Antenatal Screening

Reasons for not having some or all screening

Some people or couples we talked to had decided on principle that they did not want screening, because they felt certain they would not consider ending the pregnancy or did not want to be put in a position where they might have to face such a decision.

One woman had had screening when pregnant with her two older children, and then had an unplanned pregnancy which ended in a miscarriage. This and other factors made her think differently with the fourth pregnancy. She had the 20-week anomaly scan in both her fourth and fifth pregnancy, but this was in order to prepare for any special needs the baby might have, rather than to consider ending the pregnancy.

Whilst most staff supported her decision, the person doing her last anomaly scan was less supportive. She also had concerns about the ethics of choice and society's attitudes to people with disabilities.

Another couple had decided as Christians that they would not contemplate termination under any circumstances, and so would not want screening. They also felt that they did not want to know about any disabilities in advance, because it would make them worry during pregnancy, and because of wider concerns about attitudes to disability.

They did end up, however, having a late scan for dating purposes, and were told the baby had a minor kidney problem, despite having asked not to be told if there was anything wrong. This had made them anxious for a while and reinforced their view that another time they would prefer not to have a scan. This couple felt parents should be more fully informed about the purpose of screening and that it could lead to termination.

Other couples declined screening not for religious reasons or opposition to termination on principle, but rather because they felt they personally could not go through with a termination. One couple felt sure they would not have wanted any further diagnostic tests, and would rather not worry for the rest of the pregnancy. In any case, screening could not show how severe the baby's condition might be. They felt that screening was not very accurate and could make them worry when in fact the baby was fine. They did have a 20-week scan, but did not regard this in the same light as other screening (see below).

Sometimes people's willingness to have screening depended on the condition being screened for. For example, one woman declined screening for Down's syndrome because she would not consider ending the pregnancy for that condition and would not take the risk of amniocentesis to get a definite diagnosis, but felt differently about neural tube problems, because her family had a history of such problems.

Some people turned down screening because they thought their risks were low. A young woman who later ended the pregnancy when her baby was found to have spina bifida had decided not to have the triple test (blood test), mainly because she knew she was at low-risk for Down's syndrome and had not really thought about it as a test for spina bifida. The triple test (blood test) is now no longer offered as a screening test and the quadruple test does not give a risk assessment for neural tube defects. Spina bifida is now more commonly diagnosed during the ultrasound scan carried out around week 12 of the pregnancy or, more likely, during the anomaly scan carried out around weeks 18 to 21.

Similarly, another woman found at her 20-week scan that her baby had anencephaly (the brain had not developed), and eventually decided to end the pregnancy. She had not had the triple test partly because she was young and partly because she thought she would never consider a termination. She had not realised that the triple test looks for neural tube problems as well as Down's syndrome. (See also 'Blood test screening').

Several people noted that blood tests are clearly seen as screening tests, whereas scans may not be the seen in the same light. A woman who had ended a pregnancy after a diagnosis of Down's syndrome described the reactions of a friend who said she would never have screening but had in fact had scans.

Another couple who had declined most screening but had a 20-week scan explained why they saw it as different, partly because by then they felt it would be too late to have a termination.

Some people had considered not having any screening but in the end decided they would. One woman described her and her husband's different thoughts.

Last reviewed June 2014.
Last updated June 2014.

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