Getting an ultrasound at 32-weeks is very different than getting one earlier on in your pregnancy. In this article we’re going to talk about the different reasons why they might order an ultrasound, what to expect when you see it and what the results might mean for you. So, let’s get going!
So, how do I know so much about 32-week ultrasounds?
Hi — I’m Hilary — The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have seen hundreds of ultrasounds going on, reviewed results with patients and doctors and helped make decisions going forward…
And if you’re wanting to know more about 3rd trimester testing totally join me in my free beginning prenatal class where there’s a whole video lesson on it (and can help you communicate with your healthcare provider team on the results)
Reasons you might get an ultrasound at 32 weeks pregnant:
There are a few different reasons why a doctor will order an ultrasound at 32 weeks. Because it isn’t a “standard” exam they normally do have to put in a reason why and then a specific exam:
This is normally the most common reason to get an ultrasound scan of baby at 32 weeks. They’re looking to see how well baby is growing — and this may happen for a variety of reasons:
- Your belly is measuring small in they office and they want to check baby’s growth
- Low weight gain
- Diabetes — gestational, type 2 or type 1 (changes in blood sugar can affect baby’s growth)
- Preeclampsia/high blood pressure (can affect how much blood is getting to baby to grow)
- Issues on previous scans they want to check on
In this ultrasound they will check on baby’s growth, they may do some studies on the blood flow to the baby (often called a Doppler flow study). They’ll likely check the fluid levels and baby’s movement, etc. It will seem very similar to your previous ultrasounds, but baby will be bigger (I think it’s exciting see these giant feet and hands that were so small at your last ultrasound).
They may keep doing growth scans week by week to make sure baby is growing well in your uterus (so, more of a growth curve vs just a one-time growth point). If baby isn’t growing over time that can obviously be a problem.
Those types of decisions can be complicated if they think baby would thrive more outside the womb. But most often baby (and their lungs) are ready to be born closer to at least 37 weeks.
This is more commonly known as a BPP — this is a very routine test that checks for:
- Amount of amniotic Fluid (AFI)
- How much baby is moving (sometimes they have to “buzz” them to wake them up)
- Muscle tone (if baby flexes limbs or hands/feet)
- Breathing moments — baby still breathes in the womb and we like to see they’re “practicing” in the amniotic fluid
This test also includes an NST — a non-stress test. It means we are watching baby’s heart rate when they are not under stress (aka, contractions). There is a different test called a stress test where we initiate contractions and see how they do.
The NST is done by a trained healthcare provider (usually an RN) in fetal monitoring to know if baby’s heart rate is normal. It is NOT done with an ultrasound machine — most often is done in the office, in a perinatology clinic or in labor and delivery.
Where I have worked we start the NST and order the BPP, and then ultrasound comes up when they’re ready and hopefully we have the NST results by then as well.
Each of those measurements is given 2 points, and the total score is out of 10 (8 from the ultrasound, and 2 from the NST). Each of them is scored on a “pass/fail” basis.
Often people will order a scan for BPP and growth just to check all the things if they have any concerns.
BPP’s are as common at week 32 of pregnancy (but can start once you begin your third trimester), but get more common as you progress closer towards your due date.
They may be looking at different structures, especially if something was “off” in your first ultrasound. This can include:
- Placental placement, like a previa
- Any anatomical defects — things in the heart, kidneys etc.
If they’re concerned your fluid levels are low they may just do ultrasounds to check your fluid levels (called the AFI — Amniotic Fluid Index).
Didn’t See it Before
If they couldn’t see something well on your first ultrasound (baby positioning, or whatnot), they may schedule another one for now to get a better look at it and make sure things are right with that area.
You may be getting an ultrasound for OTHER reasons. To check-out your liver, or kidneys. Often they will order them to just take a peek at baby as well.
Personally, I had a liver ultrasound at about 32 weeks pregnancy because of right upper quadrant pain. They will likely only look at the baby if a separate ultrasound is ordered just for baby.
Types of Ultrasounds
There are 3 different types of OB ultrasounds (or pregnancy scans)
Standard: These are ultrasounds all pregnant women get. ACOG currently only recommends that it be standard for all women to get an ultrasound at 18-22 weeks (this is the one you normally find-out gender on), although most people seem to also get an early ultrasound to check for size & dates and to make sure there is a heartbeat.
