Jan Steward

http://www.nursingtimes.net/nursing-practice/clinical-specialisms/midwifery/midwifery-leader-expresses-concern-at-foetus-parties-trend/5040174.article

On Friday 13th January, I was asked to go onto Radio 4’s PM programme to counter argue with Prof. Warwick and her statement regarding so called “foetus parties” an apparently derogatory term we as a company had never heard of before. I declined for 2 reasons.

Firstly, Babybond does not provide “foetus parties” and secondly, I really didn’t want to give Prof. Warwick’s article any more credence.

On reading the article my first feeling was how very disappointing. Another example of how someone who reaches the top of their career seems to lose touch with reality. I am not really sure what the crux of Prof. Warwick’s statement is since she brings in such diverse comments. In my opinion, it sounds like a middle-aged woman who hasn’t quite got to grips with the progressing world of technology.
I stress that I am not addressing the “party element” here. It may be integral with the baby showers in the USA, but I am not aware that this has broken through into the UK yet. Nor are we defending the illegal, non CQC registered ultrasound practices in the UK who use social buying sites to promote their services.

I will though defend our use of 4D ultrasound imaging and the bonding scan principles as defined by us.

So, to address some of Prof. Warwicks’ points:

1) “However, I think the worrying trend towards the commercialisation of pregnancy and trend in ‘foetus parties’ can add to the burden and can increase the expectation for mothers which midwives then have to deal with”.

This is probably at the heart of it – the fear factor of creating more work for Midwives. This has always been the first thought of many Midwives (& GPs) since we started our private ultrasound services in 1999. The thought that extra scans would find all kinds of extra problems that Midwives would have to deal with. Surely, not scanning people isn’t going to make a problem disappear, but ignorance can be bliss and it means that you can pass the buck and leave someone else to handle the problem when the baby is born. If finding a potential abnormality is a problem, then why offer routine screening at 20 weeks?
I think history speaks for itself and in the 12 years of “commercializing” ultrasound, Babybond has given thousands of women reassurance and peace of mind (which you can’t put a value on) and found less than 0.01% of late onset problems. We have handled the questions and concerns that otherwise would be unanswered or given to the overburdened Midwife. Since Babybond has an established clinical framework, we are not shy of dealing with known problems and have helped many parents come to terms with an abnormality by removing the fear of the unknown.

2) “If a woman is celebrating much more overtly than she might normally do regarding a pregnancy at an early stage and then, at a later stage, a serious problem emerges, a mother may need increased counselling after raising everyone’s expectations of her pregnancy at a ‘foetus party’, only to learn of complications later on.”

How totally bizarre for the leader of the RCM to criticise women for “celebrating much more overtly” her pregnancy.
I would invite Prof. Warwick to sit in on one of our clinics and she will see first hand the level of anxiety that parents have in the early part of their pregnancy. In any case, baby showers are traditionally a 3rd trimester event when surely women are allowed to celebrate and look forward to the birth of their “normal healthy” child.

3) “Another issue that worries me is that there is the whole issue of the consumer society and who is able to access this new facility of having a 4D scan? Does everyone have equal access to this celebratory technology or is it only something available to the better off and the rich and famous leading to more class envy, alienation and a sense of inequity?”

Yes Prof. Warwick, everyone has access to this “new” (or rather 8 year old) technology. When asked what our customer profile is there isn’t one. The Babybond service is open to and used by everyone regardless of their “social status” (and before we started, private ultrasound was very expensive). Our services have broad appeal because they are personal and sensitive and they mean different things to different people.

Surely even the leader of the RCM can accept “the right to choose” and women should have the right to choose without being criticised for their choices?
After 12 years of running a commercially successful private ultrasound service, I can tell Prof. Warwick that the success of the company is not because of “profit” but because we listen to our clients, re-invest and offer ultrasound scans that women want.
I appreciate that Prof. Warwick’s perspective is to look after the Midwifery profession first, however please do not insult the intelligence of the pregnant woman.

