In today’s day of home pregnancy tests, moms can learn they are pregnant as early as 3 weeks along. This can lead to a flood of phone calls wanting early ultrasounds. It can be very hard to ask a woman to wait to see her tiny embryo on the screen; especially when that woman is extremely anxious to believe her pregnancy test.

Many women go through multiple cycles before becoming pregnant. Some women experience heartache and miscarriages; others have waited years. These women do not want to wait until 7, 9, or 12 weeks along to have an ultrasound. Seeing even a tiny sac on the screen will be overwhelming to them.

It is up to you to decide at what gestational age that you begin seeing women; however, it is always advisable to have a mother confirm her pregnancy with her doctor before coming into your business. If early scans are a part of your practice, make sure that you speak to your clients about what they will experience and learn during this appointment.

The mother will learn the gestational age of the pregnancy. They can see the start of a pregnancy as early as 4 weeks and 3 days along (but some pregnancies cannot be seen until 5 weeks). A mom will see the beginnings of a gestational sac, but no heartbeat or further fetal development yet at this stage. An embryo and fetal heartbeat can be detected as early as 6 weeks, but may not be picked up until further along.

Before beginning the ultrasound, inform your client of the following:

• at 5 ½ weeks gestation a tiny sac can be seen in the uterus, but the baby and its heart beat may not be detected yet. 5 ½ weeks gestation means 5 ½ weeks from the first day of the last menstrual period, which is usually about 3 ½ weeks from the date of conception.
• By 6 to 7 weeks gestation the fetus is clearly seen on ultrasound and the heart beat can be seen at this early stage (90 to 110 beats per minute under 6 to 7 weeks, then 110 to 200 beats per minute as the baby matures).
• By 8 weeks gestation the baby and its heart beat can be detected relatively easily.

Be prepared to see ectopic pregnancies, no gestational sacs, faint or no heartbeat, or multiple sacs, but always remember that you are not the mother’s doctor. While you can explain what you see, you should always recommend a follow up appointment for the client. This goes for pregnancies in which everything looks great, too. One in four pregnancies end in a loss, so confirming a pregnancy on an early ultrasound can still end in heartache. Make sure that you record every heartbeat that you can at this stage for families, as you don’t know if it will be present again in the near future.