What to expect at your first pregnancy ultrasound

When is the first ultrasound?

The timing “varies depending on your provider,” says Cleveland Clinic. Some people have a first scan at around 7 to 8 weeks, and some providers wait until closer to 12. In the U.S., Cleveland Clinic says most people have two scans in pregnancy, one in the first trimester and one in the second (Cleveland Clinic). Hospitals in England offer at least 2 (NHS).

In the U.S., it may be part of your first prenatal visit, which Cleveland Clinic says to expect at 8 to 10 weeks (Cleveland Clinic). Why your first prenatal appointment isn’t until 8 to 12 weeks explains the wait.

In England, you’re offered a dating scan “at around 10 to 14 weeks of pregnancy” (NHS). Other NHS pages give 11 to 14 weeks, or 8 to 14, so go by the date your hospital gives you (NHS, NHS).

Reasons for an earlier scan

• Pain or bleeding. The U.S. practice guideline for obstetric ultrasound lists both as reasons for a first-trimester scan, along with a suspected ectopic pregnancy (ACR–ACOG–AIUM–SMFM–SRU).
• A past ectopic pregnancy. The NHS advises telling your GP as soon as possible when you’re pregnant again, “so early scans can be carried out” (NHS). Elsewhere, tell your doctor or midwife.
• IVF. Your fertility clinic may do the first scan. At Guy’s and St Thomas’ in London, it’s usually at about 7 weeks (Guy’s and St Thomas’).

Before you go

Your clinic’s instructions come first.

• Bladder. For a belly scan, you may need a full bladder, because it makes the picture clearer (NHS). MedlinePlus says you may be asked to drink 2 to 3 glasses of liquid an hour before (MedlinePlus). For an internal scan, you may be asked to empty your bladder first (RadiologyInfo.org). Not sure which? Ask.
• Clothes. A loose two-piece outfit makes a belly scan easy, since only your lower belly needs to be uncovered (RadiologyInfo.org). For an internal scan, you’ll put on a gown or undress from the waist down (Cleveland Clinic).
• Food. No special rules. Cleveland Clinic and RadiologyInfo.org both say a pregnancy ultrasound needs no special preparation, beyond the full bladder some providers ask for (Cleveland Clinic, RadiologyInfo.org).
• Latex. Some probe covers contain latex, so mention an allergy (NHS).
• Company. The NHS and Cleveland Clinic both say you can bring someone (NHS, Cleveland Clinic). One NHS trust allows 1 adult in the scan room (Gloucestershire Hospitals). The NHS says most hospitals in England don’t allow children.
• Dates. Know the first day of your last period. Your due date is first worked out from it (NHS).
• Cost. Paying yourself? What an early pregnancy ultrasound costs without insurance has typical prices and ways to pay.

Excited, nervous, or both

In a Spanish study of 111 pregnant women at a prenatal diagnosis clinic, anxiety fell after the scan, in every trimester (Simó and colleagues, 2019). For a partner, it can be the moment the pregnancy feels real. In a British study of expectant fathers, seeing the baby on the screen “seemed to herald an escalation of their awareness of the baby, reinforcing its reality” (Draper, 2002).

Pregnant after a loss? Tell the sonographer at the start. Is an early reassurance scan worth it? has a section written for you.

Belly scan or internal scan?

The U.S. practice guideline says first-trimester scans can be done over the belly, internally, or both, and recommends an internal scan if a belly scan isn’t conclusive (ACR–ACOG–AIUM–SMFM–SRU). MedlinePlus says an internal scan is more likely in early pregnancy (MedlinePlus). A belly scan shows the early landmarks about a week later than an internal one (AAFP). Internal or belly ultrasound? goes into each method in detail.

Over your belly

You lie back while the sonographer spreads gel on your lower belly and moves a handheld probe over it. The gel may feel slightly cold and wet, and pressure on a full bladder can be uncomfortable (MedlinePlus).

