Reasons for not having some or all antenatal screening

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.

She decided to have no screening except the anomaly scan because she could not contemplate a…

Age at interview 44

Gender Female

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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.

The person doing her 20-week scan said it was a waste of money if people would not consider…

Age at interview 44

Gender Female

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She feels society is too concerned with perfection. There needs to be more debate about support…

Age at interview 44

Gender Female

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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.

She decided not to have any screening because it creates anxiety and as a Christian she would…

Age at interview 29

Gender Female

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He did not want screening because as a Christian he feels it undermines people with disabilities…

Age at interview 29

Gender Female

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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.

He feels people should be more fully informed about the purpose of screening and that it could…

Age at interview 29

Gender Female

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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.

She did not want screening because she would not have further tests, and would rather not worry…

Age at interview 36

Gender Female

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Screening cannot give you definite information and having further tests would mean more anxiety.

Age at interview 36

Gender Female

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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.

She did not want to know if her baby had Down’s syndrome but wanted to know about neural tube…

Age at interview 29

Gender Female

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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.

She decided not to have the triple test in her first pregnancy because she thought she was too…

Age at interview 26

Gender Female

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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.

A friend said she would never have screening to look for problems but had in fact had scans.

Age at interview 36

Gender Female

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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.

They explained why they had the anomaly scan but not blood tests and why they felt differently…

Age at interview 36

Gender Female

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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.

She thought about not having screening, but her husband was in favour of having every test…

Age at interview 33

Gender Female

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