Blood test screening in pregnancy
The purpose of blood tests in pregnancy was a common source of confusion for the women we spoke to. Blood tests are carried out for...
All women will be offered a 12 week dating scan and an 18–20 week mid-pregnancy scan also known as the ‘fetal anomaly’ scan.
The purpose of the 18–20 week mid-pregnancy scan is to check the baby is developing as expected and to look for any serious health conditions such as heart problems and spina bifida, and chromosomal conditions such as Edwards’ syndrome and Patau’s syndrome. This can help parents decide whether to continue the pregnancy. It can also identify problems that may benefit from early intervention following delivery and in some cases interventions that can be carried out during pregnancy.
Most people we talked to were broadly aware of this purpose. Some of them felt very well-prepared, while others would have liked more detailed information about what the scan looks for.
One woman who had a scan in California felt that her doctor in the UK explained it better. Another suggested that the person doing the scan should check that the woman was properly informed. She noted that some scan technicians do a quick check for themselves before turning the screen round to face the woman, which may be a sensible precaution in case something is wrong.
Some people saw the 18–20 week scan as somehow different to screening. They were not aware that terminations can be carried out at any stage of pregnancy where there is a severe abnormality.
The 18–20 week scan reassures the vast majority of parents that their baby is fine. Women described many positive aspects, including:
One woman who had to have an internal scan (using a vaginal probe) because of the baby’s position found this did not spoil her enjoyment of the scan. For some people, having to have a full bladder, especially if the person doing the scan then pressed hard on their abdomen, was a minor drawback. Two people mentioned they had heard that the sound waves in a scan may distress the baby, but there is no conclusive evidence for this.
Although most people said scans had made the pregnancy seem more real for their partners, for one father it was buying baby clothes that suddenly made it feel real. One mother felt the 18–20 week scan was an anticlimax after having seen the baby before. A few commented that the quality of the pictures was poor, but other people were impressed by the quality. This may depend on the type and age of equipment being used.
A very important concern for people was the way the person doing the scan (sonographer) communicated with them. Some people could compare different experiences: one woman had a senior consultant the first time, who was expert but brief, whereas the second time the scan was performed by a specialist midwife who recognised what an important emotional experience this is for parents.
Some sonographers talk throughout the scan, explaining what they are looking at and whether it is as expected. This approach was preferred by virtually everyone we spoke to, including a French woman and her British partner who had their scan in France.
Staff who are talkative during a scan may suddenly go quiet if they notice something unusual, and this can create worry. Some staff explained that they would stay silent while they concentrated on the scan. Most people we talked to still felt they would rather know immediately if staff had seen something unusual.
A moment of worry was described by a woman with previous experience of a scan which found the baby had died. She would have preferred a more immediate explanation.
One person thought it must be difficult for staff to check if there is something they are not sure about if the woman is watching throughout.
A few staff did not explain they would be silent, and this made some people worry. This is discussed further in the section 18–20 week scan: being told something may be wrong.
Not talking was sometimes more to do with pressure of work. One woman felt staff did not have much time to communicate properly and she came away anxious that something might have been missed.
Although some people had gone to the 18–20 week scan alone, most felt it was important to have someone with you for support. Two women said their partner had missed the scan because they were still trying to find a hospital car parking space.
Many experiences discussed here are common to other types of scan: see also Early dating scans and Combined screening for Down’s syndrome and other chromosomal abnormalities.
For further information on antenatal screening tests please see our pregnancy resources.
The purpose of blood tests in pregnancy was a common source of confusion for the women we spoke to. Blood tests are carried out for...
For some people the 18–20 week mid-pregnancy or 'anomaly' scan is the point at which they discover their baby may have a health condition. Many...