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Pregnancy & children
Antenatal Screening
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Making decisions about screening :
Thinking about screening and what it is for
Special reasons for wanting screening
Reasons for not having some or all screening
Discussing screening choices with your partner
Attitudes to disability and termination
Information for making decisions
Experiences of screening :
Nuchal translucency scan (low risk results)
Nuchal scan (being told something may be wrong)
Early dating scans
Blood test screening
18-20 week scan (low risk results)
18-20 week scan (being told something may be wrong)
Understanding screening test results
Having further tests and getting results :
Deciding whether to have further diagnostic tests
Having further tests and waiting for results
Getting diagnostic test results
Thoughts, discussions and info after diagnosis
Deciding to continue with the pregnancy :
Making the decision to continue with the pregnancy
What the rest of pregnancy and birth was like
Feelings about screening looking back
Deciding to end the pregnancy :
Making the decision to end the pregnancy
The experience of ending a pregnancy
Feelings and reflections afterwards
Views on screening & feelings in later pregnancies
When screening does not detect a condition :
Learning after birth that the baby has a condition
How it has affected parents' views about screening
Living with disabilities or a chronic condition :
Living with a child with a long term condition
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Antenatal Screening
Subject index
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Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN08
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She felt screening helped provide stages for getting through pregnancy.
Normal first pregnancy, routine screening experiences. Private care throughout pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN25
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She was optimistic that screening would be reassuring and give helpful information.
Two normal pregnancies. Nuchal scan not available locally, so had blood screening. Unable to have 20-week scan in first pregnancy because of staff shortages.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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Seeing her IVF twins in an early scan was reassuring and amazing, and made pregnancy seem real.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN19
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Looking back she felt more explanation of the purpose of the 20-week anomaly scan would have been helpful.
Normal first pregnancy, routine screening experiences, including combined nuchal scan and blood test.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN24
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She was anxious about her family history of Down's syndrome, although genetic tests showed no evidence it was inherited.
Family history of Down's syndrome. Had amniocentesis in both pregnancies to rule out Down's syndrome, even though nuchal scan results were low risk.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN09
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She was referred to a prenatal diagnosis clinic because of anxiety about a family history of stillbirth and hydrocephalus. A scan at 13 weeks was reas
Routine screening in two pregnancies - declined screening for Down's syndrome. Family history of hydrocephalus led to early prenatal counselling but no risk identified.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN28
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She felt reassured she had done as much as she could by having screening and genetic testing.
Healthy pregnancy after an early miscarriage. Interviewee has a brother with severe learning disabilities and describes having genetic screening and counselling in early pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN24
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She decided not to have a CVS (Chorionic Villus Sampling) when her nuchal scan results came back low risk, but was still considering amniocentesis.
Family history of Down's syndrome. Had amniocentesis in both pregnancies to rule out Down's syndrome, even though nuchal scan results were low risk.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN24
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A further scan also suggested she was at low risk of Down's syndrome, but she still wanted amniocentesis to know for certain.
Family history of Down's syndrome. Had amniocentesis in both pregnancies to rule out Down's syndrome, even though nuchal scan results were low risk.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN20
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Her experience of finding her first pregnancy had not survived made her nervous about screening in other pregnancies.
Scan in first pregnancy detected blighted ovum. Three healthy pregnancies since . Now 8 months into fifth pregnancy. 20-week scan detected possible abnormalities; subsequent scans have been reassuring.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN08
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Books can be helpful, especially in a first pregnancy, but they can also make you anxious.
Normal first pregnancy, routine screening experiences. Private care throughout pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN05
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She thought about not having screening, but her husband was in favour of having every test available, for reassurance.
4 months pregnant. Normal screening results. One scan in early pregnancy, no other scans planned. Alphafetoprotein results not yet received.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN08
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She might have considered amniocentesis if her scan results had shown she had an increased chance of something being wrong with the baby and she was f
Normal first pregnancy, routine screening experiences. Private care throughout pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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They postponed discussion of what they might do about their screening results until they had further information to discuss.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN11
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Having a great-aunt who had Down's syndrome, she would want to know in advance if her baby had the condition, but would continue the pregnancy.
Normal first pregnancy; screening carried out in US, before return to UK when 6 months pregnant. Declined amniocentesis (offered as standard). Compares US and UK.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN11
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Her doctor in America advised her it was useful preparation to find out before birth if the baby had any problems.
