Home birth ultrasound guidelines

Anatomy ultrasounds are standard practice and performed at 20-22 weeks. We will cover one ultrasound in the course of standard care for low-risk pregnancy.

To schedule an ultrasound in Western Washington, contact one of our imaging centers . In Eastern Washington, contact the Provider Assistance Unit at 1-888-767-4670 for information about Kaiser Permanente-contracted radiology services.

To request ultrasound results from our imaging centers:

• Contact an imaging center to request an ultrasound.
• Give your patient a completed Radiology imaging request form (PDF) and your business card to present to the imaging center at the time of the appointment.
• Instruct your patient to tell the radiology office staff that the results must be faxed to their home birth provider.
• If you have not received results within two to three days after the ultrasound, contact the imaging center and ask for the lead file room staff, who will fax the results to you.

Additional tests

You may order one obstetric ultrasound without a prior authorization request or physician consultation. Please use a Kaiser Permanente-owned or contracted imaging facility. If you desire more than one ultrasound, you must consult with a Kaiser Permanente obstetric specialist as outlined in the obstetric ultrasound guidelines. If the obstetric specialist approves the additional ultrasound, you need no further prior authorization before ordering the test. Please document the consultation and findings in the woman's medical record.

Patient requests for repeat ultrasounds

Patients sometimes request repeat ultrasounds that are not medically indicated. Our providers have found that the following information is helpful in responding to these requests:

• Recent studies of large groups of pregnant women have confirmed that routine ultrasound during pregnancy does not make any difference in the outcome of the pregnancy for either the woman or the baby.
• Routine ultrasound may actually cause unnecessary worry.
• Most experts in maternity care in the United States do not recommend ultrasound examinations unless there is a medical reason.
• Typically, Kaiser Permanente does not cover procedures that are not medically indicated, such as an ultrasound to determine the sex of a baby.

In the absence of medical indications, a woman's request for follow-up ultrasound may indicate concerns that can be better addressed through other means. Some obstetric practitioners use questions, such as the following, to open a discussion:

• Can you tell me about your concerns?
• What would you like to learn from the exam?

Additional ultrasounds for medical reasons

Our Home Birth Program includes only low-risk pregnancy care. You must consult with one of our obstetric physicians for each medically indicated ultrasound beyond the initial procedure or before ordering medically indicated testing or diagnostic services beyond those consistent with routine pregnancy care.

If after consultation you and the physician still consider the patient an appropriate candidate for home birth, you may order additional ultrasounds in the same way as the initial exam.

Please refer to pregnancy services locations to find this consultation in your area. See Home birth consultation for examples of conditions indicating the need for obstetrician consultation, referral, or both.