Do Growth Scans Improve Outcomes for Older Mothers? Examining the Evidence

Written By Emma Gleave

As a birth professional, I often get asked about growth scans, or fetal growth assessments, especially for older mothers.

Every scan, test, or procedure offered during pregnancy is just that—offered.

It is not mandatory. Women are best placed to make decisions for themselves and their babies, provided they are fully informed about the benefits and risks of each procedure. Unfortunately, this is not always the case. To help bridge that gap, here is a summary of the evidence.

Have growth scans contributed to better maternal and neonatal health since their introduction, or have they simply increased the rate of medical interventions?

And perhaps even more importantly—how safe is ultrasound technology itself?

In this blog, I will examine the evidence, explore guidelines for older mothers, and offer practical advice on ensuring a healthy pregnancy.

The History and Safety of Ultrasound in Pregnancy

When Did Ultrasound Begin?

Ultrasound technology was introduced into maternity care in the mid-20th century. Its use quickly expanded, and by the 1980s, it was considered a routine part of pregnancy care. Initially, its primary role was to confirm gestational age and monitor fetal development. Over time, its use extended to growth assessments in the third trimester.

Has Ultrasound Been Proven Safe?

While ultrasound is widely regarded as safe, no long-term randomised controlled trials (RCTs) have definitively proven its safety. It wouldn't be ethical to run such a trial now.  Some researchers, such as the authors of the article "Ultrasound: Unsound", have raised concerns about potential subtle effects, particularly with frequent or prolonged exposure. These include:

  • Possible effects on fetal tissues due to the heating and mechanical vibrations caused by ultrasound waves.

  • The unknown impact of repeated exposure on fetal neurological development.

Although no conclusive evidence links routine ultrasound use to harm, the precautionary principle suggests using it judiciously and only when clinically indicated.

Evidence and Guidelines for Growth Scans in Older Mothers

Do Growth Scans Improve Outcomes?

The evidence on whether growth scans improve outcomes remains inconclusive:

  • A systematic review from the Cochrane Database found no significant benefit of routine third-trimester scans in low-risk pregnancies.

  • For older mothers or other high-risk groups, growth scans may increase the detection of issues like FGR, but this does not always translate into improved outcomes. Detection often leads to increased interventions, such as inductions or caesareans, which carry their own risks.

What Does ‘Slightly Increased’ Risk Mean for Older Mothers?

Studies indicate that older mothers (commonly defined as 35 years or older) have a modestly increased risk of complications such as placental insufficiency and fetal growth restriction (FGR). For instance:

  • Women aged 16 to 19 years: The stillbirth rate is approximately 4.7 per 1,000 total births (Office for National Statistics).

  • Women aged 20 to 24 years: The stillbirth rate decreases slightly to 3.9 per 1,000 total births (Office for National Statistics).

  • Women aged 25 to 29 years: The stillbirth rate is approximately 3.6 per 1,000 total births (Office for National Statistics).

  • Women aged 30 to 34 years: The rate remains at 3.6 per 1,000 total births (Office for National Statistics).

  • Women aged 35 to 39 years: The stillbirth rate rises slightly to 4.1 per 1,000 total births (Office for National Statistics).

  • Women aged 40 years and over: The rate increases further to 5.5 per 1,000 total births (Office for National Statistics).

While these figures represent a gradual increase in risk with advancing age, it is important to contextualise them. The overall likelihood of stillbirth remains low across all age groups. These statistics can help inform discussions between mothers and healthcare providers to support balanced decision-making.

AIMS bases its guidelines on this evidence, recommending growth scans for older mothers to monitor for these risks while cautioning against over-medicalisation and unnecessary interventions.

What Can Mothers Do to Support a Healthy Pregnancy?

While growth scans provide a window into fetal health, mothers can take proactive steps to support their babies’ development and their placentas’ health naturally:

That’s why I do what I do here at Emma’s Antenatal.
I offer a range of services proven to support a healthy pregnancy, nurture both body and mind,
and increase the likelihood of a straightforward labour, birth, and transition into parenthood.

These approaches not only pave the way for a smoother birthing experience
but also offer the best chance for
successful breastfeeding and long-term benefits for both mother and baby.

1. Nutrition

  • Focus on a diet rich in whole, unprocessed foods.

