Background
This Ruling forms part of a wider piece of work on private pregnancy ultrasound scans, identified for investigation, following intelligence gathered by the ASA.
Ad description
A website for Meet Your Miracle, www.meetyourmiracle.co.uk, a private pregnancy ultrasound scan studio, seen in May 2022, stated “Award winning pregnancy scan studios offering a range of ultrasound scans including wellbeing checks for you and your family”. A page titled “Our Scans” included a listing for a “Reassurance, dating Scan + Wellbeing check”, which linked through to a further page with a description of the scan. The page was headed “Reassurance, dating Scan + Wellbeing check £59.00”, and under text stating “Description” a list included “Wellbeing check + report”, “Available from 7/8+ weeks (up to 38 weeks)” and “Dating by measurements”.
Issue
The ASA challenged whether the ad misleadingly represented the extent to which the early Reassurance scan from seven weeks could determine the “wellbeing” of an embryo.
Response
Professional Antenatal Services Ltd t/a Meet your Miracle said they did not consider that the ad was misleading. They said that dependent upon the motivation of a patient attending, during the scan (from seven weeks) they confirmed the presence of a heartbeat, if the pregnancy was single or multiple and whether the baby was located correctly in the uterus. They also dated the pregnancy, which often involved checking the size of the baby and the sac it was in, which was relevant to development of the overall pregnancy. They said that as pregnancies developed, other checks might be completed including measurement of the head or femur bone to confirm the baby was developing correctly, and that the size was consistent with the dating.
Meet Your Miracle said that typically parents attended the Reassurance scan with a singular concern of whether the baby was alive. They said this was sometimes due to factors including previous undetected losses within the first few weeks of pregnancy, which parents might have only been made aware of later at the first routine ‘dating’ scan performed by the NHS at around 12 weeks. Additionally, patients might have sought the scan due to symptoms of concern such as spotting or bleeding.
Regarding whether a scan at seven weeks could determine “wellbeing”, Meet Your Miracle offered that a simple measure of wellbeing might be whether the baby was alive, and that was possible to determine simply from observing a heartbeat (visible at seven weeks). Additionally, they said confirming the baby was alive had a hugely positive effect upon the wellbeing and mental health of the mother. They also said that when scans confirmed the loss of a baby this also meant any support or treatment needed could be provided immediately, as well as referral to the NHS.
Meet Your Miracle also said that the term wellness or wellbeing made no assurances beyond the term ‘viability’ often used in early scans, and it was a lesser claim that addressed wellness at the point of the scan. They said they specifically chose to avoid the term viability as it made much broader assurances and was defined widely by English dictionaries as ‘the likelihood of success’. Additionally, they said the Wikipedia definition of viability referred to the ability of a baby to survive outside the womb, which was not an assurance they would seek to offer in the first weeks of pregnancy.
They therefore summarised that regarding the term wellness in the ad, the information provided was an indication of whether the baby was alive based on heart activity (they referred patients to the NHS when the heart rate was lower or higher than the usual range for the stage of gestation), and whether the baby was the correct size from their measurements and as such if it was developing correctly.
With regard to the “wellbeing report” referred to in the ad, they confirmed that the content of reports would be different in each case dependent upon what was observed and specific requests made by the patient. But that at the least it contained information on whether a heartbeat was observed and the heart rate, dating from measurements, which they said differed dependent upon gestation, but included the CRL (length from crown to rump of baby), femur length, head and circumference, and also the expected due date.
Assessment
Upheld
The ASA considered that consumers’ knowledge would vary in terms of what they might expect from an ultrasound scan from seven to 38 weeks, and the extent of information about the health of their unborn baby that could be provided, but that those seeking 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 website page with the description of the “Reassurance, dating Scan + Wellbeing check” provided minimal information about the scope of assessments performed during the scan, stating only “Wellbeing check + report” and “Dating by measurements”. We considered that the terms “Reassurance” and “Wellbeing check + report” were ambiguous and could be interpreted in different ways, particularly in the absence of further information clarifying their meaning in the ad. Additionally, we considered that the term reassurance had positive connotations, and it was important to note that ultrasound scans could only provide information about the specific moment of pregnancy from which it took place.
Meet Your Miracle had explained that the wellbeing check and report provided in the Reassurance scan primarily aimed to establish whether there was a heartbeat and review the heart rate, provide an expected due date and take measurements of the size of an unborn baby to assess whether it was developing correctly. However, we considered that the content of the ad did not communicate or make that information clear, beyond stating that the wellbeing check and report were included. We also considered that the use of the term report in the context of the ad and without further explanation could be understood to mean that in-depth information and analysis about the health and progression of the pregnancy was provided in a written report.
The scan was available from seven weeks to 38 weeks of pregnancy. We understood that the information that could be provided to parents from an ultrasound scan varied, depended on the stage of pregnancy and was limited at seven weeks, from when the scan was available, in comparison to later stages of pregnancy. Early scans at seven weeks were likely to be able to provide key information such as whether a heartbeat could be detected, the estimated due date, and the location of and the number of embryos. Whereas it was possible to make more detailed assessments of the development and anatomical structure of an unborn baby and screen for a range of conditions later during the second trimester of pregnancy, as per the ‘anomaly’ scan routinely performed by the NHS at around 20 weeks.
The ad did not clarify what the advertised scan aimed to assess or provide in terms of wellbeing or clinical diagnosis, and did not make any distinction between what was provided in terms of reassurance at different stages of pregnancy. We considered this contributed further to the ambiguity of the terms reassurance and wellbeing check used to describe the scan. Furthermore, the ad did not state or provide information on whether there were limitations in the extent of assessment or clinical diagnosis that was possible in the early stages of pregnancy from seven weeks, when we understood that the scope of ultrasound scans was limited. We considered the claim “wellbeing check + report” was also likely to add to the expectation that the health of an embryo from seven weeks could be analysed in detail.
We therefore considered that in the absence of further explanation and information clarifying what the scan assessed or provided in terms of clinical diagnosis, the ad had not made sufficiently clear the extent to which it could provide “reassurance” or determine the “wellbeing” of an embryo, particularly from the early stage of pregnancy from seven weeks. On that basis 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).
Action
The ad must not appear again in the form challenged. We told Professional Antenatal Services Ltd t/a Meet Your Miracle to ensure that future marketing communications did not misleadingly misrepresent the extent to which scans could provide reassurance, or determine the wellbeing of an unborn baby, in particular in early scans from seven weeks.
