In addition to a cold or hurried demeanor on the part of their ultrasound technicians or physicians, an inability to obtain desired information led numerous women in my study to purchase elective ultrasound. For most, the information they sought was the sex of their fetuses. For these participants, like Catherine and Rachelle, obtaining a sex diagnosis was the sole reason for their seeking elective ultrasound. Rachelle explained,
I just wanted to do it because I went for my 20 week ultrasound and I really wanted to find out the gender and it came back that they couldn’t see it, it was undetermined.
Rachelle had a clear idea of the information she wanted, and when it was not provided, she sought the opportunity to obtain it elsewhere. When asked if she thought she would have
purchased an elective ultrasound if she had been given the information she desired, Rachelle responded,
I don’t think I would do it, no. I don’t know because as it is we don’t know, I guess, the long term effects of having a long, or a lot of ultrasounds.
Despite clearly stating the information she desired from her diagnostic ultrasound, the response of Rachelle’s technician reinforced that it was not, in fact, up to her to decide. In her decision making, Rachelle had to weigh out the benefits of receiving the information she desired, and the potential harmful effects of engaging with technology in an unprescribed way. I will return to this point in the following chapters.
Similarly, Catherine expressed a desire to know the sex of her fetus, and described resistance on the part of her medical ultrasound technician. She explained,
I told them straight out that that’s what I had wanted. Umm, I think about two weeks prior I had had the typical 18 week morphology exam, and that was through my general practitioner, umm and they wouldn’t tell me the gender, so...and we really wanted to know, just for planning purposes, so that’s why I contacted the 3D ultrasound place.
Again, the response of her medical ultrasound technician reiterated to Catherine that she was not, in fact, in control of determining what kind of information would be provided to her. In medical settings the ultrasound technician, along with the radiologist and physician are tasked with determining and disseminating diagnostic information. Even when participants voiced their desire for particular information, the ultimate power to decide remained with medical personnel.
Some participants felt very strongly about women being able to obtain the information they desire from medical ultrasound. Both Monique and Jamie, who were otherwise connected to the healthcare profession, were critical of the medical profession for what they felt was an
unnecessary withholding of information. Monique was highly critical of the medical profession for refusing to provide women with the information they desired. She posited,
I am a strong proponent of people having the information that they want out of healthcare. Like, I read this blog online where people were like, you know, mothers
shouldn’t be able to find out the sex of their baby because, you know - and they go into all these long arguments about abortion and child selection, and to me, that’s not the argument. The argument is, in what other scenario is it okay for, umm, somebody who wants information about their own health or the health of their child to be told, ‘I have the information, but you’re not allowed to have it’ by their healthcare provider? Never. I can’t think of another one. So why is it suddenly okay when it comes to pregnancy and your own children, that people find it okay to withhold that information?
For Monique, an awareness that healthcare providers have access to information, and thus
control over disseminating it, presents a major issue in terms of patient rights. She clearly viewed sex determination as diagnostic information that should be made available to those who desire it. Monique touched on the major argument against radiologists and ultrasound technicians
providing fetal sex information to women, which is that it makes possible sex selective abortion. This argument has led numerous medical and governmental institutions to condemn the practice of releasing sex information to women and families prior to 20 weeks gestation, which is the legal cutoff in Canada for women to obtain non-medically indicated abortions (Health Canada, 2003; Weir, 2006). It is clear that, for Monique, this was not an acceptable argument. She viewed the larger issue as women being given a choice in terms of information regarding their health and the health of their children.
Although Jamie did not wish to find out the sex of her fetus prior to birth, she felt strongly that those who did should be given that information without question. Her concern had more to do with her ability to view her fetus via ultrasound, on demand. Because she had experienced fertility issues and became connected to online networks of women with similar experiences, Jamie had come to expect a certain number of ultrasounds. After becoming pregnant naturally, she found out she would only receive two routine medical ultrasounds. She explained,
This was predominantly from the fertility website...those women tended to talk about a lot of ultrasounds, right? And so when I went - and I ended up with a midwife - and I’m like, really? Two ultrasounds? That’s it? Like, I was kind of disappointed that I wouldn’t get to see my baby every month, like, what do you mean? And so when I found out that I could pay for, and have this option, I said “Well, why not?”
Jamie’s concern was not necessarily for specific medical information, but for the opportunity to see her fetus via ultrasound. Because elective ultrasounds are not available through the
healthcare system, Jamie was happy to discover that the option existed for her as a consumer.
The above responses indicate that participants felt distanced from medical decision making. A lack of control over the experience of ultrasound and the information provided, promoted
participants to seek out a consumer alternative. The framing of elective ultrasound as a consumer alternative to prenatal ultrasound in medical settings will be discussed in the following chapter.