Viewing the image? Ultrasound examination during abortion preparations, ethical challenges

Area of Science:

• Medical Ethics
• Sociology of Health
• Reproductive Health

Background:

• Ultrasound examinations are standard in early abortion preparation in Norway.
• Understanding patient and healthcare personnel experiences with ultrasound viewing is crucial.

Purpose of the Study:

• To explore women's and healthcare personnel's experiences with ultrasound viewing during first-trimester abortion preparation.
• To analyze the factors influencing autonomy during this process.

Main Methods:

• Qualitative study using in-depth interviews with women and focus groups with healthcare personnel.
• Hermeneutic-phenomenological analysis inspired by van Manen.
• Recruited 13 women and 20 healthcare personnel from six hospitals.

Main Results:

• A core theme of "autonomy under pressure" emerged, with sub-themes of "expectations versus precautions" and "choice versus protection."
• Divergent attitudes between women and healthcare personnel regarding ultrasound viewing impacted dialogue.
• Women expected clarification based on their viewing choice, while HCP focused on protective rules, limiting optimal dialogue.

Conclusions:

• Healthcare personnel face ethical challenges during pre-abortion ultrasounds.
• Respecting patient autonomy requires sensitivity, involvement, and dialogue skills from healthcare personnel.
• Dialogue should proactively address the woman's desire to view the ultrasound image before the examination.