Abstract
This article aims to analyze the practices and meanings involved in obstetric ultrasound (USG) in women undergoing abortion at public maternity hospital in Salvador, Bahia, Brazil. This is a qualitative ethnographic study that included three months of participant observation in the interactions between these women and medical and non-medical staff in the USG room of a public maternity hospital. USG has a central place in women's abortion itinerary, and its practice is incorporated into the institution's routine and the definition of approaches to abortion care at the maternity hospital studied here. In this context, distinct categories of "women with abortion" are produced and mobilized according to the interpretation of the USG images. The way the health condition and moral status of a woman with suspected abortion are defined depends on the presence or absence of a live fetus in her uterus, in addition to the gestational age at which the attempted or completed abortion occurred. We conclude that when the USG evidence indicates that there was (probably) an abortion in the initial stages of a pregnancy, the health professionals themselves help the women by disconnecting the semiotic process that would result in assigning a sense of human nature to the embryo. The later a pregnancy is terminated, the more likely the process of defining the images will sustain the idea that there was a person there. The hegemonic morals on abortion and its criminalization in Brazil modulate the symbolic constructions and practices involved in the USG test in women experiencing abortion.
Highlights
In Brazil, obstetric ultrasound (USG) has become the gold standard for confirmation of a live pregnancy, as well as the diagnosis of abortion
This article addresses the practices and meanings involved in obstetric ultrasound, based on discussion of the results of an ethnographic study on interactions between health professionals and women undergoing abortion during the obstetric USG test in a public maternity hospital in Salvador, Bahia
We contend that in this setting of rapid encounters mediated by technology, the notions of pregnancy and fetus are not given a priori, but produced through relations with the obstetric USG
Summary
In Brazil, obstetric ultrasound (USG) has become the gold standard for confirmation of a live pregnancy, as well as the diagnosis of abortion. With widespread application in gynecology and obstetrics, USG has become an important tool in prenatal follow-up and cases of abortion (both spontaneous and induced). Obstetric USG is a useful tool in medical care or a mere “scientific advancement”, since the images it produces carry powerful symbolic efficacy. The technology, in constant evolution, has transformed the semiotic field around pregnancy and the definitions of the beginning of human life, the body, the embryo and fetus, and, in related fashion, abortion 1. We contend that in this setting of rapid encounters mediated by technology, the notions of pregnancy and fetus are not given a priori, but produced through relations with the obstetric USG. Estimates of the gestation’s timing at the moment of its termination exert an important influence on the process of signification
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