NHS and private ultrasound scans during pregnancy

Ultrasound scans help your antenatal team track your baby's health and development, as well as giving you an exciting glimpse of your little one before they're born – but do you need to pay to get the best service?

Keep scrolling to find out all you need to know about the different types of free and private pregnancy ultrasound scans, and find out if it's worth paying for additional scans. 

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What is an ultrasound scan?

During a pregnancy scan the sonographer (an ultrasound scan specialist) puts gel on your tummy and moves a handheld probe across your skin (a 'transabdominal' scan). Or in early pregnancy they may use a wand-like instrument called a probe to do a 'transvaginal' scan.

In both cases, ultrasound waves to produce images of your baby on a screen that the sonographer study to make observations and carry out checks, including:

• Checking your baby's size and calculating your due date at the early pregnancy dating scan. 
• Monitoring whether your baby is growing normally.
• Checking whether you're having one baby, twins or more.
• Detecting if there are certain abnormalities.
• Showing if you have too much or too little amniotic fluid.
• Determining the position of the placenta and your baby, which can affect whether you plan to give birth vaginally or if you might need a C-section.

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How many pregnancy ultrasound scans do you get on the NHS?

All pregnant women in England, Scotland, Wales and Northern Ireland should be offered at least two NHS 'routine diagnostic scans' (screening scans) as part of their antenatal appointments schedule.

You'll be offered a 12-week scan and a 20-week scan and in certain situations you may be offered additional scans (if there are concerns about your health or your baby's growth, for example).

If you are having entirely private antenatal and maternity care these tests are likely to be carried out by your private team.

Regardless of the route you're taking, scans aren't compulsory and you can say no. The choice you make will be respected and your antenatal care will continue as normal.

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12-week scan

Other names: Dating scan, viability scan, early pregnancy scan

When is it done: From 11-14 weeks

Type of scan: Black-and-white 2D, transabdominal scan (some hospitals offer you a picture, usually for a fee)

How long does it take: Around 20 minutes

This scan establishes how far along you are, your approximate due date, how many babies you're expecting and how your baby is developing (you can't tell the sex at this stage).

You may also be offered the 'combined test' from 10-14 weeks to work out the chance of your baby having one of three specific chromosomal conditions (including Down's syndrome). It involves a maternal blood test plus a nuchal translucency (NT) scan of your developing baby to measure the fluid at the back of their neck.

The NT gives you an estimate of your individual risk of any abnormalities for this pregnancy, calculated by taking into account maternal age, the measurement of two hormones in your blood plus scan findings (including nuchal fold thickness and blood flow through your baby's heart).

Talk to your midwife about having just the dating scan if you don't want the combined test.

20-week scan

Other names: Mid pregnancy scan, fetal anomaly scan, anomaly scan

When is it done: From 18-21 weeks

Type of scan: Black-and-white 2D, transabdominal scan (some hospitals offer you a picture, usually for a fee)

How long does it take: Around 30 minutes

This scan is highly accurate and can detect the majority of birth defects. If the sonographer sees any cause for concern you’ll be told there and then.

The sonographer will take a detailed look at your baby's heart, brain, bones, spinal cord, face, amniotic fluid, kidneys and abdomen to check for a range of conditions, as well as being able to tell you the sex of the baby (if you want to know and if your baby is in the right position).

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Can you get 3D or 4D pregnancy scans on the NHS?

Although some NHS units have 3D scanners, these are only for use if it's deemed medically necessary.

If you want a 3D or 4D 'souvenir' scan in addition to your routine diagnostic scans, you'll probably have to pay for one at a private facility.

What pregnancy scans are available privately?

A wide range of suppliers and clinics offer private scans including early pregnancy scans, anomaly and NT scans as well as gender scans. We've also come across offerings including reassurance scans, gender reveal scans and baby bond scans/bonding scans. 

Here are some of the more common private scans and what they entail.

