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Baby's First Portrait
Medical Groups Discourage It, but Businesses Are Giving Parents a Rare Glimpse Inside the Womb

Music plays softly, the lights are low, and a golden baby seems to be smirking in the darkness.

His eyebrows pop up and scrunch down. His arm moves in front of his face.

"Oh, he's waving!" exclaims his aunt, watching on a monitor. "He's so cute!"

The Sanchez family is marveling at a rare glimpse into a miraculous world: life inside the womb. The parents, Erica and Oscar Sanchez, are getting a three-dimensional ultrasound portrait of their fetus.

While watching their 28-week-old child moving inside Erica, the family sees for the first time that the baby appears to be a boy.

"That's amazing," the father marvels. "It's just so clear. It's so cool!"

After less than two months in business, Prenatal View Ultrasound in South Elgin has made similar portraits of about 30 babies. It's part of a growing nationwide trend toward businesses providing nonmedical, keepsake images of babies in the womb.

The amber-hued images are three-dimensional, show motion like a video, and are much sharper than the two-dimensional, grainy black- and-white profiles many physicians have used for decades.

It's a huge hit with parents, but the practice has drawn criticism from government regulators and the medical establishment.

The U.S. Food and Drug Administration views ultrasound portraits as unapproved use of a medical device. The FDA advises women "should avoid unnecessary ultrasound."

Similarly, the American Institute of Ultrasound in Medicine "strongly discourages" ultrasound, also known as sonography, without a medical purpose.

Yet at the same time, the institute states flatly, "There are no known harmful effects associated with the medical use of sonography."

Webmd.com calls it "harmless." Air Force radiologists call it "one of the safest diagnostic tools available today." Even the FDA never states flat-out that ultrasounds are dangerous, and the agency won't take questions on the issue.

Repeated studies of ultrasound have found no ill effects, over more than 30 years of its use in prenatal examinations. As part of those exams, doctors frequently provide ultrasound portraits for patients.

Business owners who sell the portraits say they're providing a safe, valuable service that helps parents bond with their unborn children.

"We love coming to work because it's fun to be around," said Dr. Pat Ebeling, co-owner of Stork Snapshots in Naperville. "All of our customers are happy. You leave here smiling because you have good experiences the whole day."

Those experiences mean that as long as no regulatory agency restricts the practice, it is likely to keep growing, along with questions about its safety.

Using sound to see

Like SONAR used for navigation by bats and submarines, ultrasound uses high frequency (or pitch) sound waves beyond the human range of hearing. Unlike X-rays, it does not use radiation.

The sound waves can go through and echo off human tissue, and a computer translates them into images that can examine not only a fetus, but an adult heart, breast, prostate, even blood flow.

Most ultrasounds are done with a combination transmitter and receiver that a technician rolls across the mother's belly, which is covered with gel to keep air from disrupting the picture.

In the United States, most pregnant women - an estimated 60 percent to 70 percent - have an ultrasound medical exam.
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Ultrasounds - also known as sonograms - can be done in the first trimester to establish date of pregnancy and the number of fetuses and to check for abnormalities.

In the second trimester, around 18 to 20 weeks, routine ultrasounds can check the fetus and mother for anatomical problems, amniotic fluid, blood flow and other factors, while in the third trimester, it can be used to check the position of the fetus and to prepare for any special needs at birth.

Doctors commonly use two-dimensional ultrasound - black-and- white, pie-shaped, grainy profiles of a baby's head and torso.

But the ultrasound portraits done by businesses in the Chicago suburbs are made with special scanners and software that produce detailed, three-dimensional images in amber hues that make parents go "ah!"

The equipment can also show the baby moving, like a video, known as "4-D." All the images can be printed out or recorded on a DVD.

Mothers like to surprise fathers with the pictures, and parents like to give them to relatives as gifts.

For Renee Sarosky, 23, of Des Plaines, getting an ultrasound at Stork Snapshots was a way to share her pregnancy with her husband, who is in the U.S. Army in Korea.

She was in the Army herself before the two married in June. Then she got pregnant, and he got shipped out.

She'd had a 2-D medical ultrasound previously, but couldn't see anything distinguishing about her baby.

This time, after a 3-D ultrasound at 27 weeks, she saw her child yawn, rub his eyes and suck his thumb and found out he was a boy.

"It was just so cool! I was very excited about it," she said.

"It was funny, he kept putting his hands in front of his eyes like he didn't want us to look at him," she said.

Some parents report their babies seem to grow agitated as an ultrasound goes on, but Sarosky said she didn't think that was the case.

"He just seemed tired and kept rubbing his eyes," she said, "like he was trying to sleep and we woke him up."

