The Management of Uncertainty in Obstetric Practice: Ultrasonography, In Vitro Fertilisation and Embryo Transfer

Abstract

The extent and significance of the paradox in the rapid proliferation of technologies in obstetric practice is only now apparent. By increasing the options available such technologies address ‘needs’ which, although disputed, are familiar both to those who are fertile and those who are not. Typically, women who want a child seek, in the first instance, to become pregnant. Those who are pregnant appreciate reassurance about foetal well-being. Techniques for manipulating fertilisation and monitoring the foetus have advanced apace. These technologies facilitate not only the diagnosis of certain reproductive risks but, in some cases, also the action necessary to minimise them. Nevertheless the emergence of new kinds of risk and uncertainty has been a corollary, which has been masked by features of the institution of medicine which promote confidence and by increasing medicalisation of all aspects of reproduction.