Chances and choices. Psycho-social consequences of maternal serum screening. A report from The Netherlands

Abstract

The increasing potential of prenatal diagnosis and screening implies that more fetuses with abnormalities can be detected. Maternal serum screening offers women the possibility of assessing the chance of having a baby with a neural tube defect or Down's syndrome, but the very existence of this screening also creates new responsibilities; more people are confronted with risks and decisions to be taken. How do women experience this screening, how does the screening affect them, how do they interpret the results, and what consequences do they consider the results to have? These were the central questions in our study in which 280 women participated. We interviewed 20 of the women who, by means of the serum screening, had been identified as a high-risk group. We sent a questionnaire to 200 women who, under current regulations, were not eligible for prenatal diagnosis, and another to 200 women who were eligible, and in fact had a prenatal diagnostic test. Many women are in favour of the possibility of serum screening and would apply for this test in case of a future pregnancy. However, motives behind supply and demand do not always correspond. Dealing with the risk assessment results proves to be very difficult for the women concerned. Many women who are eligible for prenatal diagnosis welcome serum screening as an extra but do not intend to decline diagnostic tests if the screening results do not indicate an increased risk.