You’re pregnant, and your first ultrasound is coming up—or maybe you’ve already had one. And you’re wondering, “Wait, how many of these will I have?” 

It’s one of those questions that seems like it should have a simple answer, but the truth is, it depends on your unique pregnancy.

Don’t worry—we’re going to break it all down for you. Let’s talk about what the guidelines say, what a typical pregnancy ultrasound schedule looks like, and what might mean you’d have more (or fewer) ultrasounds during your pregnancy.

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What the Guidelines Say

According to the American College of Obstetricians and Gynecologists (ACOG), every pregnant person should have at least one standard ultrasound during pregnancy. This usually happens around 18-22 weeks and is often called the “anatomy scan.”

That’s the baseline—the minimum. But here’s the thing: most people have at least two ultrasounds, and some have more depending on their individual circumstances. Your healthcare provider will work with you to help you determine what’s right for your pregnancy.

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Your Typical Pregnancy Ultrasound Schedule: What to Expect

If your low-risk pregnancy is progressing normally, here’s what you can generally expect:

First Trimester Ultrasound (Around 10-13 Weeks). When you’re around 10-13 weeks pregnant, many healthcare providers will do an early ultrasound—also called a prenatal sonogram—to confirm your pregnancy, check your baby’s heartbeat, and establish your due date. This ultrasound is often called a “dating scan” or “viability scan.” You might even get to see that tiny flicker of a heartbeat on the screen—it’s an amazing moment!

What they’re checking: That your pregnancy is in the uterus (not ectopic), how far along you are, your baby’s heartbeat, and the number of babies you’re carrying.

Second Trimester Ultrasound (18-22 Weeks). This is the big one—the anatomy scan, also called the 20-week ultrasound. This detailed ultrasound takes a close look at your baby’s development, including their brain, heart, spine, organs, and limbs. If you want to know your baby’s sex (or find out your baby’s gender), this is often when you can find out (though the technician can’t always tell, depending on baby’s position).

What they’re checking: Your baby’s growth and development, the amount of amniotic fluid, the location of your placenta, and screening for any potential concerns.

Third Trimester Ultrasound (Optional for Low-Risk Pregnancies). Some healthcare providers routinely do another ultrasound in the third trimester (around 32-36 weeks) to check your baby’s size, position, and overall well-being before delivery. However, many providers only do third-trimester ultrasounds if there’s a specific reason, like checking if your baby is head-down or monitoring growth.

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When You Might Have More Ultrasounds

There are lots of reasons your healthcare provider might recommend additional ultrasounds throughout your pregnancy. Having more ultrasounds doesn’t automatically mean something’s wrong—it’s often just extra monitoring to keep you and your baby safe. Here are some common reasons:

You’re carrying multiples: If you’re pregnant with twins, triplets, or more, you’ll likely have more frequent ultrasounds to monitor each baby’s growth and development.

Your pregnancy is considered high-risk: Conditions like gestational diabetes, preeclampsia, high blood pressure, or other health concerns may mean your provider wants to keep a closer eye on you and your baby.

There are concerns about baby’s growth: If your belly is measuring smaller or larger than expected, your provider might order ultrasounds to check on baby’s size and growth rate.

You’ve had complications: Bleeding, cramping, or other symptoms might prompt an ultrasound to make sure everything is okay.

Placenta or fluid concerns: Issues like a low-lying placenta (placenta previa), too much amniotic fluid (polyhydramnios), or too little (oligohydramnios) require monitoring.

Baby’s position: If your baby is breech (bottom-down instead of head-down) as you approach your due date, you might have an ultrasound to confirm their position.

Previous pregnancy losses or complications: If you’ve had a miscarriage, stillbirth, or complications in a previous pregnancy, your provider might want to monitor this pregnancy more closely.

Remember: more ultrasounds means more information and better care—it’s about making sure you and your baby are healthy.

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What About Really Early Ultrasounds?

