One of the most beautiful things about the pro-life movement is its unity. When people come together and pool resources to see a common goal accomplished, the gospel of LIFE is spread throughout the earth.

That’s exactly what took place during Heartbeat International’s Annual Conference last March.

We have the honor of hosting pregnancy help movement leaders from all around the world at Conferences every year, and the chance for those international life-savers to receive training and get equipped can be life-changing. This year, we encouraged our U.S. pregnancy help organizations to bring any foreign coins they may have to our Conference, to be distributed among those outside of the U.S.

We were overwhelmed with the response! We received a multitude of foreign coins that we were able divide up and distribute among our international partners.

Our friends from Centro de Ayuda para la Mujer (CAM) came all the way from Mexico to attend our Conference. We were blessed to be able to give CAM the pesos that we received, knowing that they would be put to good use. And we were right!

The CAM network saves lives from abortion all over Mexico and across Latin America. As it turned out, those donated pesos were spent on baptism robes and gifts for the children who have been saved from abortion by their ministry. It is a thing of beauty to see lives rescued from death now baptized in beautiful garments because of the unity and generosity of the pregnancy help movement.

Thank you for partnering with us as we work to advance the pregnancy help movement worldwide!

By Virginia Cline

I remember my father’s tears on January 22, 1973. It was the first time I had ever seen him cry.

I was 11 years old when I found him crumpled up on the stairs, shuddering, with his folded hands pressed to his face as he sobbed. I will never forget how he was curled up in the fetal position as he wept. It took him no less than 10 minutes to choke out the fact that seven men on the U.S. Supreme Court had decided it should be legal for a mother to abort her baby.

On that particularly bleak Monday afternoon, he cried for the millions of babies he knew would die at the hand of Roe v. Wade.

How could we fail to acknowledge the more than 54 million children aborted in the United States alone since the insidious Roe v. Wade decision on Jan. 22, 1973—the most tragic and unforgettable date in U.S. history?

Since the upcoming presidential inauguration is planned for Monday, Jan. 21, 2013, the 40th annual March for Life was moved to Friday, Jan. 25, leaving the anniversary itself without acknowledgement. Heartbeat International and at least 10 other partnering pro-life organizations—including March for Life—did not want the 40th anniversary of Roe v. Wade to pass by without a national day of prayer and fasting, so RememberingRoe.com was launched.

RememberingRoe.com promotes a day of remembrance and hosts a variety of interactive tools and includes an opportunity to sign up for a national hour of prayer via webcast, led by the National Pro-life Religious Council on Jan. 22, 2013, beginning at 3 p.m. EST.  

The site is also the vehicle for a national campaign that seeks to send 1.2 million red pro-life postcards to the president in honor of the 1.2 million victims of abortion in the U.S. each year. For a small donation, visitors can sign up for a red card—personalized with their name—to be delivered to the White House on Jan. 22, 2013, sending the leader of the free world a positive message about the sanctity of every human life from those he represents.

Forty years of destroying life in the womb is the battle that defines our society. The false “choice” of aborting a child has endangered our very civilization by attacking the dignity of human life and by denigrating motherhood. The escalating evil of abortion calls for a supernatural response, and so we challenge every pro-life individual to kneel together as one nation under God, and call upon Him as we remember, reflect, repent and plead for restoration on the anniversary of this disastrous turning point.

Prayer is the strongest weapon against the evil that is abortion. Our hope is that members of the pro-life movement call upon God—the Giver of Life—in prayer and fasting together as we fight for the sanctity of life in America. As the 40th anniversary of Roe v. Wade approaches, visitors are encouraged to post prayers on RememberingRoe.com, leading to greater unity among members of the pro-life community.

There’s also a place at the site to share your story of how you first heard about Roe v. Wade. Some of us are old enough to remember exactly where we were when we learned about the now-infamous U.S. Supreme Court decision.  Those born after Roe—rightly called “abortion survivors”—are also invited to share reflections on when and how they learned that the Supreme Court had declared it a “right” for every woman to choose to abort her baby.

