In reply: The aim of our article was to assess trends in Down syndrome births by rurality and type of antenatal care provider.1 Whether to have prenatal screening is a decision for expectant parents. It has been argued that the availability of screening for Down syndrome means that expectant parents are confronted with unprecedented ethical dilemmas and responsibilities.2 However, the available evidence shows that expectant parents do not take decisions about Down syndrome screening lightly and, in particular, do not take the implications of a positive result lightly.3
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- Epidemiology Services Unit, Queensland Health, Brisbane, QLD.
- 1. Coory MD, Roselli T, Carroll HJ. Antenatal care implications of population-based trends in Down syndrome birth rates by rurality and antenatal care provider, Queensland, 1990–2004. Med J Aust 2007 186: 230-234. <MJA full text>
- 2. Getz L, Kirkengen A. Ultrasound screening in pregnancy. Advancing technology, soft markers for fetal chromosomal aberrations, and unacknowledged ethical dilemmas. Soc Sci Med 2003; 56: 2045-2057.
- 3. Williams C, Sandall J, Lewando-Hundt G, et al. Women as moral pioneers? Experiences of first trimester antenatal screening. Soc Sci Med 2005; 61: 1983-1992.
- 4. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Prenatal screening tests for trisomy 21 (Down syndrome), trisomy 18 (Edward syndrome) and neural tube defects. Melbourne: RANZCOG, 2007.