The Antenatal and Newborn (ANNB) screening team are available to support you during your pregnancy and after your baby is born with UK national screening programmes.
Your community midwife will discuss these screening programmes with you and will refer you for additional care and support from the screening team if needed. You and your baby will be offered some screening tests to check on the health of you, your developing baby and for conditions that may affect you or your baby.
The tests can help you make choices about further tests and care or treatment during your pregnancy or after your baby’s born. All screening tests offered by the NHS are free.
Why we perform screening
Antenatal and newborn screening tests are used to identify people who have a higher chance of experiencing a health problem. This means they can get earlier, potentially, more effective treatment, or make informed decisions about their health enabling them to potentially access effective treatment or make informed decisions about their health or that of their unborn baby.
Screening tests are not perfect and in some cases you may be told there is a potential high probability of a condition when in fact, this may not be the case. In addition, a few people will be told that they or their baby have a low chance of having a health problem when in fact they do.
Screening tests for you and your baby
Katie is expecting a baby. During her pregnancy, she’ll be offered several screening tests, to check for health conditions that could affect her, or her baby.
Katie can choose which tests, if any, she wants. During the first 10 weeks of her pregnancy she’s offered screening for sickle cell and thalassaemia.
These are blood conditions that can be passed from parents, to their children, through their genes. The baby’s father may also be offered a test. If both parents are carriers, it doesn’t mean they have the condition, but there’s a chance that they can pass it on to their baby.
Between 8 and 12 weeks of pregnancy, a midwife offers her a blood test for three infectious diseases: HIV, Hepatitis B and syphilis. She can choose which, if any, of these to be tested for. Screening for these three infections is best done in early pregnancy, but they can be offered at any time.
If Katie has diabetes, she’ll be offered eye screening during her pregnancy. At some point between 10 and 14 weeks of pregnancy, Katie is offered the combined test.
This is an ultrasound scan and blood test, looking for down’s syndrome, edward’s syndrome and patau’s syndrome. If the combined test cannot be done, she can have the quadruple test up to 20 weeks of pregnancy. This looks for down’s syndrome only.
Between 18 and 21 weeks of her pregnancy, Katie is offered another ultrasound scan called the 20 week scan. It looks for 11 physical conditions in her baby, for example, relating to the bones, heart and brain.
Towards the end of her pregnancy, a midwife will discuss the screening offered for her newborn baby, so she knows what to expect.
Katie’s offered a physical examination for Thomas, within three days of him being born. This screens for conditions affecting his heart, eyes and hips. As he’s a boy, his testicles will be checked too. A hearing test will also be offered.
Depending where they live, this may be in the hospital, or at home. When Thomas is five days old a midwife will offer the blood spot test. Also known as the heel prick test. This involves taking a few drops of blood from the heel.
It screens for 9 rare, but serious conditions, such as cystic fibrosis.
Remember, screening is always a choice. You can decide which tests, if any, are right for you and your baby.
For more information or support, speak to a midwife or doctor.
Screening tests used during pregnancy
We offer several screening programmes for you and your baby:
screening for infectious diseases (hepatitis B, HIV and syphilis)
screening for inherited conditions (sickle cell, thalassaemia and other haemoglobin disorders)
screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome
screening for 11 physical conditions (20-week scan)
Some screening tests will also be offered to your baby after they’re born:
If any of your screening tests require further investigation you will be contacted by the Screening Coordinator to discuss these further.
Screening booklet and video resource
To help you make informed decisions about screening, all your options are explained more fully in the following booklets from GOV.UK:
What screening tests are used in pregnancy?
The screening tests offered during pregnancy in England are either ultrasound scans or blood tests, or a combination of both.
Ultrasound scans may detect conditions such as spina bifida.
Blood tests can show whether you have a higher chance of inherited conditions such as sickle cell anaemia and thalassaemia, and whether you have infections like HIV, hepatitis B or syphilis.
Blood tests combined with scans can help find out how likely it is that the baby has Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.
It is important to see your midwife early in pregnancy; who will offer you blood tests for:
- Sickle Cell Disease and Thalassaemia – inherited genetic conditions
- Infectious Diseases – Syphilis, Hepatitis B and HIV. Early detection helps treat mum and prevent transmission to the baby
If any of your screening blood tests require further investigation you will be contacted by the Screening Coordinator to discuss these further.
Ultrasound scans use sound waves to build a picture of your baby in the womb. You will be offered a scan that produces a two-dimensional (2D) black and white image
The scans are painless and have no known side effects to women or babies. For most people, having a pregnancy scan is a happy event. But please be aware that ultrasound scans can detect serious health problems so try to be prepared for that.
All pregnant women and people are offered a scan at around 12 weeks to accurately date the pregnancy; this is usually your first scan and confirm how many babies you are carrying.
The sonographer will use this scan to take measurements of your baby and estimate your baby’s due date (estimated date of delivery). It is the date from the scan that is used throughout your pregnancy, rather than going from your last period. You may choose to have first trimester screening for three chromosomal conditions, Down’s, Edwards’ and Patau’s Syndromes at the time of the dating scan and this will include a nuchal translucency (NT) measurement, which is part of the combined screening for Down’s syndrome, if you choose to have this screening.
Should your pregnancy be more advanced than 14+1 weeks but less than 20 weeks and you are unable to have this screen, you will be offered a Quadruple test for Down’s Syndrome.
Mid-pregnancy ultrasound scan
A mid-pregnancy scan forms part of the antenatal screening programme that we offer.
It usually takes place at around 20 weeks and the main purpose of this scan is to look for abnormalities as it checks for 11 physical conditions in your baby. You may have heard it being referred to as an anomaly scan.
During the scan, we take a careful look at your baby from head to toe. Usually, we learn that the baby appears to be healthy and is developing well.
