Antenatal screening: thoughts, discussions and info after diagnosis

Once parents discover their unborn baby has a particular condition, some will think about whether to continue with the pregnancy or end it (called having a termination). They may have already started to decide, individually or together, or they may have postponed discussions until getting the diagnosis. Several people said how difficult it was to even start the discussion.

Most parents felt they needed:

  • information about the condition itself and how severely their child would be affected
  • information about what would be involved in a termination
  • help in understanding the information
  • time to reflect and accept the reality of the situation
  • acknowledgement from staff that this was a serious and often difficult decision

Healthcare staff face a difficult task in judging how much detail they should go into for different individuals, when to offer which kinds of information and how much time and support different people need. For example, one woman felt the hospital was very sensitive by first of all providing information about the condition, giving her time to think overnight, and then introducing the possibility of termination the next day.

The hospital was sensitive in the way it gave her information about the baby’s heart condition…

Age at interview 38

Gender Female

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Another felt she was given excellent information by a very caring midwife about both the condition and the process of termination, but it might have been better to take more time to absorb what she had been told. She also suggested this kind of detail could be part of informing people about screening at a much earlier stage.

The midwife gave them excellent information about Down’s syndrome and about the process of…

Age at interview 38

Gender Female

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By contrast, a mother whose baby had Edward’s syndrome felt very well advised to take time to reflect, but found most of the information about the condition herself on the internet. She was not given the Antenatal Results and Choices (ARC, a charity offering impartial information and support to expectant parents facing decisions about antenatal tests and results) booklet about deciding whether to end the pregnancy until after she had taken the first tablets to start the process.

It was valuable advice to take time to reflect on their decision to end the pregnancy and keep…

Age at interview 38

Gender Female

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Some people commented on the problem of finding reliable information online. One father felt it helped them identify the right questions to ask, and their doctors had always responded honestly.

The internet was a valuable source of information, and helped them identify questions to ask…

Gender Male

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Some people felt strongly they had not been given enough information about their baby’s condition to make their decision. Although one mother knew her baby had anencephaly (a condition where the baby’s brain has not formed), she did not understand at first what this meant, and this was not helped by how dazed and exhausted she felt.

At first she did not understand what anencephaly meant and spent the night searching books for…

Age at interview 23

Gender Female

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After talking to two charitable support groups and being put in touch with a very helpful consultant in another part of the country, she felt better informed, but thought her local hospital could have done more to ensure she understood. The new information changed her mind and she decided not to continue with the pregnancy.

The consultant was shocked to discover they had not understood their baby’s condition and had to…

Age at interview 23

Gender Female

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The leaflet by Public Health England Screening tests for you and your baby should be given to all pregnant women by their midwife or GP and lists appropriate support groups for further information.

Charitable support groups such such as the ARC which as those gives information about making choices after screening as well as those focused on specific conditions were both vital for many people.

Some people thought too much information about the condition would be unnecessarily frightening. Some hospitals had offered to put people in touch with other parents who had a baby with that condition. One mother who was offered this felt it would put her under pressure to continue the pregnancy, so she did not take it up. Some people thought this might happen with charitable support groups too. Perhaps for this reason, other hospitals did not offer to arrange contacts with other parents or advised against it.

She decided not to meet another woman with a baby with Down’s syndrome, because she would feel…

Age at interview 33

Gender Female

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The hospital advised against meeting parents of babies with Down’s syndrome. She did not get in…

Gender Female

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Some parents made their own contacts with other families and people with disabilities and in some cases drew on their own past experiences. One couple also commented that just as a cardiologist explains what a heart condition will involve, a “Down’sologist” would be useful who could explain what to expect with Down’s syndrome.

During pregnancy they went to meet other families and people with disabilities to help their…

Age at interview 28

Gender Female

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Even with a firm diagnosis, it may be impossible to give parents as much information as they would like about the severity of the condition. This is especially true of conditions such as Down’s syndrome, in which the level of disability and health problems varies widely.

From her experience of meeting children with Down’s syndrome she did not realise the range of…

Age at interview 36

Gender Female

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Feelings were also mixed about how much information people wanted about having a termination. Most people felt it was important to have as much detail as possible to make a truly informed decision, and in some cases felt the information had been too little or too late.

On the other hand, one woman who ended a pregnancy at 23 weeks felt too much information at an early stage might have deterred her from having a termination. She suggested a more structured process for guiding people in steps through the decision, with built-in time for reflection at each stage.

She felt too much information about the process of termination might have deterred her from…

Age at interview 39

Gender Female

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In many of the examples given above, parents were advised by helpful and sensitive staff. People needed to feel that staff acknowledged that this was a momentous decision with long term consequences. Where this did not happen, it could be distressing.

She felt the consultant was unsympathetic and wanted her to decide quickly whether to end the…

Age at interview 33

Gender Female

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To hear more about how parents resolved their discussions see Making a decision to continue with the pregnancy and Making a decision to end the pregnancy.

See also the Resources and Information section of our website.

For more information see Ending a pregnancy due to fetal abnormality.