Normal first pregnancy; screening carried out in US, before return to UK when 6 months pregnant. Declined amniocentesis (offered as standard). Compares US and UK.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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It is helpful preparation to find out in advance if the baby has problems.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN23
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Written information from her midwife was helpful, but she still had unanswered questions.
After initial contact with NHS, decided to have antenatal care in France, including 3 scans with normal results. Baby born 2 months early in England.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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It was not always clear what different blood tests were for, but it matters less if the results are normal.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN01
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She found one helpful book with factual information. Talking to friends can make you more anxious.
Normal first pregnancy, routine screening experiences. Had to spend time in hospital late in pregnancy for investigation of bleeding.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN19
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They were impressed by the professionalism of staff carrying out their nuchal scan and felt well informed and reassured.
Normal first pregnancy, routine screening experiences, including combined nuchal scan and blood test.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN24
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Seeing her baby during the nuchal scan was a wonderful experience which made pregnancy seem real.
Family history of Down's syndrome. Had amniocentesis in both pregnancies to rule out Down's syndrome, even though nuchal scan results were low risk.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN26
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Seeing her baby during the nuchal scan was wonderful but it was alarming that staff talked to each other, not to her.
Routine screening experiences, including nuchal scan.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN26
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In her second pregnancy, she was anxious that the sonographer doing the nuchal scan seemed rushed. She needed more reassurance.
Routine screening experiences, including nuchal scan.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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In two repeat nuchal scans, she felt the consultant was much more communicative than the first person who scanned her.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN21
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The sonographer was quiet during her nuchal scan. She would rather wait till after the scan to receive bad news.
Normal first pregnancy; some early scanning after bleeding in first trimester. Screening includes nuchal translucency scan and blood testing.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN19
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She felt it was important for health staff to imagine themselves in the patient's place and remember to show human warmth.
Normal first pregnancy, routine screening experiences, including combined nuchal scan and blood test.
Pregnancy & children
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Antenatal Screening
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Continuing with an affected pregnancy
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Interview AN30
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They were asked to have a second scan but did not feel anxious about this at the time.
Down's syndrome suspected at nuchal scan. Couple declined amniocentesis and continued with the pregnancy. Further scans suggested heart problems (operated on successfully since baby's birth).
Pregnancy & children
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Antenatal Screening
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Baby's condition detected after birth
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Interview AN12
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She paid for a nuchal scan after a previous miscarriage. The result was reassuring.
Second child born with Down's syndrome after low risk nuchal scan results, and no problems detected at 20-week scan. Home birth. Daughter now aged two.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN36
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The nuchal scan reassured them, but with hindsight they felt they did not really understand the nature of screening and risk information.
Nuchal scan in first pregnancy gave low risk result, but anomaly scan at 21 weeks detected abnormalities, confirmed as Edwards' syndrome by amniocentesis. Couple decided to end the pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN05
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The 12-week scan helped check for twins and was a moving experience. The sonographer explained everything.
4 months pregnant. Normal screening results. One scan in early pregnancy, no other scans planned. Alphafetoprotein results not yet received.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN26
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It would be sensible for sonographers at the 20-week scan to check the woman is properly informed and explain how they will communicate.
Routine screening experiences, including nuchal scan.
Pregnancy & children
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Antenatal Screening
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Continuing with an affected pregnancy
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Interview AN29
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In an early heart scan in her current pregnancy the sonographer was friendly and welcoming, and made her husband feel involved.
After four miscarriages, scan in fifth pregnancy found heart defects. Couple decided to continue the pregnancy. Son, now 4, has had some additional problems. Pregnant at time of interview.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN11
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The 20-week scan was a moving experience and the person doing the scan explained everything very helpfully.
Normal first pregnancy; screening carried out in US, before return to UK when 6 months pregnant. Declined amniocentesis (offered as standard). Compares US and UK.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN27
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The 20-week scan was a lovely experience. She had an internal scan because of the baby's position, but did not mind.
Healthy pregnancy, routine screening. Some blood test results came back abnormal. Levels of information and choice have been a concern.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN25
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The 20-week scan was reassuring but not as exciting as she expected, and the pictures were unclear.
Two normal pregnancies. Nuchal scan not available locally, so had blood screening. Unable to have 20-week scan in first pregnancy because of staff shortages.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN09
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Her first 20-week scan was professional but brief. The second time she had a specialist midwife who made it a happy experience.
