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Call for improvements to antenatal screening

Current antenatal screening arrangements do not always give parents the time or information they need to make decisions about their unborn babies, according to new research.

Around 700,000 women get pregnant in the UK every year, with more than 95% of these pregnancies resulting in the birth of a healthy baby. However, in a few cases, conditions such as Down's syndrome, spina bifida or congenital heart disease can occur, which affect the baby's mental or physical development.

At present, women are offered screening at between 11 and 16 weeks for Down's syndrome and a detailed ultrasound at 19 or 20 weeks, which can reveal other conditions.

Researchers gathered views from 135 prospective parents and 100 health professionals, mainly midwives, across the UK to find out what sort of information was given out at antenatal screenings and to find out how they felt the process could be improved. Their findings included:

  • Parents felt that they did not have enough time to consider their decisions and that sometimes screening was not discussed until the second trimester. Many midwives said that they did not have enough time to spend on the issue of screening.
  • Parents and midwives both felt that too much information was given about birth and postnatal care at early appointments at the expense of information about screening.
  • Concerns were raised about how parents who have difficulty reading or those with English as a second language access printed information.
  • Pregnant women and their partners felt that a decision about screening should be made by both parents, but most midwives said that they only involved the father "if they happened to be present."
  • Concerns were expressed about the way that having a child with Down's syndrome is presented as a wholly negative experience.

The report concludes by saying that "there are significant groups of parents who are being given insufficient opportunity to consider the options" and calls for health bosses to introduce more information that is not written such as DVD or books that use images to communicate key points. It also calls for more discussion of issues around screening between midwives and parents, with discussion of things such as labour, birth and postnatal care left to a later stage in the pregnancy.

Dr Heather Skirton said: "Making sure parents have a real choice about screening is important. They need the right information at the right time, but information alone is not enough. Every family is different, and parents have to be able to think through their decisions, taking into account their own experiences, beliefs and circumstances."

The study was funded by the Foundation for People with Learning Disabilities, part of the Mental Health Foundation.

Informed choice in antenatal screening

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