My pro-life passion was ignited Jan. 22, 1973, after witnessing my father’s heartbreak and hearing his cries: “I could have done more. I should have done more to stop abortion.” 

Imagine if our stories listed online at RememberingRoe.com inspired Christians everywhere to do more to help each mother reject the “choice” to abort her child!

The goal of RememberingRoe.com—and the goal of Heartbeat International—is to make abortion unwanted now and unthinkable for future generations. The Holy Spirit has the power to kindle the fire of compassionate love within us, so that the pro-life movement can renew the face of the earth for LIFE. Let us unite so that we may never forget.

By Debra Neybert, Training Specialist

"So Pharaoh said to Joseph, 'I hereby put you in charge of the whole land of Egypt.'
Then Pharaoh took his signet ring from his finger and put it on Joseph’s finger.
He dressed him in robes of fine linen and put a gold chain around his neck."
- Genesis 41:41-42

The heart of God the Father is one of restoration. He walks with us and fulfills the dreams and destiny He ordained for us even from all eternity.

There are many aspects of Joseph’s life that have blessed and encouraged the body of Christ. The robe that Joseph received from his father when he was a young man is a great example. In Genesis 37:3, we read, “Now Israel loved Joseph more than any of his other sons, because he had been born to him in his old age; and he made a richly ornamented robe for him.”

This robe is described in the Amplified Bible as (a [distinctive] long tunic with sleeves). It was a very special garment that signified his father’s love and favor, as well as the destiny he would one day fulfill. For Joseph, it would be a daily reminder that he was covered in his father’s love.

Every time Satan looked at Joseph, he saw the robe, which constantly reminded him of his own inability to destroy the ultimate plans and purposes that God had for Joseph.

Because of that hate, Satan incited Joseph’s brothers to jealousy: “So when Joseph came to his brothers, they stripped him of his robe—the richly ornamented robe he was wearing” (Gen. 37:23). Although his brothers stripped Joseph of his physical robe, what it symbolized could not be stripped away. Even as Joseph entered into captivity without his richly ornamented robe, the covering of God’s love, favor and purpose remained over him.

Joseph walked through some very difficult places, and he must have struggled quite a bit to understand God’s plan for him in the midst of his circumstances. For a season, the Enemy took what had symbolized so much to him—the robe—out of his sight, and yet, his father’s love never changed. More importantly, God’s favor followed him wherever he went, and after 13 years of captivity, full restoration came, and he finally experienced the fulfillment of his destiny. 

When Joseph was dressed in robes of fine linen, he had suddenly become the second-most powerful and honored man in all of Egypt. The robe of restoration was finally his!

Scripture also speaks of another robe, a robe that was provided at a great price—the life of a Father’s only Son—covering all who accept it as a gift. In Isaiah 61:10, we read, “I delight greatly in the Lord; my soul rejoices in my God, for he has clothed me with garments of salvation and arrayed me in a robe of his righteousness.” 

These garments signify in part, God’s provision, favor, healing and deliverance by the death and resurrection of Jesus Christ. All of this flows from His incredible love.

In Christ, we are clothed in garments of salvation and a robe of righteousness. The Enemy desperately wants to keep us from “seeing” the robe of Christ’s righteousness that covers us, and so he sends us accusations and condemnation to try and keep us from seeing our inheritance in Christ.

The Father wants to open our eyes to see who we truly are: joint-heirs with Christ, fully restored to the position of sons and daughters, and made worthy through the blood of the Lamb. When we “see” ourselves clothed in Christ’s righteousness, we will be able to rest in His love and His favor, and fulfill our God-given destiny!

by Betty McDowell, Heartbeat International Director of Ministry Services

As a social worker in the mental health field, I was trained to assess a patient’s level of alertness and orientation by asking them four questions: (1) Who are you? (2) Where are you? (3) What is the date and time? (4) What just happened to you?