Routine screening in two pregnancies - declined screening for Down's syndrome. Family history of hydrocephalus led to early prenatal counselling but no risk identified.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN23
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At her 20-week scan in France she was given detailed information and explanation. She and her husband were very reassured.
After initial contact with NHS, decided to have antenatal care in France, including 3 scans with normal results. Baby born 2 months early in England.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN26
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Staff seemed uncommunicative on the day of her 20-week scan, and she felt anxious something might have been missed.
Routine screening experiences, including nuchal scan.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN28
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They had an anxious moment at the 20-week scan when the sonographer paused briefly. They felt he communicated honestly.
Healthy pregnancy after an early miscarriage. Interviewee has a brother with severe learning disabilities and describes having genetic screening and counselling in early pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN13
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When staff spotted something unusual during the 20-week scan, she was very anxious and would have liked more immediate explanation.
Healthy pregnancy after 2 miscarriages; following nuchal scan results they considered amniocentesis and decided against. Baby born healthy, although mother had obstetric cholestasis in late pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN22
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It must be difficult for the person doing the scan to check something they are unsure about if the woman is watching the screen throughout.
Declined all screening except 20-week anomaly scan in two most recent pregnancies.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN36
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She did not really appreciate that the 20-week scan looks for particular conditions, despite reading the leaflets.
Nuchal scan in first pregnancy gave low risk result, but anomaly scan at 21 weeks detected abnormalities, confirmed as Edwards' syndrome by amniocentesis. Couple decided to end the pregnancy.
Pregnancy & children
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Antenatal Screening
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Continuing with an affected pregnancy
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Interview AN38
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At the 20-week scan, they valued the sonographer's honesty and kindness. She called the baby 'he', not 'it'.
Problems detected at 20-week scan. Amniocentesis confirmed Patau's syndrome. Couple decided to proceed with pregnancy. Baby born at 35 weeks and died after 3 minutes.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN39
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Staff have to concentrate while doing scans, but some initial reassurance and a friendlier manner might help.
Hypoplastic left heart suspected at 19-week scan, confirmed by cardiac scan. Couple decided to end the pregnancy. Chose amniocentesis in next pregnancy (baby born 2002).
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN35
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At the 20-week scan in her current pregnancy, the sonographer explained she would be silent, but the mother still felt anxious, especially after the e
Combined nuchal scan/blood test suggested high risk; early results ruled out trisomies but subsequently diagnosed a severe form of Turner's syndrome. Couple decided to end the pregnancy; now pregnant again.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN16
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The sonographer explained she would be silent at the 20-week scan in the woman's first pregnancy. She felt staff communicated bad news with honesty an
Anencephaly detected at 20-week scan in first pregnancy. Considered continuing the pregnancy but eventually decided to induce labour early. Second pregnancy miscarried. Now pregnant again.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN19
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She was well informed about the availability of the combined nuchal scan and blood test, but her blood sample was damaged in the post.
Normal first pregnancy, routine screening experiences, including combined nuchal scan and blood test.
Pregnancy & children
>>
Antenatal Screening
>>
Normal results or declining screening
>>
Interview AN08
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The results of her nuchal scan indicated a very low risk, which was reassuring.
Normal first pregnancy, routine screening experiences. Private care throughout pregnancy.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN25
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Her blood test results were reassuringly low risk, but she knew this could not guarantee Down's syndrome was not present.
Two normal pregnancies. Nuchal scan not available locally, so had blood screening. Unable to have 20-week scan in first pregnancy because of staff shortages.
Pregnancy & children
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Antenatal Screening
>>
Normal results or declining screening
>>
Interview AN01
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Her nuchal scan results were lower risk, but she still did not feel completely reassured.
Normal first pregnancy, routine screening experiences. Had to spend time in hospital late in pregnancy for investigation of bleeding.
Pregnancy & children
>>
Antenatal Screening
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Baby's condition detected after birth
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Interview AN12
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Because her nuchal scan results reassured her she was low risk, she never expected her baby would have Down's syndrome.
Second child born with Down's syndrome after low risk nuchal scan results, and no problems detected at 20-week scan. Home birth. Daughter now aged two.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN22
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An increased risk can be difficult to interpret, without knowing about the original baseline risk.
Declined all screening except 20-week anomaly scan in two most recent pregnancies.