Asked if she was worried about the safety of the procedure, she said, "I figured if they did it at my doctor's office, what's the problem? I don't think my doctor would put me at risk like that."

Latest studies

At high power settings, ultrasound can affect the human body. It can increase body temperature and can cause pain or even kill fish in water.

It can help circulate blood to break up a clot. When concentrated, it can be used as an ultrasonic scalpel.

Ultrasound used for prenatal exams, though, typically is at much lower intensity than that used for treatment.

Some studies in labs on cells and rats have suggested problems such as cell damage or death. Studies on humans have raised concern about miscarriage, dyslexia, slow speech development or interference with right-handedness.

One study found less than an ounce lower birth weight after frequent ultrasound, but the weight difference disappeared as the children grew up.

Medical organizations such as the U.S. National Institutes of Health and the Royal College of Obstetricians and Gynaecologists in the United Kingdom have found problems with such studies and concluded that overall research has found no proven adverse effects.

The most recent study in last month's British medical weekly The Lancet reconfirmed earlier findings: repeated ultrasound medical examinations during pregnancy do not pose a risk to the baby's health.

The study of 2,700 children through age 8 found those with frequent scans showed no ill affects in growth, speech, language, behavior or neurological development.

To address any concerns, everyone would like more research to be done, particularly with newer applications.

Still, the American College of Obstetrics and Gynecology recommends against nonmedical uses of ultrasound, stating it "cannot be assumed to be completely innocuous."

The American Institute of Ultrasound in Medicine says it can't guarantee no one will find adverse effects in the future.

"Nobody's proven there's any damage, but we're never going to be able to say absolutely, 'Yes, this is safe.' " said Dr. Joshua Copel, a professor of obstetrics and gynecology and reproductive sciences at Yale University School of Medicine.

Diagnostic tools have been misused previously. In the 1940s and '50s, shoe stores used X-rays to measure feet and pediatricians routinely used flouroscopes to examine pregnant mothers, before the harmful effects of radiation were widely known.

No laws specifically address ultrasound portraits in Illinois, so parents must decide for themselves whether the benefit is worth any unknown risk.

A parent's decision

Opponents of ultrasound portraits worry that they might be done by someone who is not properly trained, or at higher intensity or for a longer time than during a medical exam.

In the Chicago suburbs, two businesses offer ultrasounds exclusively for prenatal portraits.

Prenatal View Ultrasound in South Elgin, where the Sanchez family went, is owned and operated by Michelle Lackowski, a certified sonographer who works at Provena St. Joseph Hospital in Elgin.

She uses a GE Voluson 730 Pro, the same equipment used in many medical exam rooms, and says she follows the same general procedures and uses the same intensity.

She requires clients to be under a doctor's care and have received a diagnostic ultrasound.

"I don't like to step on doctors' toes," Lackowski said. "I'd like clients to discuss it with their doctors."

Stork Snapshots in Naperville was the first business in the area to offer ultrasound portraits when it opened in 2003.

It's co-owned by two doctors, and sonograms are performed by two sonographers who have completed their training and were awaiting certification as of December.

They use a Philips HDI 4000, which cost $90,000 and commonly is used in medical exams, and say they follow the same standard medical procedures.

Some critics worry that a mother might be falsely reassured her baby is normal or might not get proper guidance if an abnormality is found, but business owners say that's why they cater only to clients who've already had medical ultrasounds.

They also make the disclaimer that their limited diagnostic exams - which check the heartbeat, number of babies, and position of the baby and placenta - do not replace a complete diagnostic ultrasound.

At Prenatal View Ultrasound, packages cost $175 for a 15-minute session, four images and a VHS video, or $300 for a 25-minute session and 4D DVD.

Lackowski likes to perform the service at 24 to 27 weeks, when the baby is well-developed but has room to move.

She urges parents to use only a registered sonographer.

"I wouldn't want anyone that doesn't know what they're doing," she said.

Ebeling first saw ultrasound portraits on "Oprah" and got one herself when she was pregnant. Her daughter, Helena, is now 15 months old.

Ebeling, who offers packages from $130 to $250, said her favorite reaction was when a family from Mexico got an ultrasound and the father was so excited, he immediately called relatives to say he was having their first boy.

Many parents feel an emotional attachment with their babies in the sessions.

One client's fetus had a medical defect and she was told the baby would probably die soon after birth. Her doctor gave her the go- ahead for a portrait session to see the baby alive in the womb.

"It was a very sad time," Ebeling said, "but we were able to provide a service no one else could."

"We're not just a photography studio," she said, "We're here to sell that experience with your baby."

Source: Daily Herald; Arlington Heights, Ill & RedNova.com.

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