Home Dopplers: Are They Safe?
Home doppler use has increased over the years, with more affordable options being made available for under $100.
Many women are intrigued by their use, either as a reassurance due to concerns over miscarriage, or as a method for bonding.
Pregnancy can be a very exciting time, but it can also bring anxiety. One in four women will experience a pregnancy or infant loss at some point in their life, so if you haven’t personally experienced it, you probably know someone who has.
This anxiety, as well as a desire to bond early in pregnancy, leads many women to want to learn more about dopplers, or use them at home.
But is there really a benefit in using them? Are they safe? As with all pregnancy choices, it comes down to benefit versus risk.
Unfortunately, A Doppler Cannot Prevent Miscarriage
Miscarriage can be a devastating experience. Many women who experience miscarriage wonder if there were something they could have done to prevent it. The majority of early miscarriages are due to chromosomal issues, and therefore the pregnancy could not have progressed beyond a certain point. The majority of chromosomal losses occur around, or prior to, ten weeks, which is often well before a home doppler can be used.
Early doppler use (some women are able to utilise one at around 8 weeks, while many are unable until 10-14 weeks) can only offer a certain amount of information. If it can pick up a heartbeat, you will be able to determine the heart rate.
However, inability to pick up a heartbeat prior to 14 weeks is generally deemed inconclusive, due to the limitations of dopplers in early pregnancy.
If you’re able to pick up a heart rate and it’s low, or of concern, and the same is confirmed by your maternity care provider, an ultrasound might be ordered to give a true picture.
Unfortunately, even if an ultrasound can confirm a problem, early miscarriages are rarely preventable. Apart from concerns picked up very early, such as low progesterone (treated with progesterone supplements) or a thyroid issue (treated with thyroid medications), there’s not much treatment available for first trimester concerns.
Neither progesterone nor thyroid issues can be detected by doppler use; they can only be tested for and treated by your healthcare provider.
Dopplers Use The Same Technology As Ultrasounds
Hand held dopplers utilise the same high frequency sound waves that ultrasounds use to make a picture on a screen. Ultrasound technology has never been proved safe during pregnancy; neither has it been proved dangerous. For this reason, ACOG (the leading obstetrical organisation in the US) recommends only one to two routine ultrasounds during pregnancy unless others are genuinely medically necessary.
The FDA also advises against keepsake ultrasound imaging, as it isn’t medically necessary. Ultrasound waves can heat tissue; repeated use raises a concern that heating tissues could affect fetal development. The FDA also advises against home doppler use.
Because hand held dopplers utilise the same technology as ultrasound, you can assume it’s a good idea to limit their use as well.
While a hand held doppler might be utilised by your midwife or obstetrician during prenatal appointments, it’s most likely used for less than a minute or two, every 2-6 weeks, when you have a routine visit. Also, the less developed the baby, the higher the risk of the heating the baby, especially his or her head. A doctor who specialises in obstetric ultrasound recommends doppler use to be avoided in the first 13 weeks, but ideally up to the 18 week mark.
For trained healthcare providers, the information gained probably outweighs any potential risk. They can assume the pregnancy is progressing well when they detect a proper heart rate, and check other things, such as fundal height. If they are concerned, they can request an ultrasound.
Using a doppler at home doesn’t necessarily provide a medical benefit and could carry potential risks. There is a risk of raising unnecessary concerns that could lead to unnecessary and expensive interventions. For example, if you’re unable to find a heartbeat or interpret your baby's heart rate, you’re likely to be concerned and reach out to your provider.
If you’re unable to locate a heartbeat and it’s confirmed by your maternity care provider, the only benefit would be shortening the length of a missed miscarriage. This potential benefit, however, might not outweigh other possible risks, in most circumstances.
Midwives And Ob/Gyns Receive Training For Proper Doppler Use
It might seem that a doppler is very simple to use. After all, your midwife finds the heartbeat in moments and can quickly evaluate the heart rate. While it looks easy, it’s important to remember that your midwife or obstetrician has received training and likely has years of experience in locating fetal heartbeats.
It’s quite easy to pick up the blood flow of the placenta, or your own heart rate, by accident. It’s also quite easy to miss a heartbeat completely. This could lead to unnecessary concern and intervention. For this reason, most maternity care providers advise against home doppler use.
Some maternity care providers even avoid doppler use altogether, either because they have concerns about the safety of ultrasound technology, or they simply prefer other methods. These providers utilise another method to check heart rate – a device called a fetoscope. This is essentially a stethoscope shaped specifically to pick up a fetal heartbeat. It can be used starting at 18-22 weeks’ gestation.
Kick Counts Are More Important Later In Pregnancy
Perhaps you’re beyond the first half of pregnancy and are no longer concerned about miscarriage. However, you might still have concerns about your baby’s wellbeing and growth. This is especially true for mothers who have experienced late miscarriages or stillbirths.
Home dopplers might sound ideal, but lack of professional training can mean they’re not the most effective in catching concerns later in pregnancy. Once a heartbeat stops, unfortunately it’s too late to prevent anything. As someone without medical training, if you’re able to find a heartbeat but you’re unsure how to interpret heart rate, the information could provide false security.
For this reason, healthcare providers recommend mothers use kick counts to monitor their pregnancy between prenatal visits. Abrupt changes in fetal movement can indicate fetal distress. If this happens, your healthcare provider would ask you to come in for more monitoring. Often, baby is simply resting. However, if a concern is found, your midwife or obstetrician will determine what steps to take, including inducing labour, or giving birth via c-section so baby can receive treatment.
There Are Many Ways To Bond With Baby
For many women, hearing the heartbeat at each prenatal visit brings excitement and a reminder that there really is a little life inside. This experience can help women connect with their pregnancy and feel as though they’re already bonding with their little one.
Recreating this feeling on a regular basis can be quite appealing. This might be especially true for women who have had previous losses and are hesitant to connect, or women who are facing really difficult pregnancies (such as hyperemesis gravidarum). When you face a challenging pregnancy, it can be really hard to remember that you’re also carrying your little one and that you’re not just ill.
While a doppler is tempting, as a way to help with bonding, there are many other ways to bond with baby. Some mothers find prenatal exercise and yoga a great way to focus on pregnancy. Journalling about pregnancy, writing to baby, taking a childbirth class, going for a prenatal massage, and other activities that focus on relaxation and on your pregnancy are all wonderful ways to connect with baby.
It's also important to remember that many wonderful mothers don’t feel a bond or connection with baby until after birth. There isn’t necessarily a correlation between how you feel during pregnancy and how you will feel about your baby once she’s in your arms. It’s completely within the realm of normal to take time to bond and connect with your baby, just like in any other relationship.
For more information, see our article, 12 Ways To Bond With Your Unborn Baby.
Ultimately, as with all pregnancy choices, home doppler use comes down to benefit vs risk. If you have concerns about your pregnancy, the best course of action is to discuss them with your midwife or obstetrician. Home doppler use is quite appealing, but before making a decision, it’s important to understand and acknowledge the limitations and the potential risks – the unknown effects of repeat ultrasound exposure, and concerns leading to unnecessary intervention.
You may even decide the cost of a doppler might be better spent on a luxurious pregnancy massage or two. The mental and physical benefits of reducing stress during pregnancy is definitely worth spending your money on.