Tuesday, March 24, 2009

Antenatal Screening - Your Choice

Health screening programmes do undoubtedly help to diagnose diseases such as cervical and breast cancer early, giving patients a better chance of survival. Antenatal screening tests, likewise, detect abnormalities and have given many parents the chance to prepare for their child's special needs - or to abort that child. However the benefits of screening programmes must always be weighed against the stress and worry they cause when they incorrectly detect a possibility of disease. And in the case of antenatal screening, amniocentesis and chorionic villus sampling carry risks of miscarriage. Though most people are content to take the tests that the doctors advise, and to follow doctors' instructions without question, articles like this one in the Telegraph do force you to think twice about the cons of screening. To summarise the article, a woman called Dawn Lewis gave birth to a healthy baby after being advised at 12 weeks that there was a 99% chance that he would be born with a condition that would cause him to die in his first year and would allow him no quality of life.

Every pregnant woman has to choose whether to have her foetus screened for Down's Syndrome. For me, the worry that would have been caused by a high-probability-of-Down's result outweighed the benefits of the test. My personal decision was that I would not abort a foetus which had a high probability of being affected by Down's and I would not even take the increased miscarriage risk caused by amniocentesis. Even if I had refuse an amnio I am certain that my risk of miscarriage would have been increased by the worry caused by a "high probability" result. I do not underestimate the difficulty of raising a child with Down's but I take responsibility for my own decisions and I, personally, would rather have a Down's baby than risk aborting a healthy foetus. So I did not take the screening blood test. Though it concerns a different disorder, Dawn Lewis's case highlights the importance of questioning what you are told by doctors and making your own decisions about what action to take following screening. And if you would be prepared to love and care for a baby no matter what abnormalities it was born with then you really should ask yourself the question of whether it is better to refuse the screening in the first place.

1 comment:

Sarah V. said...

Yes, that last sentence exactly explains why my husband and I chose not to have any sort of screening for Down's syndrome in either pregnancy. We knew we would not consider Down's a sufficient reason to abort, so we avoided the screening tests.


This isn't to say we didn't have any screening - I did go for the standard 20-week ultrasound, because I did feel I wanted to know if there was anything so badly wrong that it actually meant the baby wouldn't survive, or would be a vegetable (i.e. anencephaly). But we chose not to have Down's screening.