title: Prenatal screening for Down syndrome: a dilemma for the unsupported midwife?
abstract: OBJECTIVE
  To explore the personal and professional concerns of midwives in relation to their experiences with women undergoing serum screening for Down syndrome.
  
  
  METHODS
  Semi-structured interviews.
  
  
  METHODS
  A consultant-led maternity unit in the south of England.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  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.
authors.affiliation: School of Health Studies, University of Portsmouth, UK. isobel.ryder@port.ac.uk
authors.forename: I H
authors.initials: IH
authors.lastname: Ryder
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis*; D004509:Education, Nursing, Continuing; D004739:England; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D020380:Needs Assessment; D009721:Nurse Midwives / Q000193:education* / Q000523:psychology*; D015404:Nursing Methodology Research; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D012647:Self-Assessment; D012944:Social Support; D011795:Surveys and Questionnaires