Early pregnancy/viability scan

While not medically necessary, this scan can be reassuring if you've previously had a miscarriage or are undergoing fertility treatment. It's a 2D scan that shows the baby's heart beating, and the head and limbs forming (around the 10-week mark). Some clinics may refer to scans at the 6-11-week stage as 'early reassurance' scans.

If you experience any problems like pain or bleeding early in your pregnancy, contact your GP, midwife, or the early pregnancy assessment unit (EPAU) as they might be able to give you a scan without you having to pay to have it done privately. When we looked, a bleeding-pain symptoms scan was being offered privately for £90 (includes 10-minute scan and a 2D scan picture).

Anomaly scan and nuchal translucency (NT) scan

Although available privately, we found that these diagnostic scans aren't as widely available as other scan types, including early pregnancy and gender scans. 

Both of these are available on the NHS. Unless you are going down the private maternity care route, a paid-for anomaly scan shouldn't replace your NHS 20-week scan.

Gender scan

Sonographers can usually tell you the sex of your baby at your 20-week scan, but if it's not been possible you might decide to have a private scan afterwards to find out. 

You can have a private gender scan from as early as 16 weeks, although it's easier to tell the sex of your baby the further on in your pregnancy you are.

3D, 4D and 5D scans

While a 2D scan is black and white and you won't see much detail of your developing baby, 3D, 4D and even 5D scans can heighten the experience.

Clinically speaking, there aren't many benefits to these over 2D scans. Some experts also say these should only be carried out if there's a medical need, such as helping to assess abnormalities that may be harder to examine in 2D, such as a cleft lip.

3D images are still, 4D will give you mini clips of your baby, while 5D (also known as HD Live) uses special cameras and skin tone rendering software to give you a sharp and colourful view of your developing baby.

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How much do private scans cost?

The price you’ll pay for private scans depends on the type of scan you want, how many private scans you have, who does the scan (scanning by a doctor can cost more) and where you live. Clinics in and around London can be more expensive than elsewhere.

Some clinics also offer deals and packages, so it's worth asking what's included when you enquire about their costs and services. For example, are photos, videos or downloadable images included and will you get a free upgrade from 4D to 5D imaging if it's available?

For each type of scan, here's an estimate of what you can expect to pay:

• Early pregnancy/viability scan: £50-£250
• Anomaly scan: £150-£250
• Nuchal translucency scan: £100-£250
• Gender scan: £50-£250
• 3D/4D/5D scan: £69-£250

_{Estimates correct as of February 2024.} 

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Are private pregnancy scans better than NHS scans?

One of our parent surveys, carried out in February 2022, revealed that 83% who'd had a child in the past five years had decided to pay for at least one private pregnancy scan. 

Of these, 84% said they found the procedure 'very useful', with a further 14% saying they found it 'fairly useful'.

However, paying for a scan doesn't mean it's better than one that's free. In fact, the NHS ultrasound scans at 12 and 20 weeks are still the safest way to monitor your baby's health and growth and to look for any complications. 

These extra scans are generally seen as 'nice-to-haves' rather than must-haves, and it's important to understand that coming away with a handful of pictures, a video or an image of your growing baby on a keyring or mug isn't the same as being thoroughly scanned to check their development. 

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6 tips for choosing a baby scanning service

1. Check the service is registered with the Care Quality Commission

Services offering diagnostic and screening procedures that use ultrasound (sonography) to examine the body must register with independent health regulator, the CQC, whether it's diagnostic or souvenir baby scans. 

If they aren't CQC registered, the service may be practising illegally and their insurance might not cover them if anything goes wrong. 

Find and compare baby scanning services registered with the CQC or phone them on 03000 616161.

2. Understand what scanning service you're getting

Independent baby scanning services may offer diagnostic scans, souvenir scans or a combination of both. Make sure you know what you're paying for so you know what to expect.

Diagnostic scans are to check the health of you and your baby so you know your pregnancy is progressing well, whereas souvenir scans are an opportunity to record pictures and videos as a memento and are not diagnostic.

The CQC says: 'If you are thinking about having a souvenir scan, it might be helpful to talk it through with your GP, midwife, obstetrician or NHS sonographer.'

