Abstract
Objective:
Although prenatal ultrasound (US) is a common clinical undertaking today, little information is available about women's experience of the procedure from the perspective of women themselves. The objective of this study was to explore women's experience of undergoing a routine prenatal US examination associated with an unexpected fetal diagnosis.
Study Design:
Qualitative methods were used to explore the prenatal US experience of 13 women. Five women were given unexpected news of multiple pregnancy and eight women were given unexpected news of congenital fetal abnormality. One in-depth audio-taped interview was conducted with each woman. Content analysis of interview data identified themes common to women's experience of US.
Results:
Identified themes of women's experience of routine prenatal US examination associated with an unexpected fetal diagnosis are: experiencing the setting, sensing information, feeling connected/disconnected, the power of the image, and communication rules.
Conclusions:
Women's experience of prenatal US examination is influenced by physical and environmental factors and by the behaviors of the US examiner. Behaviors of the examiner contribute to a woman's labeling of the US experience as positive or negative. Women identify being objectified by the examination and experience poor communication patterns after a fetal US diagnosis. Women's description of the US screen image as a baby suggests it is a powerful influence on subsequent clinical and ethical decision-making about the pregnancy.
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References
Hemingway AP . 25 years of imaging. Br J Hosp Med 1991; 46 (4): 235–237.
Goldberg BB . Obstetrics US imaging the past 40 years. Radiology 2000; 215: 622–629.
Boyd PA, Chamberlain P, Hicks NR . 6-year experience of prenatal diagnosis in an unselected population in Oxford, UK. Lancet 1998; 352: 1577–1581.
Ewigman BG, Crane JP, Frigoleto FD, LeFevre ML, Bain RP, McNellis D . Effect of prenatal US screening on perinatal outcome. NEJM 1993; 329 (12): 821–827.
Reading AE, Cox DN, Campbell S . A controlled, prospective evaluation of the acceptability of US in prenatal care. J Psychosom Obstet Gynaecol 1988; 8: 191–198.
Turner R . Perinatal and maternal outcomes not improved by routine US. Fam Plan Perspec 1994; 26 (1): 47–49.
Freeman A . The influences of US-stimulated paternal-fetal bonding and gender identification. J Diagn Med Sonography 2000; 16 (6): 237–241.
Michelacci L, Fava GA, Grandi S, Bovicelli L, Orlandi C, Trombini G . Psychological reactions to US examination during pregnancy. Psychother Psychosom 1988; 50: 1–4.
Villeneuve C, Laroche C, Lippman A, Marrache M . Psychological aspects of US imaging during pregnancy. Can J Psychiat 1988; 33: 530–536.
Zlotogorski Z, Tadmor O, Duniec E, Rabinowitz R, Diamant Y . Anxiety levels of pregnant women during US examination: coping styles, amount of feedback and learned resourcefulness. US Obstet Gynecol 1995; 6 (6): 425–429.
Eurenius K, Axelsson O, Gällstedt-Fransson I, Sjöden P . Perception of information, expectations and experiences among women and their partners attending a second-trimester routine US scan. US Obstet Gynecol 1997; 9: 86–90.
Zlotogorski Z, Tadmor O, Duniec E, Rabinowitz R, Diamant Y . The effect of the amount of feedback on anxiety levels during US scanning. J Clin US 1996; 24: 21–24.
Abramsky L, Fletcher O . Interpreting information: what is said, what is heard – a questionnaire study of health professionals and members of the public. Prenat Diag 2002; 22: 1188–1194.
Whynes DK . Receipt of information and women's attitudes towards US scanning during pregnancy. US Obstet Gynecol 2002; 19: 7–12.
Simpson R, Bor R . ‘I'm not picking up a heart-beat’: experiences of sonographers giving bad new to women during US scans. Br J Med Psychol 2001; 74: 255–272.
Ursing I, Jorgensen C . US screening during pregnancy: psychological strain experienced by staff. US Obstet Gynecol 1993; 3: 100–103.
Neilson JP . Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev 1998 Issue 4. Art. No.: CD000182. DOI: 10.1002/14651858.CD000182.
Bricker L, Neilson JP . Routine ultrasound in late pregnancy (after 24 weeks gestation). Cochrane Database Syst Rev 2000 Issue 1. Art. No.: CD001451. DOI: 10.1002/14651858.CD001451.
Anderson T . Routine US in early pregnancy. Pract Midwife 1998; 12 (1): 13–14.
Alkazaleh F, Thomas M, Grebenyuk J, Glaude L, Savage D, Johannesen J et al. What women want: women's preferences of caregiver behavior when prenatal sonography findings are abnormal. US Obstet Gynecol 2004; 23 (1): 56–62.
Detraux JJ, Gillot-De Vries FR, Vanden Eynde S, Courtois A, Desmet A . Psychological impact of the announcement of a fetal abnormality on pregnant women and on professionals. Ann NY Acad Sci 1998; 847: 210–219.
Rempel GR, Cender LM, Lynam MJ, Sandor GG, Farquharson D . Parents' perspectives on decision making after antenatal diagnosis of congenital heart disease. JOGNN 2004; 33 (1): 64–70.
Denzin NK, Lincoln YS . The Handbook of Qualitative Research. Sage: Thousand Oaks, CA, 2000.
Sandelowski M . Sample size in qualitative research. Res Nurs Health 1995; 18: 179–183.
Crabtree BF, Miller WL . Doing Qualitative Research. Sage: Newbury Park, CA, 1992.
Loiselle CG, Profetto-McGrath J, Polit DF, Tatano Beck C . Canadian Essentials of Nursing Research. Lippincott Williams & Wilkins: New York.
Kowalcek I, Mũhlhoff A, Bachman S, Gembruch U . Depressive reactions and stress related to prenatal medicine procedures. US Obstet Gynecol 2002; 19: 18–23.
Filly RA . Obstetrical sonography: the best way to terrify a pregnant woman. J US Med 2000; 19 (1): 1–5.
Garcia J, Bricker L, Henderson J, Martin M, Mugford M, Nielson J et al. Women's views of pregnancy US: a systematic review. Birth 2002; 29 (4): 225–250.
Zechmeister I . Foetal images: the power of visual technology in antenatal care and the implications for women's reproductive freedom. Health Care Anal 2001; 9: 387–400.
Acknowledgements
This research was funded by a grant from the Social Sciences and Humanities Research Council of Canada (806980113). The funder had no role in any aspect of the study or in subsequent data analysis, manuscript preparation or publication approval. Many thanks to the women who participated in this research, to Sandra MacPhail and Diane Godkin for their valuable assistance and to Patrizia Dambrosia for manuscript preparation.
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Van der Zalm, J., Byrne, P. Seeing baby: women's experience of prenatal ultrasound examination and unexpected fetal diagnosis. J Perinatol 26, 403–408 (2006). https://doi.org/10.1038/sj.jp.7211540
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DOI: https://doi.org/10.1038/sj.jp.7211540
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