Early scans
Depending on your loss, you may be offered an 8 week ‘viability’ scan. It is up to you whether you want it. Some parents want to hear a heartbeat as soon as possible. Others wish to wait until 12 weeks. Whatever your choice it is up to you. If you were seen by a bereavement midwife and are having your care at the same hospital, she may be able to book your scan. You can also ask her to sit with you while you wait for the scan too.
What to ask
Supplements and medication
When you first receive a positive test ask your GP whether you should be taking lose dose aspirin or high dose folic acid. Depending on your individual circumstances your GP may ask you to take lose dose aspirin as studies have found that this can improve the flow of blood to the placenta and to the vessels that feed it. Heparin is another drug that is sometimes used
The studies have found no negative side effects to the baby. Your GP will be able to explain this to you in more detail should this be something you want to know more about. If you would like to know more about these drugs in preventing pregnancy loss please look at these studies here here and here
Sometimes the level of folic acid in suppliments (400mg) may not be absorbed for various reasons. High dose folic acid is 5000mg, more than 10x that found in regular supplements, which ensures that it will be absorbed. It also improves the flow of blood down there, but is not routinely prescribed unless by a consultant. More information on high dose folic acid here
Where your placenta is
Ask the sonographer to tell you where your placenta is. If it is at the front of your tummy then you will not be able to feel the baby move so much. This can be reassuring to you if you know that is the reason why you can’t feel movements as much
Ask the healthcare provider if the placenta is over the cervix. If so ask them if it is safe for you to have sex. If you are using aspirin, or if your placenta covers the top of the cervix, the midwife/consultant/sonographer may ask you to wait until the placenta moves (as your uterus expands the placenta moves round usually)
When to ask for another scan
Babies sleep in 40 minute cycles. When you go for a sonograph the baby may not move as much as they may be sleeping which is normal. However, an active baby is always a good sign. If you have been to scans and the baby is not that wiggly at both, for peace of mind either ask to be scanned again later that day, and insist, do not take no for an answer or go for a private scan
The health team should be deeply sympathetic to your anxiety should you go in for monitoring to check your baby’s movements. You can ask them to turn the sound on the doppler or sonograph sound off until they have heard them.
Post 28 weeks, if you need to go for a check because you are concerend about movements, the midwife will undertake monitoring of the babys movements by putting two straps over your belly, one to measure their movements and the other to measure if there are any contractions. You should also be offered a follow up scan. This is not the case pre 28 weeks.
Sometimes the midwife may just listen to the baby’s heartbeat for a very short amount of time. If you feel reassured by this that is fine. You may be told that the baby is too small and that’s why you don’t feel their movements. Only you know what you feel and whether something feels right or not.
Insist on a scan for reassurance.
Ask them to measure the baby’s growth. Ask them to look at the flow of blood and blood pressure in the surrounding vessels. Post 23/24 weeks the flow of blood CAN be measured in the placenta, if they tell you that it can’t then that is not true. Go to a different hospital, or call up a private scan clinic and ask them if their sonographe machines can measure this. For private scans it is best to go to a clinic with professional sonographers who ideally currently work in hospitals.