Questions to Ask at Your 20 Week Ultrasound
Questions to ask at your 20 week ultrasound, the anatomy scan offered around the middle of pregnancy, and at the 20 week appointment with your midwife or doctor when that is a separate visit. They start with the basics (what the scan checks, whether the sex can be seen, whether you will hear results today), move through the baby's measurements, the placenta and your own anatomy, then the report and what follows, and end with the check-up: the tests, visits and plans for the second half of pregnancy. Both are timed, so mark the handful that matter most to you.
The questions
Each question, and why to ask it
The basics
What exactly are you checking for at this scan?
Why ask it
The survey works down a list that most services share in outline: head and brain, face, spine, heart, stomach, kidneys and bladder, limbs, then the placenta, fluid and cord. Hearing it at the start gives you the shape of the appointment and makes the long silences between measurements easier to sit through.
Can you talk me through what you're looking at as you go?
Why ask it
Some sonographers narrate happily and others need quiet to measure, so ask which this one prefers before the gel goes on. If the answer is to wait, ask them to point out a few landmarks at the end, when they can turn the screen and slow down.
Does everything look the way you'd expect at 20 weeks?
Why ask it
It is the question everyone has, and it is fine to ask it outright. Be ready for a limited answer: in many services the person scanning can describe what they see but has to leave the conclusion to whoever signs the report, so a careful reply is a rule being followed and not a hint.
Can you tell the sex today, and how sure can you be?
Why ask it
Say first whether you want to know, because the survey passes over that area either way. It is a judgement from a picture and depends on how the baby is lying, so ask how clear the view was. A few clinics have a policy of not saying at all, which is worth finding out before you plan a reveal.
Will I get the results today, or does a doctor review the images first?
Why ask it
Arrangements differ a lot. Some clinics have a doctor come in before you leave, others send the report to your midwife or obstetrician and you hear at the next visit. Find out which it is, so that going home without a verdict doesn't read as bad news.
How long will this take, and will I be able to see the screen?
Why ask it
Anatomy scans usually run longer than earlier ones, and how long depends partly on how the baby is lying. In some rooms the screen is angled away while measurements are taken. Knowing that beforehand stops the setup from feeling like something is being kept from you.
If we'd rather find out the sex later, can you write it down and seal it?
Why ask it
Plenty of parents want the answer saved for a party or a quiet moment at home. Ask before the scan starts, bring your own envelope in case, and have the sonographer tell you when to look away from the screen. Not every clinic will do it, so check before you promise anyone a reveal.
Do you have my earlier screening results and medical history in front of you?
Why ask it
A referral doesn't always carry the full picture: blood test results, medications, a previous pregnancy, a heart condition in the family. Any of these can decide which structures get a longer look, so a quick check at the start beats assuming the file arrived.
Can my partner stay for the whole scan, and may we film or photograph the screen?
Why ask it
Rules on who may come in, children included, are set by each clinic. Many rooms ban phones during the medical part and then allow a short clip at the end. Asking first saves being told to put the phone away halfway through.
Can I have printed or digital images, and is there a charge?
Why ask it
Policies range from free printouts to a paid photo package to nothing at all, and a 3D picture, if you were hoping for one, is often not part of a medical scan. Asking at the start tells you whether to have a card or cash ready, and beats finding out at the end, when the sonographer is already saving and closing.
Do you need my bladder full for the whole scan, or can I empty it partway?
Why ask it
Preparation instructions vary between clinics, and at this stage some don't ask for a full bladder at all. If yours did and you are uncomfortable, say so early: the views that need it can often be taken first.
Might you need to do an internal scan today, and would you ask me first?
Why ask it
It occasionally comes up when the cervix or a low placenta can't be seen clearly through the abdomen. Raising it before anything starts means the reason and your yes or no are settled in advance, and you can say now if you would want a chaperone in the room.
Is a scan this long safe for the baby?
Why ask it
A common worry once you hear how long the survey takes, and a fair one to say out loud. Ask how the unit thinks about scan time. The usual answer is that they scan for as long as the examination needs and no longer, which is also why the tour of the face at the end is brief.
The baby
How big is the baby, and does that fit my dates?
Why ask it
You will usually hear measurements of the head, the abdomen and the thigh bone, sometimes with an estimated weight. A weight worked out from a scan carries a margin of error, so the half of the answer to hold on to is whether the size is in keeping with your dates.
Are the measurements plotted on a chart I can look at?
Why ask it
Seeing a point on a growth curve is more informative than hearing a number, because it shows how much of the normal range sits either side. It also makes clear that these are population ranges rather than targets.
