An elective (keepsake) ultrasound is a pregnancy scan you book and pay for yourself, to see your baby, with no medical reason behind it. A diagnostic ultrasound is the medical kind: your doctor or midwife orders it, and a trained health professional interprets it (in the U.S., a physician). Medical scans are the ones that date a pregnancy and check the baby’s anatomy and growth. In the U.S., health plans pay for medically necessary care, so keepsake scans aren’t covered, and the FDA and the AIUM discourage scans done only for keepsakes.
From here, the guide covers the terms, who scans, the rules by country, insurance and the limits.
What “elective” means for an ultrasound
An elective ultrasound is one you choose for yourself, to see your baby and take pictures home. Nobody orders it for a medical reason, and it isn’t a medical exam. You’ll also see it called a keepsake, souvenir, entertainment or non-medical scan.
Regulators, medical bodies and the medical press use the same words. The FDA writes of ultrasound used for “non-medical purposes such as obtaining fetal ‘keepsake’ videos” (FDA). The American Institute of Ultrasound in Medicine (AIUM), a U.S. professional body, describes “freestanding commercial fetal imaging sites” that are “sometimes called ‘baby video studios’” (AIUM). The Care Quality Commission (CQC), “the independent regulator of health and adult social care in England” (CQC), writes of “souvenir baby scans” (CQC). In Germany, such scans were commonly known as “Babyfernsehen,” or baby TV (Deutsches Ärzteblatt).
A diagnostic ultrasound is the medical kind. A U.S. practice guideline, written by radiology, obstetric and ultrasound societies, says a pregnancy scan “should be performed only when there is a valid medical reason” (ACR–ACOG–AIUM–SMFM–SRU). The American College of Obstetricians and Gynecologists (ACOG) puts it this way: ultrasound should be used only when it’s expected “to answer a relevant clinical question or otherwise provide medical benefit to the patient” (ACOG Committee Opinion 723). The phrase can also mean the equipment itself: the same guideline warns about using “a diagnostic ultrasound system” for keepsake videos.
A word that means something else in a hospital
In medicine, “elective” can simply mean nonemergency. Merriam-Webster’s medical sense is “involving a nonemergency medical procedure and especially surgery that is planned in advance and is not essential to the survival of the patient,” as in “elective hip surgery” (Merriam-Webster). In that sense, a medical scan booked weeks ahead is elective too. Scan studios use the word more narrowly, for a scan with no medical purpose at all.
Elective and medical scans, side by side
The equipment can be much the same. The purpose differs, and the rest follows from it.
Who asks for it
Medical: a doctor, midwife or other licensed provider, for a medical reason. Elective: you, because you’d like to see your baby.
Who reads it
Medical: in the U.S., a physician (RadiologyInfo.org), and the report goes into your medical record (ACR–ACOG–AIUM–SMFM–SRU). In England, “the sonographer will be able to tell you the results of the scan at the time,” the NHS says (NHS). Elective: at freestanding studios, usually no physician review at all, the AIUM says.
What it checks
Medical: from the second trimester, the baby’s anatomy and growth, the placenta, the fluid and more. Elective: nothing medical. It’s for watching, and for pictures.
Who pays
Medical: in the U.S., your health plan, if you have one and the scan is medically necessary, though you may still owe part of the cost (HealthCare.gov); in England, the NHS, for free. Elective: you, directly.
The two can overlap, because you can ask for pictures at a medical scan. The FDA calls keepsake images “reasonable if they are produced during a medically-indicated exam,” as long as “no additional exposure is required” (FDA). In England, the NHS says to check whether your hospital offers pictures: “If they do, there may be a charge” (NHS).
Who does the scanning
In England, “most scans are carried out by sonographers,” the NHS says (NHS). In the U.S., a physician interprets a medical scan: RadiologyInfo.org describes a radiologist sending “a signed report to the doctor who requested the exam” (RadiologyInfo.org).
Training and credentials
In the U.S., sonographers “typically need at least an associate’s degree or a postsecondary certificate,” and “some diagnostic medical sonographers need a state-issued license,” says the Bureau of Labor Statistics. Employers “may require or prefer” professional certification (BLS). One credential is the RDMS (Registered Diagnostic Medical Sonographer) from ARDMS. To earn it, you “must meet the examination prerequisites” and “pass the physics and a corresponding specialty examination within five years,” such as obstetrics and gynecology (ARDMS).
In the UK, “the title of sonographer is not legally protected” (NHS Employers). The CQC says “anyone trained to use ultrasound equipment to perform the scan can describe themselves as a sonographer.” It suggests asking who will scan you and how qualified they are. Ask too whether their course was accredited by CASE, which checks sonography courses against set standards (CQC).
At keepsake studios there’s less to go on. The AIUM says they usually work “without any physician review of acquired images and with no regulation of the training of the individuals obtaining the images.” It recommends that “appropriately trained and credentialed medical professionals” with specialized training in fetal imaging do every fetal scan (AIUM). Inteleos, which runs the ARDMS credentials, says: “We do not recognize or endorse use of ultrasound for non-diagnostic purposes” (Inteleos).