This simple exercise helped determine the next steps in diagnosing the patient and constructing a treatment plan. But I have since discovered the value of asking the same four questions to those serving in ministry when I try to help them diagnose a problem and move forward in a clear direction.

How would you answer these four questions?

1. Who are you?
   The simple answer Christians like to give is, "I am a child of God."  While this is true, it’s also true that we are uniquely created with specific gifts, talents and dreams. Living the abundant life Jesus promised requires us to further discover who we really are, and who we were created to be. Take time, through God's word, prayer and the counsel of others, to discover what you really believe about yourself, God and the world around you. Your decisions come from the core of who you are and what you believe — and that includes what you believe about yourself.
   
   
2. Where are you?
   Is this the ministry, career and life that you are meant to be living? What are the dreams God has placed in your heart? Are you on your way to fulfilling those dreams and callings? Most of us lead busy lives and are trying to find ways to do the things we do faster, but it’s a healthy practice to slow down for a moment and make sure you’re where you belong.
   
   
3. What time is it?
   There are seasons in our lives that require different commitments of our time and attention. For example, several years ago, through the leading of the Holy Spirit and conversations with my husband, we decided that it was best for our family if I focused most of my time, talent and attention on our children—even though it meant modifying my career ambitions. Then, once our children were in school, I devoted more time to ministry outside of the home, and to my career. Now that our children are grown, the time has come for me to engage more fully in the calling on my life, and I’m now able to chase the dreams of my heart. What is the time and season of your life?
   
   
4. What just happened?
   Are you walking around in a haze—or a daze—and unaware of the world around you? What are you witnessing in the lives of those around you?  What are others witnessing in your life? Sometimes, we are so caught up with our goals and to-do lists that we miss opportunities to fully connect with God and the people we love most. 

I have found that spending a little time at the end of each day to review my answers to these four questions has been a great habit. You too may find this practice valuable in becoming alert and oriented x4.

Also check out the link to "The Daily Examen" by St. Ignatius:
http://www.ignatianspirituality.com/ignatian-prayer/the-examen/how-can-i-pray/

As yet another controversal election draws ever nearer, it's time to refresh on what is—and isn't—allowed for your organization during the election season. Let's take a look at the key do's and don'ts as we come up to the 2020 presidential election.

The first platinum rule for you as a nonprofit and as representatives of the nonprofit is that you may not endorse, support or oppose any specific candidate or political party. Your activities must be nonpartisan. The second platinum rule is that you as an individual—regardless of what your job is—may personally endorse, support or oppose any candidate or political party. To state it again:

• A 501(c)(3) is not permitted to endorse, support or oppose any candidate for public office or any political party. Period. That is the law.
• Second, as individual citizens who happen to be employed by nonprofits, you are certainly able to exercise your rights as citizens as guaranteed under the Constitution.

Let’s talk about what a nonprofit CAN do:

• A nonprofit can conduct a voter education forum in a nonpartisan manner…in other words it is not truly nonpartisan if a nonprofit only invites one candidate. The forum must be held for the purpose of educating and informing voters, which provides fair and impartial treatment of candidates, and which does not promote or advance one candidate over another.
• A nonprofit can operate a voter registration booth with its name displayed on the booth.
• A nonprofit can provide transportation to the polls as long as it does not drive only those who will vote for a favorite candidate.
• A nonprofit can target turnout efforts to the people or areas they serve, or population groups, students, elderly, minority groups.
• A nonprofit can continue to do normal lobbying on issues.
• A nonprofit can work on behalf of a ballot measure.
• A 501(c)(3) can rent or sell mailing lists to candidates at fair market value, as long as it is made available to all candidates.

