Is Transvaginal Ultrasound Painful During Pregnancy? What to Expect

Pregnancy scans can be exciting yet nerve-wracking, especially during the first trimester when everything is new. And, Ultrasounds are a common part of prenatal care. They help doctors check on the baby’s growth, see the heart beat, and find any early issues. One type, the transvaginal ultrasound, uses a probe inserted into the vagina for clearer images early in pregnancy. For many pregnant women, it’s natural to ask: Is this painful? Is it safe?

To clear things up, we asked Dr Indumathi Thayar, Senior Consultant in Obstetrics & Gynecology and Laparoscopic & Robotic Surgeon at Apollo Speciality Hospitals, Vanagaram, Chennai, to explain what you need to know.

Why a Transvaginal Ultrasound Is Done in Early Pregnancy

Dr Indumathi explains, “In the first three months, the baby and uterus are still deep within the pelvis. When we do an abdominal scan through the tummy, it might not show everything clearly. The vaginal ultrasound uses a small, long probe inserted into the vagina to scan the uterus closely, giving a much clearer picture of the pregnancy.”

She adds that a transvaginal ultrasound in early pregnancy helps:

• Confirm the pregnancy and ensure the gestational sac is visible.
• Check if the pregnancy is inside the uterus, as an ectopic pregnancy (outside the uterus) is dangerous.
• Date the pregnancy accurately to predict the due date.

“At around four weeks after the last period, we can see a small sac. At five weeks, a yolk sac, and by six weeks, we usually find a tiny fetal pole and even detect the baby’s heartbeat,” she says. “These details appear earlier and more clearly with a vaginal scan than with an abdominal one.”

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What Happens During the Procedure

Many women worry the scan might be painful. Dr. Indumathi reassures, “The vaginal ultrasound is not painful, though it can feel a little uncomfortable.”

Here’s what happens:

• You’ll be asked to empty your bladder before the scan (unlike abdominal scans which require a full bladder).
• You’ll lie down on an examination couch.
• A thin, long probe, about the thickness of a finger, is covered with a clean sheath and gel before being gently inserted into the vagina.
• The probe emits sound waves that create images of the uterus and baby.
• “The procedure takes around five to ten minutes,” Dr. Indumathi says. “There’s no radiation, and it’s completely safe for both mother and baby.”

Is It Safe for the Baby?

Many expecting mothers hesitate because they fear it could affect the baby or increase the risk of miscarriage. Dr. Indumathi clarifies, “The vaginal ultrasound does not harm the baby or cause miscarriages. It does not involve any radiation and is one of the most reliable ways to confirm early fetal development.”

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When Is It Recommended?

The scan is typically done up to 12 weeks of pregnancy and serves several purposes:

• Confirming pregnancy growth and heartbeat.
• Identifying potential chromosomal abnormalities during first-trimester screening.
• Checking for miscarriage risks in women with lower abdominal pain or bleeding.

A review published in the Cleveland Clinic Journal of Medicine (2025) concludes that transvaginal ultrasounds are extremely safe and carry no known health risks for the mother or fetus when performed by trained professionals.

Tips to Feel Comfortable During the Scan

• Wear loose, comfortable clothing.
• Communicate with your doctor if you feel anxious or have had pelvic pain before.
• Remember to relax as tensing up makes insertion less comfortable.
• Ask to have a female technician present if it helps you feel at ease.

Dr. Indumathi adds, “If you ever feel discomfort, inform your sonographer immediately. The probe can always be adjusted for comfort.”

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Conclusion

A transvaginal ultrasound may sound intimidating at first, but in expert hands it is a safe, quick, and effective tool in early pregnancy care. According to Dr Indumathi Thayar, it gives clarity when abdominal scans might fall short, and it does so with minimal discomfort. If you’re preparing for one, ask your doctor what to expect, relax, and remember that the scan is meant to give you and your baby the best start.