Does anything today change my due date?
Why ask it
In most services the due date is fixed at the first-trimester scan and rarely moved afterwards, because babies differ more in size as pregnancy goes on. If someone proposes changing it now, ask what specifically justifies the change.
Is the baby moving much in there, even if I can't feel it yet?
Why ask it
Watching kicks on the screen that you can't feel is one of the stranger pleasures of this scan, and a comfort if you have felt little so far. If the baby is still, you may be asked to cough, roll onto your side or take a short walk. That is the sonographer trying for a better view.
What is the heart rate today, and is that what you'd expect?
Why ask it
A baby's heart beats far faster than an adult's and the rate shifts from minute to minute, so one number means little without the expected range beside it. Ask for both. This is also the natural moment to ask to hear it, though not every clinic plays the sound.
Could you see all four chambers of the heart, or does it need another look?
Why ask it
The heart is small, fast and easily hidden by an arm or by the way the baby is lying, which makes it a common reason for being asked back. If the views are complete, ask what a clear heart view does and doesn't rule out, since not everything about a heart can be seen this early.
Have you been able to see the whole spine and the structures inside the head?
Why ask it
These views take up a good part of the appointment and depend on how the baby is lying. Ask whether each was seen in full or only in part. 'Not seen today' and 'seen, and it looks unusual' are very different sentences, and you want to be sure which one you are hearing.
Can you see the stomach, kidneys and bladder?
Why ask it
A stomach bubble and a bladder that fills and empties are part of how the survey checks that the baby is swallowing fluid and passing it. That is why a sonographer may return to the same spot ten minutes later: sometimes the organ was simply empty on the first pass.
Could you show me the face, hands and feet before we finish?
Why ask it
The lips, fingers and feet are looked at as part of the survey, and they are also the pictures most parents came hoping for. Asked at the end, once the measuring is done, this gets you a slower tour. If the hands stay fisted or tucked away, a clear look may not be possible today.
Is the baby lying in a good position for you to see everything?
Why ask it
A baby curled facing your back, or with an arm across the chest, can hide structures that are perfectly fine. The answer tells you whether an unfinished scan today is about anatomy or about geometry.
Is the baby head down or breech right now, and does it matter yet?
Why ask it
There is still room to turn at this stage, and position is written down mainly because it explains which views were hard to get. The follow-up worth asking is when in pregnancy your team starts to care which way up the baby is.
Placenta and you
Where is the placenta, and how far is it from my cervix?
Why ask it
A placenta on the front wall can cushion early kicks, which explains a lot if you have felt less than you expected. If it is described as low, ask for the distance from the cervix and the week it will be looked at again, because a low position found now is commonly rechecked later in pregnancy.
Is the amount of fluid around the baby what you'd expect?
Why ask it
The usual answer is a short 'normal', and that is all you need. If you hear 'a little high' or 'a little low', ask what it is being weighed against, such as the baby's size, kidneys and bladder. A single reading is an estimate, and the common next step is another look in a few weeks.
How many vessels does the cord have, and where does it join the placenta?
Why ask it
Both details are on the checklist and both tend to appear in the report with no explanation. If the count or the attachment point is described as unusual, ask what the practice is where you are: some services add growth scans later on, others simply note it.
Are you measuring blood flow to the placenta or through the cord today?
Why ask it
Some units add a Doppler reading at this scan, some only when there is a reason, and many not at all. If yours does, ask what the reading is meant to predict and whether it changes how often you will be seen. If it doesn't, that is a difference in protocol and nothing was skipped.
Do you measure my cervix at this scan, and what did it show?
Why ask it
Whether the cervix is measured now depends on the service and on your history, with an earlier preterm birth or cervical surgery the usual reasons. If yours was measured, ask for the number and whether it changes anything. If it wasn't and you have that kind of history, say so before you leave the room.
Did you see anything on my uterus or ovaries, such as fibroids?
Why ask it
The survey is of the baby, but the probe passes over you too, and a fibroid or a cyst can end up in the report as a single unexplained line. If something was noted, ask where it sits and whether anyone expects it to matter for the pregnancy or the birth, so the report isn't where you first meet the word.
Results
Did you get every view on the checklist, or is anything still outstanding?
Why ask it
Ask this before you get off the couch. An incomplete survey is common, and the list of what is missing tells you exactly what a second appointment would be for. 'We got everything' is also worth hearing said aloud.
If something doesn't look right, what happens before I leave today?
Why ask it
Units handle this differently: a second sonographer, a doctor called in, or a call from your own clinician within a set number of days. Once you know the routine, a sonographer stepping out of the room stops being frightening by default. Ask too whether you would go home with a written plan.