Pregnancy & children
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Antenatal Screening
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Normal results or declining screening
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Interview AN14
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She had good information about the scan results but sometimes having more information raises more questions for staff to explain.
Seven and a half months pregnant with twins conceived by IVF. Has had scans throughout pregnancy; nuchal translucency scan had to be repeated because of the babies' position.
Pregnancy & children
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Antenatal Screening
>>
Normal results or declining screening
>>
Interview AN20
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She was impressed with the medical care in her current pregnancy, but felt overwhelmed with information. She would have preferred more reassurance tha
Scan in first pregnancy detected blighted ovum. Three healthy pregnancies since . Now 8 months into fifth pregnancy. 20-week scan detected possible abnormalities; subsequent scans have been reassuring.
Pregnancy & children
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Antenatal Screening
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Continuing with an affected pregnancy
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Interview AN06
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The doctor performing the CVS (Chorionic Villus Sampling) put them at their ease, and his care was a good example for students present.
Third pregnancy, after two miscarriages. Nuchal scan suggested problems; CVS ruled out Down's syndrome but heart problems identified by further scan. Baby born March 2003, successful surgery completed.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN39
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It helped to try to relax during the amniocentesis in her most recent pregnancy, and it did not hurt.
Hypoplastic left heart suspected at 19-week scan, confirmed by cardiac scan. Couple decided to end the pregnancy. Chose amniocentesis in next pregnancy (baby born 2002).
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN31
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CVS (Chorionic Villus Sampling) was very painful, but it helped that the professor doing it was kind and comforting.
Problems detected in first pregnancy at nuchal scan - confirmed as Down's syndrome by CVS. Couple decided to end the pregnancy. Subsequent normal pregnancy and birth.
Pregnancy & children
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Antenatal Screening
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Continuing with an affected pregnancy
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Interview AN15
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She felt screening was not effective in her case. She would have screening again another time but would want more scans.
Following two miscarriages, during next pregnancy had frequent scans. A scan at 8 months unexpectedly found hydrocephalus and brain problems. Termination offered but rejected.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN36
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She still feels screening is valuable, but thinks that the way it is presented to women is too reassuring
Nuchal scan in first pregnancy gave low risk result, but anomaly scan at 21 weeks detected abnormalities, confirmed as Edwards' syndrome by amniocentesis. Couple decided to end the pregnancy.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN17
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She considered not having any screening in her next pregnancy. Screening is valuable but sometimes raises more questions than it answers.
Hydrocephalus detected by 20-week scan and amniocentesis in first pregnancy. Felt the decision to end the pregnancy was rushed. Miscarriage and two healthy pregnancies since.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN18
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She would definitely want screening again, but will always feel anxious in subsequent pregnancies that something could go wrong.
Spina bifida detected at 20-week scan in first pregnancy - some family history of the condition. Couple decided to end the pregnancy. Now pregnant again.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN32
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The consultant doing the 12-week scan in her current pregnancy recognised her anxiety and reassured her as quickly as possible.
Problems detected in first pregnancy at routine 12 week dating scan - confirmed as Edward's syndrome by CVS. Couple decided to end the pregnancy. Now pregnant again.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN40
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In her next pregnancy she wanted to know for certain if anything was wrong, so she had amniocentesis again.
Down's syndrome detected by amniocentesis in first pregnancy. Couple decided to end the pregnancy. Baby son born since.
Pregnancy & children
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Antenatal Screening
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Ending an affected pregnancy
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Interview AN31
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In her next pregnancy, she thought she would want CVS (Chorionic Villus Sampling), but decided against it because her nuchal scan results were low ris
Problems detected in first pregnancy at nuchal scan - confirmed as Down's syndrome by CVS. Couple decided to end the pregnancy. Subsequent normal pregnancy and birth.
Pregnancy & children
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Antenatal Screening
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Baby's condition detected after birth
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Interview AN03
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The mother thought something was wrong with her baby after birth, but everyone reassured her till the baby developed pneumonia when she was several we
Daughter born November 2000 with congenital heart problems not detected by antenatal screening, diagnosed when the baby was 10 weeks old. Corrective surgery at 11 months and 2 years.
Pregnancy & children
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Antenatal Screening
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Baby's condition detected after birth
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Interview AN10
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As not all problems can be detected at the 20-week scan, she felt more screening should be offered in later pregnancy.
Baby born in April 2002 with hydrocephalus which had not been picked up during screening. Baby has had surgery and is making good progress.
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