Further, if a representative of a nonprofit is asked to speak publicly during an election cycle or specifically asked for opinions about candidates, representatives of a 501(c)(3) should:

• Decide who will speak publicly on behalf of the 501(c)(3) organization, so that non-designated staff will not inadvertently say something inappropriate.
• Script responses before talking to reporters.
• Focus on what was said (the issue), not who said it (the candidate). Avoid talking about a candidate’s qualifications or whether someone is a good or bad candidate.
• Avoid discussing a candidate’s record; commenting on a candidate’s record is very close to commenting on a candidate’s qualifications or whether he or she should be elected.
• Avoid talking about voters and making references to the election. For example, instead of saying “Voters will not accept…” say, “Americans won’t accept...”
• Avoid identifying the candidate by name. It is better to say: “During the recent Republican debate, statements were made about [topic]. We disagree…”
• Be very cautious if a reporter asks about which candidate is better on the 501(c)(3)’s issues, or whether the 501(c)(3) agrees with a statement a candidate made. Issue the disclaimer: “Well, as you know, we are a nonprofit and are not permitted to endorse, support or oppose any candidate.” Then go back to scripted statements and rules above.
• A 501(c)(3) organization may urge all candidates to take a stand or act on an issue, without commenting on specific candidate statements. For example, a 501(c)(3) organization may want to urge both major party candidates in a local, state, or federal race to take more forceful action on the issue of illegal guns and violence. A 501(c)(3) making this kind of communication should be careful to avoid criticizing any candidate, and should focus on the need for all candidates to take action.

What can a nonprofit NOT do:

• A nonprofit cannot post anything on its website or in its office that favors or opposes a candidate for public office.
• A nonprofit cannot distribute printed material that favors or opposes a particular candidate.
• A nonprofit should monitor any content linked to its website.
• A nonprofit cannot do political fundraising for any candidate.
• Do not use the “magic words” vote for or vote against a particular candidate.
• A nonprofit cannot contribute time, facilities or money to a candidate.
• Do not coordinate activities with a candidate.
• Do not publish anything in official newsletters, brochures or publications of any kind that favors or opposes a candidate.
• Do not increase the organization’s level of criticism or praise of an official or devote a special issue of its publications to an incumbent’s favorable or unfavorable record.
• Do not distribute more copies than usual of a regular publication during the campaign year.
• Do not focus on the personal character or qualifications of an incumbent, or campaign contributions of the incumbent.
• Do not connect the organization’s criticism of a voting record of an official to an election. For example, publicly remarking that an official is anti-immigrant and mentioning that people should register to vote.
• Do not point out that a particular candidate’s actions (as opposed to official actions) or views are incorrect. For example, a 501(c)(3) should not urge the public to withhold campaign contributions for a Senator’s re-election if she votes for the repeal of “Don’t Ask Don’t Tell,” or remark that one candidate would be better than another candidate at creating green jobs if elected than another candidate.

Resources:

• http://www.irs.gov/pub/irs-tege/election_year_phone_forum_slides.pdf
• http://bolderadvocacy.org/
• https://www.nonprofitvote.org/nonprofits-voting-elections-online/
• https://www.councilofnonprofits.org/tools-resources/political-campaign-activities-risks-tax-exempt-status

Maybe you didn’t know it, but there could be political vacancies right within your local community that need your pro-life leadership. Based in your neighborhood, the most local level of political office is that of precinct captain.

A precinct captain (also referred to as a central committee member or a precinct chairperson) acts as a liaison between a specific political party and the voters of a local precinct. Precinct captains are elected by their neighbors, and generally serve as volunteers, though in some cases they receive a small stipend from their respective political party.

A precinct captain serves his or her community by:

• Facilitating voter registration and absentee ballot access
• Leading “Get Out the Vote” outreach efforts
• Assisting with voters’ transportation to the polls
• Distributing party literature
• Promoting his or her respective political organization

The pro-life movement needs precinct captains!

