Two sides of the same coin – an interview study of Swedish obstetricians’ experiences using ultrasound in pregnancy management

BMC Pregnancy and Childbirth

Ingrid Mogren¹  Rhonda Small²  Sophie Graner⁴  Ann Lalos¹  Kristina Edvardsson²  Margareta Persson³  Annika Åhman¹ 

[1] Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden;Judith Lumley Centre, La Trobe University, Melbourne 3000, Vic, Australia;Department of Nursing, Umeå University, Umeå, Sweden;Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden

关键词: Sweden;    Qualitative study;    Prenatal diagnostics;    Pregnant women;    Pregnancy;    Obstetrician;    Obstetric ultrasound;    Human rights;    Autonomy;   

Others  :  1233977
DOI  :  10.1186/s12884-015-0743-5

 received in 2015-04-25, accepted in 2015-11-17,  发布年份 2015

【 摘 要 】

Background

The extended use of ultrasound that is seen in maternity care in most Western countries has not only affected obstetric care but also impacted on the conception of the fetus in relation to the pregnant woman. This situation has also raised concerns regarding the pregnant woman’s reproductive freedom. The purpose of this study was to explore Swedish obstetricians’ experiences and views on the role of obstetric ultrasound particularly in relation to clinical management of complicated pregnancy, and in relation to situations where the interests of maternal and fetal health conflict.

Methods

A qualitative study design was applied, and data were collected in 2013 through interviews with 11 obstetricians recruited from five different obstetric clinics in Sweden. Data were analysed using qualitative content analysis.

Results

The theme that emerged in the analysis ‘Two sides of the same coin’ depicts the view of obstetric ultrasound as a very important tool in obstetric care while it also was experienced as having given rise to new and challenging issues in the management of pregnancy. This theme was built on three categories: I. Ultrasound is essential and also demanding; II. A woman’s health interest is prioritised in theory, but not always in practice; and III. Ultrasound is rewarding but may also cause unwarranted anxiety.

Conclusions

The widespread use of ultrasound in obstetric care has entailed new challenges for clinicians due to enhanced possibilities to diagnose and treat fetal conditions, which in turn might conflict with the health interests of the pregnant woman. There is a need for further ethical discussions regarding the obstetrician’s position in management of situations where maternal and fetal health interests conflict. The continuing advances in the potential of ultrasound to impact on pregnancy management will also increase the need for adequate and appropriate information and counselling. Together with other health care professionals, obstetricians therefore need to develop improved ways of enabling pregnant women and their partners to make informed decisions regarding pregnancy management.

【 授权许可】

   
2015 Åhman et al.

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