For generations, the standard question you got as a pregnant woman was "when's it due?". But no longer. "Do you know whether it's a boy or a girl?" is what I'm most frequently asked when someone spies my bump. When I say I've no way of knowing because I'm not having any antenatal tests - no, not even ultrasound scans - people are generally flabbergasted. Isn't ultrasound a routine part of antenatal care in this day and age? Doesn't everyone have to have a scan?
The answer is no, and no again. Antenatal screening is now universally offered in the UK, in one form or another, and it's true that the vast majority of pregnant women take up the offer of at least one scan. But it certainly isn't - or shouldn't be presented as - something you've no choice about. Ultrasound scanning, although it might be terribly moving and hugely involving for the parents-to- be, certainly isn't about giving you a pretty take-home picture for the family album, still less to help with the bonding process. The hard truth about ultrasound tests is that they're there to screen or diagnose problems or potential problems in the baby-to-be. Which is why if, like me, you'd rather not know if your baby has anything wrong with it until the day of the birth, you're best off declining politely when you're offered a scan or a blood test.
The trouble is that more and more pregnant women and their partners seem to overlook the strings attached to screening tests in general, and ultrasound scans in particular. The flip side of that is that they can be horrified when they're told there is, or might be, a problem. Women such as Sue Carter (not her real name) who with her partner James was looking forward to her "routine" antenatal scan and was shocked to be told it showed she had an "above average" risk of the baby having Down's syndrome. The scan she had, at 11 weeks, was in fact a special screening scan called a nuchal fold scan in which a "marker" for Down's involving a fluid sac at the back of the embryo's neck is looked at in detail. The trouble is that Sue hadn't taken in what the scan was actually checking for - she just thought it was something everyone went along to, so went along too.
Sue hadn't given the consequences of her scan a second thought - suddenly, she was thrown into the turmoil of having to decide whether to live with the question mark that had been placed over her baby's condition, or to opt for a conclusive test - an amniocentesis - which carried a small risk of miscarriage. "I decided I couldn't live with the uncertainty in the end, and we went ahead with the amnio," she says. "The results took two weeks to come through, and it was hell. By that stage I was just starting to feel the baby move, and to be honest I thought I'd never be able to go through with a termination."
The news was good - the baby hadn't got Down's. But Sue resents the fact that her pregnancy was put "on hold" for several weeks, and that she had to live with the uncertainty. In another pregnancy, she says, she'll think very carefully about whether to have a nuchal fold scan or not.
Unfortunately, though, it's usually only women like Sue who've been on the sharp end of antenatal testing who give it a lot of thought before they turn up at the hospital on the appointed day. In fact in at least one area of the UK the nuchal fold scan is now a pregnant woman's very first contact with the maternity services - antenatal care kicks off with a letter suggesting a date and time for the scan, after which the woman gets her first appointment with a midwife. With the letter comes a brief outline of what the scan involves, but clearly it's being presented as routine - and clearly if you turn the scan down, you'll be "stepping out of line" with what's considered "normal".
Linda Thompson of the group Antenatal Results and Choices, which offers telephone support and counselling to …