Antenatal Screening

Special reasons for wanting antenatal screening

Several people had wanted screening because of their own family history*. This included three women with a family history of babies born with certain conditions.

All these women felt they would not have continued with the pregnancy if they found their baby had the condition that had affected their family, particularly where they had seen the impact it had on the rest of the family, but they did not necessarily feel the same about other conditions (see also 'Attitudes to disability and termination').

For one woman, screening was important because her brother had severe learning disabilities, for which a cause had never really been established, and an early miscarriage had been a further cause for anxiety. She was impressed with the genetic counselling and testing she was offered, which reassured her that she was at no greater risk than anyone else of her age.

Having a brother and an aunt with Down's syndrome had made another women feel strongly that she needed to know whether her baby had Down's syndrome. Although there was no evidence from genetic tests that it was the rare inherited form of Down's syndrome, she remained anxious about her family history.

Another woman was influenced by her mother's experience of having a stillborn baby with hydrocephalus (water on the brain). In her first pregnancy she went to the prenatal diagnosis clinic. At this stage it was unclear whether the hydrocephalus had been caused by a neural tube defect, so she was offered an early scan. This ruled out anencephaly (undeveloped brain), which reassured her, but it was distressing for her mother to have to think about it again. Later it was discovered that a brain tumour, not a neural tube defect, had caused the hydrocephalus.

Concern for their own mother's feelings mattered to other women too. One decided not to tell her mother she was pregnant until she at least had her nuchal scan results. Another waited until she had fixed her first genetic counselling appointment.

For some people the results of screening and genetic testing were enough to reassure them. One explained that she felt satisfied she had done everything she could.

Another woman with a family history of Down's syndrome was not reassured and felt she needed to be certain that her baby was not affected. In fact she had felt all along that she wanted a diagnostic test, but described how she hesitated at various stages because her screening results showed she was at low-risk. Eventually she did have an amniocentesis, and in her second pregnancy decided straight away this was what she wanted.

As well as a family history of disabilities, experiences of previous miscarriages may affect people's attitudes to screening. Several women we talked to had experienced miscarriages, and some had not been aware there was a problem until they came for a scan at around 12 weeks.

This experience made them nervous and pessimistic about screening in later pregnancies, and often meant they had earlier and more frequent scans. Having already lost a baby made some people more determined to have every test available, but it made others hesitate.

One couple who had experienced miscarriages described their reaction to being told their nuchal scan result, which reduced their risk based on age alone, but was still quite high. Eventually they decided they did not want an amniocentesis, because they did not want to risk losing another baby, even though they had originally thought they would not be able to cope with a baby with Down's syndrome.

* See also our section on 'Screening for sickle cell and beta thalassaemia'.

 

Last reviewed July 2017.
Last updated June 2014.

 

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