Antenatal Screening

Thinking about antenatal screening and what it is for

For the great majority of parents, antenatal screening (scans and blood tests) will provide reassurance that the chances of their baby having any problems are very low. Many people we talked to said they saw screening as a routine part of pregnancy care, and some said they did not think about it much beforehand. Some felt it was presented to them just as something everyone did, rather than something they had to make an active choice about. One woman explained she was happy with this approach because she trusted medical advice.

Around 700,000 women get pregnant in the UK every year. Over 95% of these pregnancies result in the birth of a healthy baby (UK National Screening Committee January 2016). However, in a few cases, there are problems affecting the baby's development. Fetal anomaly screening is a way of checking whether the unborn baby (fetus) could develop or has developed an abnormality or other condition during pregnancy. The screening tests offered in pregnancy are either ultrasound scans or blood tests or a combination of both.

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Others felt maybe looking back more explanation and discussion would have helped, but many felt they had been given good information, and that there was a real choice to be made.

(See also 'Reasons for not having some or all screening' and 'Attitudes to disability and termination').

Most people were aware that screening was looking for conditions such as Down's syndrome or spina bifida, but many said they never really thought anything like that would happen to them, and were optimistic that screening would be reassuring. One woman in her first pregnancy felt screening at various points had also helped divide the pregnancy into reassuring stages.

Some people had discussed in detail with their partners what they might do if the results came back suggesting they were at high-risk - for example whether they would consider further tests or a termination. Some people had gone part-way with this discussion and then decided that they could not take it further until they got their results.

One woman emphasised how important it was for people considering screening to be aware that one decision could lead to another. Even those who had explored in detail how they might react recognised that their views might change if they had actually had to face such a situation.

One woman felt she had been given very clear information about the difference between screening, which gives you risk information, and diagnostic tests which can give you more definite answers. She also raised the importance of being prepared for having a baby with particular needs, even if you would not consider ending the pregnancy.

(See also 'Discussing screening choices with your partner' and 'Attitudes to disability and termination').

There were many comments about how scans have become an important part of pregnancy; the chance to see the baby and have a photograph to show friends and family is a major reason for people deciding to have scans. For men, scans can be especially emotional and happy experiences. It makes their partner's pregnancy and the prospect of parenthood seem more real to them.

For women too, scans make pregnancy seem more real, especially as they have not usually felt the baby move before they have their scans. A woman expecting twins after fertility treatment described her feelings on seeing the two babies at a 6-week scan and being reassured they were alive and doing well.

Even though this has become a major reason for people to have scans, one woman explained how she knew this was not the main purpose and another encouraged people to think more carefully about why they are going.

Pregnancy can be an uncertain and anxious time for many women, and coping with fears is a normal part of pregnancy. Some people are able to deal with uncertainty by remaining optimistic that the chances of anything going wrong in their case are small. Others may imagine the worst.

A few people we talked to did go into screening feeling worried that something might be wrong with their baby. Sometimes this was because they or someone they knew had had previous experiences such as a miscarriage or having a baby with a particular condition, or because they had a family history of disabilities (See also 'Special reasons for wanting screening').

Blood screening tests are much less prominent in people's thinking about screening than scans, and awareness of what all the blood tests were for varied a lot (see 'Blood test screening').

Clearly people who have found out that there is something seriously wrong with their baby may have very different feelings about screening looking back, and when making choices next time they are pregnant. This is discussed in later sections. When they first go for screening, however, they describe very similar feelings of optimism and not expecting they would face bad news.

Last reviewed July 2017.
Last updated July 2017.


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