Sonography

Medical sonography, in which very high-frequency sound waves are bounced off internal organs to gather information about their shape and density, was first used to create images of a fetus in utero in 1955, using machinery built to detect flaws in industrial metal. Often called ultrasound, it has been incorporated into the routine practice of obstetrics and widely used as a noninvasive diagnostic and monitoring technology in pregnancy since the 1970s. Physicians have used sonography to assess fetal development and determine either the birth due date or the appropriate method for abortion; to detect gross anatomical abnormalities, usually untreatable; to establish and tighten definitions of "normality" in fetuses; and by the 1990s, to provide visualization for invasive monitoring and therapies such as amniocentesis and fetal surgery. In the United States by the late 1990s, many physicians also claimed that sonography provided the psychological benefits of reassuring parents that the fetus was healthy and providing an opportunity for "bonding" with the fetus. In some countries, such as India and China, in which it is financially or legally unfeasible to raise many children and boys are valued strongly over girls, ultrasound has frequently been used to identify female fetuses, which are then aborted.

Ultrasound safety has not been confirmed through large-scale medical trials; it has been assumed to be safe because there has been no evidence of harm after widespread use. However, a 1993 study also concluded that the use of ultrasound in routine pregnancies did not improve outcomes. Despite these results, the use of ultrasound during pregnancy is almost universal at the beginning of the twenty-first century in most of North American and Western Europe, and quite common in other places as well.

Some feminists have raised concerns about sonography's role in medicalizing reproduction, pointing out that evidence based on women's experiences of pregnancy (such as a woman's sense of her fetus's health and growth as indicated by its movements) is usually dismissed by doctors in favor of ultrasound images, and that ultrasound is yet another mode of surveillance of women's bodies by those in positions of power. Feminists have also noted that in the United States, ultrasound images have been popularized by anti-abortion activists, who manipulate, interpret, and publicize the images to promote the idea that fetuses really are just like babies, and should be protected as such. On the other hand, anthropologists have observed that in the United States and Canada, pregnant women and their partners often enjoy viewing ultrasound images, sharing them with family and friends as prebirth "baby pictures," and appreciate what they perceive to be the psychological benefits of visualizing their fetuses. In the United States, images of fetuses are viewed by the general public as well, in advertising that promotes consumption in the name of fetal safety and comfort.

Ultrasound carries very different meanings depending on the cultural context in which it is being used. In contrast to the United States and Canada, in Greece, where ultrasound is used even more heavily, women, their partners, and their doctors see it as part of a package of technologies and practices necessary to having a desirable "modern" pregnancy. The uses and meanings of ultrasound have been culturally shaped in many different ways; but in every place where it is widely used, it has offered the possibility of altering understandings of pregnancy, the fetus, and the role of physicians and technology in reproduction.

See also: Conception and Birth; Obstetrics and Midwifery; Pediatrics.

bibliography

Duden, Barbara. 1993. Disembodying Women: Perspectives on Pregnancy and the Unborn. Cambridge, MA: Harvard University Press.

Farquhar, Dion. 1996. The Other Machine: Discourse and Reproductive Technologies. New York: Routledge.

Saetnan, Ann Rudinow, Nelly Oudshoorn, and Marta Stefania Maria Kirejczyk. 2000. Bodies of Technology : Women's Involvement with Reproductive Medicine. Columbus: Ohio State University Press.

Taylor, Janelle S. 1998. "Image of Contradiction: Obstetrical Ultrasound in American Culture." In Reproducing Reproduction: Kinship, Power, and Technological Innovation, ed. Sarah Franklin and Helena Ragoné. Philadelphia: University of Pennsylvania Press.

Lara Freidenfelds

sonogram An image of the body's interior produced by sound waves — or, rather, by ultrasound, because the waves are of much higher frequency than those which can be heard. Sound imaging originally helped military personnel locate enemy aircraft and submarines in World War II. After the war, medical researchers began to apply this technology to the human body. Doctors first employed ultrasound to look at the brain, to diagnose heart disease, and to detect tumours. Obstetricians also started to utilize the diagnostic technique because of the dangers associated with X-raying fetuses, a practice that resulted in deaths from cancer in children under the age of 10. Sonograms have become an established part of prenatal care in the First World because the equipment used to produce these images is affordable and can be used in the doctor's office. Ultrasound is ordered routinely — although one study in 1993 concluded that sonograms provide no substantial health benefit for the mother or the fetus. Many physicians, however, disagree with this assessment and argue that sonograms furnish important information about the development, health, and age of fetuses. Sonograms confirm pregnancies, ensure that fetuses are developing normally, determine age, and indicate delivery dates more accurately. Ultrasound technology also represents a non-invasive form of medical diagnosis that can take the place of exploratory surgery.

The ability to ‘see’ inside the human body has had effects far outside medicine. Mothers and fathers proudly display sonograms in baby albums and on refrigerators. The sonogram itself is an expected element of modern pregnancy. Pro-choice defenders argue that the fetus, not the pregnant woman, has become the major actor in this biological and cultural drama. Pro-life proponents, by contrast, embrace the fetus as the symbol of their struggle. They have employed ultrasound technology in the film The Silent Scream in order to highlight the personhood of the fetus and they use fetal imagery in their advertising campaigns.

Karol K. Weaver

Bibliography

Busch, A. (1995). Ethical fervor and the graphics of choice. Print, 49, 52–6.
Duden, B. (1993). Disembodying women: perspectives on pregnancy and the unborn, Hoinacki. Harvard University Press, Cambridge, MA.
Kevles, B. H. (1997). Naked to the bone: medical imaging in the twentieth century. Addison Wesley, Reading, MA.

son·o·gram / ˈsänəˌgram/ • n. 1. a graph representing a sound, showing the distribution of energy at different frequencies.2. a visual image produced from an ultrasound examination.

sonography (sonn-og-răfi) n. see ultrasonography.