A “high chance” result from a combined test

A “high chance” result from a combined test

What does it mean to get a "high chance" result from a combined test? In the NHS women are offered a screening test intended to identify if it is likely that their baby is affected by any of three specific conditions. These are Down's, Edward's and Patau's syndromes (trisomy 21,18 and 13). The result will be reported as "high chance" or "low chance". Sometimes this will be termed "high risk" or "low risk", but this rather suggests that the conditions are bad or pose a threat.  I have discussed...

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Why employ a independent specialist midwife?

Why employ a independent specialist midwife?

The main reasons that people give for considering using an independent specialist midwife is that they want extra care or support that isn’t readily available on the NHS. They want to have more flexible (and longer) appointments, and want to see and get to know one midwife who can support and guide them throughout pregnancy, labour, birth and beyond. In the UK, most women will be able to access free NHS services. The NHS is working to develop continuity of care for pregnant women, so do ask...

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“I would love a private midwife, but….”

“I would love a private midwife, but….”

Do you wish you could choose your midwife? Do you wish you had care from the same midwife throughout pregnancy, labour, birth and beyond? Would you like time to discuss your questions with an expert? Time and support to make decisions about your care in pregnancy and your birth choices? Midwives working in the NHS are under extreme pressure (I know, I was one until earlier this year). Most hospitals are trialling schemes to provide continuity of care, but this may be with a team of midwives...

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Why I offer NIPT

Why I offer NIPT

Several people have asked me recently why I offer NIPT. These tests (non-invasive prenatal tests) have become a significant part of antenatal test provision in the last few years. They are available under a range of trade names including The SAFE Test, Harmony. Panorama, NIFTY and many more. They are now widely accepted internationally and are validated (considered reliable) for trisomy 21,18 and 13 (Down's , Edward's and Patau's syndromes). I offer NIPT in Surrey and Sussex, usually during a...

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Language in healthcare and why it matters

Language in healthcare and why it matters

The way we use language in healthcare can help people to understand or it can cause additional confusion. It can open discussions or it can create barriers.  In my work as a specialist midwife, every day I hear from people who say that they didn't understand what a health professional has tried to tell them, or I realise that there has been fundamental miscommunication due to the way things have been expressed. When you are faced with unexpected news about your baby during pregnancy, this can...

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Fetal abnormality and informed choice.

Fetal abnormality and informed choice.

If you are told during pregnancy that your baby has a life threatening, life changing or life limiting abnormality, you are faced with one of the most complex ethical debates of the 21st century. Much of my work involves walking with parents when a fetal abnormality has been identified, providing information, time and a safe place for them to process the news and to make an informed choice about what to do. In the UK we have the legal right to end a pregnancy (termination/ abortion), a choice...

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Is my baby ok? Antenatal scans and test result concerns

Is my baby ok? Antenatal scans and test result concerns

Every week, I talk to many people who are worried in pregnancy. Unusual findings at a pregnancy scan or antenatal test concerns. There is clearly something "of interest" to the professionals, but is it something to worry about? I always feel sad that the communication with the professional wasn't clear enough. I worry that there are so many people in this sort of situation who will end up trying to make sense of things alone, or by asking friends (or strangers on the internet) rather than...

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Edward’s syndrome (trisomy 18) or Patau’s syndrome (trisomy 13). What should we do?

Edward’s syndrome (trisomy 18) or Patau’s syndrome (trisomy 13). What should we do?

"There is a 1 in 100 chance that your baby is affected by Edward's syndrome or Patau's syndrome". That unexpected phone call from a stranger can change your life in a moment. Your brain scrambles to make sense of what you are hearing, to understand, to "un-hear" and deny that this news applies  to you. For many years I was the midwife who made those phone calls. Every time I received a "higher chance" result from the laboratory I would hold that result in my hands recognising the...

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Choices in maternity care

Choices in maternity care

Most of my long term work with families is when there are major issues of concern or a history of pregnancy difficulties, but I love working with families for whom things are going well. This is often short term, often a single consultation. My role with these clients is to provide information and discuss choices in maternity care. They often also appreciate me showing them how I work out their baby's position, listening to baby's heartbeat and explaining what antenatal screening tests and...

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Having a child with Down’s syndrome

Having a child with Down’s syndrome

In the UK, part of the routine antenatal care is the offer of a screening test for Down's syndrome. What would having a child with Down's syndrome mean? Why might you want to know? If the test is offered, does that mean that it is an awful thing for you baby to be affected by? Oh - did you say it is a choice whether to have the test? Questions and assumptions So many questions, and so many assumptions. In the many years I worked as a midwife in the NHS, I think it is fair to say that the...

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Angie Bowles, specialist midwife supporting choice. Reach out for help or advice today. Angie reads and replies to every one.