Análise do tópico parto e do conceito de orientação na interação entre médicos e gestantes durante o exame de ultrassom obstétrico

Abstract

Obstetric ultrasound examinations are a part of almost all women’s prenatal care around the world, be it offered by either public or private healthcare systems. Being undertaken several times or not throughout pregnancy, the context created by the exam arouses some reflection upon issues of different orders, both at micro and macro levels. With the present investigation, we aim at analyzing interactions between sonographic practitioners and pregnant women during the exam. We specifically intend (1) to analyze how the topic delivery – here understood as a macro-level issue – is brought up at the interactional level and (2) to systematize and (re)define the term orientation (widely used by conversation analysts), by means of reviewing the literature and analyzing the moments during the interactions in which problems of orientation between participants were made evident. This research study is mainly based on the theoretic-methodological apparatus of Conversation Analysis (SACKS; SCHEGLOFF; JEFFERSON, 1976). In order to support the analysis, we also rely on studies that reflect upon childbirth issues and Conversation Analysis literature that fosters the attempt to define orientation. The data analyzed consist of 85 obstetric ultrasound examinations which were audio e and video recorded at a private healthcare clinic. With respect to the first objective of this investigation, we found that pregnant women, even before the exam and its findings, bring up the type of childbirth, mainly caesarean, as their desired (if not already chosen) form of delivery. It was also possible to identify that there are distinctive understandings by physicians and pregnant women about the meaning of the word engagement, which ends up leading to interactional conflicts. With regards to the second objective, the investigation shows that the participants’ orientation becomes evident – on what concerns being demonstrated by the participants and observed by the analyst – when divergent between them and related to differing knowledge (such as technical and lay) and to the interpretation of the images projected on the screen. From the analysis of divergent orientations, it was possible to understand that orientation is present in the interaction to help intersubjectivity maintenance between participants.