Are screening tests important? I feel healthy, so do I have to do it?
You don't have to do anything you're not comfortable with but your health care provider should at least explain what the test is for, so you can decide if it's right for you or not. A screening test often screens a generally healthy population of people to find those who are unaware that they have a concern. For example, your healthcare provider might recommend a urine test in early pregnancy, not to check that you're pregnant but because when you're pregnant you can have a urinary tract infection without realising it (no symptoms). If this is undiagnosed and untreated it can lead to implications for both you and the baby, including premature labour. So it's relatively easy to do a urine test for everyone to find the few who have an infection and would benefit from treatment.
The benefits of a screening test should outweigh the potential harm of the test. It should improve the outcome of the population targeted, increase choice and provide reassurance. This should be weighed up against the anxiety of false positives, potential errors, missed cases, or unwanted incidental information. Getting information about a test's purpose and accuracy is a component of informed consent. Informed consent is about having the information you need to make the decision that's right for you; not being surprised by the information, after the event, that may have played a part in your decision-making had you known.
If a screening test returns a positive result or is inconclusive, a further test may be needed to diagnose if it is really a problem for you.
In the earlier example of a urine test, the screening test can also be a diagnostic test. That is, we recommend screening for the pregnant population (regardless of whether they have symptoms or not) and if the result is positive, it diagnoses an infection in the same test and can state the antibiotics the organism is sensitive to, and allow appropriate treatment.
If you have questions about the tests recommended for you, discuss your concerns with your midwife or care provider.
As with everyday life, it's important to get healthcare information prior to testing/procedures so you are making an informed choice. After all, your healthcare professional might be a specialist in a certain area, but you are the specialist of you and your baby. They may have a medical opinion about what is right for you, but only you can say if it is right for you.
But, how do you know what you don't know?! Ask questions! Use the acronym B.R.A.I.N. to generate fact-seeking conversation. B. benefits- what are the advantages of this thing? R. risks- are there any risks ínvolved or disadvantages? A. alternatives- are there any other options or different paths?↪ I. intuition/instinct- what is your gut saying is right for you? N. nothing- what happens if we do nothing, can I wait? for how long?
It's also good to ask what costs, if any, are involved.
Want more information? Head to Hello Baby Midwifery or come and visit the SA Privately Practising Midwives stand in Adelaide!