Asking for a prenatal diagnosis after the birth of a child with Down's syndrome.

Three years ago we undertook, in collaboration with André and Joëlle Boue (Inserm U 73), a research project investigating the psychological aspects of prenatal diagnosis following the earlier birth (and sometimes death) of a child with Down's syndrome. For this study we selected 20 couples who had requested such an examination. These couples present some particularities which justified, in our opinion, a specific study. In a few cases, one of the parents happened to be a carrier of a balanced chromosome translocation, but usually the trisomy was free. Moreover, the mother's age did not increase the risk factor. Our investigation was carried out on the basis of a series of one or several interviews, the man and the woman being seen separately. These unstructured interviews, with the fewest possible questions and interventions on our part, were tape-recorded with the permission of our subjects. We then analyzed the precise content of the typed texts of the these interviews. Two main topics emerged from this analysis: 1) The extreme impact of the birth of a child with Down's syndrome and the place and role of such a child in the family's life, and 2) The relationship between the parents and physician before and after the birth, including the request for a prenatal diagnosis.