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Excited and a bit scared are normal reactions when your doctor or midwife schedules you for a 6-week ultrasound. It’s exciting because you get to actually see what’s going on inside your body.

But it can also be a little anxiety-inducing, because you may know that such an early ultrasound isn’t always typical.

So what’s the reason for the early scan? And what can you expect to see?

Typically, the end of your first trimester (around 11 to 14 weeks) is when you have your first ultrasound in pregnancy.

But if your doctor or midwife wants you to have one at 6 weeks, they’ll tell you why. If not, ask them.

It may be because you’ve had pregnancy complications or early pregnancy losses in the past. Or it may be due to your age or medical history, or if you’ve had bleeding, or your recollection of your last period is hazy because that’s the best time to set the due date.

In reality, there are many reasons your doctor may want an early scan. Typically, in this initial pregnancy ultrasound, your doctor wants to check on:

  • Early heart development. Your embryo has not yet developed a fully-formed heart at 6 weeks, but you may hear a cardiac pulse on the ultrasound. Be prepared: This may be the first time you see signs of your baby’s heartbeat, and it can be very emotional.
  • Number. You might find out you’re having twins or higher-order multiples. (In the United States, the chance of having twins is about 3 percent.) Be aware, though, that sometimes 6 weeks is too early to tell.
  • Location. The ultrasound can locate where the embryo is implanted. Your doctor wants to know if it’s high in the uterus or low. They also want to check that it’s in the uterus and not an ectopic pregnancy. It’s an ectopic pregnancy when a fertilized egg implants in a fallopian tube or elsewhere outside the uterus. An ectopic pregnancy can’t be carried to term, and is a life-threatening emergency.
  • Size. Your doctor will want to know the size of the embryo to confirm the due date.
  • Yolk sac. At this stage of your pregnancy, a yolk sac should be visible inside the gestational sac. It tends to look like a tiny balloon, and your doctor wants to see its size and shape, which are indicators of your pregnancy health.

Often it can be a challenge to find a heartbeat by ultrasound before you’ve reached the seventh week of pregnancy.

Also, it can be difficult to pinpoint the exact start of your pregnancy, so you might not actually be at the sixth week yet.

If you go by the date of your last monthly period, keep in mind that you may have ovulated later in your cycle than you thought, especially if your cycles are longer than 28 days from the start of one period to the start of the next, or if you have irregular cycles or are using any hormonal contraception like pills or implants.

If the heartbeat can’t be picked up and you have no other symptoms, you’ll probably be scheduled for another ultrasound in a week or two.

Waiting for that next ultrasound can result in a stressful week. If you feel you need more support than what is being offered by your family and friends, talk about it with your doctor.

If you’re having your first pregnancy ultrasound at 6 weeks, there are some things you should be aware of. This is an exciting step, and being prepared can help you focus on the positive aspects.

  1. At 6 weeks, you’ll likely have a transvaginal ultrasound rather than the abdominal one you may be thinking of. Before 7 weeks, babies are often so small that the abdominal ultrasound may have trouble picking up the information the doctor wants. While the traditional abdominal ultrasound involves a wand (transducer) that’s placed on your belly, a transvaginal ultrasound involves a wand being inserted into your vagina. It shouldn’t hurt, but it may not be the most pleasant feeling in the world.
  2. Your baby, at this stage, is only about a quarter of an inch long — so you might not see much detail. You have to wait until 11 to 12 weeks to get a 91 percent accurate identification of your baby’s biological sex, for example.
  3. The technician operating the ultrasound may not be permitted to answer many of your questions. Typically, the sonographer will get the results to your doctor for a follow-up visit (often right after the scan) where they’ll interpret the data for you in detail.
  4. The facility where you get your ultrasound may or may not be set up to give you a printout. If you want a picture, they may let you take a snapshot of the screen — so have your phone handy.
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6-week ultrasound showing a clear fetus with measurement of the crown-rump length. The fetal pole is the earliest sign of the developing fetus.

A pregnancy ultrasound uses sound waves to create a picture of your baby developing in your womb. There’s no radiation used.

Doppler uses more intense (louder) sound than imaging and has the potential to raise tissue temperature, so it’s best to minimize throughout pregnancy but especially in 1st trimester. A few seconds of Doppler is very unlikely to cause any problems.

According to the National Library of Medicine, ultrasounds are considered safe — there are no known risks — during all stages of pregnancy.

Prenatal care, such as medical checkups and screening tests, help keep you and your baby healthy. A 6-week ultrasound is a safe part of that process, providing important information to your doctor so they can offer you the best care.

Like many other aspects of your pregnancy, your first ultrasound is an exciting and potentially stressful part of your prenatal care. If possible, take a support person with you and try not to worry if you can’t see what you’re expecting — it may just be too early.