New scanning protocols have been drawn up for the thousands of expectant parents affected by pregnancy complications each year.
Research led by the University of Leeds will for the first time provide sonographers with specific words and phrases to be used consistently when explaining miscarriages, foetal deaths and anomalies during scans.
Previously, there was no standardised way of communicating scan findings, which can lead to increased distress for the expectant parents. Each year around 150,000 families in England and Wales are affected by pregnancy complications: 20% of pregnancies end in miscarriage or stillbirth, while one in 20 scans reveal an anomaly which could indicate the presence of a foetal health condition.
Parents often recall the exact words and behaviours that the sonographer used when conveying unexpected news. The new training framework will help sonographers provide clear information for expectant parents in stressful situations.
Dr Judith Johnson, a Clinical Psychologist at Leeds’ School of Psychology, who led the research, said:
"The language used during scans can have a powerful emotional impact on the parents. It can influence how they respond to the news, and any decisions they then make regarding how to move forward.
"Addressing this issue has been particularly challenging because sonographers may have to communicate a wide variety of findings to parents, from miscarriages to a specific type of foetal anomaly. However, sonographers receive no mandatory training in news delivery and up until now, there was no agreed guidance for how to communicate these findings to expectant parents."
A wide range of charities including Sands, international academics, healthcare professionals and policy experts worked together on the new, comprehensive set of guidelines.
Jen Coates, Director of Volunteering and Bereavement Support at Sands said:
"Sands is delighted to have been involved in the development of this new training framework, which will help sonographers provide clear information for expectant parents in unexpected situations. It is vital that sonographers feel confident in being honest and clear in their communication with parents, even with uncertain findings.
"The language used during scans can have a powerful emotional impact on parents and will stay with them, influencing how they respond and grieve for their baby. For example, they should use the word baby, even in earlier loss, except where parents use other terminology. And sonographers should not expect parents to make decisions during scans, before they have had the opportunity to process the news and think about what they want.
"We hope that these guidelines can both improve the experiences of expectant parents and help to reduce sonographer anxiety around the delivery of unexpected news."
The recommendations include:
• prioritising the use of honest and clear communication, even with uncertain findings
• using technical terms, but these should be written down for parents, together with non-technical interpretations
• the term ‘baby’ should be used as a default, even in early pregnancy, unless expectant parents use other terminology such as ‘foetus’
• at the initial news disclosure, communication should focus on providing information
• expectant parents should not be asked to make decisions during the scan