Organisational and professional structures shaping the sonographer role in obstetrics

Introduction Advances in ultrasound technology along with increased knowledge and expectations of pregnant patients have substantially changed the sonographer role. Sonographers are now the frontline practitioners as patients expect to know the results of a scan immediately, including if there is an adverse outcome. Communicating ‘bad news’ to pregnant patients is very often left to the sonographer without any departmental or organisational policies or protocols in place to guide the actions and communication required in these situations. Where there are protocols in place, the sonographers may not have been included in the decision-making process and therefore find that these are unclear or not readily accessible and/or they restrict open communication with patients. Methods This paper reports on the hierarchical relationships that shape the patient-sonographer encounter in obstetric ultrasound, particularly those with an adverse outcome, and provides an overview of the legislative, organisational and professional framework that structures the delivery of ultrasound services generally, and obstetric ultrasound services in particular. Results/Conclusion There is a need for an evidence-based and inter-professional approach to develop departmental policies and protocols to provide clear guidelines, and a definite line of authority that clearly acknowledges the integral role a sonographer plays in their interaction with a patient.