3. Don't skip your routine diagnostic scans

A souvenir scan isn't a replacement for the routine diagnostic scans you have through the NHS or your independent healthcare provider.

You should still have your 12-week and 20-week routine scans. Your medical team may also recommend scans at other times.

4. Ask who is performing your scan

Before you book, ask who your specific scan is going to be performed by on the day and how qualified they are.

Anyone trained to use ultrasound equipment can describe themselves as a 'sonographer', but this isn't the same as a scan being carried out by a healthcare professional such as a radiographer, nurse, midwife or doctor. 

Don't be tempted to go by other people's experience, which may not be based on clinical judgement.

5. Ask what training your sonographer has had

Have they had CASE accredited training? The Consortium for the Accreditation of Sonographic Education (CASE) checks whether sonography training courses meet certain standards. Although sonographers don't have to go on CASE courses and not all training is accredited by it, completion of a CASE-accredited course shows their training has at least met the UK standard.

Are they listed on the Register of Clinical Technologists (RCT)? This is a voluntary register and not all sonographers choose to join it (some may also be registered elsewhere, for example if they are a radiographer or a midwife). It isn't a cast-iron guarantee of competence, but it can offer some reassurance because registrants have to give certain details including their qualifications.

6. Ask what happens if something unexpected is detected

The hope is that every scan you have will only reveal good news, but statistically there will be occasions when this isn't the case and it's important to know you'll get the care you need.

The service provider should have a system in place if they discover something untoward. For example, will they inform you so you can check at your next midwife/hospital appointment, or will they (with your permission) contact your team on your behalf to share information?

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Can I get a private pregnancy scan without a referral?

For most private clinics, you won't need a referral from your GP or healthcare specialist in order to get a pregnancy scan.

If you're thinking of getting a mixture of private and NHS scans, make sure your GP, midwife, or whoever is taking care of you during the pregnancy is up to date with the results of each scan. 

Many private institutions have relationships with NHS hospitals and should be able to pass on information and make further appointment arrangements if necessary (with your permission).

Are pregnancy scans safe?

Ultrasound scans have been used for many years, and there are no known risks to you or your baby from having the routine scans offered in pregnancy.

If you’re considering a private 3D or 4D scan, it’s worth considering that these scans often last longer, meaning your baby will be exposed to more ultrasound than they are during routine scans.

While there’s no evidence to suggest that this is unsafe, it’s recommended that non-medical scans are avoided in the first 10 weeks of pregnancy, as the embryo is potentially more vulnerable at this early stage, according to a paper published in 2015 by the Royal College of Obstetricians and Gynaecologists.

The CQC says that a report published by the Health Protection Agency found no definite evidence souvenir scans harm your baby, 'but it's important to understand there may be risks we do not know about yet.'

Pregnancy scan myths

'Ultrasound scans are 100% accurate'

Although routine ultrasound scans are performed at certain stages of pregnancy to give the most revealing or accurate results in the designated time frame, it doesn't mean they'll pick up everything.

Scans are carried out by humans, and therefore even the best equipment has to factor in a margin for error – a skilled sonographer might be tested by baby that's wriggling or facing the wrong way.

'Pregnancy scans use radiation'

While X-ray images (radiographs) are created using radiation, ultrasound scans use high-frequency sound waves to look at what's going on inside you. However, this isn't a green light to have as many scans as you like.

Experts consider ultrasounds to be 'safe', but there are potential effects that can lead to tissue damage or problems with development, depending on factors such as the stage of pregnancy, the power of the machine and the scan time, so ultrasound shouldn't be used without clinical need. 

'It's fine to buy or rent your own ultrasound machine'

The Society and College of Radiographers and the British Medical Ultrasound Society caution against it. Repeated exposure in untrained hands could provide false reassurance of your baby's wellbeing or even cause harm to sensitive organs such as the eyes if exposure is prolonged.

Devices produced for home scans might not have the same level of control and regulatory compliance as devices approved for healthcare settings.

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