This study investigates attributions and reported communication in 97 neonatologists who responded to a vignette-based questionnaire depicting a woman with 1 of 3 prenatal screening histories for Down syndrome (DS) who had just given birth to a child with DS: not offered screening, refused screening, or received a false negative result on screening. Neonatologists reported blaming and attributing more control to women who refused prenatal screening for DS. Attributions of blame, but not control, were associated with reports of communicating more negative information on DS to parents. Neonatologists may make attributions about women on the basis of their screening histories, which appear to influence some but not all aspects of how they report communicating a diagnosis of DS.