By Sharon Kirkey, Postmedia News March 25, 2014
Canada’s pregnancy specialists and the nation’s radiologists are calling for a halt on using ultrasound for the sole purpose of determining the sex of a fetus.
In a new joint policy statement, the Society of Obstetricians and Gynaecologists of Canada and the Canadian Association of Radiologists also say it could be considered unethical for private, commercial clinics to offer “entertainment” ultrasounds purely for the purpose of creating “keepsake” videos for expectant parents.
The position statement comes amid mounting concerns that in Canada, people are using ultrasound to determine the sex of a fetus early in pregnancy and to have it aborted if it is a girl.
The Harper government condemned gender-selection abortions at the party’s convention in November, while Canada’s leading medical journal has urged medical licensing bodies across the country to rule that doctors should not reveal the sex of the fetus to any woman before about 30 weeks of pregnancy “when an unquestioned abortion is all but impossible.”
The Canadian Medical Association Journal, in an editorial published in 2012, said research in Canada has found the strongest evidence of sex selection among people from India, China, Korea, Vietnam and the Philippines.
“What this means is that many couples who have two daughters and no son selectively get rid of female fetuses until they can ensure that their third-born child is a boy.”
In Canada, abortions are rarely performed after 24 weeks of pregnancy.
“Fetal ultrasound is a valuable tool in modern obstetrical care,” the position statement reads. The scans use sound waves to monitor a baby’s growth and development in the womb.
But the widespread availability of ultrasounds for purchase “has led to a proliferation of ‘entertainment’ ultrasound units throughout Canada,” and there have been media reports of private clinics offering sex determination in the first trimester of pregnancy.
While no definitive proof exists that the high-frequency, low-energy sound waves emitted by ultrasounds can cause fetal abnormalities, recent studies in animals have reported subtle effects on the development of the fetal brain, the authors write.
Commercial, for-profit clinics are offering special packages that include three- and four-dimensional ultrasound pictures and videos of babies in the womb, cellphone ringtones of a baby’s fetal heartbeat and live broadcasting to family and friends.
The concern is that the machines may be used for as long as an hour to get a video of the fetus. The fetus may be exposed to unnecessarily high energy levels for prolonged periods, and those operating the machines may be poorly trained to recognize abnormalities, according to the position statement.
That could lead to “false reassurance to the patient that everything is ‘normal.’ ”
“The fetus should not be exposed to ultrasound for commercial and entertainment purposes, and it could be considered unethical to perform these scans,” the new and updated joint policy statement from the obstetricians and radiologists reads.
The technology should also never be used “for the sole purpose of determining fetal gender without a medical indication for that scan,” the groups say.
Alla Boulavkina, a registered diagnostic medical sonographer and owner of Tri-Cities 3D Sono Image in Vancouver, which offers non-medical fetal ultrasounds, said the scans improve bonding between parents and babies, and that she limits exposure times. “I know how to do it correctly.”
Boulavkina offers gender determination, starting at 20 weeks’ gestation only. Demand for the service, she said, is growing.
“Everybody wants to know, ‘boy or girl?’ Not just to start shopping … it takes time to be mentally ready for the baby,” she said.
“It’s very important to know. It helps people to prepare and be happy. Because sometimes daddy wanted a boy, and then he sees girl, and he’s not happy, and it’s no good for the family. In this case, it gives time to slowly be prepared.”
However, “We strictly never, ever tell” before 20 weeks into the pregnancy, she said.