  • Prioritise animal fats, such as butter and fatty fish, and B vitamins for placental health.

  • Include probiotic foods like kefir, sauerkraut, and yogurt to support gut and immune health.

  • Opt for organic, local produce when possible to reduce exposure to toxins.

  • Eggs, fruits, and vegetables provide essential vitamins, minerals, and antioxidants.

2. Pregnancy Massage

Pregnancy massage improves circulation, increasing blood flow to the placenta and delivering vital nutrients and hormones.
It also promotes relaxation, reducing stress and boosting maternal well-being.
Read about some of the proven benefits and my services in my blog HERE

3. Gentle Exercise

  • Walking in nature improves cardiovascular health and reduces stress.

  • Pregnancy yoga has been proven to lower cortisol levels for up to a week, as demonstrated in the CALMA study by the University of Manchester. This study highlighted that regular yoga sessions significantly reduce anxiety and fear of childbirth while protecting against depressive symptoms.

4. Stress Management

  • Prioritise rest and incorporate practices like mindfulness, breathing exercises, and meditation.
    Check out my 5 minute breathing practice you can do anywhere to create a moment of calm.

5. Avoid Environmental Toxins

  • Minimise exposure to chemicals found in processed foods, cleaning products, and cosmetics.

6. Stay Hydrated

  • Proper hydration is crucial for overall health, supporting blood flow and nutrient delivery to the placenta.

  • Avoid unfiltered tap water for drinking.
    Mothers in the Forest of Dean are particularly fortunate to have access to a range of highly regarded natural drinking sources.
    See The Rewild Project’s "Springs and Wells of The Forest of Dean" for further information:
    www.therewildproject.com/springs-and-wells.

7. Regular Check-ins with a Trusted Provider

Having access to a dedicated midwife and unhurried appointments to discuss your unique risk factors and options is ideal for ensuring personalised care. However, this may not always be feasible within the constraints of the NHS, where appointments can be brief and with unfamiliar practitioners. For those seeking a more tailored approach, exploring the services of independent midwives, such as those listed by Independent Midwives UK, could be an option worth considering.

Alternatively, non-medical practitioners such as doulas or antenatal teachers can also provide valuable support. Many of these professionals are trained to break down complex information, including statistics, into understandable terms, helping you feel empowered to make informed decisions about your care.

If you’re feeling uncertain or overwhelmed, I also offer a Power Hour session tailored to your needs.

In this focused session, I can help you make sense of your risk factors, clarify confusing information, and explore your options—leaving you feeling more confident and informed about your choices.

Questions to Consider for Informed Decision-Making

If your provider recommends growth scans, here are some questions to ask:

  • What evidence supports the use of growth scans in my circumstances?

  • What are the potential risks and benefits of this scan?

  • How might the findings influence my care plan?

Useful Links and Resources

Final Thoughts

Growth scans are part of a risk-based and fear-driven approach to pregnancy care, often focused on identifying potential problems rather than celebrating the natural resilience of the pregnant body.

While they can provide useful information in high-risk cases, their routine use does not guarantee better outcomes and can lead to unnecessary interventions.

Proactive approaches, such as nourishing your body with whole foods, engaging in pregnancy yoga, and enjoying the benefits of massage, offer tangible ways to enhance health. These practices not only support placental function and fetal development but also create an empowering experience of pregnancy—one that helps mothers connect deeply with their own bodies and their babies.

Hi I’m Emma

As a birth professional with 16 years experience supporting parents, I am passionate about providing evidence-based information to empower women in making informed decisions about their pregnancy and birth.

My work focuses on nurturing confidence, offering holistic evidence based support, and helping parents navigate the complexities of modern maternity care with clarity and calm.

Whether it’s through antenatal classes, one-to-one support, or creating resources like this blog, my goal is to help families feel informed, prepared, and connected during this transformative time.

Explore Supportive and Evidence-Based Services for Your Pregnancy Journey

If you're looking for safe and effective ways to support your pregnancy, I offer a range of services designed to nurture both you and your baby. From pregnancy massage, which promotes placental health and relaxation, to antenatal classes and pregnancy yoga, which are proven to reduce stress and enhance well-being, my approach combines evidence-based practices with holistic care to empower you on your journey.

Learn more about my services and book a session today!

Emma Gleave
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