In the UK, the Society of Radiographers warned in November 2025 that some high-street baby-scan clinics use non-specialists, and that “anyone with an ultrasound machine can call themselves a sonographer.” It wants the title protected. Private clinics there “often offer a sexing scan ahead of the 20-week scan in hospital,” it notes (Society of Radiographers).
Where elective scans are allowed, and who sets the rules
There’s no single rule. This is what we could confirm, as of November 2026.
In the U.S.
The FDA. Ultrasound machines are medical devices, and “must also comply with the medical device regulations,” the FDA says. It discourages scans done only for keepsakes. It also says: “Individual states regulate the use of diagnostic ultrasound through recommendations and requirements for personnel qualifications, quality assurance and quality control programs and facility accreditation” (FDA).
The practice guideline. It says the FDA considers promoting, selling or leasing ultrasound equipment for “keepsake fetal videos” to be “an unapproved use of a medical device.” Using a diagnostic ultrasound system for this “without a physician’s order, may be in violation of state laws or regulations,” it adds (ACR–ACOG–AIUM–SMFM–SRU).
Connecticut. Since July 1, 2009, state law has barred any obstetric ultrasound unless it’s “ordered by a licensed health care provider” and “for a medical or diagnostic purpose” (Connecticut General Statutes § 19a-901).
Oregon. State law bars performing a medical imaging procedure, ultrasound included, unless it “serves a medical purpose.” A licensed health care practitioner must also order it and interpret it (Oregon Laws 2013, chapter 87, 2014). The 2013 law took effect on January 1, 2014. In 2015, the AIUM’s blog counted Oregon as the second state to act, after Connecticut (AIUM).
Other states. We couldn’t confirm a similar law anywhere else in the U.S.
Outside the U.S.
Germany. Scans in pregnancy that aren’t medically justified have been banned since December 31, 2020, when the rule took effect (Federal Environment Ministry). The ban covers Doppler, 3D and 4D scans too (Deutsches Ärzteblatt). The rule is § 10 of Germany’s regulation on non-ionizing radiation: ultrasound is sound, not X-rays. It bars exposing a baby in the womb to ultrasound used for non-medical purposes (NiSV § 10).
England. Services that use ultrasound to examine the body must register with the CQC, and that “includes diagnostic as well as souvenir baby scans.” “If the service is not registered with us they may be practising illegally,” the CQC says (CQC).
Canada. The Canadian Association of Radiologists and the Society of Obstetricians and Gynaecologists of Canada “strongly oppose the non-medical use of fetal ultrasound and encourage governments” to address it. Their statement, reaffirmed in August 2025, cites Health Canada’s advice that ultrasound shouldn’t be used just to take pictures of a baby or to learn its sex, without a medical reason, or for commercial purposes. It’s a professional position, not a law (CAR and SOGC).
India. The PC&PNDT Act requires any clinic with an ultrasound machine to be registered. It also bars anyone, including the person doing the scan, from telling a pregnant woman, her relatives or anyone else the baby’s sex (Ministry of Health and Family Welfare).
Rules change, and we couldn’t check every country, so look up the rules where you are before you book.
Why insurance doesn’t pay for an elective ultrasound
In the U.S., health plans pay for care that’s medically necessary: services “needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine” (HealthCare.gov). A scan booked so you can see your baby doesn’t meet that test, so you pay for it yourself.
Insurers spell it out. One Louisiana Medicaid plan’s policy, revised in 2026, lists scans done only to learn the baby’s sex, or to give parents photographs, as “not medically necessary” (Louisiana Healthcare Connections). The state health department lists it among its Medicaid managed care policies (Louisiana Department of Health).
Some doctors’ offices and hospitals sell keepsake pictures as “added-cost visits” outside your insurance, the AIUM notes. It says such arrangements “may violate the principles of medical ethics” of the American Medical Association and ACOG (AIUM).
How much does an early pregnancy ultrasound cost without insurance? covers what a medical scan costs in the U.S., what insured patients may still owe, and ways to pay less. In England, “all screening tests provided by the NHS are free,” and hospitals offer at least 2 scans, at 11 to 14 weeks and usually at 18 to 21 weeks. “Some private companies also provide screening tests that you have to pay for” (GOV.UK, NHS).
What an elective ultrasound can’t tell you
A keepsake scan is for seeing your baby. It isn’t designed to look for problems, so it can’t:
Date your pregnancy or give you a due date. That comes from a medical scan your doctor or midwife orders.
Check your baby’s anatomy, growth or health. From the second trimester, a standard medical scan checks the number of babies, the heartbeat, the baby’s position and the fluid. It also checks the placenta, where the cord joins it, and the baby’s measurements, anatomy and growth (ACR–ACOG–AIUM–SMFM–SRU). A keepsake 2D, 3D or 4D scan checks none of that, and it doesn’t replace the anatomy scan.
