July 14, 2006 -- Spending just a few extra minutes with a mother-to-be during her fetal ultrasound exam can pay off by strengthening her bond with the unborn baby and quelling her anxiety, according to a new study.
"You might call it personalizing the ultrasound," says C.F. Zachariah Boukydis, an associate professor at the Erikson Institute in Chicago, and an author of the study, presented July 12 at the 10th World Congress of the World Association for Infant Mental Health in Paris. The study was also published in the June 2006 issue of the Journal of Ultrasound in Medicine.
"Clinically we have known that ultrasound can influence attachment," says Boukydis. But he says this study is the first to scientifically examine the connection.
Boukydis and his colleagues assigned 24 women to a "routine care" group, which received the standard fetal ultrasound exam. They assigned another 28 women to a "consultation" group. They also received an ultrasound, but with a specific consultation on fetal development and encouragement to interact with the unborn child. All the women were between 16 and 26 weeks pregnant.
Fetal ultrasound uses reflected sound waves to produce a picture of the fetus, which can be displayed on a TV screen or monitor. The test is a safe way to check for problems in the unborn baby and obtain information such as the fetus' size and position within the womb.
Just 3 Minutes More
The extended consultation takes little extra time, Boukydis says. "In our standard care group the average time [for an exam] was around 14 minutes or so, and for the ultrasound consultation group, 17 minutes."
During the consultation, the sonographer pointed out some of the physical features and organs of the fetus and determined the sex, only telling parents if they wanted to know. The sonographers also allowed the mother-to-be (and father-to-be, if he was there) to ask questions and explore the unborn baby's responses to the woman's actions, such as pressing on the abdomen, laughing, singing, or speaking to the fetus.
Before and after the exams, Boukydis asked the women to complete questionnaires assessing a variety of measures, such as maternal anxiety and their feelings of attachment to the unborn baby.
"The feelings of attachment in the consultation group increased by about 20% [compared with the routine care group]," he says. "Anxiety scores went down by about 30% (again compared with the routine care group)."
Boukydis is hopeful the more detailed consultation will also inspire women to pay closer attention to their prenatal habits, such as eating healthfully and not drinking alcohol. He plans to study that soon.
While he only questioned the mothers, Boukydis says the consultation experience is likely to help fathers feel closer to their unborn child as well. "About 15% of both study groups had the fathers present," he points out.
Another Expert's Perspective
"The results definitely make sense," says Khalil Tabsh, MD, medical director of The Perinatal Center at Santa Monica -- UCLA Medical Center in California, and chief of the division of obstetrics at UCLA's David Geffen School of Medicine. "It's been shown that both mother and father bond with a baby just by observing movement on ultrasound."
While other studies have examined the ultrasound-bonding link, the new study looks at it in a more scientific way, Tabsh says. "They used psychological scores to document and prove it."
Time constraints in medical practices might be an issue in extending the exam time, Tabsh says. But he says most doctors and sonographers already spend some time pointing out physical features of the unborn baby.
Time can be maximized by zeroing in on what Tabsh finds is important to most parents. "Most parents want to see the face, the hands, the legs; and they want to see the baby moving. Most of the time they want to find out the sex of the baby," he says.
What Parents-to-Be Can Do
Ultrasound exam practices vary across the country, Boukydis says. "There are still places where the woman is not invited to look at the monitor."
Before having a fetal ultrasound, he says, a woman can say: "I would like to look at the monitor while you are doing this." She can also ask, "Can you tell me not only what the baby looks like, but can we take a minute to look at what my baby does?"
Also, women can request pictures or tapes to take home, a common practice.