How to Deliver the News?

Pregnant women

Parents prefer to know the results
of prenatal testing early; © SXC

A research team found that in a 2004 survey approximately 45 percent of obstetric fellows rated their training as "barely adequate or nonexistent"; a similar survey four years later found little change. In 2005 a survey of 2,500 medical students showed that 81 percent believed they were "not getting any clinical training regarding individuals with intellectual disabilities."

To improve this scenario the team set out to answer critical questions which physicians should consider before delivering a diagnosis: The team reviewed research ranging from 1960 to present day and found that while many sources are available, expectant couples prefer to receive the news from the health care professional with the most knowledge, the physician.

Also, women who decided to undergo definitive prenatal testing for DS prefer to receive the diagnosis as soon as possible in the company of their husbands or partner, while women who had arranged for the diagnosis to be delivered by a phone call were better prepared for the news then those who received the news from an unarranged call. Women who received the diagnosis through an unscheduled call expressed intense resentment towards their obstetricians and counsellors.

Regarding the amount of information a couple should be given, mothers emphasised that they should be provided with up-to-date information about DS, its causes and the expectations for a child living with DS today. Parents also found that they benefited from personal stories that demonstrate the potential and possibilities for children with DS and if possible contact information for other parents who have children with DS.

Instead of saying "I'm sorry" or "unfortunately I have some bad news," physicians should use neutral and nondirective language. Mothers emphasized that physicians should discuss all options available to them, including continuing the pregnancy, offering the baby up for adoption after birth, or pursuing termination.

The research review found that mothers who received the diagnosis prenatally and continued their pregnancy were happier with the birth of their child then those who received the diagnosis after the baby had been born. Receiving the diagnosis in advance seems to allow parents the needed time to overcome the shock and initial grief of the diagnosis and begin preparing and celebrating the upcoming birth of a child.

MEDICA.de; Source: Wiley-Blackwell