You’ve made it through the first trimester! Early miscarriage is no longer a fear. You feel more energetic. Your appetite has returned and hopefully you’re feeling better. The only thing that may not have eased is the fear and anxiety that seem to always persist. You’re still waiting for the other shoe to drop, even if it’s just in the back of your mind most days.

And then comes the anatomy scan. The 20-week look at your growing baby.

For most expecting parents, the 20-week ultrasound is an exciting time. You can find out your baby’s sex at this ultrasound. You are able to spend a significant amount of time looking at all features of your baby. Some of the best pictures you get before birth are taken at this scan.

But for those expecting again after a loss, the 20-week ultrasound can be a scary, anxiety-ridden time. It may be the time that you found out something was wrong with your other baby, or when you found out that other baby had already passed. For some, it may be the first time you’ve ever even made it this far in pregnancy. This may be the first time you’ve had this ultrasound, and you’re not sure what to expect.

Once you enter the pregnancy and infant loss world, you become acutely aware of all the different ways babies can die in pregnancy and infancy.

I remember the first thing I said to my husband after our first support group after our baby, Lily, died: “I had no idea how many different ways babies could die.” Lily also died at 20-weeks and we never made it to that anatomy scan. It was scheduled, but I went into labor before it, and she was stillborn before we could make it.

So, for me, the 20-week scan was kind of an enigma. It didn’t feel like an exciting milestone, even though all our family and friends seemed so excited for it. I was fearful of everything that could happen at that scan. Every little thing they could tell me that was going wrong with my pregnancy. A friend at group found out there was no heartbeat at the 20-week scan. Another friend found out about the congenital heart defect the baby had that would require the baby to have surgery pretty much immediately after birth. Yet another found out that the baby had Trisomy 18, and would likely not make it to birth, or if so, would die shortly thereafter. It was terrifying imagining all the things they could tell me at that appointment. And of course, none of what came to mind was good.

In the end, my scan was fine.

It was incredible to see the baby and the intricacies of the baby’s organs – four chambers of that beautiful heart! What an incredible spine. How strong was that arm muscle! The baby looked so very different from the 12-week ultrasound. They did find out there was something slightly concerning with the baby’s kidney, but a re-check at 28 weeks may show that it resolved itself (it did).

Sometimes, medical technology is a blessing and a curse. It’s amazing how much they can tell from that scan. It’s incredible how much you can learn that early on. But, at the same time, there’s so much development that there’s so much that could still change. It’s hard to get “news” that may or may not be a problem later on.

I went through three pregnancies after losing Lily, and each time I felt the same way about the 20-week ultrasound. I was always waiting to hear the worst possible news. While they always found something they wanted to keep an eye on or re-check, it was always fine in the end. Luckily.

So, what can you do to help manage anxiety leading up to the scan? Here are some tips from a rainbow mom who’s been there a few times.

  • Tell your healthcare provider about your fears. Let them know how triggering this appointment will be for you and they can hopefully help you navigate the time. It may be possible to set up a care plan if the scan indicates a problem, whether it be an immediate consult with a specialist, or an appointment quickly thereafter to debrief. The minimum they can do is brief the team doing the scan so they know how to handle the anxious parent.
  • Tell the sonographer to be gentle with you and why some extra TLC is needed. Also, ask them for more time and more pictures of this baby. If they can explain more about what they’re looking at and what they’re looking for, that will help ease anxiety. It always feels worse when they’re not saying anything!
  • Get a good night’s sleep and try to schedule the appointment for first thing in the morning, so you don’t need to wait all day just letting the anxiety build!
  • Relax and breathe. Relaxation exercises and meditation can do wonders for calming nerves.
  • Try to remember that until someone tells you otherwise, there’s no reason to believe your baby is anything but healthy.

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