Care for Wishek's Unborn: Understanding Ultrasounds
by Zoe Sayler
The first ultrasound visit is often the most anticipated visit during pregnancy and a source of excitement for the new baby's family. Ultrasound is a safe way to see baby prior to birth and uses sound waves to see structures like facial features, the heartbeat, fingers, and toes. This is also a way to find out baby's sex. Doctors share in the excitement at these visits because ultrasound allows them to check-in on baby's overall well-being.
The American College of Obstetricians and Gynecologists currently recommends at least one ultrasound during pregnancy that is performed sometime between 18 and 22 weeks. If the “baby bump” size isn't matching with weeks of pregnancy, the ultrasound is often done earlier. During this first scan, referred to as the anatomy or morphology scan, doctors and ultrasound technologists can check baby's brain, spine, kidneys, heart, and other internal organs.
More often than not, the ultrasound exams are normal. If the ultrasound shows an abnormal finding, doctors schedule more check-ups and repeat ultrasounds for baby. Ultrasounds are also done more often if moms have certain health conditions like diabetes or hypertension, a situation where the pregnancy is called high-risk. These frequent check-ins guide birth plans. For example, sometimes ultrasound information may indicate an early delivery is best for baby if growth has slowed. If other concerns are seen, the rural and urban medical teams will discuss if the delivery is best in the home community or if a larger city facility with specialized baby doctors is necessary.
Sadly, some of North Dakota's moms don't get medical care during their pregnancy. This results in missing the chance for ultrasound to play its important role in the care of mom and baby. The North Dakota Health Department reports that in 2016, nearly 15% of pregnant women either received no care at all during their pregnancy or no care after their first 3 months of their pregnancy. That translates into more than 1,600 North Dakota newborns missing out on their first physical or follow-ups.
In many rural North Dakota communities, ultrasound technology is not available. According to Bev Vilhauer, CEO of Wishek's South Central Health, this lack of ultrasound capability is often due to lack of rural technologists. Although they do have ultrasounds 3 days a week in Wishek, she said they do not have someone trained to perform the more detailed scans. To access this technology, round trips of close to 100 miles are sometimes necessary. Vilhauer said that currently, the Wishek area has a transportation option to overcome that barrier.
Change is likely coming for Wishek and other North Dakota rural women and their newborns. With recent advances in technology for ultrasound, more rural providers may be able to receive more training and to do more local testing with handheld technology connected to devices like smartphones. These advances – combined with specialists in urban areas using telehealth – may soon decrease travel needs and the difficulties in finding specialty-trained professionals to provide care in rural communities where the need for ultrasounds for unborn babies will always be present.
About the Author
Zoe Sayler is a fourth year medical student at the University of North Dakota School of Medicine & Health Sciences. As a participant in the Center for Rural Health's Targeted Rural Health Education (TRHE) project that emphasizes the importance of rural newspapers, Sayler has written this column for North Dakota citizens living in Wishek and other rural areas of North Dakota. This information is not for diagnosis or treatment, and should not be used in place of previous medical advice provided by a licensed practitioner.