As an informed voter, concerned with pro-life values, here’s what you can do to get involved in the political process in your own community:

1. Educate your precinct captain. Start by finding out who your precinct captain is, then educate him or her about pro-life issues on a regular basis. You can search online to obtain a list of your county’s precinct captains by entering your political party, along with your county and state.
2. Become a precinct captain. Perhaps your precinct’s leadership position is currently vacant, or your current precinct captain isn’t seeking reelection. This could be your chance to get involved in bringing about needed change by your grassroots involvement.
3. Encourage your pro-life friends to become precinct captains. As you take a more active role in your local community’s political landscape, encourage your pro-life friends to join you. 

To find out how you can impact future elections through your local precinct captain position, watch this simple, straightforward presentation: http://instantteleseminar.com/?eventid=30560385.

By Amy Scheuring, Executive Director, Women’s Choice Network

The recent barrage of news coverage following Susan B. Komen for the Cure’s proposed defunding of Planned Parenthood, as well as the Roman Catholic Church’s response to President Obama’s proposed healthcare mandate have many wondering: What’s wrong with contraceptives?

For over 50 years, we’ve heard that pills, injections, devices, and hormones will prevent “unwanted” pregnancy, protect women’s health and stop everything from AIDS to acne, creating a happy, healthy, and sexually fulfilled generation of men and women.  

After more than 40 years of government-subsidized contraceptives, why shouldn’t we welcome additional healthcare packages that require an assortment of miracle drugs and preventative hormones to be offered by every employer? Part of the answer lies in the stunning facts about the collective failure of these products to deliver on their promises:

• According to Planned Parenthood’s Guttmacher Institute, 53% of women obtaining an abortion were using birth control when they got pregnant.  
• At the Women’s Choice Network Centers, almost 65% of our pregnant clients were using birth control when they got pregnant.
• Hormonal birth control methods do not prevent STIs or AIDS, and condoms are virtually useless against many viral forms of STIs, such as Human Papilloma Virus (HPV).
• Teens using birth control pills and injectables feel safer, leading them to engage in sex more frequently than peers who are not using birth control.
• One highly touted study indicates that 99% of sexually active women ages 15-44 have used at least one form of birth control, but the fact remains that half the pregnancies in the U.S. are still “unintended.”

As we consider whether our future health care should include contraceptives, let’s remember that many who suffer because of a previous abortion or STI have relied on their false promises. The pursuit of true sexual intimacy—joyfully building a family and strengthening a lifetime commitment—has been replaced by a false notion that, given the proper health care, we can control or eliminate the inconvenient “outcomes” of sex.  

So, what’s wrong with contraceptives? Before we even enter into the moral, economic, or social arguments, the answer is clear: They simply don’t work as promised.

While contraceptives entrench themselves as the gateway drug to abortion, birth control proponents are still stuck in the mid-20th century, clinging to the hopeless assertions that if we just spend more, educate earlier and use birth control “better,” the desired outcomes will one day kick in.

After four decades of government-funded birth control, and all our best efforts to create a world where sex has no consequences, are we any better off? You decide.

The gospel of life in China is taking root. Lofty prayers are being answered!

Because of the nature and scope of this effort, Heartbeat International is releasing Executive Director of Global Advancement John Ensor to begin a new labor, called PassionLife Ministries.  Though independent of Heartbeat, PassionLife will seek to work collaboratively with us in our life-saving mission when it officially launches Oct. 1, 2012.

PassionLife is a global missions initiative created to spread the gospel of life and expand the pregnancy help movement in especially difficult places and among people plagued by abortion, infanticide and gendercide. PassionLife will seek to use God’s Word to open the eyes of the Chinese people to the beauty of human life and the ugly truth of abortion.

All of us at Heartbeat are excited to be a part of what the Lord is doing as He expands His work in especially needy areas like China. When God's people respond with a desire to start a pregnancy help organization, Heartbeat’s goal is to provide leadership training and support to assist in equipping those that have been called.
John has played an integral part in our movement for nearly 20 years, first as founder and president of a Heartbeat affiliate in Boston, then as a key member of the Heartbeat International Board. He served as a Heartbeat staff member for the past six years before being called to devote his time to bringing God's life-saving message to China.

