Prenatal screening for Downʹs syndrome: some psychosocial implications of a ‘screening for all’ policy

The National Screening Committee of the Department of Health has made recommendations to the Government advising that prenatal screening for Downʹs syndrome should be offered to all pregnant women regardless of their age. As most women over 35 are already offered some form of testing, affected pregnancies in younger women will account for the majority of any increased overall detection rate. Therefore, while a ‘screening for all’ policy will offer wider reproductive choices to more women, it is likely to specifically increase the number of young women experiencing termination of pregnancy for abnormality. A number of inter-dependent factors predispose some women to high levels of psychological distress following termination, and a combination of these factors is most likely to be found in the very young. In addition, very young women often have little knowledge of prenatal testing and may be more likely to accept screening presented as ‘routine’ without considering the consequences. At the point where decisions about diagnostic testing or termination are made, more specialised support may be indicated for some very young women. If the UK National Screening Committeeʹs recommendations are taken forward therefore, service providers should ensure suitable support is available for some of their more vulnerable clients. Public Health (2001) 115, 356–358.