Internal (transvaginal)

You lie back with your knees bent, sometimes with your feet in stirrups. The probe is covered with a condom or probe cover and gel, then gently inserted. Only a small part of it goes in. MedlinePlus says that in most cases there’s no pain, though some women may feel mild discomfort from the pressure (MedlinePlus). The NHS says it can be uncomfortable as the probe goes in or moves (NHS). Afterward, a little bleeding or cramping is possible, but temporary and uncommon (Cleveland Clinic). If you have heavy bleeding or severe pain, call 911 or go to the emergency room now. For milder pain or spotting, call your doctor or midwife today.

In England, the NHS says you’re in control of an internal scan: you can ask for a chaperone, someone else in the room, and can ask the person scanning to stop at any time (NHS). Elsewhere, ask about a chaperone when you book. If pelvic exams are hard for you, say so at the start.

Is it safe this early? How early can an ultrasound see a pregnancy? answers that for internal scans. In short, ACOG says ultrasound isn’t associated with risk, but should be used only to answer a medical question or bring a medical benefit (ACOG Committee Opinion 723). The FDA and the American Institute of Ultrasound in Medicine (AIUM) discourage scans done only for keepsakes (FDA, AIUM). Safety, in plain words has their statements. Is an early ultrasound safe for the baby? goes through the evidence.

During the scan

The sonographer works through a checklist set out by the practice guideline and the NHS (ACR–ACOG–AIUM–SMFM–SRU, NHS):

• Where. That the pregnancy is in the uterus, or as the NHS puts it, “that the baby is growing in the right place.”
• How many. Whether you’re expecting more than 1 baby. Can you see twins at 6 weeks? explains when twins can show.
• The heartbeat. The flicker of the early heart, recorded on a short video clip or with a mode called M-mode.
• The size. The length from head to bottom, called the crown-rump length, which is used to date the pregnancy (University Hospitals Sussex). Your due date may change as a result (NHS). How far along am I? explains why test, app and scan dates differ.

If the baby is in an awkward position, one NHS trust may ask you to wriggle your hips, jump up and down or walk around (University Hospitals Sussex).

How long it takes

NHS and hospital guides give about 10 to 30 minutes. The NHS says its dating scan usually takes about 20 minutes (NHS). Cleveland Clinic gives 15 to 30 minutes for an internal scan, and one NHS hospital about 10 (Cleveland Clinic, Leeds Teaching Hospitals). It can take longer if a good image is hard to get (NHS).

Why the sonographer may go quiet

A quiet room can be hard to sit through. Hospital guidance points to two things that can keep a sonographer quiet. One is focus: an NHS trust leaflet says the sonographer “needs to concentrate fully throughout the scan,” but will explain what they’re checking at each stage (Gloucestershire Hospitals).

The other is who gives the results. In the U.S., Cleveland Clinic says that in most cases the sonographer won’t discuss them. An obstetrician reviews the images and goes over the results with you, often at a follow-up the same day (Cleveland Clinic). When a radiologist reads the scan, they report to the doctor who asked for it, who shares the results (RadiologyInfo.org). In England, the NHS says the sonographer will be able to tell you the results at the time (NHS).

Want a running commentary? Ask. If you’d rather not watch the screen, say so. At one NHS hospital’s scans for early pregnancy concerns, the person scanning gives you the choice (Leeds Teaching Hospitals).

What you’ll see at 6, 8, 10 and 12 weeks

These are rough guides for an internal scan, counted from the first day of your last period. How early can an ultrasound see a pregnancy? goes through it week by week.

