When Can You Hear a Fetal Heartbeat?

If you can't hear it, here's why

A prenatal care appointment in pregnancy
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Are you wondering when you can hear the fetal heart beat? You can typically hear your baby's first heartbeat with a Doppler stethoscope between nine and twelve weeks of pregnancy. This might be at your first prenatal visit, depending on when you are seen for the first time. There are some women who will hear it slightly earlier and some who will hear it slightly later. While it is easier said than done, try not to panic if you don't hear it when you're hoping to.

When You Don't Hear the Heartbeat

If your doctor or midwife does not hear the heartbeat when they would expect to hear it, they have several options for further investigation. They may:

  • ask you to come back to the office to try again at your next regular appointment
  • have you come in earlier than your next regularly scheduled exam (two weeks versus four)
  • perform an ultrasound to check on the progress of your pregnancy
  • provide you with more information on not hearing the heartbeat when expected

Why Don't I Hear My Baby's Heartbeat?

While it's frightening not to hear your baby's heartbeat when you're hoping and expecting to, there are logical reasons why this may be happening. Before you panic, consider these.

1. Your Due Date is Wrong 

If you weren't sure of your last period or if your due date is calculated using something other than ultrasound, your due date may be later than you thought, meaning you really aren't twelve weeks pregnant.

This makes your baby's heart beat would be harder to hear. This is one of the most common reasons, particularly if this is your first prenatal visit.

2. Uterine Position

If you have a tilted uterus, you may have a harder time hearing your baby's heartbeat at first. This is because a Doppler is directional, so when your doctor or midwife aims it where the uterus would typically be, yours is placed slightly differently.

This is not a problem, just a difference.

3. Baby's Position

At this stage of pregnancy your baby is very small. The Doppler needs to hit the baby in just the right way to catch the heartbeat. Sometimes it simply 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. The time it takes to find the heartbeat is not indicative of a problem.

4. Maternal Size

If you are overweight, sometimes the padding between baby and the Doppler is significant enough to cause it to be harder to hear the baby. Typically this can be overcome by using a transvaginal ultrasound if you or your practitioner are worried about the baby.

This is not always a problem through your entire pregnancy, but mainly when the baby is so small and the uterus is tucked into the pelvis. As you get into the second and third trimester, it usually becomes easier to find.

5. Miscarriage

Sometimes the reason you are not hearing the heartbeat is because you are in the process of miscarrying, even if you have not had any signs of miscarriage, or you had had a miscarriage. This may be a missed miscarriage, where you haven't yet had any signs of miscarriage, or even a blighted ovum, where the baby never really begins to form, despite you having pregnancy symptoms.

This is the reason that worries most people when a heartbeat isn't heard. You should talk to your practitioner if this is your concern. They can help you understand what is going on and what the best next steps are for your care.

A Word From Verywell: What to Do When You're Concerned

If you are concerned, speak up. Be sure to talk to your midwife or doctor about your preferences and concerns. If they do not offer you options, ask specifically what your options are, why those are your options, and why other options are off the table.

For example, if you aren't offered an ultrasound, ask them why. It might be that they don't have the facilities available or that they simply didn't think about it because they aren't concerned.

Only you can decide what feels right for you and your pregnancy.

If you can't hear the heartbeat, try not to panic. It is a fairly frequent occurrence and it has some perfectly plausible explanations. Worrying about it won't do anything but make you feel terrible. You should convey your level of concern to your practitioner to get guidance from them for a quick resolution.

Sources:

Fetal Development. Sacks, D. Medline Plus. September 2015.

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

The Official Lamaze Guide. Lothian, J and DeVries, C. Meadowbrook; Third edition.

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