ABSTRACT
This chapter shows how the practices through which Down's syndrome screening is organised contribute to it being 'downgraded'. It defines downgrading as practices which denigrate and minimise the importance, value, and reputation of someone or something. The chapter shows how screening is routinised and downgraded as a trivial, non-prioritised task in the organisation of clinical life in three interrelated ways. In Freymarsh, Down's syndrome screening is located, for the most part, in the antenatal department (FAD). In Freymarsh and Springtown, consultants' involvement in Down's syndrome screening is mostly limited to performing subsequent diagnostic tests (amniocentesis/CVS) and managing parents-to-be with previous pregnancy complications. The specific roles, or temporal identities, of a couch and specialist clinic midwife, among others, are displayed on a whiteboard in FAD. In Springtown, the notion that screening consultations can be done 'on a whim' is essentially impossible since only one sonographer works a shift.
