Letter: Obstetricians, mothers and Down's syndrome babies

Sir: It is interesting that Michelle Huberman's action ('Doctors criticise 'patchy' use of Down's baby test' and 'The right to a perfect baby', 24 August) should be against a private obstetrician rather than the NHS.

The Maternity Alliance is used to women asking why the Bart's triple test has not been offered to them and usually we have had to refer them to the private sector. In this case, however, the issue does not seem to have been unavailability but rather that Ms Huberman's obstetrician appears to have made her choices for her. Few people will be surprised at this as doctors do it all the time.

The Parliamentary Select Committee on Health, at the end of its exhaustive inquiry into the maternity services, concluded that:

many women at present feel that they are denied access to information in the antenatal period which would enable them to make truly informed choices about their care . . . Too often they experience an unwillingness on the part of the professionals to treat them as equal partners in making decisions about the birth of their child.

Antenatal testing is only one area in which it is vital that proper counselling is offered both before and after any procedure.

In your editorial you cite the US experience of 'defensive medicine' leading to unnecessary interventions in order to protect doctors and nurses from litigation. The British context is different and the threat of increasing 'defensive medicine' should not be used to suppress legitimate complaints from those who have received substandard treatment.

If women could believe that they would be adequately informed about the risks and benefits involved in their care and that, should things go wrong, the circumstances would be promptly, openly and fully investigated with medical staff held properly accountable, we believe few would resort to distressing litigation.

Yours faithfully,

MEG GOODMAN

The Maternity Alliance

London, WC1

25 August