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In 1973 the Supreme Court did not mention ultrasound technology when it struck down state abortion limits in Roe v. Wade. Many hospitals started using ultrasound machines in the early 1980s. General Electric now runs television ads for its "4-D" ultrasound machine, which shows an in utero child moving in real time.

Marzulla estimates that about 20 percent of visitors to Expectant Mother Care want a sonogram because of concerns about fetal health. But she said that less than 1 percent of the exams found significant birth defects or other problems. Many problems are not detectable by ultrasound until after 16 weeks of gestation. Some CPCs have a policy to discourage pregnant women from seeking a sonogram to find fetal birth defects, but staff members will disclose defects if the exam finds any.

Evidence that ultrasound helps to persuade women not to abort came in an unpublished study by Eric Keroack, medical director of A Woman's Concern, a CPC in Boston. Keroack compared two 18-month periods in the crisis pregnancy center's history and kept data only on women who expressed interest in abortion. Without a sonogram, about 60 percent of 366 tracked women had abortions. But with a sonogram, 25 percent of 434 tracked women aborted. He estimated that 125 babies were born who would otherwise have been aborted.

Keroack concluded, "Ultrasound is an amazing reality check."

Sonograms quicken a mother's emotional attachment to her unborn child, experts say. Before sonograms, maternal-fetal bonding often occurred after the 15th week of pregnancy, when the mother senses fetal movement for the first time. But with sonograms, bonding is possible within the first 13 weeks, according to British researchers Stuart Campbell and Judith Lumley.

At six weeks gestation, mothers can see and hear an embryo's beating heart. Just before 10 weeks, they can see the fetus sucking its thumb.

"When they see the hands or feet of the fetus, they're much more attached," said Dolores Pretorius, professor of radiology at the University of California at San Diego.

But CPC workers say that pregnant women need more than a sonogram. They need encouragement to choose life. "You can't put all your hope in sonograms saving babies. You're always going [to need] good counselors," said Chris Slattery, president of Expectant Mother Care.

Right now, few crisis pregnancy centers can afford to buy ultrasound machines. A basic ultrasound machine, which produces flat black-and-white images, costs $15,000 or more. A CPC needs another $10,000 for a Doppler heartbeat monitor. Machines that show 3-D images cost about $120,000; 4-D machines cost $145,000.

Many crisis pregnancy centers have small budgets. For example, a CPC in Bowie, Maryland, operates on less than $15,000 per month. To pay for these expensive machines, crisis pregnancy centers apply for grants or approach individual donors. Pamela Palumbo, executive director of Maryland's Bowie Crofton Pregnancy Center and Medical Clinic, was able to raise enough money after 17 weeks of contacting donors in 1998.

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March 2003, Vol. 47, No. 3