What would this scan not be able to pick up?
Why ask it
The answer keeps a normal result in proportion. Some conditions only become visible later in pregnancy, some never show on ultrasound, and how much can be seen depends on position and image quality on the day. A clinician who answers this one readily is easier to believe on the reassuring parts.
If you see a soft marker, how is it read alongside my earlier screening?
Why ask it
A soft marker is a small variation that nudges a probability, and it is not a diagnosis. What it means for you depends heavily on results you may already have, such as first-trimester screening or a blood test. Ask whether the two have been put together, and by whom, before you take the term home.
Is there anything on the report that looks alarming but is actually routine wording?
Why ask it
Reports are written for clinicians, so phrases such as unremarkable, no gross abnormality or views limited by fetal position read worse than they are meant. Getting the translation now saves an evening of searching.
Can I get a copy of the report, and when will it be available?
Why ask it
The report is the record that follows you through the rest of your care, and how you get it varies: an app, a letter, or a request to the clinic. Asking now is easier than chasing it in two weeks.
How will I be told if something comes up when the images are reviewed later?
Why ask it
The scan and the doctor's read of it can be days apart. Ask who would phone or write, roughly how soon, and the date after which silence is worth chasing. 'No news is good news' only holds if you know when the news was due.
Once I've read the report, who do I ask if I have questions?
Why ask it
The report often lands in an app or the post after everyone has gone home, with a term in it that nobody explained. Get a name or a desk and a number, and ask how long a reply normally takes, so the choice isn't between a search engine and waiting for your next visit.
Is there anything from today I should raise with my midwife or doctor?
Why ask it
A sonographer who can't give a verdict can often still say 'mention the placenta position at your next visit' or 'nothing in particular'. It is a way of asking for a steer without asking them to break their rules, and either answer hands you the first line of your next appointment.
Next steps
If you need me back to finish the views, how soon should that be?
Why ask it
Ask who decides the timing and whether there is a window your service aims for. Then book before you leave if the desk allows it, since a repeat arranged by letter can drift by weeks.
If everything is normal today, is this my last routine scan?
Why ask it
Schedules differ by country and by provider. Some offer a growth scan in the third trimester as standard, others scan again only when there is a reason. Finding out which applies stops you reading meaning into an empty calendar, or into a new appointment.
Will my midwife or doctor have this report before my next appointment?
Why ask it
Scan units and antenatal clinics don't always share one system, and a report can turn up after the visit that was meant to discuss it. If your appointment is within a few days, ask whether to carry a copy yourself or have the unit send it ahead.
Does anything from today change who leads my care from here?
Why ask it
In some systems a scan finding moves you from midwife-led care to a doctor or a specialist team. In others your obstetrician stays in charge and adds a referral. If anything moves, ask what changes in practice: where you are seen, how often, and whether it affects where you can give birth.
Does anything you saw today change what I can do, like exercise, travel or work?
Why ask it
Usually the answer is no, and hearing it said is the point. Where a low placenta or a short cervix has been noted, some clinicians give specific instructions and some give none. Get them from whoever is responsible for your care, in words you can repeat, and not as a passing remark in the scan room.
If I book a private scan as well, will what it shows reach you?
Why ask it
A keepsake or private scan sits in a separate record, so something mentioned there may never reach the team making decisions about your care. Ask what you would need to bring, and to whom, for it to count.
Will a follow-up scan be billed or covered the same way as this one?
Why ask it
Where you pay or claim for care, a routine anatomy scan and a repeat can be coded differently, and a referral to a specialist unit may sit under another provider altogether. Ask the front desk, then your insurer. In a publicly funded system the question is only whether the next scan is on the standard schedule.
What should I know about the baby's movements between now and my next appointment?
Why ask it
Around this stage many people begin to feel movement, and patterns become the thing you are asked about later. The useful part of the answer is what to do if a pattern changes, including who to call outside clinic hours.
20 week appointment
Can we go through the scan report together while I'm here?
Why ask it
If the ultrasound was a few days ago, this visit is often the first time you sit across from someone who is allowed to interpret it. Bring the terms you didn't follow, and for each one ask whether it changes anything about your care.
Which tests are coming up between now and the third trimester, and roughly when?
Why ask it
Schedules are set locally, so the list in a pregnancy book may not be yours. Many include a blood sugar test and a repeat blood count somewhere in the weeks ahead. Find out which need fasting or a longer slot, since those are the ones to plan a morning around.
How often will I be seen from here, and when do the visits get closer together?
