This Ruling forms part of a wider piece of work on private pregnancy ultrasound scans, identified for investigation, following intelligence gathered by the ASA.
A website for London Private Ultrasound, https://londonsono.com, a medical ultrasound service, seen in May 2022, featured a section titled “Pregnancy”, with text stating “London Private Ultrasound offers various Pregnancy Scans suitable for all stages of your pregnancy”, and with a drop-down menu that linked to web pages for various available scans, including a “Reassurance Scan (from 8-40 weeks)”. On the page with a description of the scan, text stated “Reassurance Scan (from 8 weeks) £100.00 … If you are looking for reassurance scan [sic] to reduce your parental anxiety and to confirm a normal progress of your pregnancy, book a reassurance Ultrasound scan [sic]. This [sic] is a suitable scan for parents to be if you would like to confirm a healthy pregnancy, if you have pain or bleeding, or if you cannot feel the baby’s movements. This scan is not routinely offered in NHS but at LPU we offer you a reassurance scan to provide you a piece [sic] of mind about the health of your baby and your pregnancy”.
Further text with questions and answers in collapsible sections included “What is Reassurance Scan? This is an optional 2D ultrasound scan, which can be performed for the couples who have any concerns about their pregnancy or unborn child” and “What information can the Reassurance Scan provide? During your appointment, we will address all your concerns and questions. Your baby’s heartbeat, movements, and structural development will be assessed during the scan. We can also determine the cause of any symptoms such as pain and bleeding”.
The ASA challenged whether the ad misleadingly represented the extent to which a pregnancy scan from eight weeks could assess the “health” of an embryo and provide “reassurance” to expectant parents.
Ultrasound London Ltd t/a London Private Ultrasound (LPU) said that the advertised “Reassurance scan” (8-40 weeks) assessed the date of the pregnancy, the position of the embryo (known as the site), the number of embryos, the presence of a heartbeat and the general state of a pregnancy, and was compliant with the industry standard. They said that medically speaking the scan involved the same procedure as their “Early pregnancy scan” (6-11 weeks). However, the key difference between the two scans was that the Reassurance scan allocated more time for the patient to discuss any concerns and anxieties about their pregnancy.
LPU said they understood that pregnancy was a stressful time, so they offered that option for the extended consultation to service users to give them peace of mind by allocating time to focus on their concerns. They said that helped as such concerns or any distress could often be eased simply by talking to a medical professional. They said they also understood that some patients were more confident and did not need this additional time to discuss their worries in detail, and therefore the Early pregnancy scan they provided was another option to provide the key details of the pregnancy.
LPU said their ad was never intended to suggest that the Reassurance Scan provided extra medical information to the patient, but rather to address any concerns that the patient may have. They added that the Early scan was priced at £80 while the Reassurance was £100 due to the longer time frame. Furthermore, the £100 was a lower price than later scans in the second and third trimester such as the Anomaly Scan, as the Reassurance Scan was less detailed than those. They said they also explained to patients what they did in each scan to ensure that was fully understood.
LPU also said they had immediately removed the listing for the Reassurance Scan from their website.
The ASA considered that consumers’ knowledge would vary in terms of what they might expect from an ultrasound scan from eight weeks, and the extent of information about the health of their unborn baby that might be provided, but that those considering a private scan for reassurance were potentially more likely to be anxious or vulnerable if they had concerns about their pregnancy, for a range of possible reasons.
The ad for the scan, available during pregnancy from eight weeks through to full term, was titled “Reassurance Scan” and included the claims “we offer you a reassurance scan to provide you a piece [sic] of mind about the health of your baby and your pregnancy”, “reduce your parental anxiety and to confirm a normal progress of your pregnancy” and “for the couples who have any concerns about their pregnancy or unborn child”. We considered that terms such as “the health of your baby” and “normal progress”, in the context of the “reassurance scan”, were ambiguous and could be interpreted in different ways. For example, we considered those terms might be understood to mean that the scan checked whether a heartbeat and normal signs of life were present, or that it meant the scan reviewed an unborn baby’s health and development in greater detail, including checking for abnormalities or conditions. We also considered that the language in the ad was positive and particularly emphasised the reassuring nature of the scan, in terms of determining whether a foetus was healthy and developing as expected, and its aim of addressing or reducing any concerns or anxieties that parents may have. It was also important to note we understood that ultrasound scans could only provide information about the specific moment of pregnancy from which it took place.
The ad stated “During your appointment, we will address all your concerns and questions”, and we acknowledged that the length of appointments for the “Reassurance Scan” had been extended to allow patients time to discuss any concerns or anxieties in comparison to other scans. However, we considered that statement did not change the overall impression of the ad that the ultrasound scan itself could assess the health of the pregnancy.
We understood that at the early stage of eight weeks in pregnancy the information that could be provided to parents about the health of an embryo from an ultrasound scan was limited in comparison to more detailed assessments possible in later scans. For example, we understood that early scans at approximately eight weeks usually aimed to provide key information to parents such as the expected due date, detecting a visible heartbeat, and confirming the location of and the number embryos. Whereas “Anomaly” scans typically performed later in pregnancy (approximately at 20 weeks by the NHS), measured and assessed the anatomical structure and major systems of a foetus in detail and checked for certain rare conditions.
The ad included limited information explaining what the LPU’s Reassurance Scan included, assessed or provided in terms of clinical diagnosis, stating only that “Your baby’s heartbeat, movement and structural development will be assessed during the scan”. Given the range of the timeframe in which the scan was available, from eight weeks through to full term of pregnancy, we considered the ad had not made sufficiently clear that there were differences or limitations in the extent of possible assessments over the course of pregnancy, particularly at an early stage from eight weeks.
Given the emphasis on providing “reassurance” and using the scan to “confirm” the health of the foetus, and in the absence of further information clarifying what the scan assessed and was able to perceive, particularly from the very early stage of eight weeks into a pregnancy, we concluded that the ad was likely to mislead.
The ad breached CAP Code (Edition 12) rules 3.1, 3.3 (Misleading advertising) and 3.9 (Qualification).
The ad must not appear again in the form challenged. We told Ultrasound London Ltd t/a London Private Ultrasound to ensure their ads did not misleadingly misrepresent the extent to which scans could provide reassurance and determine the health of an unborn baby, particularly in early scans from eight weeks.