However, sometimes we may find a problem. Some problems are quite common, and others are rare. A few of these problems are serious, but most are minor, and any problems identified will be explained in detail to you.
Scans have their limitations. Sometimes we have to say there might be a problem but cannot say for certain. In a small number of cases, babies are born with abnormalities, even though no problem was identified by the scan.
This scan is not designed to tell you the sex of your baby, but once all checks have been made the sonographer may be able to offer you the chance to find out if you are having a boy or a girl if requested. Please note this is not always possible and is not always 100% accurate.
NOTE – If you would like to purchase a print of your baby’s scan, simply let your sonographer know that you would like one as you can purchase images on the day for £4. We currently take cash or card payments.
Sexual health and wellbeing in pregnancy
The risk of acquiring HIV, hepatitis B and syphilis does not end with a negative antenatal screening result taken at your first booking appointment.
Did you know?
- 56.4% of babies born with congenital syphilis in the UK between 2015 and 2021 were born to women with a negative antenatal screening result, meaning they acquired syphilis during pregnancy after screening
- 62.3% of children with vertically (mother-to-child) acquired HIV between 2006 and 2021 were born to women diagnosed with HIV after pregnancy. The vast majority of women had a negative screening result in pregnancy, meaning they acquired HIV during the pregnancy or while breastfeeding
Rescreening is available
Re-screening can be offered at any point in your pregnancy if you have any of the following risk factors:
- A change of sexual partner
- If you or your partner(s) are sexually active with other people
- If your partner is diagnosed with a Sexually transmitted Infection
- Injecting recreational drugs
- Involvement in sex work
Please speak to your midwife or doctor if you can answer ‘yes’ to any of the above questions and our team can support a further screening appointment.
Frequently asked questions
What are the risks of a screening test?
Screening tests will not harm you or your baby, as far as we know the scans that we offer are safe for mother and baby. But there are some risks to consider. Some screening tests during pregnancy can lead to serious decisions for you.
For example, screening tests for Down’s syndrome comes with no risk, however if you are diagnosed with a high chance result, this can lead to difficult decisions about whether to have a diagnostic test that carries possible risk of miscarriage.
If the results of the diagnostic are positive, they can lead to a decision about whether you want to continue or end your pregnancy. Having further tests or termination will always be your decision, and health professionals will support you whatever you decide. You may want to think carefully about whether you want to have these screening tests or not.
When will I be offered screening?
Different screening tests will be offered at different times during pregnancy.
The screening test for sickle cell and thalassaemia should be offered by 10 weeks.
It’s recommended that screening blood tests for HIV, hepatitis B and syphilis should happen as early as possible in pregnancy too. This is so you can be offered specialist care and treatment to protect your health and reduce the chance of your baby getting infected if required. These blood tests should not be delayed until the first scan appointment.
You will be offered screening for Down’s syndrome around the time of your dating scan, which happens when you are around 11 to 14 weeks pregnant.
You will be offered screening for abnormalities at a mid-pregnancy scan when you are around 18 to 21 weeks pregnant.
Will screening tests give me a definite answer?
This depends what the screening tests are looking for.
Screening tests for HIV, hepatitis B and syphilis are very accurate, and will tell for certain whether you have these infections.
If the test is positive, you’ll be offered further tests and examinations by specialist doctors to find out the treatment you need.
Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome cannot say for certain whether your baby has the condition. It tells you if your baby has a lower or higher chance of having the condition.
If your baby has a higher chance of a condition, you’ll be offered another blood test known as Non-Invasive Pre-natal testing (NIPT) or a diagnostic test that gives a more definite “yes” or “no” answer Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome: NIPT – GOV.UK (www.gov.uk).
Screening tests for sickle cell and thalassaemia will tell you for certain whether you’re a carrier or have these conditions. They will not tell you whether or not your baby has the condition.
If you or the baby’s father is a carrier or has the condition, you’ll be offered diagnostic tests to find out if your baby is affected.
Do I have to have the screening tests?
No, you do not have to have the screening if you do not want to. It is a personal choice that only you can make, and it has to be the right decision for you and your family.
You can discuss each of the screening tests you are offered with your midwife or doctor before deciding. We will respect your choice.
Some of the screening tests you will be offered are recommended by the NHS, such as:
- Blood tests for infectious diseases
- Eye screening if you have pre-existing diabetes (not gestational diabetes)
- Newborn checks
This is because the results from these tests can help to make sure that you or your baby get urgent treatment for serious problems.
Before having any screening performed you will be asked to give consent before it is carried out, please make sure you understand – feel free to ask any questions.
By law, everyone working in, or on behalf of, the NHS must respect your privacy and keep all information about you safe.
The NHS Constitution sets out how the NHS should handle your records to protect your privacy.
In addition, there are laws in place to ensure confidentiality is maintained. Screening records are only shared with staff who need to see them.
Sometimes information is used for audit research purposes to improve screening outcomes and services. Information about this will be provided when you’re screened.
Some private companies also provide screening tests that you have to pay for. The NHS cannot guarantee the quality of private screening.
Find out more about private screening.
Antenatal and Newborn screening service
If you need to contact the specialist screening team they are available Monday to Friday between 9am and 5pm.
Please leave a voicemail if not answered and we will respond within 3 working days. Alternatively, you can email the team.
Email: [email protected]
Phone: 01642 624234
ARC is a national charity who help parents through antenatal screening and it’s consequences.
Contact offer advice, information and support for parents and carers with a disabled children aged from birth to 25, living in any part of the UK.
Antenatal pathway for higher risk pregnancy
This document explains the antenatal pathway for women deemed of higher risk in pregnancy:
What syphilis is and what increases risk of infection
Syphilis is an infection passed on through sexual contact. It can be passed from mother to baby during pregnancy.