It is our honor to help launch this new organization, and we greatly anticipate working closely with Chinese leaders who emerge, helping them plan and implement pregnancy help organizations in their own communities.

Please join us as we continue to pray for John's work, and for PassionLife.

May the Lord continue to bless this great and heroic outreach!

Spreading the good news... Pregnancy help is doing great work

Heartbeat is constantly trying to get the word out about the excellent work of pregnancy help organizations around the world. Whether it's consistently sharing recent news about pregnancy help organizations over at PregnancyHelpNews.com or sharing the real story of pregnancy centers in a world where the media is biased against them at PregnancyCenterTruth.com, we are committed to making sure that the pregnancy help movement has a voice in the public conversation.

Over at Pregnancy Help News, we share daily news, opinion, and commentary related to the pregnancy help movement and it's place in the larger pro-life movement. You can even sign up for a weekly email update of what's going on in the movement to be delivered to your inbox every Monday. Or... share a story about something new or interesting happening at your center. In other words, we want to share what you may need to know and tell your story here!

Pregnancy Center Truth is built to combat the lies told by Big Abortion about the pregnancy help movement. There, anyone can see the reality laid out clearly with studies to back up claims and sharable quick stats built for social media. It's just one way we defend the reputation of pregnancy centers around the world.

Commending the pregnancy help movement... Babies Go to Congress

Every year, Heartbeat International brings moms and their children to Washington, D.C. to remind our congressmen and women that pregnancy help centers are good for America. Babies Go to Congress, held every year close to the March for Life, shows our elected officials at the federal level the amazing way lives change with the help of grassroots organizations like yours. There's no replacement for the flesh-and-blood testimonial of a mother holding her child to show lawmakers that pregnancy centers are good for america.

A key piece of information Heartbeat International always hopes to underscore through the event is the privately funded, non-profit status of pregnancy help organizations. Unlike most meetings congressional offices hold with their constituents, there is never any request for public funds as part of the event, a fact that also stands in stark contrast to highly profitable, publicly funded abortion businesses like Planned Parenthood.

Since beginning the program in 2009, over 100 women and children representing over 50 centers have visited over 200 congressional offices.

Your center can benefit from participating in Babies Go to Congress this January. Click here for more information and take this opportunity to share during a truly historic moment in our nation's history!

Defending the life-savers... Heartbeat has your back

Over the years, pregnancy centers have been under attack by abortion advocates from Planned Parenthood, NARAL, and many others. Heartbeat International is there to both officially refute the unfounded claims (through news coverage at PregnancyHelpNews.com), and to pass along needed information to affiliates through emails, conference calls, live or recorded webinars, and more. 

So wether it's a protest from "The Handmaids", a "glitter bomb" in the mail, or a campaign of false reviews on your organization online, Heartbeat International is always there to help affiliates respond appropriately. 

Learn more about Heartbeat's work of defending the pregnancy help movement here. (Note: Must be a Heartbeat affiliate to access)

By Kimela Hardy, MA, RT(R), RDMS

Available literature states the fetal heart beat begins its lifelong work at approximately six weeks, and depending on the sonographer’s skills, ultrasound system, and maternal body habitus, the heart beating may be visualized at this time. There are several factors that can be used to not only see this little miracle at work, but also improve general images.

Back to the Basics of Ultrasound

Before a specific organ, for example the fetal heart, image can be improved on, first obtain the best image possible. To begin any ultrasound study, but especially in Obstetrical scanning, the correct manufacturer’s Preset must be selected. Presets are essentially a “recipe” set for the ultrasound system. These parameters may include depth, gain, frequency, and focus among other factors. Using the OB Preset sets the Thermal Index (TI) and Mechanical Index (MI) which are generally lower for obstetric ultrasound examinations. In general, the TI and MI are not deliberately manipulated during routine ultrasound examinations.

