ULTRASOUND Messages for September, 1999: Re: Policy re: Fetal gender

Re: Policy re: Fetal gender

From:

MGalles@aol.com

Sun Sep 12 12:24:05 1999

<< It bothers me that many sonographers are being put on the spot for something as trivial as the sex of the baby. I had a case that the parents were very instant that they be told the sex, no question about well being, unfortunately this baby had no kidneys. Should I have made them happy about the sex only to visit their doctor and be told their baby was not compatible with life? We usually tell the sex if parents ask and if we are 99% sure, however we always make sure they know nothing is guaranteed, and always put a question mark when we label their picture of the sex. Unfortunately I think this is one of the reasons' we are not taken seriously in our work, too many people consider ultrasounds as only important for getting a picture of their baby, and not as a true diagnostic study. >>

Sally, Our policy is also that we will tell if the parents want to know, and if we are as sure as we can be. If we cannot determine without a doubt in our minds, we do not say. We also make sure parents know nothing is 100%. Most of our scans are done at 18 weeks, so things aren't always crystal clear at that point.

My co-workers and I often discuss the concern's you've raised as well. Seldom does a parent-to-be come in and say they just want to know that the baby is healthy. But multiple times each day, we all hear "I just want to know if it's a boy or girl". And often after you tell them, they are upset because it is not the sex they wanted. No comments at all about it being a healthy baby. I, too, feel it demeans the profession- parents have no idea that they are undergoing a medical procedure. As far as they are concerned, the whole process is for fun, and so they know what color to paint the nursery. In these cases, we feel like glorified children's portrait photograhpers

Also, in a lot of cases this strong desire on the parent's part to know gender adds to my scanning time. I have done the entire diagnostic exam, the baby still has not cooperated enough to be able to determine gender, and the parents want me to keep scanning until I can tell. Of course, I don't keep scanning indefinately (we usually have patient's scheduled back to back), but many times I do scan longer than medically necessary just to try to determine gender.

Some parents are also very unwilling to believe we can't tell. I think TV (and other media) and often times the referring practioners encourage this perception when they tell the parents that we will be able to determine sex. I've had patients offer to jump around to get the baby to move into a position that will facilitate sex determination, and parents who get upset and suspicious that I'm holding out on them when I say that I cannot see genitalia well enough to call the sex!

Of course, this is not the case with all parents. Many do not want to know, and others ask but make the comment that they don't care, as long as it's healthy. Unfortunately, though, these seem to be in the minority. Or maybe it's just that the other type tends to stand out in my memory!!

I wouldn't be a bit upset if our policy changed to not telling parents the sex. It could still be noted on the doctor's report, as it is sometimes used in cases of medical diagnosis (Family Hx's of Fragile X, hemophilia, evidence of posterior urethral valves, etc).

It will be interesting to read what other facilties do in regard to telling parents the sex.

Marcia Galles, RDMS

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