Jan Steward

Maternity care must involve fathers more - http://www.nationalhealthexecutive.com/Maternity-care-must-involve-fathers-more.htm

Babybond is 12 years ahead of this statement. Since day one, involving Fathers has been a priority.
Mike is a hands-on dad, and hates being left out (always has done and always will do) and, knowing this, made me feel uncomfortable when it happened. This is not a criticism of the NHS because we received excellent care both times. Unfortunately, it is an observation that, in a busy situation, there is little or no time for on-lookers.
I think the majority of Women are more relaxed when their partners are happy. Therefore at Babybond we welcome Dads to be and give them the best chair in the house.
It’s surprising how many men do come in to the scan room expecting to be excluded. They look very nervous when I ask their name and tell them to come close to their partner. However, you do get the other Dads who are so involved it’s sometimes difficult to get the probe on the tummy – they look at, talk to and often stroke the bump – its wonderful to watch them making that emotional and physical connection.
As a Sonographer, one of the most rewarding aspects of my work is watching Dad melt! It is not uncommon to see that the Mum to be has instigated the scan appointment and is trying to justify the time and cost to her partner, but when they both see their baby in real time 4D or watch the baby’s heartbeat, the emotion in the room is palpable.
Quite often the Babybond scan is the time when parents find out the sex of their baby, “it” becomes a son or daughter and it can be elation or a fleeting moment of tension or disappointment if the gender is not as hoped. I love it when Dad turns and says “I don’t care its not a boy/girl, he/she is beautiful.
As far as the NHE statement to get more Fathers involved I agree with the aspect of responsibility and the Fathers role doesn’t start and end with conception, however for how much he endures in the delivery room must be a decision for the couple. Personally I feel I would prefer to take the pain myself than watch someone you love and care for suffer. I don’t think we should underestimate how hard this can be for a partner.
I would love to know how people felt about their partner’s reaction to their scan and if there is anything we can offer partners to enhance their experience.

Boy or Girl?

What is a gender scan?
Fairly obvious really – this is where the Sonographer will try to get a good view of the baby’s bottom. This is the only way you can tell the sex of the baby with ultrasound. I really don’t want to rule out all “Old Wives Tales” (OWT) completely, but this is definitely a time when science and technology does win out over nature. One very common OWT we hear, even apparently given by some midwives, is the speed of the baby’s heartbeat distinguishes between a boy and girl. 140 BPM appears to be the commonly used threshold, or “try to tell between a galloping horse and a steam train.” But surely its common sense – a baby’s heartbeat is normally irregular during development. If baby is awake and active it will be faster than when the baby is having a quiet time. This is all very normal. So a one off heartbeat reading won’t give you any information since you probably don’t know what the baby is doing at the time.
Another common OWT is carrying the baby all up front means boy and on the hips mean girl. How can this be? Women are all different shapes and sizes, what does it mean if there is a nice even spread all the way round?

When to do a gender scan?
The baby isn’t fully formed until 12 weeks so, technically, from that point onwards is possible. Lots of talk about the “angle of the dangle” at this age, but I do feel the accuracy is lower at this early stage. We offer a gender scan from 16 – 24 weeks, as the baby is much bigger and the genitalia fully distinguishable. There is no magic that happens at the 20 weeks stage, that’s just the usual time for an anomaly scan on the NHS where the gender may or may not be disclosed. After 24 weeks, the gender is included as a complimentary part of all Babybond scans and is entirely a personal choice.

Why do a gender scan?
This is really a very personal decision for any new parents to decide.
For me, it enhanced my pregnancy and we definitely bonded at that point. “She” became our daughter and was no longer an “it”. I started to “talk” to her. We could plan colour schemes and buy coming home clothes.
However the majority of first time parents do still prefer to have the surprise in the delivery suite and, interestingly, it is usually the 3rd question post delivery; first “is everything OK”, second “how big” then finally “girl or boy”.
It is common in all races and ethnic groups to have preferences especially if there are already 2 or more children of the same sex. It is natural for some to want a mixed family and also natural to feel some disappointment if that is not to be the case. Its well known there is a desire within some religious groups to have a male child and this can also compel a woman to find out.
If there is a difference of opinion between the couple (to find out the gender) then there is no pressure to decide at a Babybond scan. We can seal the answer in an envelope and they can take it home to continue the argument.

