Chris Richards reflects on how scans point to the reality of life in the womb

In the UK, pregnant woman are routinely offered an ultrasound scan at 11-13 weeks for dating purposes and at 18-20 weeks to detect any fetal anomalies. More recently 3-D images (and even so-called 4-D, which is animation of sequential 3-D images) have brought home the reality of life in the womb.

Pregnant women are rarely scanned before eleven weeks, unless there is a complication. For this reason women in early pregnancy often have little understanding of the development of the baby inside their womb. Sometimes relatives and health professionals reinforce the idea that the developing baby is not yet a life. This perception will influence women considering having an abortion towards going ahead with the procedure, since they do not realise the nature of what is at stake.

Yet from the very early days of pregnancy an ultrasound scan bears witness to new life. A heart beat can be seen from three weeks and five or six days after fertilisation (yes, the 'timetable' is that precise) and independent movement from six weeks after fertilisation. Through ultrasound we have the immeasurable privilege of seeing what the psalmist described as the baby being 'intricately woven' in the 'secret' place of the mother's womb. (2)

Although no longer routinely required in RCOG recommendation, (3) most women requesting an abortion are given an ultrasound scan prior to the procedure to check on gestation and for anomalies. The RCOG recommend (4) that women who do have a scan are offered the opportunity to see the scan images if they wish. In practice this is not always done, perhaps for fear of influencing their decision. Our local hospital had a policy of not showing a scan of twins to abortion-minded women, because so often the recognition of 'a special pregnancy' turned the mother's decision in favour of preserving life. This reveals something of the pro-abortion mindset of those providing abortion services.

Since 2008, our pregnancy centre (Tyneside Pregnancy Advice Centre) in Newcastle upon Tyne, has been offering an ultrasound scan to women facing unplanned pregnancy. A service such as this is widely available in the US, but our centre remains, to our knowledge, the only pregnancy advice centre in the UK to offer ultrasound. There are plans for two further centres in Salisbury and Sheffield and the potential, we believe, for many more. As Baroness Cox said when she officially opened our centre, 'So often in these circumstances, women are told that there is only a blob of tissue in their womb. The scan will help them realise that there is a little life inside of them. I hope this will be the first of many such services around the country.'

Approximately 100 women with unplanned pregnancy attend our centre each year. About a third of these are referred by their GP; the rest selfrefer having heard about us through word of mouth or the internet. Women who attend are initially offered a consultation with one of our advisors who is able to provide information on issues relating to pregnancy, parenting, adoption and abortion. During the consultation women are helped to discuss the circumstances of their pregnancy, explore their concerns, and consider the moral, emotional and spiritual implications of pregnancy and abortion. Our centre offers ongoing care and support for women, their partners and families. During a first appointment the opportunity for an ultrasound scan is offered, either immediately after the consultation or some days later, according to preference and availability. Some 80-90% of women who attend the centre choose to have a scan.

The scan is not intended to detect fetal abnormalities nor be used as a medical service for those with pregnancy complications such as threatened miscarriage; each woman signs a form to acknowledge the limitation of the scan (we have established referral routes with local early pregnancy assessment centres for women whose scans appear abnormal). During the scan the scanner shows the woman the developing baby as well confirming viability (presence of a heartbeat), location within the womb (to exclude an ectopic) and gestational age. Though our machine has the technical capacity, we do not provide 3-D scans. Though they may produce striking images in late pregnancy, early 3-D scans are less easy to interpret than 2-D scans, which clearly show the baby's outline and heartbeat.

There are a number of practical challenges to setting up the service. Staff members need to be trained in early pregnancy ultrasound scanning, which includes a two-day course, supervision of 150 scans and external assessment. For this purpose we offer early scans to local volunteers, which has turned out to be very popular and an unintended, but very effective way of advertising the service. Those who perform the scans need not have a radiographic training; our current scanners are a medical physicist, an occupational therapist and a dietician. Scanning skills are assessed on a regular basis by a qualified radiographer. The ultrasound service now needs to be approved by the Care Quality Commission (CQC), a process which we found straightforward but somewhat time consuming. Our staff needs to be covered by professional indemnity, for which we pay a total annual bill of over £2,000 for those scanning and around £500 for all our advisors.

The provision of an ultrasound service has been criticised by some who consider that showing a scan to a woman facing unplanned pregnancy could amount to emotional manipulation. We have found this to be an objection amongst both Christians and non-Christians, by those who favour reflective only, non-directive counselling. In response we would point out that every woman attending our centre chooses whether she has a scan or not, and that we are simply showing a truth in images – the presence of independent life that may be denied by those around her. As Christians, we serve the Lord God of truth. We understand that, though the truth may disturb, ultimately it will be of benefit.

Whilst there has been occasional opposition from those who are pro-abortion, particularly from within sexual health services, we are grateful that the centre's good reputation has gradually been established amongst health professionals and the general public. Feedback from those using the service has been positive, with women reporting that their views are respected and they do not feel judged or pressured.

What has been the response of abortion-minded women to a scan? More extensive data is available from the US in terms of the impact of ultrasound scanning in unplanned pregnancy. Through our service we have only limited means of quantifying the response, but we can confirm that the impact of an early scan is often profound, as illustrated in the case study. Whilst we do not know the outcome in the majority of cases, we are aware of many women on Tyneside who have decided to continue with their pregnancy following their visit to our centre. We would be pleased to help anyone interested in setting up a similar service in their area.

Chris Richards is director of Tyneside Pregnancy Advice Centre and a consultant paediatrician.