Paper short abstract:

For some pregnant couples, the routine screening for Downs Syndrome takes a disruptive turn when they receive a 'high-risk' result. The expected normal pregnancy is questioned. This paper will discuss how professionals and couples negotiate and make sense of this disruption.

Paper long abstract:

In Denmark, ultrasound screening for Down's syndrome is widely perceived as an - often enjoyable - routine pregnancy examination. For app. 5 % of all pregnant couples, this routine takes a disruptive turn when they receive a test result in the 'high-risk' end. They are subsequently offered invasive diagnostic testing (CVS) which involves a risk of miscarriage. Achieving certainty (of normal chromosomes) therefore involves a risk (of miscarriage). The majority decides to take the CVS and in most cases, the CVS will show normal chromosomes. Being categorized as high-risk calls into question the expected normal pregnancy and the imagined future parenthood. It generates anxiety, uncertainty and sadness. Based on 4 months of fieldwork at an obstetric ultrasound clinic and in-dept interviews with health-care professionals and 'high-risk' couples, this paper will show how professionals and couples negotiate and make sense of this disruption. Preliminary analyses indicate how doctors and sonographers work to frame the high-risk category and the CVS as a serious and uncertain situation, but also one of hope. Through their interaction with high-risk couples, doctors and sonographers negotiate, explain, tone down and elaborate on information in order to make the situation manageable for the couples. Couples use medical information and personal experience to negotiate and make sense of a process characterised by waiting and hoping. However, obtaining medical certainty - normal chromosomes - does not necessarily re-establish the couples' trust in normal pregnancy and future parenthood. This paper will reflect on how the 'high-risk' category generates uncertainties to which there are no medical answers.