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NI women ‘discriminated against’ as not offered early pregnancy screening
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NI women ‘discriminated against’ as not offered early pregnancy screening

Getty Images Picture of fetal scanning machine in hospitalGetty Images

Scans at weeks 11 to 13 are not routinely offered in Northern Ireland.

Pregnant women in Northern Ireland are being discriminated against due to a lack of early screening for fetal abnormalities, gynecologists say.

Early screenings are routine in the rest of the UK.

Many patients contacted by BBC News NI described their trauma after their “unviable” pregnancies were not detected until around 20 weeks.

In Scotland, Wales and England, prenatal screening, which tests for abnormalities, is offered to all pregnant women in the first trimester (between 11 and 13 weeks).

The Royal College of Obstetricians and Gynecologists (RCOG) has said women in Northern Ireland are being diagnosed with fetal abnormalities “too late” and should not have to wait until their 20-week scan.

‘An unthinkable choice’

One couple said they chose to terminate the pregnancy after the fetus was diagnosed with several anomalies during the 20-week scan.

In fact, the woman was more than 21 weeks pregnant by the time she was treated.

The couple, who wanted their identities protected, said it was “such a lonely time that they didn’t wish it on anyone else.”

Sarah (not her real name) said her family and friends believed she had miscarried at 20 weeks.

“We were afraid to tell our family and friends about the terrible situation we were in and the impossible choice we had to make for fear of being judged.

“Choosing to terminate a much-wanted pregnancy is a terrible situation to be in and an unthinkable choice, no matter how far along you are.

“We believe that if we had been in a position to do this early in the pregnancy, it would have been much less traumatic, both emotionally and physically.”

He added that terminating a pregnancy leads to “mental torture that babies born in the second trimester can and do survive.”

‘Sleepwalking into a situation’

Another woman, Emily, not her real name, said it was “devastating” to have known about her baby’s “fatal anomaly” beforehand.

“The lack of a scan meant we were allowed to believe everything was fine and sleepwalk into a situation where it was obvious to everyone around me that I was pregnant,” she said.

“We only learned a year after our loss that there was a discrepancy between care in Northern Ireland and mainland UK care,” Emily said.

At 21 weeks pregnant, Emily said the only option available was to be medically induced into labor to terminate a non-viable pregnancy.

“As someone who had never given birth before, these conditions were traumatic, painful and frightening.”

He added: “Being given no option other than birth at 21 weeks is a completely different proposition to being given the sad news with options at 12 weeks.”

‘Physical and mental health’

Dr Caitiona Monaghan has long brown hair and is standing in front of a green plant and a brick wall, wearing a black turtleneck sweater and a black jacket

Late diagnosis affects how women manage pregnancy, says Dr Caitiona Monaghan

A new framework for abortion services in Northern Ireland, prepared by the Northern Ireland Office, came into force in March 2020.

This also means that there is no time limit for termination when there is a “substantial risk” that the fetus will suffer a serious mental or physical impairment.

The RCOG has called for earlier screenings, while some health officials argue women in Northern Ireland are being “discriminated against”.

Consultant in maternal fetal medicine and ROCG member Dr. Caitiona Monaghan said late diagnosis at the 20-week “big scan” affected how women managed their pregnancies.

“It restricts access to care, including palliative care; It limits the decisions they can make and puts them under time pressure to make decisions at a later stage in their pregnancy,” Dr Monaghan said.

“It also affects a woman’s physical and mental health.”

Dr Fiona Bloomer has short strawberry blonde hair and wears framed glasses with a turtle design - she also wears a dark jacket and an abstract patterned top (in yellow, red, blue and green)

Dr Fiona Bloomer says there’s still too much stigma around abortion in NI

Dr. from Ulster University. Fiona Bloomer said there was still a lot of stigma around abortion in Northern Ireland, preventing couples and families from speaking openly about their experiences.

Participating in academic research on fetal abnormalities, Dr. The main hurdle is financing early screening, Bloomer said.

“I hope the Department of Health will take a stand, I think they will see the need for earlier screening – the problem will be when they allocate the budget to that,” he said.

The Department of Health confirmed that official guidance in Northern Ireland means that scans to detect abnormalities are only carried out in the second trimester.

The ministry said work was “ongoing” on how and for how long recommendations should be made available on “first trimester prenatal screening for fetal anomalies and hereditary conditions.”

He added that once the information has been collected it will be considered by the Northern Ireland Screening Committee before future policy decisions are made.