Some people have ultrasounds very early in pregnancy—like at 6-8 weeks or even earlier. This might happen if:

• You’re experiencing symptoms like cramping or bleeding
• You have a history of ectopic pregnancy
• You conceived through fertility treatments
• There’s uncertainty about how far along you are
• You’re having symptoms of miscarriage

These early ultrasounds can confirm that your pregnancy is developing in the right place and check for a heartbeat, which typically becomes visible around 6 weeks.

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Are Ultrasounds Safe?

Yes! Pregnancy ultrasounds use sound waves—not radiation—to create images of your baby. They’ve been used for decades, and there’s no evidence that they cause harm to you or your baby when performed by trained professionals for medical reasons.

That said, medical organizations recommend that ultrasounds be done when there’s a medical purpose. “Fun” ultrasounds just to get extra pictures (like 3D/4D boutique ultrasounds) aren’t medically necessary, and some experts advise caution with them since they may use settings or durations that aren’t typically used in medical settings.

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Questions to Ask Your Provider

Wondering about your specific ultrasound schedule during pregnancy? Here are some questions that can help you understand what to expect:

• How many ultrasounds do you typically recommend for a pregnancy like mine?
• What will you be checking for at each ultrasound?
• Will I need any additional ultrasounds based on my health history?
• If something unusual is found, what happens next?
• Will my partner or support person be able to come with me?
• How soon after the ultrasound will I get results?

Don’t hesitate to ask questions! Understanding what’s happening during your prenatal care can help you feel more confident and less anxious.

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What to Expect During Your Ultrasound

Before the appointment: For some ultrasounds (especially early ones), you might be asked to come with a full bladder. This helps create a clearer image. Ask ahead of time so you know what to expect.

During the ultrasound: You’ll lie on an exam table, and the technician will put gel on your belly (it might feel cold). Then they’ll move a handheld device called a transducer over your skin to capture images. For early ultrasounds, you might have a transvaginal ultrasound instead, where the transducer is gently inserted into your vagina for a closer look.

What you’ll see: The images can be hard to interpret if you’ve never seen an ultrasound before. The technician can point out what you’re looking at—your baby’s head, arms, legs, and more. 

Getting results: Sometimes your technician will share what they see, but in many cases, a doctor will review the images and discuss the results with you later. If you don’t hear right away, that doesn’t mean something’s wrong—it’s just part of the process.

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How Your Doula Can Support You

Prenatal ultrasounds can bring up a lot of emotions—excitement, nervousness, maybe even anxiety if there’s been a concern. A doula can be there for you before, during (if your facility allows it), and after your ultrasounds to:

• Help you prepare questions to ask your provider
• Talk through any worries or concerns you might have
• Celebrate the joy of seeing your baby on the screen
• Support you if unexpected news comes up
• Help you process and understand information from your healthcare team

Remember, a doula isn’t there to give medical advice, but they are there to support you—emotionally, physically, and as an advocate for your wishes and questions.

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The Bottom Line

Most people have 2-3 ultrasounds during pregnancy in a healthy, low-risk pregnancy, but your provider will recommend what’s right for your specific situation. Each ultrasound is a tool to help ensure you and your baby are healthy and thriving.

If you have questions about your pregnancy ultrasound schedule, bring them to your next prenatal appointment. Your healthcare team is there to guide you and give you the information you need to feel confident.

And remember: you’re doing an amazing job taking care of yourself and your growing baby. Every step of this journey matters, including those incredible glimpses of your little one on the ultrasound screen.

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Need Support During Pregnancy and Birth?

A doula can help—and you may qualify for free.

A doula is a trusted support person you can talk with about pregnancy questions. They can also help you prepare for your birth, support you during your labor and delivery, and help you once you are home with your new baby.

If you live in Linn, Benton, Lincoln, Lane, Marion, or Polk counties and have Medicaid/OHP, you are eligible for free doula care through the Community Doula Program.