Sonograms "R" Us

By Julie Rawe

Eleven years ago, an obstetrician in Salt Lake City, Utah, delivered a brand-spanking-new franchise into the world. Noting that pregnant women seemed to have an insatiable appetite for ultrasound images of their babies, Dr. Leon Hansen set up a retail offshoot of his practice that offered high-tech images in a low-rent setting--a mall. Women soon flocked there to buy sonogram videos and pictures made strictly for keepsake purposes. Hansen has since sold his stake in Fetal Fotos, but the business is booming with a dozen outlets across the country and a host of imitators with cutesy names like Peek-a-Boo Ultrasounds and Womb with a View.

Forget the grainy, two-dimensional images you typically get at the doctor's office. The 3-D footage these companies provide of yawning, smiling, blinking fetuses, in sepia tones and often set to music, is rapidly becoming the hip new baby-shower gift. Couples or their friends can spend upwards of $250 on deluxe packages that may include 5-by-7 portraits, DVDs and a personalized Web page. Denver's First View Ultrasound even offers catering and limousine service to accommodate large parties, in addition to unlimited Kleenex because customers are so moved by the ultrasound experience.

Misti Cordova, 20, decided to go to First View after seeing a flyer in a Babies "R" Us. The video-store clerk soon found herself sitting in a tidy office park and cooing as she watched her unborn baby curl his upper lip: "Looks like he's doing an Elvis pose!"

While the state-of-the-art images have thrilled thousands of moms-to-be, the same isn't true for many of their doctors. Generally, ob-gyns make it a practice to avoid exposing fetuses to powerful sound waves any more than is necessary. Both the FDA and the American College of Obstetricians and Gynecologists (ACOG) have warned against the trivial use of sonograms. Yet several keepsake-ultrasound companies actually offer discounts to encourage repeat visits.

Dr. Joshua Copel, president-elect of the American Institute of Ultrasound in Medicine, can come up with only one other example of medical imaging equipment being used in a nonmedical setting--and that fad became extinct decades ago: "They no longer have those X-ray machines in shoe stores so you can look at the bones in your feet as much as you want."

Although ultrasound is an indispensable diagnostic tool, doctors worry about excessive exposure. "You walk a tight line about how much you want to scare people," says Dr. Laura Riley, director of labor and delivery at Massachusetts General Hospital in Boston and head of ACOG's obstetric-practice committee. "To the best of our knowledge, ultrasound is safe. Ultrasound that's done in a mall, where they don't know what the settings are on, may not be as safe."

Doctors are also concerned about the proficiency of retail sonographers, who aren't supposed to provide medical diagnoses but sometimes do. Sonographers in doctors' offices take at least 18 months to get their licenses, whereas training requirements vary widely from retailer to retailer. "You want someone there who can actually interpret the ultrasound for you, so you don't go away either frightened by something you think you saw or, worse, reassured that things are fine when in fact there's something wrong," says Riley. Many an obstetrician has seen patients who have spent sleepless nights worrying after being told--incorrectly--by a keepsake-ultrasound technician that their baby may have a major defect.

The FDA has issued several warnings over the past decade against the use of keepsake ultrasounds, and last year its consumer magazine went so far as to list an address readers could use to alert compliance officers whenever retail sonographers set up shop in their community. Since then, a few states, including California and Illinois, have proposed legislation banning such ultrasounds. In the meantime, says Copel, "physicians can do a fair amount to blunt the impact of these places." If provided with a blank videotape beforehand, his staff will happily pop it into the VCR and record the sonogram for posterity. Some of his colleagues will do the same with DVDs. "But we do it only when there is a medical indication to do the ultrasound," he emphasizes. And patients eager to have the full sentimental experience will have to add their own music. --With reporting by Rita Healy/Denver

With reporting by Rita Healy/Denver