How accurate are gender scans?
When a % number is given it should be based on historical accuracy, not on how much evidence of the gender is seen at one scan. I don’t understand when some ladies are told that the hospital said “about 75% sure”, what does that mean? It probably means that particular department gets 25% of the gender opinions wrong. Either you can or can’t see the gender during the allocated appointment time (and bear in mind nature gives you 50% chance).
By providing a dedicated gender scan, our historical accuracy is in excess of 99%. Whilst we are proud of this number, it does not mean “100%” and there are no guarantees on gender with ultrasound.

Jan Steward

After 12 years of Babybond I still need to pinch myself when I read comments from all over the UK from people who have been to Babybond. The Babybond Facebook page is a delight to read and a great way for me to see & feel the experiences of families all around the UK that have been touched in someway by their Babybond experience.
To understand the ideas and the concepts behind Ultrasound Direct, it is perhaps better to start at the beginning of Babybond and get to know who is behind it and how it all began.

Since the early 1980s Mike and I individually have been involved in Ultrasound in different ways. Mike started as an apprentice electronics engineer based at Leicester Royal Infirmary, and quickly became passionate about the technology and I qualified as a Radiographer at York District hospital. I knew from my student days that it was Ultrasound that I wanted to do. I loved the direct contact with the patients – far more personal than standing behind a cumbersome X-Ray machine. As ultrasound scanning is a hands-on modality you have instant contact with your patient. It is totally operator dependant, and this should be a consideration when it comes to choosing your private ultrasound scan provider.

Our paths met in 1993 when I was applying for a job as an Applications Specialist for an Ultrasound Company which was later acquired by GE Medical (from where we now purchase all of our ultrasound equipment).

Mike and I married in 1994 and have 2 daughters, Ella and Lucy. Despite 15 years of scanning, it wasn’t until after we had experienced the anxieties, anticipation and excitement of pregnancy ourselves that we fully appreciated the emotional impact of the antenatal scans. Through Mike’s development project at the time, we also got 3D images of our eldest at 25 weeks – it took literally hours to digitally process each image.

In 1998 after a company / family relocation to Silicon Valley, California was unexpectedly curtailed, we knew we had the opportunity to take private pregnancy scans to market.
It was to be a first – to offer private ultrasound scans directly to pregnant women on a self refer basis. As this hadn’t been done before and as there was very limited availability of the internet / home computer it was far more difficult than I anticipated but we totally believed in what we wanted to do.
We wanted to design a service that would be different to what was generally available on the NHS namely Dating and Anomaly scans. We wanted this scan experience to be a special occasion for the whole family. The scan we wanted to offer was to give parents more time to get to know their baby and this is the core philosophy that is still with us today.

The Bonding scan was conceived (the name says it all) and from there, Babybond as a service was born.

This was all performed with 2D imaging and still 5 years before 3D & 4D pregnancy scans became commercially available.

There were some sceptics and critics from areas within the Healthcare Profession and some genuine concerns about the commercialisation of Ultrasound. As a Healthcare professional myself (Radiographer, RA22684) I took these concerns seriously and have campaigned along with other independent Ultrasound Professionals for some form of regulation for our services. Up until October 2010, there was no form of regulation available for self-referral services. In the absence of any Regulation, Babybond Ltd decided to be self regulating and invested in ISO 9001/2010 and set the standard of being a “Quality Endorsed” company. Since October 2010 all independent Healthcare providers must be registered with the Care Quality Commission (CQC). Anyone performing ultrasound imaging, even those companies who claim to be “Non-Diagnostic” should be registered. Today it is with great pride that Ultrasound Direct is one of the first private ultrasound providers to have become registered with The Care Quality Commission

For 3 Years, Babybond was attracting parents to be from all over the UK to Uppingham in Rutland. Many of our clients who came to Uppingham will remember placing a “Red Dot” on a map of the UK from where they had travelled. It soon became obvious from this that we needed to expand and open another location.

