Social Implications of One-Stop First Trimester Prenatal Screening, 2002-2003

In 2003, the offer of screening for foetal abnormality and particularly Down’s syndrome became a routine part of antenatal care in the UK for the first time. The 2003 NICE antenatal care guidelines state that 'all pregnant women should be offered screening for Down’s syndrome with a policy that provides a minimum detection rate of 75% with a false-positive rate no greater than 3% by 2007', indicating a move to first trimester screening technologies which achieve this greater level of accuracy. <br> <br> Thus the findings of this study of the <i>only NHS site</i> in England offering combined first trimester screening in a one-stop clinic setting are of particular relevance at this time and has provided the opportunity to look at the implications of an IHT (Innovative Health Technology) prior to wide-scale implementation in the UK. The study findings raise questions about the implications for non-directiveness and informed decision-making of the resulting routinisation of screening, and the shift from an ‘opt-in’ to an ‘opt-out’ service.<br> <br> The implications of the introduction of a routine offer of screening for Down’s syndrome in the first trimester of pregnancy raises new issues for women and their partners, for the organisation and management of screening and for society. The development of prenatal screening technologies is a contested and politically charged arena with ethical and public policy considerations.<br> <br> In the light of the above concerns, the study aimed to explore: <br> <li>the impact of new screening technologies on the social management of pregnancy, service delivery and professional roles</li><br> <li>participants’ broader responses to the new reproductive technologies, and views about routinisation of screening</li><br> <li>perceptions of self, the foetus, and the management of reproductive risk</li><br> <br> <i>The qualitative aspect of this study has not been deposited along with the quantitative data, as the staff interviewed could be identified as the NHS unit was the only place in the country which conducted this type of work at the time of the study.</i>