Which Knobs Can Improve Your Picture?

Once the Preset is selected, consider the overall gain in the image on the monitor.  Is it all black, all white, or a combination with many grays?  Adjust the overall gain, often a large dial easily accessible, so it is easiest to identify the landmarks and in general is appealing to one’s eye and interpretation.  This may differ somewhat with each sonographer, but not to an extreme.

The importance of correctly interpreting the landmarks cannot be over stressed, know the anatomy well.

Be sure the size of your image, or depth, allow demonstration of the area of interest.  On some machines, this is either a dial knob or toggle switch labeled Depth, Size, or a combination of these. There is a scale on either side of the image that registers this depth in either centimeters or millimeters, and changes as the dial/toggle is adjusted.

Most transducers/probes are multi-herz, which means they offer more than one frequency, usually 2, 4, and 6 MHz.  Once the landmarks have been identified and the overall gain is satisfactory, try each frequency with a simple adjustment and determine which provides the best penetration and resolution.  

Remember:

• The lower the frequency, the higher the penetration but lower the resolution.
• The higher the frequency, the less the penetration but the better the resolution.

This means images of a patient with Large Maternal Body Habitus (LMBH) most often improves with the lowest frequency, and our smaller, more athletic patients can use the higher frequency for better resolution images. The frequency is often displayed at the top of the image where the TI and MI are located.

The optimal area of the ultrasound beam is the focus, demonstrated by a triangle or karat along the depth scale. Place this at the area of interest at the correct depth.  On some systems, the focus makes a significant difference in clarity, but in other systems, there does not appear to be much change.

After the above have been set to optimize the image, the slide pods or TGC/STC can be used to fine tune the image even more.  These are a step alteration in the gain, with the slides on the top affecting the top of the image and vice versa. Most often the “slope” is a gradual downward slope to the right.

Manufacturers frequently have specific image enhancing features under proprietary names which reduce haze, clutter, and artifacts allowing for improved clarity of images. These harmonic features may allow for increased penetration without details lost. Simply turning this feature on and determining its benefit (or not) is required.

Looking at the Heart

Once the optimal image has been achieved by using the features discussed above, there are additional tips to see that small fetal heart.
Some systems have a Field of View (FOV) which has the effect of “coning down” and creating a smaller field visible and increases image clarification.  This is the consequence of taking only a portion of the available area to scan instead of the entire area seen prior to using this option.  Often, a pie-shaped icon is on the image top to illustrate and highlight the FOV area.

Using the Zoom option will increase the image size, which also can make it easier to visualize the fetal heart.  In addition, most of the Zoom also has a feature which allows the size of the area, or box, to be increased/decreased.  Another key to using a zoom option is to be certain the item of interest is directly in the center of the box.

When viewing the small fetal heart, another gain adjustment making the image brighter aids in recognizing the wave form during Motion-mode (M-mode). This gain is sometimes located by turning the M-mode dial.  The brighter the image, the more likely the wave form is visualized. Also, the wave form will be in direct relationship to the location of the heart in the 2 Dimensional (2 D) image.  For example, if the heart is in the center, the q, r, s, etc. waves will be in the center of the strip.  If the heart is at the bottom of the image, the wave form will be at the bottom of the strip.

Oftentimes, maternal respirations interfere with achieving a well demonstrated strip.  To overcome this, ask the patient/client to suspend breathing or hold her breath.  Be aware, if she takes in a deep breath, the fetal heart may move out of the image, and you will need to make the necessary adjustments.

All of these discussed options to improve ultrasound images pertain to both Transabdominal and Transvaginal imaging. However, it is reasonable to anticipate that Transvaginal images will be larger and therefore improve the ability to obtain a fetal heart rate.

Using these tips should increase the skill set and confidence for the nurse sonographer and show this little miracle to his or her maximum potential.  The tips prior to the “M-mode” can be used for general imaging as well.