Why I chose to screen before birth

Why I Chose to Screen Before Birth

by Lois Bunyan

26-10-20

Introduction from Dr Mark

"My ante-natal scan suggests a major problem," is heartrending news – whether it's your patient, partner or daughter. Reaching for abortion facts and checking risks of abortion is a common next move.

You may be asked by a woman or couple – should we screen or not screen before birth?

Now a Polish court has banned abortion for any foetal disability however severe, see  here.

So, I asked Lois Bunyan to help with the screening dilemma.

Dr Mark Houghton MB BS, MRCGP (London). 

Big questions

Its 11:30 on a Friday morning and I'm sat in my living room with a cup staring at my three-month-old daughter. Her smile is contagious; I find myself getting lost in it for hours. Before she was born, I couldn’t imagine just how much I would love her.

But would I love her any less if she had a life limiting illness or a disability like Down’s Syndrome? Well, as a society we seem to be writing a narrative that suggests yes.

In recent years we have seen new screening technology and alongside it a huge increase in abortions for a prenatal diagnosis of Downs Syndrome (50% more in 10 years). With terminations for foetal abnormalities now the norm, we are posed big questions around the society we have created.

What happens at the first antenatal visit

The Combined Screening Test by blood sample has become a normal part of antenatal testing in the UK. It helps identify whether there’s an increased chance of your unborn baby having a genetic condition: Down’s Syndrome, Edward’s Syndrome or Patau’s Syndrome. Results can be mis-leading.

Screening tests are usually mentioned at your first appointment with the midwife. Parents will be given some information and are often advised to screen, not even gathering this screening is optional.

(More on this in the new  Pregnancy and Abortion Guide paperback £7.99 ($10.58) or e-book £4.99 ($6.99) Buy UK here or Buy globally here).

About 4% of foetuses present parents with a significant problem such as Down’s. [1] When suddenly facing worrying results, parents may find themselves un-prepared – as well as facing a huge life decision about their pregnancy. Shock is common.

In that moment they need balanced information and support to reach a decision that they will be comfortable with for a lifetime. Even better is to be prepared by reading a short guide to screening – see later.

Looking forward in hope

I worked for many years in the disability arts sector and have taken on a voluntary role at our local church, ensuring that outreach groups are accessible to all. So, you may be surprised to know that my husband and I choose to screen. If it wouldn’t make a difference as to whether or not we kept our child, then why screen?

Well I want to argue that as a society we are thinking about this all wrong. Currently the common assumption is that if you get a positive test for a life limiting condition, the best thing to do is to end the pregnancy. But what if these tests could be used differently?

What if they became an aid to help us prepare for the future? A future that may be different to the one we anticipated, a future that may include some suffering, but one that also brings great joy.

Practical solutions

You see, there are a range of charities and organisations out there who specialise in support for parents caring for a child with a disability. The UK has one of the best care sectors in the world. We have a growing understanding of the need for inclusion and the great value that those with disabilities bring to our communities. North America has pioneered a wide range of palliative care options for dying new-borns and bereavement support.

Benefits

Through working alongside families in deeply sad and tragic situations, we see there are lasting benefits for continuing with a pregnancy. Having the opportunity to meet, love and cherish your child for a few short hours or days can have benefits not only for the child but for the whole family. This creates an opportunity to grieve normally over such a great loss.

Options

For some, screening can help you to feel in control while for others it creates feelings of anxiety. For some the news of a genetic condition will help them to prepare for the birth of their new baby; others may wish to build a fostering or adoption plan. And some may decide not to continue.

Some parents feel comfortable to have the first test but later opt to refuse further (diagnostic) testing due to the risk of causing a miscarriage. Others wait for the physical scan around 20 weeks. Others may opt out of all screening and look forward in expectant hope.

Conclusion

You may agree with me. or you may want to challenge or question my argument. Either way, screening is a choice and there are options we can talk about as a community – see Choices Community

A decision-making resource

I’d highly recommend Dr Esther Luthy and Dr Mark Houghton’s new book ‘Pregnancy and Abortion – A Practical Guide to Making Decisions.’ They cover screening dilemmas and can a fetus feel pain? Home abortion essentials and medical abortion side-effects are made easy to understand.

[1] Pregnancy and Abortion Guide paperback £7.99 ($10.58) or e-book £4.99 ($6.99) Buy UK here or  Buy globally here 

Lois Bunyan and her husband live in London. They recently became first time parents. Prior to this Lois worked in the disability arts sector and more recently as a youth and children’s worker, championing Special Educational Needs from their local church in Teddington. This article is Lois’s personal view.