Prenatal screening for Down's syndrome: some psychosocial implications of a 'screening for all' policy

The National Screening Committee of the Department of Health has made recom mendations to the Government advising that prenatal screening for Down's sy ndrome should be offered to all pregnant women regardless of their age. As most women over 35 are already offered some form of testing, affected pregn ancies in younger women will account for the majority of any increased over all detection rate. Therefore, while a 'screening for all' policy will offe r wider reproductive choices to more women, it is likely to specifically in crease the number of young women experiencing termination of pregnancy for abnormality. A number of inter-dependent factors predispose some women to h igh levels of psychological distress following termination, and a combinati on of these factors is most likely to be found in the very young. In additi on, very yoking women often have little knowledge of prenatal testing and m ay be more likely to accept screening presented as 'routine' without consid ering the consequences. At the point where decisions about diagnostic testi ng or termination are made, more specialised support may be indicated for s ome very young women. If the UK National Screening Committee's recommendati ons are taken forward therefore, service providers should ensure suitable s upport is available for some of their more vulnerable clients.