Tell you that everything is fine, or explain what isn’t. Canada’s radiologists and obstetricians list “false reassurance to the patient that everything is ‘normal’” among the possible harms, and “false-positive diagnoses leading to unnecessary investigations and anxiety.” Operators “may not be adequately trained to recognize fetal and placental abnormalities,” they add (CAR and SOGC).
Promise you’ll feel closer. The AIUM says “there is only some scientific evidence that 3D sonography has a positive impact on parental-fetal bonding.” Does a 4D ultrasound help you bond with your baby? looks at the research.
The CQC sums it up: a souvenir scan “is not a replacement for the routine diagnostic scans you have through the NHS or your independent healthcare provider.” Keep every scan your doctor or midwife orders. If you’re worried about anything in your pregnancy, call them, not a studio.
Is an elective ultrasound safe?
Ultrasound uses sound, not X-rays. The FDA says it “is based on non-ionizing radiation, so it does not have the same risks as X-rays,” and that it “has an excellent safety record.” It also says ultrasound “can heat the tissues slightly,” can sometimes form small pockets of gas, and “the long-term consequences of these effects are still unknown” (FDA).
Safety bodies ask for a medical reason behind each scan. ACOG says ultrasound should be used “prudently” and only to answer a relevant clinical question or bring a medical benefit. The FDA and the AIUM discourage scans done only for keepsakes, and 3D and 4D scans are ultrasound too. 4D ultrasound side effects: what is and isn’t known goes through the evidence. Is an early ultrasound safe for the baby? covers the first trimester, and Safety, in plain words has the statements in full.
Our studio: what we are, and what we aren’t
We’re Prenatal Ultrasound of Glendale (mybaby4D), in Glendale, Los Angeles County, since 2006: “an elective keepsake studio, for the joy of seeing your baby.” We’re not a medical exam: we can’t diagnose or rule anything out. We’re not a replacement for prenatal care, so keep every appointment with your doctor or midwife. And we’re not covered by insurance: sessions are elective, and you pay us directly.
Each of our three sessions has its own purpose:
Pregnancy Check, from 5 weeks: a private 2D ultrasound, for seeing your pregnancy on the big screen.
Gender Confirmation, from 13 weeks: boy or girl, out loud or sealed in an envelope. We book from 13 weeks, and we’re surest from 15.
4D Bonding, 16 to 40 weeks: watching your baby move, live, on the big screen. Come for the joy of it, not for a health benefit. Which week suits you depends on what you want to see.
Every session books online, no call needed, and each session’s price is on one page. Whether to have a keepsake scan is your decision, and a reasonable thing to ask your doctor or midwife about.
4D BondingFrom 16 weeks to your due date. Faces look best from 28 to 34.Book 4D Bonding
Your date stays on this device. We never see it.
Not sure which of the three fits your week? Give the planner your due date and it shows what’s ready now and what opens next. Your date stays on your device, and we never see it.
Questions
What is an elective ultrasound?
A pregnancy scan you choose and pay for yourself, to see your baby rather than for a medical reason. It’s also called a keepsake or non-medical scan. It can’t diagnose anything, date your pregnancy or check your baby’s health, and the FDA and the AIUM discourage scans done only for keepsakes.
What’s the difference between an elective and a diagnostic ultrasound?
A diagnostic ultrasound is a medical scan: your doctor or midwife orders it for a medical reason, and a trained health professional interprets it (in the U.S., a physician). An elective (keepsake) ultrasound is one you book to see your baby. It checks nothing medical and doesn’t replace any scan your doctor or midwife orders.
Is an elective ultrasound covered by insurance?
In the U.S., no. Health plans pay for care that’s medically necessary, and a scan to see your baby isn’t. One Louisiana Medicaid plan’s policy, for example, lists scans done only to learn the sex or to give parents photographs as not medically necessary. You pay for an elective scan yourself.
Are elective ultrasounds legal?
It depends on where you are. Connecticut has required a medical purpose and an order from a licensed provider since 2009, and Oregon’s law also requires imaging to serve a medical purpose. Germany has banned non-medical scans in pregnancy since December 31, 2020. In England, services offering souvenir scans must register with the Care Quality Commission.
Who performs an elective ultrasound?
It depends on the studio. In the U.S., sonographers can earn credentials such as the RDMS, but the AIUM says keepsake studios usually work without physician review and with no regulation of the training of the people scanning. In the UK, “sonographer” isn’t a legally protected title. Ask who will scan you and what training and credentials they have.
Can an elective ultrasound tell me if my baby is healthy?
No. A keepsake scan doesn’t check your baby’s anatomy, growth or health, and it can’t rule a problem in or out. Keep every scan your doctor or midwife orders, including the anatomy scan, and call them with any worry.
Is an elective ultrasound safe?
The FDA says ultrasound has an excellent safety record, but it can heat tissue slightly, and “the long-term consequences of these effects are still unknown.” ACOG says ultrasound should be used only to answer a medical question or bring a medical benefit, and the FDA and the AIUM discourage scans done only for keepsakes.
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