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Advice for health professionals providing pregnancy screening tests published

News 2 December 2020

Leading Colleges have released advice for healthcare professionals to ensure they provide screening results to pregnant women and their partners in an unbiased and non-directive way, making families aware of their options and giving them time to decide their next steps.

The Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and Society and College of Radiographers have developed a consensus statement which gives professionals clear advice on how to speak to women and their partners about screening options, test results and where families can go for additional support. 

It comes as a new and more accurate screening test called Non-Invasive Prenatal Testing (NIPT) is due to be rolled out on the NHS in England over the next few years. NIPT is a blood test taken from a pregnant woman to assess the chance of the baby having Down's syndrome, Edwards’ syndrome and Patau’s syndrome. 

NIPT is not a diagnostic test, and women and their partners with a higher chance result, who wish to know for sure if their baby has or does not have one of the conditions, can choose to have further prenatal diagnostic tests.

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said:

“There is an opportunity with the introduction of NIPT to ensure the information and support women and their partners are receiving is impartial, factual and respectful so that families can make a personal and informed choice. It’s also important that all options to them are provided in a non-directive manner and their choices are accepted, noted and respected by medical staff.

“We have recognised the need for high quality guidance to ensure women are supported to make the choices that are right for them and their families. That’s why we are currently in the process of developing clinical guidelines that will outline the care and support to be provided to women who choose to continue with a pregnancy following a diagnosis of Down's, Edwards’ and Patau’s syndrome.”

Clare Livingstone, Professional Policy Advisor at the Royal College of Midwives, said: 

“Screening during pregnancy can cause a lot of anxiety to parents. It is important they are given sufficient time, support and consistent information to enable them to make the informed decisions that are right for them. It is important they know that midwives will always respect women’s choices. 

“The RCM has valued the opportunity to work with a range of stakeholders in developing this consensus statement, which will go towards supporting the whole professional team involved in delivering care to women during pregnancy.”

Gill Harrison, Professional Officer for Ultrasound at the Society and College of Radiographers (SCoR), said:

“The development of the consensus statement will provide all health care professionals involved in antenatal screening with a clear message about the importance of non-directive communication and enabling true values-based care in pregnancy. Sonographers have an important role in communicating antenatal screening test information to parents. These guidelines, inter-professional training and associated team working amongst all maternity colleagues are important for ensuring consistency of communication and support. 

“The SCoR have welcomed the opportunity to work with a range of key stakeholders to develop this consensus statement. We value the reference to relevant support groups within the document, who provide such valuable additional support to parents making decisions about screening.”  

Annette McHugh, programme lead in the Public Health England Screening Team, said:

Public Health England is delighted to support this consensus statement. We have worked with parent support organisations to develop information for pregnant women that makes it clear that NIPT is one of several options they can choose following a higher chance combined or quadruple test result. It is important that they can make the right choice for them and healthcare professionals are there to provide support. Women should always be given time to think through their options and be able to ask for more information in a format that’s right for them.”

Hugh Whittall, Director of the Nuffield Council on Bioethics, said:

“We have been pleased to see significant shifts in approaches to prenatal screening and the language that surrounds it since we published our inquiry on the ethics of NIPT in 2017. This important statement from three professional bodies is a signifier of that shift. We welcome the messages it sends to all healthcare professionals involved in the delivery of prenatal screening across the UK.

“The statement couldn’t be clearer: women and couples should be provided with accurate, balanced and non-directive information and support to enable them to make choices at each stage of prenatal screening. Critically, their choices must be fully respected. Whilst this should always have been the case, the introduction of NIPT to the NHS pathway has created an opportunity to ensure a high quality service is being offered consistently.”

ENDS

Notes to editors

For media enquiries, please contact the RCOG press office on 020 7772 6444/300 or email pressoffice@rcog.org.uk

To read the consensus statement visit: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/consensus-statement-prenatal-screening/

For more information about Non-Invasive Pre-natal Testing (NIPT), visit:
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/consensus-statement-prenatal-screening/

We would like to thank the following organisations who contributed to the development of the consensus statement.  

  • Royal College of Midwives
  • Society and College of Radiographers
  • British Maternal and Fetal Medicine Society
  • Public Health England screening team 
  • Nuffield Council of Bioethics working party
  • Antenatal Results and Choices
  • Down’s Syndrome Association 
  • Down’s Syndrome Research Foundation
  • Positive about Down’s Syndrome
  • Support Organisation for Trisomy 13/18 (SOFT-UK)
  • RCOG Women’s Network