M B Stephens1, R Montefalcon, D A Lane. 1. Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. mstephens@usuhs.mil
Abstract
BACKGROUND: Most women in the United States will have a routine sonogram during pregnancy. The medical necessity of this is debatable. The goal of our study was to examine maternal beliefs about prenatal sonography. METHODS: We surveyed 150 prenatal patients at their point of entry to maternity care at a large military medical center. The main outcome measures were the patient's desire for a prenatal sonogram, the reasons for wanting a sonogram, the number of sonograms wanted, and the patient's willingness to pay for the examination. RESULTS: Of the 150 eligible subjects, 137 (91%) participated and 135 (98%) wanted a prenatal sonogram. Fifty-one (37%) of the respondents were willing to pay for the sonogram if it was not ordered by their provider. The reasons for wanting a sonogram (to determine the sex of the fetus, to ensure that the fetus was healthy, general maternal reassurance, and to ensure adequate fetal growth) were similar across age, race, and income (military rank). CONCLUSIONS: Our study indicates that most women want a sonogram during pregnancy, and many are willing to pay for the examination. Women appear to want sonograms for reasons that may not assist their provider with immediate clinical decision making. This is a potentially important disagreement between cost-saving and patient satisfaction that maternity care providers must consider when deciding whether to perform prenatal sonography for women with low-risk pregnancies.
BACKGROUND: Most women in the United States will have a routine sonogram during pregnancy. The medical necessity of this is debatable. The goal of our study was to examine maternal beliefs about prenatal sonography. METHODS: We surveyed 150 prenatal patients at their point of entry to maternity care at a large military medical center. The main outcome measures were the patient's desire for a prenatal sonogram, the reasons for wanting a sonogram, the number of sonograms wanted, and the patient's willingness to pay for the examination. RESULTS: Of the 150 eligible subjects, 137 (91%) participated and 135 (98%) wanted a prenatal sonogram. Fifty-one (37%) of the respondents were willing to pay for the sonogram if it was not ordered by their provider. The reasons for wanting a sonogram (to determine the sex of the fetus, to ensure that the fetus was healthy, general maternal reassurance, and to ensure adequate fetal growth) were similar across age, race, and income (military rank). CONCLUSIONS: Our study indicates that most women want a sonogram during pregnancy, and many are willing to pay for the examination. Women appear to want sonograms for reasons that may not assist their provider with immediate clinical decision making. This is a potentially important disagreement between cost-saving and patient satisfaction that maternity care providers must consider when deciding whether to perform prenatal sonography for women with low-risk pregnancies.