At my 14-week OB check-in, the doctor said that if I wanted, I could get a “level 2” ultrasound with MFM for my anatomy scan. I presumed this is because I’m 40 this time around. But, as I then pointed out, this embryo is from the same “batch” as my son, when I was 38. And with my son, they never mentioned a level 2 ultrasound.

Ultrasound image - Mary's Bump Day Blog, Week 19: Anatomy Scan Anxiety

Author’s Personal Collection/Mary Mathes

So, I asked her, what matters more? The age I was when my baby was conceived, or the age I am while carrying her? Did she think I needed a level 2 ultrasound? Did she recommend it? Frustratingly, the answer was basically, “It’s entirely up to you and what you’re comfortable with.” She was just giving me the option. An option that might come with greater detail, clarity, and peace of mind, yes, but likely also higher cost, depending on the vagaries of how it got coded for insurance purposes.

At my next check in around 18 weeks, I saw a different doctor in the practice.

I asked her about it, hoping to get a more definitive answer. But again, she said they aren’t recommending it one way or the other, just giving me the option. She also reassured me that if I did the “regular” anatomy scan in their office, they’d still send me to MFM if they saw anything concerning.

While I guess I understand why they can’t / won’t give a clearer answer as to whether I should do this, it’s still frustrating. “I’m not the expert, you are!” I want to retort. You dangle this option in front of me but won’t say that I need it. It’s up to me, my husband, and our pregnancy loss + infertility + “advanced maternal age” baggage to decide.

I think I liked it better last time when this “option” wasn’t a possibility. I went to my anatomy scan completely confident it was the right course, unaware I could have made a “higher level” choice.

So, should I do the level 2 this time because it’s available, and having a more thorough check may help assuage my anxiety?

(The side benefit is that it won’t be in the same ultrasound room where I learned my first baby no longer had a heartbeat). Or has debating whether to do it these last few weeks just fed my anxiety? Would the more hopeful choice be to stick with level 1, and trust that if needed, level 2 is there?

I called my husband from the exam room after the doctor stepped out. We decided, for now, to stick with the “normal” anatomy scan. So, that’s what I scheduled, coming up in a few weeks. Until then, I will eagerly await the first definitive “flutters” of my little Butterfly. And probably continue to debate whether it’s the “right” choice. Fingers crossed.

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