The birth of a child with Down's syndrome need not have been "a period of obscurity" for parents if more emotional and practical support had been available, according to a new study.

The study highlights the difficulties, and sometimes the inadequacies, of doctors in breaking the news to parents that their newborn has this condition.

Presented to the Prime Minister earlier this month, the report, called A Baby First, delved into the reflections of parents on the way the diagnosis of their child's condition was delivered to them.

Conducted by Eden Foundation's Parent and Child Educational Services, the study involved questionnaires to 80 families; 25 were returned.

Recommendations were drawn up, based on parents' views, to improve the communication between professionals and parents and attempt to make the experience less traumatic.

The average age of female respondents was 36.1 at the time the child was born. The study also pointed out that there were just two children born to respondents in a local private hospital, the rest were delivered at a state hospital.

A great majority of parents said they were satisfied with the timing of the deliverance of the news, though one parent said the news was delivered 24 hours after the birth. Another even said she was given the news over the phone, and she received the report and the bill by post.

In spite of the fact that there was an increased use of prenatal testing in many countries, the majority of parents who have children with Down's syndrome did not learn of the diagnosis until after their child was born.

This news can challenge even the most experienced health professionals, while receiving it was very alarming to the otherwise happy new parents.

According to the Chicago National Association for Down's Syndrome, the probability of a baby being born with this condition is of one out of 800 live births. The Maltese study showed that most parents, with the exception of three, felt the doctors had dedicated enough time with them to discuss matter.

However, when they were asked about the sensitivity of the situation, responses varied - while some were caring and very careful how to deliver the news, others were cold and insensitive.

Inappropriate language - such as: "It is like you have a piece of lard wrapped in paper", "You have a mongol", "What are you going to do with it now?" and "Prepare your pockets to fork out money" - was used by some hospital staff when the baby was born and in the presence of the parents.

Some parents also complained that when they posed questions, the answers they got were full of technical words and clinical details, which made it hard to understand.

On the contrary, parents felt the outpatient services were very thoughtful and considerate. Parents also felt that in general they were not provided with enough, or adequate up-to-date printed information or contact details about where to seek educational material, networking and emotional support.

Most reported that they had to seek help on their own after they took their baby home.

The mothers who took part in the study rarely described the birth of their child with Down's as a positive experience. They were frightened and anxious on receiving the diagnosis, and frustrated at their physicians and other staff for failing to talk about the positive aspects of the disability.

Many mothers said that medical staff talked mainly about the negative aspects of the condition, such as medical complications and cognitive difficulties.

They were also frustrated to see nurses pass silent comments among themselves in their presence before they were told of the diagnosis, making them realise that something was wrong but not knowing what.

Among the most salient recommendations by parents, was that the news of the diagnosis should be delivered when both parents were present, whenever possible.

More often than not hospital staff tended to break the news to the father first, burdening him with the responsibility of telling his partner.

Parents felt this was unfair and inappropriate since it put the father in a very unpleasant role. If the presence of both parents was not possible, then medical staff should ensure that a family member, friend or staff member who had a good relationship with the mother be on hand to offer support.

Whenever possible, parents preferred the option of being alone after the birth, in order to receive the news and live the emotions of the experience together and in private. Unknown staff and other people such as medical students and other doctors should not be present.

The report recommended that when breaking the news to parents they should provide an uncomplicated explanation and steer clear of offensive language.

Furthermore, parents wanted to hear more about the positive possibilities and realities for people with Down's today and what they could achieve.

"Being introduced to your child as a list of medical, behavioural and social problems definitely does not provide any form of solid support for the parents," the study said.

It recognised that delivering the diagnosis well could be challenging even to the most practised medical professionals. But being adequately trained in psychological matters could help.

"Parents must be encouraged to enjoy the 'baby days' and to see light in their path as parents of a child whose talents and personality are unique.

They must look at their child as a baby first who will, as he or she grows older, still be able to lead a full, meaningful and worthwhile life," the study concludes.