Prenatal anomaly screening: Medical expert or counsellor: a plea for integration of life-questions

The availability in many countries of new prenatal anomaly screening methods, such as the non-invasiveprenatal test (NIPT), and the potential broadening of testing for genetic conditions, creates an ongoingdebate about the accompanying existential dilemmas at both societal level and for individual newparents. In many countries, the main goal of counselling for prenatal anomaly screening is to facilitate thereproductive decision-making process of future parents. Therefore, counsellors share information toenable a woman and her partner to think about the pros and cons of participating in screening, try toclarify possible moral dilemmas, and dwell on existential life questions. In line with the CanMEDSframework, healthcare professionals must combine the role of communicator (providing healtheducation) with that of professional (by recognising and responding to existential life questions whilefacilitating decision-making). This is not easy but it is essential for providing balanced counselling. Atpresent, counselling tends to be sufficient regarding health education, whereas guidance in decision-making, including attention for existential life questions and philosophy of life, offers room forimprovement. In this paper, we suggest slowing down and turning the traditional prenatal counsellingencounter upside down by starting as a counselling professional instead of a healthcare informationsharing communicator and thus making the story of the woman and her partner, within their societalcontext, the starting point and the basis of the counselling encounter.