ScienceDirect - Midwifery : Women's accounts of the physical sensation of chorionic villus sampling and amniocentesis: expectations and experience

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doi:10.1016/j.midw.2008.02.002

Women's accounts of the physical sensation of chorionic villus sampling and amniocentesis: expectations and experience

Louise Locock M Phil, PhD^a^,^,, University Research Lecturer, Kate Field MSc, D Phil^a, Senior Qualitative Researcher, Ann McPherson MBBS, FRCGP, FRCP^a, University Lecturer and Patricia A. Boyd MBBS, MD^b, Senior Clinical Research Fellow

^aDIPEx Research Group, Department of Primary Care, Old Rd Campus, University of Oxford, Headington, Oxford OX3 7LF, UK ^bDepartment of Public Health, National Perinatal Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK

Received 20 September 2007;

revised 11 February 2008;

accepted 16 February 2008.

Available online 15 May 2008.

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Abstract

Objective

to understand women's expectations and experience of discomfort during chorionic villus sampling (CVS) and amniocentesis, and relate them to aspects of clinical practice.

Design

thematic analysis of narrative interviews. Interviews were recorded and transcribed verbatim, coded and analysed using computer-assisted qualitative data analysis software.

Participants and setting

sample recruited nationally for two wider studies of experiences of antenatal screening (n=47) and experiences of ending a pregnancy for fetal abnormality (n=40). Of these, 31 women had experienced amniocentesis and/or CVS at least once.

Findings

most women found the procedures less painful than expected. A smaller group were shocked or surprised at the sensation, and were worried that they had jumped and that the needle might have damaged the baby. A few found it very painful, using vivid imagery of being stabbed or punctured. However, even those who found it worse than expected felt it was worth the pain to get a definite diagnosis. Women identified a range of factors affecting their experience, including levels of anxiety, prior experience or knowledge of the procedures, levels of information provided, trust in the skill of the operator, or reassurance and empathy of the staff involved.

Conclusions and implications for practice

the needs of a small minority of women who find CVS or amniocentesis shocking and/or painful may be overlooked. A review of pre-test information and procedures is recommended to ensure that women are better prepared for possible physical sensations during the procedures to address the needs of this minority.

Keywords: Amniocentesis; Chorionic villus sampling; Pain; Qualitative research

Article Outline

Introduction
Methods The studies Ethics Sample Interviews Data analysis
Findings Finding the procedure not painful or less painful than expected An unexpected sensation Painful experiences
Strengths and limitations of the study
Discussion and conclusion
Funding
Competing interests
Acknowledgements
References

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