix itself.

Transabdominal ultrasound: This non-invasive type of ultrasound tends to be more common after 11 to 12 weeks of pregnancy. The technician moves the transducer along a pregnant person's abdomen, applying a small amount of pressure as they go. The transducer transmits sound waves that create a picture of the fetus inside the body; it may be rotated at different angles to get a complete picture. If you're ticklish, you might find yourself challenged by this procedure. Breath deeply and try to relax!

When Do You Get Your First Ultrasound?

The answer differs for everyone, and depends on things like your age, existing medical issues, your health care provider's preference, and any risks they feel you may be facing during the pregnancy.

In early pregnancy (6 to 8 weeks)

Some providers schedule their patients' first ultrasound around 6 to 8 weeks into the pregnancy, which could be during their first prenatal visit. Others will only arrange for an ultrasound that early if the pregnancy is considered high-risk, whether because of age, current medical symptoms (bleeding, abdominal pain), or a history of miscarriage, birth defects, or pregnancy complications.

At this time, the fetus is tiny, and your uterus and fallopian tubes would be closer to your birth canal than to your abdomen, so a transvaginal ultrasound is clearest. This allows your provider to look for a heartbeat, forecast a due date, and check for multiples. It can also be used to screen for an ectopic pregnancy, a rare condition in which the fetus grows in the fallopian tube instead of the uterus.

The dating ultrasound (10 to 13 weeks)

Ultrasounds conducted now capture the baby's growth. A technician measures the length of their body from crown to rump, which serves as a marker of gestational age (and better predicts a due date). "This helps us determine if the size of the fetus matches up with the size it should be based on the patient's last menstrual period," says Michele Hakakha, M.D., an OB-GYN in Beverly Hills and the co-author of Expecting 411. "A smaller crown-rump length may signal an embryo that is not developing normally and may have a chromosomal problem." It could also mean your previous due date was off.

During this period, you should be offered a nuchal translucency test, which evaluates your child's risk of being born with chromosomal abnormalities and certain heart defects. This two-part exam includes a blood test that measures the level of specific hormones and proteins in your body, and an ultrasound that assesses thickness at the back of baby's neck (increased thickness indicates that they may be at risk for Down syndrome, trisomy 18, and other genetic disorders).

The anatomical survey (18 to 20 weeks)

This may be a second ultrasound, and it is fairly comprehensive. "We look at about 35 elements, including the brain, heart, kidneys, limbs, face, [sex], and more," says Jane Chueh, M.D., director of prenatal diagnosis at Lucile Packard Children's Hospital Stanford, in Palo Alto, California. The baby will have measurements taken of the diameter and circumference of her head, the circumference of her abdomen, and the length of her femur bone. Ultrasounds can't detect all medical and genetic issues, but they can highlight physical characteristics that are suggestive of potential disorders.

How Do You Prepare for an Ultrasound?

After you make an appointment, your health care provider will give you an instruction sheet telling you what to do next. People who are less than 14 weeks pregnant are usually asked to fill their bladders to capacity before the exam. Sound waves travel better through liquid, and a full bladder improves the quality of the ultrasound. As the pregnancy progresses, this is not as essential because the uterus and fetus become so large—but even then, some providers still ask patients to come in with bladders full.

Here are a few other tips for your first ultrasound:

  • Wear two-piece outfits to the exam so the technician can easily access your tummy.
  • Be cautious when getting a 3-D ultrasound (for a keepsake, or for medical reasons). If you must get one, ask your provider if they can do it first, as they will be sure to follow safety protocols.
Updated by
Nicole Harris
Nicole Harris Author Bio
Nicole Harris joined the team in 2018 as a staff writer and was promoted to SEO editor in 2021. She now covers everything from children's health to parenting trends. Her writing has appeared in Martha Stewart Weddings, Good Housekeeping, The Knot, BobVila.com, and other publications. A graduate of Syracuse University, Nicole currently lives in Queens, New York with her husband.
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