Fetal Heartbeat in Early Pregnancy

4 reasons you may not hear your baby's heart beating right away

A prenatal care appointment in pregnancy
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From the plus sign on your home pregnancy test to your child's first cry after she's born, the nine months you spend expecting a baby is packed with an array of wondrous milestones. One of the most exciting is hearing your baby's heart beating for the very first time.

This is most likely to take place at your first prenatal visit when you're between nine and 12 weeks pregnant. At this checkup, your doctor or midwife will use a Doppler stethoscope to pick up the sound of your baby's heartbeat.

4 Reasons You May Not Hear a Fetal Heartbeat

Very rarely, you won't be able to hear your baby's heart beating. There's no question this can be a scary moment, causing you to worry that there's something very wrong with your baby or your pregnancy. And it is true that silence on the other end of the stethoscope could mean that the pregnancy isn't viable and you're in the process of having a miscarriage.

More often, though, everything is OK. There are a number of common reasons a heartbeat can't be detected in early pregnancy. Knowing what they are ahead of time can save you a great deal of anxiety.

It's earlier in your pregnancy than you thought. If your due date was calculated based on the first day of your last period, it may be that you aren't as far along as you thought—especially if your periods are irregular or you weren't certain when you last had one. A faulty due date is one of the most common reasons a fetal heartbeat can't be detected. It's likely your doctor will do an ultrasound, which is a more reliable way to measure the age of a pregnancy, or have you come back for a second visit sooner than you would otherwise (in two weeks instead of four, for example).​

You have a tilted uterus. The way your uterus, or womb, is oriented in your pelvis can affect how easy it is for a stethoscope to pick up the sound of your baby's heartbeat. This is because a Doppler is directional, so when your doctor or midwife aims it where the uterus would typically be but yours is placed slightly differently, it won't pick up any sounds inside. 

Your baby is out of range of hearing. In early pregnancy, the baby is very small. In order to pick up the sound of the heartbeat, the Doppler will need to zoom in on the baby in just the right way. In early pregnancy, the baby is very small, of course, and so it sometimes takes a lot of patience and a bit of luck to find the baby and "catch" it via the Doppler. The waiting to hear the heartbeat while your practitioner is searching might seem like it takes forever.

You're overweight. In this case, the layer of padding between your baby and the Doppler could get in the way of picking up the sound. An alternative to using a Doppler stethoscope, in this case, is to do a transvaginal ultrasound, in which the ultrasound wand is inserted into the vagina for more direct access to the uterus.

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  • Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Fifth Edition.