This study explores discourses around private three- and four-dimensional (3/4D) ultrasound scans in pregnancy, the experiences of women who have 3/4D scans and what impact these scans may have on pregnant women. A critical discourse analysis of scanning company websites was undertaken to explore the discourses, identities and genres set up on the websites. Longitudinal interviews exploring women’s experiences of 3/4D scans were analysed using interpretative phenomenological analysis. Case studies, using longitudinal questionnaire and interview data, were used to investigate the psychological impact of 3/4D scans on pregnant women. The critical discourse analysis revealed mixed discourses, identities and genres. While 3/4D scans are not overtly medical, they nevertheless contain medical aspects. They are promoted as enhancing bonding and reassurance. In the interview analysis, two superordinate themes emerged: ‘Getting to know the baby’ and ‘Experiences of pregnancy’. While the women’s physical and emotional experiences of pregnancy varied considerably, there were more convergences in the desire to ‘get to know’ the fetus and how women approached this. While routine and 3/4D scans played an important role, fetal movement also emerged as a significant factor. The case studies showed that the psychological impact was not consistent. Scans had no effect on fetal health locus of control, may have reduced anxiety about specific issues for some women and may have had a positive impact on some components of bonding for some women. It is not possible to state categorically that they reduce anxiety or increase bonding. The psychological impact of 3/4D scans appears to be individually mediated and depends on pregnancy experience and individual psychological differences, highlighting the significance of individual factors in both research and practice. Two opposing discourses portray 3/4D scans as either beneficial, by enhancing reassurance and bonding, or problematic, by undermining women’s embodied knowledge and experience and being potentially risky. This study suggests that neither of these two conflicting discourses are reflected in women’s experiences. The women in this study were not motivated primarily by bonding or reassurance when choosing 3/4D scans, but considered them a nice experience; on the other hand, the scans do not seem to have had a detrimental impact either. The interview analysis suggests that women acquire knowledge about the fetus through scans and fetal movement and combine these to make sense of the fetus. This study also provides evidence that the concept and measurement of bonding during pregnancy is problematic and that professional and academic perspectives are not necessarily reflected in women’s experiences.

Podoconiosis is a neglected tropical skin disease caused by a fault in skin barrier function (SBF) combined with a genetic predisposition. Irritant minerals and pathogens entering breaches in plantar skin cause an inflammatory reaction and lower leg lymphoedema. This has a considerable negative impact on the quality of life and economic status of some of the poorest people in 20 countries. Podoconiosis is preventable and treatable but not curable. No previous pre/post controlled intervention studies on skin treatment for the disease have been published. The aim of this randomised control trial (RCT) was to evaluate the effectiveness of a low-cost evidence-based skin care intervention to improve the SBF in the legs/feet and enhance disease related quality of life. A pilot study (n=10) indicated that adding 2% glycerine to the existing skin management regime used in Ethiopia could have a positive effect on stratum corneum (SC) hydration levels and trans-epidermal water loss (TEWL). The study recruited participants from two Ethiopian clinics (n=193). The control group used the existing treatment regime: washing legs/feet with soap, soaking in 6 litres of water with disinfectant added and applying Vaseline®. The experimental group added a 2% dilution of glycerine to 1/6 of the amount of soaking water and 0.0045% less disinfectant. After 3 months the experimental intervention had a highly significant positive effect on TEWL (p = < 0.001) and SC hydration (p = < 0.002) compared to the control. The reduction in foot circumference was highly significant (p = < 0.001). There was no significant group difference in Dermatology Life Quality Index (p = 0.907). The study indicates the very positive effect on SBF of adding 2% glycerine and less disinfectant to the current treatment. This finding offers a significant contribution to the body of knowledge on the management of the disease. The addition of 2% glycerine to treatment regimens may also have positive effects on other skin diseases with compromised SBF.