Why ask it
The gap between appointments usually shrinks toward the end, but the pattern depends on your service and sometimes on whether this is a first baby. Rough dates now make it easier to warn an employer or line up childcare.
Were my blood pressure and urine check today what you'd expect?
Why ask it
Both tend to be done at every visit and reported with a nod. Hearing the actual reading, and what each check is watching for, gives you a baseline to hold later months against.
Are there vaccines you'd recommend during this pregnancy, and at which weeks?
Why ask it
What is offered, and when, differs by country and sometimes by season. Check where they are given as well, because in some places that is the clinic and in others a pharmacy or your family doctor.
Which symptoms should I call about the same day, and which can wait for my next visit?
Why ask it
Write the list down in the words your midwife or doctor uses, next to the number to ring and where to go if nobody picks up. A list from your own team reflects your history, which a general one cannot.
What can I safely try for the backache, heartburn or bad sleep I've been having?
Why ask it
Name the specific complaint, how often it comes and what you have tried already. Check before taking anything from a pharmacy shelf, herbal remedies included, since what is considered fine in pregnancy isn't always what you would guess.
When should I book antenatal classes, and are there ones you'd point me to?
Why ask it
Popular courses can fill well ahead, and some are free through the hospital while others charge. Whoever runs your care will usually know which local ones cover feeding and the early weeks as well as the birth.
When do we start talking about where and how I'd like to give birth?
Why ask it
Halfway is early for a birth plan, but not for learning what the options are where you live: which hospitals or birth centres you can choose, and whether anything in your history narrows the choice. Some units want you registered by a certain week.
Is there paperwork I'll need from you for work or maternity leave, and from which week can I have it?
Why ask it
Leave and pay rules belong to your country and your employer, so the clinic can only tell you its part: which form or certificate it issues and when. Take that date to whoever handles leave at work and get the rest from them.
Who can I talk to if I've been feeling low or more anxious than usual?
Why ask it
Visits at this stage tend to centre on measurements, and mood gets a passing 'how are you feeling?' at best. Saying it outright lets them tell you what support exists and how a referral works where you are.
Working through the appointment
Practical guidance for the conversation itself
Before and during
Use the instructions from your own clinic
Guidance on food, drink and bladder differs between services, so follow the letter or message you were sent instead of general advice. Bring your maternity record if you hold one, along with any earlier scan reports from elsewhere.
Decide in advance about being told the sex
Say what you want at the start, because the survey involves looking either way. If one of you wants to know and the other does not, or you want it written down for later, agree beforehand how that will be handled in the room.
Match the group to the moment
The basics are for the first minute, before the gel goes on. The baby and Placenta and you fit the pauses between measurements, or the end if your sonographer prefers quiet. Results and Next steps are for the last few minutes, before you leave the room, because they are the hardest to get answered by phone afterwards.
If the 20 week appointment is a separate visit
In some services the scan and the check-up with a midwife or doctor fall on the same day, and in others they are a week or two apart. Keep the last group for whichever visit puts you in front of the person who manages your care, and take the scan report, or your questions about it, along.
Keep questions for the end unless something worries you
Measurements need concentration, and most sonographers will set aside time afterwards. If something on the screen worries you during the scan, it is reasonable to say so instead of waiting.
If your scan is at a different week
The basics, Results and Next steps apply to any pregnancy ultrasound. An early scan is mostly about dating and a late one about growth, position and fluid, so the detailed anatomy questions here belong to the mid-pregnancy scan. Ask at the start what this particular scan is for.
Reading the report
- Measurements are compared to a range for the gestation. A value near the edge of that range is common and often means nothing on its own.
- A soft marker shifts a statistical likelihood and is not a diagnosis. Ask how it is read alongside your earlier screening before drawing any conclusion from the term.
- A normal scan lowers risk but does not exclude every condition. Some are not detectable at twenty weeks.
- Unremarkable and no abnormality detected are the phrases you want to see, however blunt they read.
- If a term is unfamiliar, ask the clinic what it means before you search for it. A search tends to put the rarest and most frightening explanations first.
If a repeat scan or referral is arranged
Get the reason in writing
Ask what exactly is being rechecked and why. Being called back to finish views the baby's position hid is a different thing from being called back to look again at a finding, and knowing which yours is spares you weeks of guessing.
Confirm who is booking it and by when
Referrals fall through at the handover between departments. Note who is arranging it, the expected timescale, and the number to call if the appointment has not arrived.
Bring someone to the follow-up
A second person remembers what you miss. If nobody can come, ask whether the discussion can be summarized in writing or recorded for you.