A guide for difficult news in pregnancy

Ultrasounds during pregnancy can be a time of joy for many but may also be the moment people receive unexpected, and sometimes devastating, news. New guidelines have recently been released to support sonographers in the best ways to share this type of news with expectant parents.

Led by Clinical Psychologist Dr Judith Johnson (University of Leeds), with expertise from sonographers, midwives, an obstetrician, lay experts, academics, third-sector organisations and policy experts, the guidelines lay out the best ways to communicate before, during and after an obstetric ultrasound. The authors also give suggestions of some of the better phrases to use when telling patients that they have lost a baby or if their baby has a condition or is not developing as expected.

The key principles of the guidelines are based on the ASCKS framework which stands for Avoid assumptions, Set up the scan, Clear, honest information, Kindness and Self-care. For example, in setting up a scan the authors suggest among other things that sonographers should clearly explain their role and the purpose of the scan, check the woman's understanding of the purpose of the scan and explain there will be periods of silence during scanning.