1. About 6 weeks. A small sac with a yolk sac inside, and maybe a tiny embryo, 1 to 2 millimeters long (Radiopaedia). An embryo with a heartbeat is “typically visualized at 6 weeks,” say radiologists’ consensus guidelines (Society of Radiologists in Ultrasound).
2. About 8 weeks. A baby around 16 millimeters long, about the size of a raspberry (NHS). At 8 to 9 weeks, the head can be seen as separate from the body, and limb buds appear (Radiopaedia).
3. About 10 weeks. Around 30 millimeters long, with jerky movements that can be seen on a scan (NHS).
4. About 12 weeks. About 5.4 centimeters long (NHS). At its dating scan, one NHS trust also looks at the head, brain, abdomen, arms and legs (University Hospitals Sussex).

Only your doctor or midwife can say what a particular measurement means for your pregnancy.

Seeing the heartbeat versus hearing it

At an early scan, the heartbeat shows as a flicker on the screen, and you may not hear it. The AIUM says spectral Doppler imaging “should not be used to document the fetal heart rate unless clinically indicated” (AIUM). From around 10 or 12 weeks, Cleveland Clinic says, your provider may check the heartbeat with a Doppler (Cleveland Clinic). When can you see the heartbeat on an ultrasound? has the timing and heart-rate numbers.

Pictures, and what to ask

It depends where you’re scanned. Cleveland Clinic says you may be given pictures to take home (Cleveland Clinic). In England, the NHS says to check whether your hospital provides them, and that there may be a charge (NHS). As of October 2026, one NHS trust charges £4.50 per image, or £10 for 3, and doesn’t allow photos or videos during the scan (Gloucestershire Hospitals).

What to ask while you’re there

• “Can you talk me through it?” Some sonographers explain as they go. Others won’t discuss results until a doctor has looked.
• “When will I get the results, and from whom?”
• “Has my due date changed?”
• “Will I need another scan?” Cleveland Clinic says to expect one at around 18 to 20 weeks (Cleveland Clinic).
• “Can I have a picture, and is there a charge?”
• “Who do I call about pain or bleeding before my next visit?”

If the scan can’t show something

Sometimes the screen looks empty, there’s no heartbeat yet, or the baby measures smaller than your dates. Any of these can simply mean it’s early, or that your dates are off. It can also be a sign of a problem, and only your doctor or midwife can tell which. Tell your doctor or midwife, even if you feel well.

The next step may be another look: the NHS says a scan may need repeating if a good image is hard to get. If a scan suggests a problem with the baby, the sonographer may ask a colleague for a second opinion. You may be offered more tests, or referred to a specialist (NHS).

These go through it gently: No heartbeat on an early ultrasound and Measuring behind on your first ultrasound.

Waiting is hard. The National Maternal Mental Health Hotline is free, confidential and open 24/7, in English and Spanish: call or text 1-833-TLC-MAMA (1-833-852-6262) (HRSA). Postpartum Support International’s HelpLine is 1-800-944-4773, and PSI runs online support groups, including for pregnancy loss (PSI).

Want a first look sooner?

If your medical scan is weeks away, an elective (keepsake) scan is one way to see the pregnancy sooner. They aren’t allowed everywhere (where elective scans are allowed).

Our Pregnancy Check, in Glendale, Los Angeles County, is a short, private 2D ultrasound in the first 10 weeks that takes a few minutes. You watch on a big screen while we point out what you’re looking at, and we tell you what we could and couldn’t see. Bring partners, family or friends, or come on your own. You leave with 8 black-and-white prints, for one price of $100, with no referral and no insurance. Hearing the heartbeat isn’t part of it; heartbeat-only visits start at 11 weeks.

Call (818) 243-7010 first with the first day of your last period, and we’ll tell you whether it’s a good day to come. If it’s too early to see, you come back for a second look, almost always at no charge. Same-day appointments are often available. Irina, our lead sonographer, has more than 30,000 pregnancy ultrasounds behind her. We can’t diagnose, date your pregnancy or check on your health, and a visit never replaces prenatal care. See how the Pregnancy Check works and what a visit is like.

The planner works from a due date, even a rough one: it shows which of our sessions you could book now and which unlock next. Whatever you enter is kept on your device.

Questions