2023-12-02 07:00:00
Private companies offer pregnant women non-medical so-called “pleasure” ultrasounds, in addition to the three ultrasounds planned during pregnancy. They are carried out by people who are neither doctors nor midwives. A practice that is both illegal and not without risks.
An ultrasound from 16, 14 or even 12 weeks of pregnancy for “100% guaranteed” sex determination. Another in 3D or 4D to “discover your baby at your own pace” in a “unique” moment of “happiness and sharing”. This is what private companies are promising that offer so-called “pleasure” or “comfort” fetal ultrasounds.
The practice is not new. In 2012, the government contacted the High Authority for Health (HAS), which had already denounced these non-medical ultrasound scans. But more than ten years later, firms that offer them are still well established. The senator from the North Marie-Claude Lermytte also sent at the end of October a question to the Minister of Health on the legality of these ultrasounds.
Some gynecologist’s offices offer this type of ultrasound, in addition to the three recommended in each trimester of pregnancy to monitor the development of the fetus. The companies offering these “pleasure ultrasounds” specify that the ultrasounds performed are non-medical and have no diagnostic aim. The staff is “trained by specialists”, for example laconically states one of them on its website. Ultrasounds are therefore carried out by people who are neither doctors nor midwives. Problem: it’s prohibited.
The illegal exercise of the profession of midwife?
BFMTV.com contacted several of these companies which offer “pleasure”, “happiness” or “affective” ultrasounds by presenting themselves as a pregnant woman interested in this type of service. To the question: is a doctor present? We are told: “No”. Who performs ultrasound? “Me, not a midwife.” But we are immediately reassured:
“I’ve been doing this for seventeen years.”
“This is the illegal exercise of the profession of doctor and midwife,” denounces Sandrine Brame, vice-president of the national council of the Order of Midwives, for BFMTV.com. An offense punishable by two years of imprisonment and a fine of 30,000 euros.
A 2018 decree on the modalities of care for pregnant women specifies that only doctors and midwives can carry out obstetric and fetal ultrasounds. Moreover, a 2017 decree relating to the restriction of the sale, resale or use of ultrasound machines intended for human fetal imaging indicates that “the use of ultrasound machines for human fetal imaging by natural persons not exercising the profession of doctor or midwife is prohibited.
“It’s a medical procedure”
Philippe Courtois, lawyer specializing in medical law, has no doubt regarding the irregularity of these ultrasounds. “It’s totally illegal,” he adds for BFMTV.com. “Even specifying that it is an ultrasound for non-medical purposes.”
“From the moment we show the parts of the baby’s body and in addition the sex is revealed, it is a medical procedure,” he adds.
Letters of formal notice were thus sent by the national council of the Order to several companies. One of them has since closed shop.
Philippe Courtois is also concerned regarding the potential endangerment of these pregnant women. “To what extent, since they saw the child and he seemed to be doing well, might they forgo consulting their doctor and performing the ultrasounds planned as part of pregnancy monitoring?” As for the precision on staff “trained by specialists”, for this health law professional, it is worthless. “A specialist can very well be the reseller of the equipment.”
“I have already received panicked patients”
This is why Sandrine Brame, from the Order of Midwives, warns pregnant women who would be tempted to turn to these offers. “As healthcare professionals, we are trained in the words we use. Often during an ultrasound, we say little. We are focused and pay attention to both what we are doing and what we are doing. said.”
She thus wonders regarding the possible damage that a remark might cause to parents who sometimes tend to overinterpret. “It’s entirely conceivable that an untrained person might say that the baby is ‘big’ or that there’s ‘not much amniotic fluid,’ words that can immediately raise concerns.”
This is exactly what happened in the office of Philippe Bouhanna, doctor, specialized in fetal ultrasound and fetal medicine, and president of the ultrasound commission of the National College of French Gynecologists and Obstetricians (CNGOF).
“I have already received panicked patients following carrying out this type of ultrasound,” he assures BFMTV.com.
Some, whose 3D or 4D rendering was not optimal, were genuinely afraid that their baby’s head would be deformed. “If, at the time of the ultrasound, the hand of the fetus is in front of the nose, this creates a cone of shadow, like a black hole. These are called false positives. I am authorized to detect, not these people.”
A “lie” promise
Another situation that has already arisen in her office: the announcement of an anomaly by the doctor during one of the three official ultrasounds planned as part of pregnancy monitoring. “The patient replied to me that, however, during this pleasure ultrasound, the image was super beautiful, that everything was fine,” recalls Philippe Bouhanna.
“I’ll let you imagine the psychological impact on a woman who is told bad news following seeing her baby’s face.”
Especially since, according to this specialist, the promise of sex determination from 12 weeks of pregnancy is “false”. “Whatever happens and whatever we do, the sex of the baby is only visible at 15 weeks of amenorrhea (i.e. 13 weeks of pregnancy, Editor’s note). Not before.”
“At 12 weeks, there is a 10% error.”
Although he notices that few of his patients use this type of service, this doctor, who specializes in fetal ultrasound, is still concerned regarding the possible risks and consequences of these ultrasounds, which he describes as a “spectacle”.
The “reserves” of the Academy of Medicine
Since 2004, the National Academy of Medicine expressed “reservations” with regard to these fetal ultrasounds for non-medical purposes. “If it is accepted that ultrasound examinations carried out during pregnancy, for medical purposes, have not to date led to any detectable complications and do not seem to have any harmful biological effects, the fact remains that a potential risk, any ultrasound acoustic wave having biological effects on tissues”, wrote the academy which recommends limiting ultrasound scans to strict medical necessities.
Concerned regarding the subject, the HAS considered in 2012 that fetal ultrasounds should only be carried out for medical purposes. And recalled that these examinations might only be carried out by “doctors specializing in gynecology-obstetrics or medical imaging and midwives (…) holding the interuniversity diploma in ultrasound in gynecology-obstetrics or the certificate in obstetric ultrasound.
Despite this opinion, more than ten years later, companies still offer this type of service. Although it is difficult to estimate their number in the territory, they are easily identifiable, particularly on social networks.
The HAS mentioned “the absence of data confirming or refuting a risk linked to exposure to ultrasound during a fetal ultrasound”. For Philippe Bouhanna, from CNGOF, ultrasound does indeed generate thermal and mechanical modifications. “Like vibrations,” he explains.
“In medicine, there is a principle, it is that of precaution. If an ultrasound does not present any medical benefit, whether for the mother or the fetus, it is no.”
And while some of these centers offer “ten to fifteen minutes of ultrasound,” others guarantee up to twenty minutes. Far too much, believes Philippe Bouhanna.
“Minimal” but “potential” risks
This doctor points out that in the context of a classic ultrasound carried out by a doctor or midwife, the examination meets “specifications”. “We scan the heart, the bladder, the brain, we never stay long on a structure.” Unlike these “ultrasound shows”.
“We want to show the genitals and the face. We will therefore spend a lot of time, almost twenty minutes, on a single area; in this case the genitals and the brain. This is not trivial.”
In addition to pointing out the lack of medical control of these ultrasounds carried out by people “without particular qualifications”, the National Academy of Medicine deplored the absence of limitation of duration and repetitions.
Because some companies do indeed offer decreasing prices: one announces 60 euros per session, or 110 euros for both. “An ultrasound on the head to reveal the face is ultrasound that passes over a developing brain,” explains doctor Philippe Bouhanna. “You might as well avoid bombarding the brain of a fetus with ultrasound.” Risks that he considers “minimal” but “potential”.
“We can’t play with that.”
Contacted by BFMTV.com, the Ministry of Health did not respond.
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