Midwives and screening for haemoglobin disorders.

Abstract

This chapter raises the issue of ethnicity in relation to selective screening for haemoglobin disorders such as sickle cell and beta-thalassaemia. The chapter begins with a description of sickle cell and thalassaemia, outlines some background to issues surrounding selective ante-natal screening for haemoglobin disorders, and reports on the problematic nature of ethnic categories apparently in use in effecting such selectivity. The chapter then examines possible pragmatic strategies available to health care workers, including taking cues about ethnicity of clients from skin colour, names, geographical origins, unspecified combinations of these three, from an imposition of the U.K. Census categories, or by asking the client. Each in turn is felt to present certain problems with regard to the haemoglobin disorders. A number of strategies are proposed. One is to document the social encounter whereby ethnic categorization is socially constructed by health care workers. Others include combining asking for clients' self-defined ethnicity in tandem with an open explanation of the haemoglobin disorder-specific reason for which the information is being sought.