By Erica Russo for the Museum Of Motherhood Student-Blog Project.

How might sonograms influence the interpsychic experience of pregnancy for mothers and interfere with this purposeful developmental process? To answer this question, we should talk about what sonograms are able to provide pregnant mothers and those involved in her prenatal care.

According to the American Pregnancy Association, sonograms (or ultrasounds) “are diagnostic procedures that detect or aid in the detection of abnormalities and conditions related to pregnancy.” They are medically indicated for a variety of reasons, including to confirm a viable pregnancy and heartbeat, molar or ectopic pregnancy, measure gestational age, assess abnormal gestation, observe fetal presentation and movements, and evaluate fetal well-being.

So, sonograms are able to provide answers regarding multiple factors that comprise the health of a pregnancy. Other diagnostic procedures are able to provide some of the same information that sonograms do, but sonograms provide the most comprehensive evaluation of the health of the fetus. Given the information from this evaluation, sonograms undoubtedly have the potential to interfere with a mother’s pregnancy. They are able to identify abnormalities that prompt a mother to make a decision – whether to act or not.

Viewing a sonogram can be an incredible experience for pregnant mothers – but it is a much more complex experience than we think. Much of the ambiguity in the health of a fetus is resolved through sonograms, with a visual image having the power to evoke a wide range of emotions. The picture of the developing fetus itself, the report of a “healthy” baby from a clinician, or the image confirming things “just as imagined” may encourage positive emotions including joy, excitement, and relief.  On the flipside, diagnosis of an abnormality, a visual contradiction of things “just as imagined”, or the loss of the fetus are likely to induce more negative emotions like sadness, anger, grief, and loss.

How does the mother internalize the meaning of this experience? There are as many narratives as there are individual experiences, but for all of these experiences, the sonogram provides answers that can either support a woman’s belief of control or lack of control.

Our culture doesn’t really need any help in identifying the benefits of technology and for sonograms specifically, it seems obvious that the opportunity to improve the health of a fetus is a benefit. So, let’s focus on the cost instead.

For a mother who feels she has done everything she can to provide a healthy environment for her fetus and receives a “healthy” sonogram report, she internalizes a model of the world where she has control. We know that individuals who believe they have control over outcomes generally do better than those who believe they lack it However, what happens when this ability for control is repeatedly reinforced through other measures of fetal health, but then a situation arises that is not positive? Instead of feeling as if the particular situation was out of her control – which happens – she resorts to self-blame, because she believes that it has been her actions all along that have influenced outcomes before.

If the same type of mother  - who feels she has done everything she can to provide a healthy environment for her fetus – had a sonogram and received an “unhealthy” report, she may internalize a model that lacks effortful control. Despite her efforts in trying to ensure a healthy outcome, she didn’t get one. If internalized, the mother can potentially manifest a view of future outcomes as either “lucky” or “unlucky”, which rejects the ability to control and leaves her helpless.

These examples provide implications on how we can reduce these costs of sonograms for pregnant women. Healthcare providers should show that they value the interpsychic experience of pregnancy just as much as they value the physical health of the mother and fetus. It’s important that they are aware that the picture of a mother’s uterus that they are able to show her takes away some of the ownership in that experience. Instead of believing in sonograms as the true representation of pregnancy, it should valued only for the extent to which it is the best diagnostic tool to promote the physical health of the fetus. The mother’s experience and perception of pregnancy matters just as much. By valuing it as such, we reduce the current cost of sonograms and enhance the interpsychic experience of pregnancy — a purposeful, developmental process.

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