What to know about at-home fetal Dopplers

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There is no evidence that at-home Dopplers injure the baby. However, there is also no evidence that they are safe. For that reason, in 2014, the Food and Drug Administration (FDA) strongly advised consumers not to buy or use these devices.

One of the main concerns about ultrasound devices is that they slightly heat bodily tissue. Research has found that prolonged heat increases the risk of certain congenital abnormalities and can potentially lead to pregnancy loss.

Using ultrasound devices, including at-home Dopplers, can expose the baby to increased heat, and frequent use may be especially dangerous.

As these devices are not well-regulated, and most of the people who use them lack medical training, at-home Dopplers may increase the risk of heat-related injury to the developing fetus.

Moreover, these devices offer no medical benefits, unlike diagnostic ultrasound, which can detect certain problems and ensure that the pregnancy is not harming the mother.

At-home Dopplers can also stoke needless fears. It is difficult to detect a heartbeat on these devices, and most cannot do so for weeks or even months after a medical ultrasound can.

Using a device and not finding a heartbeat can trigger anxiety and even panic, especially when a person has already heard the heartbeat in the doctor’s office.

Some expectant parents, however, find that these devices offer peace of mind. People with a history of infertility, stillbirth, or pregnancy loss, in particular, may find that the reassuring sound of a fetal heartbeat can ease anxiety.

Yet, the authors of an article in The BMJ caution that these devices can provide false reassurance. They describe the experience of a pregnant woman who noticed a decrease in fetal movement but delayed going to the doctor because she believed that she had heard the baby’s heartbeat on an at-home fetal Doppler device. At the doctor’s office, an ultrasound confirmed intrauterine death.

Emotional health is very important. Anyone who feels anxious about a pregnancy should speak with a healthcare professional about managing their anxiety.

A doctor or midwife may also offer safer alternatives to at-home Dopplers, such as more regular in-office ultrasounds.

The safest option is to not use at-home Dopplers devices, at least until more research has investigated their safety.

Any expectant parents who feel that they cannot wait should:

• Ask a doctor or midwife whether they can recommend a specific device that they believe to be relatively safe.
• Check with the doctor or midwife about any specific factors that might make the use of a Doppler especially risky.
• Read the instructions carefully.
• Do not use the device too early — in most cases, a device will be unable to detect a heartbeat before the start of the second trimester.
• Use ultrasound gel or aloe vera gel on the skin to make it easier to hear the heartbeat.
• Use the device at maximum volume.
• Use the device for extremely limited periods: If the heartbeat is not detectable within 1–2 minutes, do not keep trying.
• Use the device as infrequently as possible.
• After the baby starts moving, stop using the device, as fetal movements are a reliable way to check on the baby’s health.

It is crucial to note that detecting a heartbeat can be difficult, even in a healthy developing baby. Not hearing the heartbeat on a Doppler does not necessarily mean that anything is wrong.

If a person does not hear a pulse, the best thing to do is to schedule a visit with the midwife or doctor. If a person wants to try their Doppler again, wait for a few days.

Keep in mind that even with medical-grade equipment, obstetric providers do not expect to hear the heartbeat until 12–14 weeks of pregnancy.

Research has not proven any particular kit to be superior to the others. All at-home fetal Dopplers present the same risks and potential benefits. For help making a decision, people can try:

• asking a doctor or midwife for guidance
• reading the manufacturer’s instructions to understand how early the device can detect the heartbeat
• reading online reviews (only in addition to the stages above)

Using an at-home Doppler is not a medical approach, and the device cannot reliably detect any health issues. Therefore, the best option is to refrain from using one and to ask a doctor or midwife about appropriate prenatal care.

Pregnancy is a time of great vulnerability, as no one really knows how it will turn out. It is completely natural to feel anxious or worried about the health and well-being of a baby.

Often the best, and safest, way to cope with these concerns is to have a healthy support system. Speak with supportive friends and family members, as well as a counselor or healthcare provider. This will provide far greater and more lasting benefits than using a potentially unsafe ultrasound device.

Any woman with risk factors for pregnancy loss, or anyone who is experiencing significant anxiety should consider these strategies:

• Ask a doctor or midwife about having an early ultrasound. Some ultrasounds can detect a heartbeat between the sixth and eighth weeks of pregnancy.
• Ask about in-office Doppler monitoring. These Dopplers are safer because a doctor or midwife knows how to use them. With an in-office Doppler, it is usually possible to hear the baby’s heart at about 12 weeks.
• Monitor for signs of pregnancy loss, such as spotting, bleeding, or leaking fluid. Bleeding is common in pregnancy, including in healthy pregnancies. However, it always warrants a call to a healthcare professional.
• Begin kick counting late in the second trimester. If the baby stops kicking or moving and does not respond to sugary beverages or a change in position, this may signal a problem.

There is no evidence that at-home fetal Dopplers are harmful. However, the heat that they generate can pose a risk to the baby, so it is reasonable to assume that overusing them can cause a problem.

If a person is feeling anxiety about the well-being of the baby, they should ask a trusted doctor or midwife about coping strategies and discuss any fears and risk factors.

Even when people have a great deal of anxiety about the health of a developing baby, the best strategy is to refrain from using these devices. This will help minimize risk.