For many people, seeing an ultrasound for the first time is both exciting and overwhelming. Alongside the emotion often comes a long list of questions about timing, safety, and what each scan is looking for. That’s completely understandable. Knowing what to expect can make the experience feel a little less uncertain and help you feel more prepared for the appointments ahead.
Most pregnancies include at least one routine ultrasound, with the main anatomy scan usually taking place between 18 and 22 weeks. According to the American College of Obstetricians and Gynecologists (ACOG), some people will also have an earlier scan during the first trimester, depending on their stage of pregnancy or medical needs. This information explains when ultrasounds are typically recommended, what each one shows, and what to expect at each stage.
Why an Ultrasound During Pregnancy Matters
For a lot of people, that first ultrasound image is one of the most emotional moments of early pregnancy. It’s the first time the pregnancy feels a little more real. That feeling is valid, and it’s part of why this appointment matters so much.
Ultrasounds give your healthcare provider important information about how your pregnancy is progressing. They help confirm how far along you are, monitor your baby’s development, and identify anything that may need closer attention. According to MedlinePlus, an early scan can confirm a pregnancy, estimate the baby’s age and due date, and check the heartbeat, while later scans evaluate your baby’s growth and position, as well as the placenta and the amount of amniotic fluid.
From the Nurse’s DeskWhat do you wish every patient understood before their first pregnancy ultrasound?
– Christine Kulle MSN, ANP-C, CNM, APRN, Advanced Care Provider |
When You Need an Ultrasound During Pregnancy: A Trimester Guide
The table below outlines the ultrasounds that are typically performed throughout pregnancy and what each one is designed to evaluate. While this timeline focuses on ultrasound appointments, your prenatal care also includes other routine assessments, such as bloodwork and blood pressure monitoring.
| Stage | Typical Timing | Type of Ultrasound | What It Can Show |
|---|---|---|---|
| First trimester | As needed, often 6–13 weeks | Early/dating ultrasound (plus nuchal translucency at 11–14 weeks) |
Confirms the pregnancy and heartbeat, estimates your due date, and may include a nuchal translucency ultrasound between 11 and 14 weeks as part of genetic screening. |
| Second trimester | 18–22 weeks | Standard anatomy scan (the main routine ultrasound) | Checks growth, the baby’s anatomy (heart, brain, spine), placenta, amniotic fluid, and can reveal the baby’s sex if you’d like to know. |
| Third trimester | As needed (usually after 28 weeks) | Growth or well-being scan (as needed) | Checks your baby’s growth and position, the placenta, and amniotic fluid when additional monitoring is recommended. |
Not everyone follows the exact same ultrasound schedule. The nuchal translucency ultrasound is often offered between 11 and 14 weeks as part of first-trimester genetic screening. Some pregnancies may require additional ultrasounds, including pregnancies involving multiples, gestational diabetes, or other conditions that require closer monitoring.
What Your Provider Is Actually Looking At
It helps to know what the sonographer is looking for during a standard second-trimester anatomy scan. The exam takes a detailed look at your baby’s development and the pregnancy overall, including:
- Growth and measurements — measurements of the baby’s head, abdomen, arms and legs help assess growth and development.
- Heart — the sonographer examines the baby’s heart, including its chambers.
- Brain, head and spine — these structures are examined as part of the baby’s developing anatomy.
- Placenta — the scan checks the placenta and where it is located in the uterus.
- Amniotic fluid — the amount of fluid surrounding the baby is also measured.
The sonographer also examines other developing structures and organs, including the baby’s face, kidneys, bladder, stomach and lungs.
This is systematic, not mysterious. As ACOG notes, a standard second-trimester ultrasound is typically performed between 18 and 22 weeks. Your provider can explain what was evaluated during your scan and whether additional imaging is recommended.
Is Ultrasound Safe for My Baby?
It’s understandable to have questions about whether ultrasound is safe during pregnancy.
According to the FDA, ultrasound imaging has an excellent safety record and, unlike X-rays, doesn’t use ionizing radiation. Ultrasound can produce effects in the body, including slight heating of tissue, which is why it should be used appropriately by trained healthcare providers. The American Institute of Ultrasound in Medicine (AIUM) similarly recommends using ultrasound prudently and limiting exposure to what is necessary to obtain diagnostic information.
Both the FDA and AIUM discourage the use of ultrasound solely for non-medical purposes, including “keepsake” scans. While diagnostic ultrasound has a strong safety record, these organizations recommend avoiding unnecessary exposure when there is no medical benefit.
Questions Worth Asking at Your Next Scan
Before your next appointment, it can help to know what you actually want to ask. Consider jotting down:
- Is this scan routine, or are you looking into something specific?
- What did my measurements show this time?
- Is my placenta in a normal position?
- Do I need a follow-up scan, and if so, why?
Bringing a short list like this turns a passive appointment into a real conversation. Don’t hesitate to ask why a scan or follow-up is being recommended. At RealOptions, our ultrasound imaging team will never make you feel like your question is too small.
When to Call Your Provider Between Scans
Some symptoms during pregnancy shouldn’t wait until your next scheduled appointment or ultrasound. The CDC’s HEAR HER campaign identifies urgent maternal warning signs that may require immediate medical attention. These can include:
- Vaginal bleeding or fluid leaking during pregnancy
- Your baby’s movement stopping or slowing down
- Severe belly pain that doesn’t go away
- A severe headache that won’t go away or gets worse over time
- Changes in your vision
- Extreme swelling of your hands or face
- Trouble breathing
- Chest pain or a fast-beating heart
This isn’t a complete list. If you experience any of these symptoms or feel that something isn’t right, CDC recommends seeking medical care immediately. Tell your healthcare provider that you’re pregnant or were recently pregnant and describe the symptoms you’re experiencing.
Take the Next Step with RealOptions
If you’re due for an ultrasound or have questions about your pregnancy, RealOptions Obria Medical Clinics offers ultrasound and prenatal care services across four Bay Area locations. Our team is here to provide clear information and compassionate support based on your needs.
Schedule Your Confidential Appointment
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Clinic Locations
Central San Jose
1671 The Alameda, Suite #101, San Jose, CA 95126
(408) 978-9310
East San Jose
12 N. White Road, Suite #1, San Jose, CA 95127
(408) 272-5577
Oakland
400 30th St, Suite #401, Oakland, CA 94609
(510) 891-9998
Union City
33523 Western Ave, Union City, CA 94587
(510) 487-4357
Medical Disclaimer
This website and blog do not provide medical advice, diagnosis, or treatment. Content from this website and blog is not intended to be used for medical diagnosis or treatment. The information provided on this website is intended for general understanding only. We do not refer for or provide abortion services at our clinics.
Frequently Asked Questions
How many ultrasounds will I have during pregnancy?
Most people have at least one standard ultrasound, usually the anatomy scan between 18 and 22 weeks. Some may have an earlier first-trimester scan or additional ultrasounds based on their individual pregnancy and medical needs, according to ACOG.
Is an ultrasound safe for my baby?
Ultrasound has an excellent safety record and doesn’t use ionizing radiation, per the FDA. Because scans can slightly warm tissue, the guidance is to use ultrasound when there’s a medical reason rather than for non-medical “keepsake” videos, which the FDA and AIUM both discourage.
What is the 20-week ultrasound looking for?
The standard second-trimester scan (often around 20 weeks) checks the baby’s growth, anatomy (including the heart, brain, and spine), the position of the placenta, and the amount of amniotic fluid, as MedlinePlus describes. It can also show the baby’s sex if you’d like to know.