ANXIETY AND ATTACHMENT OF WOMEN AT THE TIME OF ROUTINE SCREENING FOR FETAL ABNORMALITY: AN EXPLORATORY STUDY.
Within the political culture of the late twentieth century childbirth has become a business, a medicalised event that must be managed and made economically viable. The need for the new N.H.S. to be prudent and to eliminate long term public health expenditure has been covertly demonstrated in the national maternal serum screening programme for fetal abnormality, specifically Neural Tube Defect (N.T.D.) and Downs Syndrome.
Antenatal anomaly screening allows the diagnosis and selective abortion of those fetuses identified as suffering serious congenital malformation. However, not all types of congenital malformation are aborted, the selection criteria appear to include only those fetuses who are either not compatible with life or whose disability would result in possible mental incapacity and probable life-long dependency.
In Western utilitarian society, women are being insidiously coerced to participate within these programmes. Far from being beneficial, these screening testsand the potential loss of a much-wanted child may result in women suffering psychological harm.
Pregnancy, once perceived as a time to luxuriate in the fulfilment of womanhood and the nurturing of a growing life, has become within modern society a time of stress, anxiety and unwanted decision making. It is further suggested that anxieties relating to the viability of the fetus intrinsically affect the maternal-fetal attachment process.
As the result of concern for the wellbeing of women, a research study was conducted with a two-fold aim: -
The primary aim was to investigate whether maternal serum screening causes maternal anxiety and affects maternal-fetal attachment.
The secondary aim was to investigate whether maternal-fetal attachment was progressive in nature, in order to measure whether attachment scores were lowered during screening.
The results of the study showed no significant increase in cases of anxiety, although over one third of the women scored above the designated threshold for anxiety. A significant correlation was found between anxiety and lowered levels in the quality of attachment. Maternal-fetal attachment was found to be progressive in nature, with no significant lowering of attachment scores at the time of screening.
The results of the study demonstrated a divergence in time and quality of attachment. These categories are implicit within Condon's Maternal Fetal Attachment Score (1993) -- "time" reflecting behaviours indicative of attachment and "quality" reflecting the woman's subjective emotions towards the fetus. "Time" was unaffected; in a pro-natalist society where it would be considered deviant to engage in any activity that may be detrimental to fetal wellbeing this may be expected. However emotional investment is intangible and cannot be observed, so that a woman is able surreptitiously to withdraw, an attempt perhaps to limit the grief that must result if the fetus has to be aborted.The study raised many issues, including: -
Differences in responses to the questions relating to their pregnancy in primigravid and multigravid women -- challenging the tool used.
The nature of maternal-fetal attachment and whether it is possible arbitrarily to separate behaviour and emotion.
The wide range of anxiety scores within the participants, and possible causes of this.
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