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All pregnant women in England are offered screening tests to identify the chance of having a baby with Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.

It’s important for women to make an informed, personal decision about whether or not to have the tests, and midwives help them to do this by providing information and having a discussion during the first antenatal appointment.

Midwives want to give everyone the support they need to make their own decision about these tests, although they can be uncertain of the best approach to discussing the tests with women without influencing the decision they make.

Wellbeing of Women Research Midwife, Jayne Wagstaff, has been exploring how midwives and women talk about screening tests, to support future improvements in midwives’ training.

Learn more about the background and methods used in the project from Jayne.

Understanding how midwives and pregnant women talk about antenatal screening

Wagstaff and her team recorded 27 antenatal appointments where antenatal screening tests were discussed. Conversations within the real-life video and audio recordings were analysed to explore how midwives and women talk about antenatal screening tests.

Highlights from the findings

• Women may be more likely to share their thoughts on screening or ask questions when midwives use open questions.
• Women may indirectly seek advice from midwives about whether they should choose antenatal screening.
• Time constraints alone do not fully account for the way in which screening conversations are navigated by midwives.
• The way screening services are delivered may influence the choices made by women.

Jayne Wagstaff says:

“Every pregnant woman’s needs are different, so when it comes to antenatal screening midwives want to ensure they support women to make their own decision without influencing the choice they make”

“This study, co-funded by Wellbeing of Women, the Royal College of midwives and the Burdett Trust for Nursing, may inform potential improvements in future training for midwives. This may support midwives to have better conversations with women to help them decide for themselves if they want to have antenatal screening tests.”

Other research studies funded by Wellbeing of Women to improve care and health outcomes during pregnancy and birth include:

• Joanne Cull’s research into how maternity services empower pregnant women affected by trauma
• Dr Shuby Puthussery exploring ways in which we can remove barriers to antenatal care for Black, Asian and minority ethnic women, and those from socioeconomically disadvantaged backgrounds
• An investigation by Prof Marian Knight into how midwives and doctors can best care for pregnant women hospitalised with COVID-19
• Dr Matina Iliodromiti’s work about how we can identify health risks in babies too small or too large during pregnancy