"20 week antenatal scan"

I attended the QMC Antenatal department yesterday for my 20 week pregnancy check up. I would like to begin with the fact I am absolutely aware of the tremendous pressure the NHS are experiencing currently on top of any normal stresses of the job and appreciate the services you provide.

Yesterday however, was an experience I wish to never have to experience again, nor wish upon any other pregnant woman. When my name was called out, I retrieved my husband from the corridor, as we entered the room the sonographer quite swiftly told him to sit in the square allocated and not to move from that spot. We understand the restrictions with Covid, however this was a very short demand which put us both on edge however we brushed it off, nervous and excited to begin the scan.

For context, this is my first pregnancy which would have been clear from my notes and during our 12 week scan our baby was extremely active so that was the expectation set in our minds. When the sonographer started the scan, we were both shocked as we looked at the screen at the lack of movement shown by our baby and we also couldn’t see a heartbeat which was extremely obvious during the first scan. I was tilted back to try and encourage the baby to move positions, however this meant I could no longer see the screen and only had my husbands face, the sonographers face and the ceiling. At the beginning they did inform us that their review would take 10 minutes then they would talk everything through with us, so we sat there in absolute silence for 15 minutes with the sonographer at points asking me to lie on my side to get different angles but every time I saw the screen there was no movement which was coupled with the look of fear on my husbands face. The only reassurance I had was that the sonographer had not immediately referred for a second opinion and they continued to look at the screen with concern.

My husband after 5 minutes started making the odd comment about her movement, or suggesting she was sleeping just to try and engage with sonographer and to seek assurance that our baby was okay to which the sonographer didn’t respond. After 10 minutes or so my husband spoke out and outright asked ‘is that the heartbeat?’ when he saw a flicker to which the sonographer replied ‘yes’ and turned back to the screen in silence. The fact my husband had to ask this question following the previous comments would have surely indicated to the sonographer that we had little understanding and showed concern from us, however they continued to review the screen in silence.

Finally towards the end of the scan my husband said he saw some movement from our baby when she extended her legs and move her arm, however as you can imagine by this point we still had no idea whether this previous lack of movement was reason for concern and all we simply knew now was that she hadn’t died or wasn’t critical. The sonographer finally spoke to us and said with a smile that our baby was ‘being naughty’ and therefore they had been finding it difficult to complete all the required checks, but believed this had now been done. This comment alone caused a huge relief for us because it indicated some normality of behaviour from our baby, but we did feel it was too little too late. Now that the scan was finished, we therefore were expecting to be given a run down of all the information collated during those 15 minutes, however the sonographer simply provided me some tissue to wipe the fluid off my stomach and said I could go and wait in the waiting room.

At this point, we started asking multiple questions whilst we had the chance – was the lack of movement normal? Were the figures collected in line with the expected growth for 20 weeks? Where was my placenta situated? Did you manage to identify the gender? To which this person replied with extremely brief answers in order of each question asked.

My only assumption left was that once they inputted the data into the computer they was going to talk me through the results before leaving, however when they called me up to collect my maternity notes they simply advised that ‘it was a difficult scan due to the persistent fetal position’ and ‘based on the limited view, they couldn’t identify any anomalies’. I left the hospital feeling completely empty, confused and worried.

Experiencing my first pregnancy during a pandemic without the support of close family & friends is difficult enough however following yesterdays experience I felt completely shaken and worried for my baby’s wellbeing so I have therefore managed to get a last minute appointment at a private clinic to hopefully be given the support and information I need to put my mind at ease.

The NUH values and behaviours clearly encourage and endorse Trust, Mindfulness and Nurturing among others of which were not observed yesterday. I am fully appreciative that the purpose of these scans are not to provide a magical experience, it is a medical procedure and the sonographer is there to do a job at the 20 week anomaly scan to be able to check off a list of factors that our baby might have developed. However I will say, that the smallest amount of verbal cues and information during these checks, with more focus on patient centred care would have made the whole experience very different. I am writing this because there is a chance that the sonographers may simply not be aware of the significant impact their personable skills have on the patient, their mental health and whole view of pregnancy of which is crucial feedback to be provided immediately to those working in patient facing roles.