Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 87, Umeå, Sweden.
Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia.
BMC Pregnancy Childbirth. 2019 Jan 16;19(1):33. doi: 10.1186/s12884-019-2178-x.
Midwives are the main providers of routine antenatal care services including the routine ultrasound examination in Norway. The ultrasound examination can be perceived by expectant parents not only as a medical examination but also as a social event facilitating attachment to their fetus. This study explores Norwegian midwives' experiences and views on the role of ultrasound in clinical management of pregnancy.
A qualitative study design was applied. Twenty-four midwives who all performed obstetric ultrasound examinations were recruited for focus group discussions and individual interviews. Data collection took place in 2015 in five hospitals in two different regions of Norway. Data were analyzed using qualitative content analysis.
Midwives described obstetric ultrasound examinations as very valuable although doing ultrasounds placed high demands on their operational and counselling skills. Increasing requests for ultrasound from pregnant women were mentioned. Advancements in ultrasound diagnosis were considered to have put the fetus in the position of a patient, and that pregnant women declining ultrasound could be viewed as irresponsible by some health professionals. Ethical concerns were raised regarding the possibility of pregnancy termination when fetal anomalies were detected. Fears were also expressed that prenatal diagnoses including those following ultrasound, might create a society where only 'perfect' children are valued. However, participants stressed that their intention in performing ultrasound was to optimize pregnancy outcome and thereby assist expectant couples and their unborn children.
Midwives in Norwegian maternity care services describe obstetric ultrasound as very valuable, playing a central role in pregnancy management by optimizing pregnancy outcomes. Although high demands are placed on operators' technical skills and counseling, midwives described performing obstetric ultrasound as very satisfying work. However, midwives believed that expectant parents' approach to the ultrasound examination, both its medical value and the precious images obtained of the fetus, could put extra strain on the midwives performing ultrasounds. The potential of ultrasound to detect fetal anomalies and the possibility that this may lead to termination of pregnancy, seemed to create some ambivalent feelings in midwives towards its use.
在挪威，助产士是常规产前护理服务的主要提供者，包括常规超声检查。超声检查不仅被孕妇视为一种医疗检查，也被视为一种促进与胎儿联系的社交活动。本研究探讨了挪威助产士对超声在妊娠临床管理中的作用的经验和看法。
采用定性研究设计。招募了 24 名进行产科超声检查的助产士参加焦点小组讨论和个人访谈。数据收集于 2015 年在挪威两个不同地区的五家医院进行。采用定性内容分析法对数据进行分析。
助产士描述了产科超声检查非常有价值，尽管进行超声检查对他们的操作和咨询技能要求很高。提到了孕妇对超声检查的需求增加。有人认为，超声诊断技术的进步使胎儿处于患者的地位，一些卫生专业人员可能认为拒绝超声检查的孕妇不负责任。当发现胎儿异常时，还提出了与终止妊娠相关的伦理问题。一些人担心，包括超声检查在内的产前诊断可能会导致一个只重视“完美”孩子的社会。然而，参与者强调，他们进行超声检查的目的是优化妊娠结局，从而帮助期待中的夫妇及其未出生的孩子。
挪威产科护理服务的助产士将产科超声描述为非常有价值，通过优化妊娠结局，在妊娠管理中发挥核心作用。尽管对操作人员的技术技能和咨询要求很高，但助产士表示，进行产科超声检查是一项非常令人满意的工作。然而，助产士认为，孕妇对超声检查的态度，包括其医学价值和获得的胎儿珍贵图像，可能会给进行超声检查的助产士带来额外的压力。超声检测到胎儿异常的可能性，以及这可能导致终止妊娠的可能性，似乎使助产士对其使用产生了一些矛盾的感觉。
