Like most people under the age of one, Kyler Jonathan Galloway doesn't much like posing for pictures. At a recent photo session, he simply refused to cooperate, squirming constantly despite high-pitched pleas from his grandmother and parents, who were looking on. "We have our hands full with this one," said his father, Dave Galloway. "He's just 90 miles an hour all day long."
Nonetheless, Kyler has been the star model for numerous professional photo sessions, six videos and a couple of DVDs. He has more baby pictures now than some kids do before age 10. And if he's often a little restless, well, give him a break-his mother, Jennifer Auger, loves coffee, and all that caffeine she drinks goes straight through the umbilical cord to Kyler's two-and-a-half pound body.
Oh, by the way, Kyler hasn't been born yet.
Auger is one of thousands of expectant mothers who will opt this year for "keepsake" ultrasound sessions at clinics like Fetal Fotos, a fast-growing franchise. Three years ago, it had just one office, in Salt Lake City. Today it has 12, and three more will open this summer, in Nashville, Boise, and Cincinnati. "We're busy," says national director of operations Tracie Pierce. That's for sure, and especially impressive given Pierce's own admission that "there are a lot of groups out there that don't like this type of business"--including the FDA. Keepsake ultrasound services tread a thin line in terms of legality, but they are still popping up everywhere.
In exchange for less than $200, companies like Fetal Fotos will perform as many 2-, 3-, and 4-D ultrasounds as a mother wants. (The fourth dimension is time--some 3-D machines can take 14 images a second, giving the impression of video, flip-book-style.) The results are gorgeous photos and videos, with superimposed text helpfully pointing out hands, feet, and other baby body parts. That includes the private ones. Some women come to Fetal Fotos just to get their baby's gender double-checked. "I had a hard time understanding what I was looking at," says Mary Russo of the blurry, standard 2-D ultrasound her doctor originally performed; though her 28-week-old fetus appeared to be a boy, she wasn't sure. But in the high-definition 3-D image Fetal Fotos made for her, there was no ambiguity that this was baby Christopher, not baby Jana.
There are more emotional reasons to get keepsake ultrasounds, too. "It's an opportunity to make the pregnancy real," says Danielle Kuznetsov, a Fetal Fotos technician who owns the Hartford, Conn., branch with her husband. "There are so many hopes, worries, and dreams wrapped up in that belly. This makes all those things tangible. Seeing that baby makes it much more real." Invariably, she says, her patients are "elated"--some so much that they come back for multiple sessions. Jennifer Auger has already had two and is scheduled for another before baby Kyler arrives. Mary Russo's husband, Frank, is also a big fan. He travels frequently for work and is scared he'll miss the delivery. "At least I'll have the video at home," he says. "This'll make me feel closer to him."
An inexpensive procedure that helps parents bond with their babies in utero: What's not to love about that? A lot, if you believe the FDA. Though ultrasounds carry no proven medical risk for fetuses (or mothers), the agency's official position is that exposing a fetus to ultrasound energy when the benefits may not outweigh the potential risk is a bad idea. "Are ultrasounds harmful? Some studies say yes, and some say no, and there's just not enough good evidence," says the FDA's Dr. Mel Stratmeyer. "As long as there's a benefit, we aren't really that alarmed about ultrasounds--but it should be more than a psychological benefit." Stratmeyer finds the videos particularly troubling. "It's fun to watch a fetus move around, watch it suck its thumb," he says. "But sometimes these videos can go up to an hour. In animal and cell models, that has some negative effects at diagnostic or slightly above diagnostic levels. So when you start talking about it in terms of a fetus, we're just not sure what to think. " The murkiness of the evidence leaves women with a difficult choice: Should they bond with their babies if it means exposing them to possible risks? "It's ethically troublesome," says Frank Chervenak, chair of OB-GYN at Cornell and a medical ethics expert. "I'm a strong advocate for women in this country having access to ultrasound, but I don't consider it a priority to create beautiful pictures and charge extra for it."
Officially, the FDA can't do much about keepsake ultrasound facilities. In 1994, when the clinics first appeared on the scene, it issued a warning that it viewed the keepsakes as "unapproved use of a medical device." ("They love to drag out that letter," says Pierce.) The popularity of clinics waned after that, according to FDA spokesperson Sharon Snider. But in the last few years, with the advent of 3- and 4-D ultrasounds--which make much better photos for keepsake purposes--they've jumped in number again. "There were quite a few companies doing it in the early 90s," Snider says. "After we took action at that time, they stopped, but now we see that they're back." The agency doesn't actually know how many clinics exist, and even if it did, it couldn't force them to stop operating; its only option is to go after people who promote, sell, or lease ultrasound equipment to the clinics. Performing an ultrasound without a doctor's order is a violation of some state and local laws.
But like most clinics, Fetal Fotos requires patients to bring in a physician's permission slip. The FDA has visited its clinic in Utah and okayed them. "They wanted us to be a little more medical," says Pierce, so the company started checking some of the babies' vital stats in addition to taking pictures of them. Although doctors don't perform the Fetal Fotos ultrasounds, the technicians are licensed and trained intensively for four weeks at corporate headquarters under the supervision of an OB-GYN. Kuznetsov bristles at the suggestion that Fetal Fotos is merely giving women something for the scrapbook. "We're not an entertainment industry," she says. "A mother having this has a direct medical benefit. If a lady is drinking a lot of caffeine and she sees her baby being so restless on the screen, that might cause her to think twice about it." That was the case with Jennifer Auger. "Maybe I shouldn't have drunk all that coffee," she said sheepishly while still lying on the table, her stomach smeared with ultrasound jelly. She may or may not have put Kyler under stress with all those ultrasounds, but chances are, when she comes in for her next appointment--at 9 months--she'll have laid off the lattes.