In 2001 as I had 2 young children and a business, we decided the best option for growth was to Franchise. At the same time, one of our customers wrote and expressed her interest of opening a Babybond location so in 2002 Babybond Heathrow was put on the map. (Today there are 49 locations around the UK with more scheduled to open this year).

From that point on, the business started to gain momentum partly due to the second Babybond but also due to public awareness and demand. The news was beginning to spread that it was possible to have a private pregnancy scan.

A significant part of a pregnancy scan for many parents is the choice to find out the Gender of the baby. This is an incredibly personal and often difficult decision whether to find out or not. My personal feeling was that it enhanced my pregnancy by finding out – She became my daughter at 20 weeks and both Mike & I bonded with her, we had her name chosen, decorated the room for her & just couldn’t wait to meet her when she was born.
However, I do really admire the parents who have the strength and will power to keep natures secret. The Gender Scan from 16 weeks is a popular service and there are many different reasons for finding out if it’s a Boy or a Girl. There are some sad occasions when a family member is ill and would like to know before the baby is born but many more happy reasons to find out if the new baby is a brother or sister – its all part of the bonding.
Occasionally some parents have their hopes set on a particular gender and feel guilty if there is a feeling of disappointment at finding out. I have had many people feedback that they were pleased we had given them time to accept what they were having and were accepting and at peace by the time of delivery.

It is not rocket science – there is only one way to tell the sex of the baby with ultrasound and that is to get a good clear view of the baby’s bottom, often called the “potty shot” or “nappy view”. At this scan we do need the cooperation of the baby to give us the right view. Despite popular opinion this is more accurately done using the standard 2D Ultrasound. It can be very difficult to tell using 4D especially in younger babies less than 24 weeks.

The next major development happened with the introduction of the 4D Ultrasound scan, coinciding with the opening of Babybond Cirencester.

For me as a Sonographer this was a defining moment. I can’t deny initially I had to be persuaded to view the machine. I wasn’t convinced it would be practical to offer and had no idea what public demand would be. GE therefore invited me to a demonstration of their Voluson Expert system at Birmingham Women’s Hospital in 2003. I was absolutely blown away, I knew from that point on we had to offer the Bonding scan in 4D and within one week of that demonstration we had purchased the machine and were one of the first companies outside of London to offer 4D scanning.

It has to be noted that 4D scanning is not always successful on everyone. It is totally dependent on the position of the baby. Ideally the baby needs to be laid on its back “looking up” at the probe. It is a window of amniotic fluid that is needed to give the clearest picture. Arms & legs can get in the way as Baby’s don’t lie with their hands down by their sides and most do suck their toes. The cord can also float in & out of the image to cause a “spotty” effect. Despite all this you can clearly see family features and how the baby will look when they are born. The ideal time to have a 4D scan is 26 – 29 weeks when the Amniotic fluid is at its maximum & the baby has room left to move.
Because some babies can be difficult to view on the day of the appointment, we do offer one rescan free of charge with most of our 4D Scan options.

2006 saw the introduction of our combined Nuchal Translucency (NT) screening services (ultrasound and blood test combined) and Anomaly scans and, in 2008, we extended the services again to include the Early Scan from 7 weeks and the Presentation Scan.

The early scan is a vital service for both the parents, GPs and Midwives alike. Most hospitals now struggle for appointments and are only able to offer a first scan at 12 weeks. This can seem like a long time to wait without the reassurance of seeing if everything is OK.
This scan is to confirm viability, assess how many weeks and how many baby’s there are. Sadly not all early scans have a happy outcome so that is why this scan has a longer appointment with us – time for parents to deal with this information & be given any support they need. Babybond Sonographers are skilled in “breaking bad news” and are given the time needed deal sensitively with the situation. http://www.arc-uk.org

So, to bring everything up to today, it is with the success of delivering all the pregnancy ultrasound services directly to women, that an evolutionary not revolutionary move into providing Men’s Health and Women’s Health Ultrasound was made and ULTRASOUND DIRECT was conceived.