Biomedical Engineering Reference
In-Depth Information
her measurements, is commented on as expected or according to the norms.
Even differences between calculated dates of delivery are commented on as
being within normal variation.
An additional way of managing normality can be seen in the next phase of
the examination, when the midwife tries to make the image comprehensible
for the parents, by showing the baby's body parts as well as the structure
and function of vital organs. The midwife here changes from a professional
perspective, where the purpose is to confi rm that the expected baby follows
the medical norms, to an everyday perspective as she interprets the image
with references to the characteristics of the baby. As she interprets the
ultrasound image from a professional as well as an everyday perspective, the
midwife visualizes a normal and healthy baby and also confi rms normality
rhetorically.
This way of combining the two perspectives on the image can been seen
again towards the end of the examination. Here, the midwife fi rst presents
the estimated date of delivery. She also communicates her summing-up of
the examination from a professional perspective by stating that everything
looks fi ne, sometimes without any explicit reference to normality. She then
changes her way of interpreting of the image, and comments on the image
as related to the biographical context of the family. Finally, she hands over a
paper copy of the ultrasound image, a photo that shows the expected baby.
Together, these ways of handling the image provide pictorial evidence of the
normal child.
The issue of normality is thus not explicitly talked about from within a
professional perspective.
What
, more precisely, the midwife is examining, is
rarely talked about during the examination. Instead, normality is
visualized
as she interprets the image to the parents. The typical pattern is that the
midwife shows the parents the baby with all body parts and everything
that functions as it should - but this is not talked about as a check-up of
normality. Normality is simply shown. This might be understood as a way to
avoid worrying parents-to-be. Instead of talking and explaining the different
assessments of the baby, the baby is shown, and the parents are left to raise
questions if they want to. This way of managing the assessment of the
expected baby's normality has many similarities with the 'indirect' strategies
that have been demonstrated in earlier studies of how professionals manage
health surveillance practices in situations where the examination in itself
might evoke (groundless) worry (Olin Lauritzen and Sachs 2001; Bredmar
and Linell 1999; Adelswärd and Sachs 1996; Strong 1979).
A similar way of handling normality is used when a potential deviance is
found. In this study, no serious deviancies from normality were identifi ed.
However, it did happen that the midwife got a measurement that did not fi t
with the norm. When confronted with this type of deviant measurement, the
midwife does not comment on her assessment until she has completed all the
measurements she needs to come to a conclusion. When presenting the results,
the midwife typically emphasizes the measurements do correspond with what
