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Prenatal screening for Down syndrome: a dilemma for the unsupported midwife?
1School of Health Studies, University of Portsmouth, UK. isobel.ryder@port.ac.uk
Objective:
To explore the personal and professional concerns of midwives in relation to their experiences with women undergoing serum screening for Down syndrome.
Design:
Semi-structured interviews.
Setting:
A consultant-led maternity unit in the south of England.
Participants:
Ten midwives based in areas which most commonly support women undergoing this test.
Methods:
Interviews were recorded and transcribed and a grounded theory approach involving coding was used to identify categories which were analysed.
Findings:
Themes identified were: education needs on introduction of the test and in relation to current research about the test; strategies for explaining the concept of 'risk'; personal and professional conflict in relation to the dilemmas raised.
Key Conclusions:
Accurate information (including psychosocial aspects) should be available to midwives prior to the introduction of potentially complex investigations. Continuing education should prepare midwives to meet the challenges related to prenatal screening for Down syndrome. Some strategies which could be considered include the use of reflection sheets, prompt cards and case studies or vignettes. Interprofessional education could provide the opportunity to increase understanding of individual roles and the conflicts experienced.