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Special reasons for wanting antenatal screening
Special reasons for having a scan include: A family history of health conditions that scans can pick up Previous pregnancy-loss (miscarriage) Family history Three women...
Some people decide not to have pregnancy screening because of not wanting to end a pregnancy if there was a major problem, or potentially be faced with having to make that decision.
One woman said that she had screening in her 4th and 5th pregnancies in order to prepare for any special needs the baby might have, rather than to consider ending the pregnancy.
Whilst most health care staff she dealt with 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 end the pregnancy 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 worry 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.
Other couples turned down screening because they felt they would not end the pregnancy regardless of the results. One couple felt sure they would not have wanted any further 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, if the baby had one. They felt that screening was not very accurate and could make them worry when in fact the baby was fine.
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. She would not take the risk of amniocentesis, a test which carries a small risk of causing a miscarriage, to get a definite diagnosis. She felt differently about neural tube problems, because her family had a history of such problems.
Some people turned down screening because they thought there was a low chance of their baby having a health condition. 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 (a 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 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 ending a pregnancy. She had not realised that the triple test looks for neural tube problems as well as Down’s syndrome. (See also Blood test screening in pregnancy).
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 about screening.
Special reasons for having a scan include: A family history of health conditions that scans can pick up Previous pregnancy-loss (miscarriage) Family history Three women...
Most parents interviewed went into the screening process hoping and expecting that it would reassure them. For the great majority of parents in this country...