Life Affirming Imaging

According to Merriam Webster, the definition of life affirming is the following:
indicating that life has value: positive and optimistic. Even though the heroine dies at the end, her struggle for a better world gives the movie a life-affirming message.

When it comes to imaging, specifically OB imaging through ultrasound, there are many examples of the definition of life affirming given above. In the case of a pregnancy loss, the above definition could read: Even though the mother lost her baby early in pregnancy, her struggle to find peace provides her with a life affirming approach to loss. It could also be stated from the imaging specialist’s point of view as follows: Even though the sonographer could not find the fetal heartbeat, her words to the patient provided life affirming support at this difficult time.

It is important to consider the clinical settings where imaging is performed when looking at what it looks like to take a life affirming approach to ultrasound imaging. A radiology office, an imaging center, a hospital, private office, or a community health center could all be places to offer life affirming imaging. What isn’t clearly outlined, for all sonographers to consider, is what life affirming imaging (LAI) is.

Does it provide better patient care?

Does it lead to a better patient outcome?

All would agree that better patient care and better outcomes is what contemporary medicine is all about. Let’s take a closer look.

I’ve listed what I believe to be the variables in ultrasound imaging. From performing an exam and being unable to share a word of what is on the imaging screen, to open discussion about what is being seen on the imaging screen. Patients don’t hesitate to share their experiences at various healthcare facilities. They are sharing their experiences with friends who might be in need of the same services. Those experiences go a long way in the community.

1. LAI includes patient education with the imaging process. 
A. No education.
Clinic is not allowed to educate about images.

B.Some education.
Clinic offers minimal education about images; basic one/two anatomical images are s
hown to the patient.
C. Free to educate. LAI approach.
Clinic allows general anatomy to be identified as sonographer deems appropriate.

2. LAI includes patient engagement with Imaging.
A.  Clinic allows no exchange during exam.
Sonographer is essentially not allowed to have conversation during exam.
B.  Clinic allows minimal exchange with patient during exam.
Sonographer is trusted with a small amount of imaged education. 

C.  Clinic allows full exchange with patient during exam. LAI approach.
Sonographer can answer questions as he/she sees fit for the exam.

3.  LAI include support/family in exam time. 
A.  Clinic allows no support or family in the exam room.
Sonographer is not permitted to have others in the exam room.
B.  Clinic allows 1 support/ family member in the exam room.
Sonographer can bring in 1 person to share in the exam time. 

Recommend protocol is determined whether it should be during or post exam.
C.  Clinic allows 1+ support/ family in the exams room.
Sonographer is allowed to bring others to exam room as determined by patient, Sonographer, and clinical appropriateness.

Examples of life affirming or non-life affirming experiences as stated by the patient:

“The ultrasound that they did at the hospital, provided me with no information. The person who did it, didn’t say a word.”

“It was good to be able to see the baby and learn about it.”

“My boyfriend never did get to come in and see the ultrasound.”

“Thank you for getting the doctor and answering a few things for me.”

“I’ve had several miscarriages, will you be able to show me the baby’s heartbeat?”

“The Emergency Department was no help. I wasn’t told anything.”

“I see it moving, but I have to abort this baby, the timing just isn’t right.”

These words, spoken by the patient, give any sonographer an opportunity to be life-affirming. In some clinical settings, we understand that it is suboptimal to engage the patient to certain levels of a LAI.


The Emergency Department is a busy place, not a place for family involvement necessarily. The hospital is operating at such a rapid pace, it can be almost impossible to involve the patients support person(s) as it will delay every other exam for the day.

Not ideal.

However, the private clinic or PMC, is the perfect place for LAI. The schedule is typically accommodating and the heart of the sonographer matches the patients desire to be educated about the pregnancy, her pregnancy.

When it comes to imaging those experiencing early pregnancy and all its decisions, those of us who cross their paths have opportunities to choose to be intentional about being life affirming in our conversation. It is important to be positive and optimistic to every young woman with a positive pregnancy test. Each sonographer should consider how they can do that in their current organization.

From the abortion-determined to the family-ready patient LAI has a place. A valuable place. As the family-ready patient crosses a sonographers path, she is in  need of facts. LAI can support such patient inquiries. LAI can answer the immediate questions.

How far along is the pregnancy?

Is there a fetal heartbeat?

What types of additional imaging will be offered? (Nuchal Translucency testing for example)

What does she need to know as she proceeds in the pregnancy?

In the abortion-determined, what does LAI look like? From a life affirming approach, a medical imager has the same care platform before her.

Share with her the gestational age and fetal development.

Show her the fetal heartbeat in an abortion approach.

It is not helpful to either woman to not be given information. From the family-ready woman to the abortion-determined woman, a sonographer should serve them the same. The patient has a right to choose from a menu of modern pregnancy options when it comes to testing and procedures. Honor her by educating her. Engage her in conversation or steer her to someone who can.

Life affirming imaging is so valuable it should be counted in our statistics. In a time when our culture tears down instead of building up, be the one to build up.

Be the clinic that is positive and optimistic. Be known for it. It’s your choice.

Connie Ambrecht

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