Limited: This is to just look at one thing. Maybe it’s if the baby is breech or cephalic (head down), or where the placenta is
Specialized: This is to look at one area further due to a problem, or a suspected problem. Often these are called “level two” ultrasounds — so, they don’t see something quite right on a standard ultrasound, so they then upgrade to a specialized ultrasound.
There are also 3d or 4d ultrasounds, but that really depends on where you get your ultrasound and their type of technology. These types of things can be done even with a 2d baby scan. The newer machines do detect more though (but aren’t always 3d or 4d).
I thought this article from ACOG about ultrasounds was helpful if you want more information on what they recommend.
Do you always need an ultrasound at 32 weeks?
No, not at all. A 32 week ultrasound is not routine. Most of often it is done for a specific reason as I have mentioned.
Some doctors routinely order them to check for size, but that isn’t the normal standard of care in the US. According to the American College of Gynecology and Obstetrics (ACOG) they only call the 18-22 week ultrasound “standard” (meaning every expectant patient should get one).
During the Ultrasound
You may approach this ultrasound with both excitement and anxiety.
In case you didn’t know — An ultrasound uses sound waves to create images of the baby in the womb. They are done by ultrasound techs also known as sonographers.
Some sonographers do all types of ultrasounds, and some are more specialized and only do OB (and are likely better at it since that’s all they do).
Upon going into the ultrasound room, the ultrasound technician will often ask questions about the mother’s medical history and lifestyle to gain a better understanding of how she is progressing through her pregnancy.
They will likely do this ultrasound on your abdomen (vs a trans-vaginal ultrasound which may have been done early on). However, if they need to check cervical length, or issues with the cervix and then sometimes they do a transvaginal ultrasound — meaning a probe is placed in your vagina).
Depending on the reason for the ultrasound, how much they’re checking and how cooperative your baby is being the timing of the ultrasound varies, but you can always ask the ultrasound tech how long they think it will be.
Your Baby at 32 Weeks Pregnant
At pregnancy week 32, your baby is about the size of a pineapple and preparing for birth. Baby’s weight is normally around 1700 grams (3.75 pounds). During this time, you may feel a lot of movement as your baby turns around and kicks. He or she is likely in a head-down position (known as cephalic presentation), which is the ideal position for delivery. However, some babies are in a breech position at 32 weeks pregnant, meaning their feet or bottom is pointing downwards instead of their head. If this happens to you, there’s no need to worry; your doctor can help you find ways to turn the baby so that they are in the correct position for delivery, and baby may still be transitioning to head down… I have a whole post on signs of baby to head down.
Your baby, at week 32, still has lungs that are maturing and they will continue to develop until full term (around week 37). You should be feeling lots of movement from your little one – it’s an amazing experience! Make sure to rest when you can and enjoy all the special moments before the big day arrives.
32 weeks pregnant checklist
Before we get into it– grab my postpartum checklist you’re going to need soon:
☑️ At 32 weeks pregnant, it is important to check in with your doctor and make sure that everything is progressing normally — make sure you’re going to all prenatal appointments.
☑️ You’ll want to check in with baby’s position, because you’re hoping they’re head down at this point (although often they don’t migrate to head down for a couple more weeks).
☑️ You’ll also want to be sure that the placenta isn’t in the way of your cervix — if it hasn’t been mentioned before, you’re likely fine — placenta’s don’t go to the cervix as you get bigger, they move away from it.
☑️ You’ll also want to be sure of any signs/symptoms of when to go to the hospital. You may be getting some irregular contractions, some cramps or feeling their uterus tighten at times along with some lovely heartburn… things may be very magical right now. 🙂
Pro Tip: Irregular contractions are hopefully just “practice contractions” also known as Braxton Hicks — be sure to ask your doctor when you should get to the hospital.
☑️ And you’ll obviously want to get started on that childbirth class. With just a couple of months left it is all starting to become very real, and in order to prevent it from feeling scary, make sure you guys get prepared.
The Online Prenatal Class for Couples is the simple way to get prepared for your baby’s birth. It can be done in just a few hours and couples absolutely love it.
I love what Carissa said about the class:
“The course was very thorough. I liked how Hillary talked through each stage. As a first-time mom this was very helpful. Everything is explained in a simple and relatable way. Thanks, Hillary!”Check-out the Online Prenatal Class Reviews here!
And, if you’re not quite sure you’re ready for that whole thing (or, want to make sure we’re a good fit), check out my free prenatal class. It’s your first step toward getting in the driver’s seat of your birth.
- About the Author
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A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.
She has 20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.