Submit Your work request!

Work Request Form

Grab a Coffee — Let's Talk About Our Webinar Wednesday with Shari Richard

Hey there! Is it break time yet?
 

Go grab your coffee (or your third cup — no judgment here), pull up a comfy chair, and let me tell you about the Webinar Wednesday we just wrapped up.  Because this one?

This one was really special.

Here’s a little backstory first. After our last webinar, a bunch of you reached out and said, “Hey, could we get a session that speaks more directly to us — the nurse directors and sonographers?”

And we said… absolutely. You asked, we listened.

That’s kind of how we like to do things around here.
 
And honestly, we felt so blessed that Shari Richard was able to hop on with us on pretty short notice to make it happen.
Now, if you don’t already know Shari — oh, friend, you are in for a treat.
Shari Richard webinar Wednesday image
Shari Richard webinar Wednesday image

First, a Little About Shari (Because Wow)

Shari has been doing ultrasound for over 40 years — she literally started right after real-time ultrasound was invented. She trained at Bowman Gray at Wake Forest back in 1981, and then in 1990 she prayed a prayer that changed everything: she asked God to use her ultrasound expertise to help pregnancy centers. Out of that came Window to the Womb in 1992, the video that got so many centers to say, “Wait… we can do this too.”
She went on to establish the very first ultrasound pregnancy center in the country, teaming up with Tom over at NIFLA — he handled the legal side, she handled the medical side. And here’s the number that gave me chills: they saved 90% of the women who walked through their doors.
So yeah. When Shari talks about early ultrasound, we all lean in and take notes.

Why This Talk, Why Now?

Shari opened with something we’re all feeling but maybe haven’t said out loud: the landscape has completely changed. It’s not like it was fifteen years ago, when you could comfortably wait until a woman was seven or eight weeks along to get that first scan.
With the rise of chemical abortions, women are taking that pill earlier and earlier — sometimes as early as four weeks — and a lot of them are ordering it in the mail without ever seeing a doctor. That means we, at the centers, need to get those ultrasounds in earlier, and we need to be sharp about what we’re looking at.
And why does earlier matter so much? One big word: complications. Shari zeroed right in on the one that keeps her up at night — retained products of conception. If it goes undiagnosed, it can lead to infection, sterility, and in the worst cases, a hysterectomy. That’s not something any of us want to take lightly. Which is exactly why follow-up after a chemical abortion is such a big deal.

The Heart of It: Viability Is More Than a Heartbeat

If you take one thing away from this webinar, let it be this. Shari said it plainly, and it’s been rattling around in my head ever since:

“Viability is not just the heartbeat, like so many people think.”

 
Shari Richard webinar Wednesday image of earl ultrasound
 
She walked us through just how precise that first trimester really is. The gestational sac shows up around four to five weeks. The yolk sac at five (and it needs to measure under 6mm, or that pregnancy isn’t going to make it). The little embryo and that beautiful cardiac motion at six. That sac should be growing about a millimeter a day, and — get this — ultrasound dating in the first trimester is accurate to within one or two days. More accurate than her LMP, every time.
So viability isn’t just “is the heart beating?” It’s the shape of the sac, where it’s implanted, the size of the yolk sac, whether things are growing the way they should. Shari showed us slide after slide of what normal looks like, because as she put it — and I loved this — once you truly know the normal, you’ll recognize when something isn’t right, even if you can’t say exactly why.

"It's About the Mother"

Here’s the moment that got me. Shari reminded us that when we’re doing these very early scans, some of us worry — what if the baby doesn’t look like a baby yet and it pushes her toward an abortion? And her answer reframed the whole thing:

“At this time, it’s not about the baby. It’s about the mother, and it’s about her safety.”

Think about it. If that pregnancy isn’t viable — if she’s going to miscarry naturally — then getting her in early gives her a gift: she doesn’t have to carry the weight of that decision at all. No chemical abortion. No unnecessary complications. Just information, and time to consider her options. That’s what a good early ultrasound really offers a woman. Time, truth, and safety.
Shari Richard webinar Wednesday image of mother

Words You Can Actually Use

One of the most practical parts of the whole session was around scope of practice, because I know that’s a real source of stress for so many of you. Shari was reassuring here: nurses providing limited ultrasound are not expected to diagnose an ectopic — that’s outside your scope. Your job is to identify and document the uterus, confirm an intrauterine pregnancy, and — this is the key — know when to refer.
And when something looks off, you don’t have to diagnose anything. You just reach for what Shari called your favorite words:

“I’m not seeing what I expect to see.”

Simple, honest, and it keeps you right inside your lane while still caring well for the woman in front of you.

A few other gems she hammered home:
  • Use both probes. Transabdominal and transvaginal — because without the vaginal probe, you’ll miss those critical early structures.
  • No Doppler on early pregnancies. This one’s important. That early heartbeat is incredibly sensitive, and running a Doppler through it can actually harm the baby. Save it for later.
  • Slow down and take a real history. Shari gave us a whole set of questions to help pinpoint when conception happened — LMP, cycle regularity, pain, bleeding and its color, dates, that first positive test — so you can decide whether to follow up in a few days or refer right away.
  • Keep your charts nearby. Tape those reference charts right next to your machine. Nobody’s memorizing all of this, and that’s okay.

The Q&A Got Real

One of the most practical parts of the whole session was around scope of practice, because I know that’s a real source of stress for so many of you. Shari was reassuring here: nurses providing limited ultrasound are not expected to diagnose an ectopic — that’s outside your scope. Your job is to identify and document the uterus, confirm an intrauterine pregnancy, and — this is the key — know when to refer.
And when something looks off, you don’t have to diagnose anything. You just reach for what Shari called your favorite words:

“I’m not seeing what I expect to see.”

And One More Thing — Her Testimony

Shari didn’t have to share this, but I’m so glad she did. Years ago, she had a molar pregnancy that ruptured her uterus. She was told she’d never have children. She prayed and asked God to heal her and to use her. Today she has three boys — and a four-decade calling to bring ultrasound to pregnancy centers around the world. As she said, “But God — that’s my testimony.”
 
She closed with a line I keep coming back to: her prayer that this work would keep bringing healing and hope, and help the world “recognize the hidden and inherent beauty of every life.” Amen to that.

So, What Now?

Here’s your little take-home list:
  1. Talk to your team. Should your center be doing earlier ultrasounds and follow-ups after chemical abortions? Bring it to your medical director.
  2. Get comfortable with “normal.” The better you know it, the faster you’ll spot what isn’t.
  3. Post your charts. Right next to the machine.
  4. Grab the resources below. The slides and recording are all yours.

Want the Slides & Recording?

Good news — we recorded the whole thing, and just like always, it’s going out to everyone who registered (even if you couldn’t make it live). You can also always find it right here on our Webinar Wednesday page.
 

See You Next Month!

Jacob and I host these Webinar Wednesdays every month — new speakers, fresh insights, and real, practical stuff to help you do this beautiful work even better. We’d love to save you a seat.
👉 Register for our next Webinar Wednesday here: icon iRapture Wednesday Webinar
Until then, finish that coffee, take a deep breath, and remember: the work you’re doing matters more than you know. You’re offering women truth, safety, and hope at one of the most pivotal moments of their lives. What a gift.
See you next month!
 
Sandy MacNaughtonStrategic Director of Client Success — Team Development & Production iRapture.com