What pregnant women think about routine ultrasound tests for fetal abnormalities is largely ignored by the health profession ...
... while prenatal screening in New Zealand is officially referred to as a choice, there has been little discussion about the pros and cons and the first trimester scan for fetal abnormalities test has effectively become an automatic part of pregnancy care.
"Women have been done something of a disservice in this area. Minimal information or support is provided and, in spite of the expectation that women give their informed consent, they are not encouraged to see ultrasound screening as something they need to deliberate over."
Dr Donovan interviewed a group of women in the Wellington region with varying experiences of ultrasound screening. Some chose not to have a scan, several had false positive tests and one a false negative test during their pregnancies.
She says the accuracy of screening has recently been improved with the addition of a second check, requiring a blood test, but the results still need to be recognised as not completely reliable.
"Amniocentesis ... is the only way to diagnose Down Syndrome with certainty and this carries the risk of miscarriage.
"Many women don't realise that screening is not a precise science. Having a scan can be a negative experience because it can make women feel that pregnancy is a risky business. For those who had an abnormality detected it was a frightening and lonely experience. They felt they were left alone to make the decision about whether to opt for termination or proceed with the pregnancy."
Dr Donovan believes the majority of women do back the availability of prenatal screening but want more information and support around deciding whether to have a scan and what to do if abnormalities are detected. She says a pamphlet on screening options has recently been developed, but this will only be beneficial for women if their GP or midwife takes the time to offer it and talk it through early enough in the pregnancy.
"There is an unrecognised tension between how screening is understood within the medical profession and how it is experienced by pregnant women themselves. The public health sector endorses screening which is seen as a health good and an economically useful approach.
... "There are actually a range of views out there including women who believe families should have the right to give birth to a disabled child and not be discriminated against for their choice." ...