Midwives' Knowledge of the α-Fetoprotein Test

Abstract

In a survey of antenatal clinics which offer the α-fetoprotein (AFP) test and together deal with approximately 25% of the births in Sweden, midwives were asked about their knowledge of prenatal screening using AFP. Between 50 and 60% correctly answered the basic questions necessary for giving information to pregnant women. Between 24 and 46% gave evidence of a deeper understanding of AFP bio-dynamics. With regard to the attained level of knowledge, the greater experience of older midwives does not seem to compensate for specialised training which is more often present in younger midwives. Opinion on whether or not AFP screening should continue, was not generally based on knowledge but depended on 3 other influential factors: the disquieting effect of the test (on pregnant women), the problems of the test procedure, and the ethical views of the midwives. The results emphasize the need for specialized training of midwives to increase their knowledge of the test and to make them more aware of their own attitudes. The results stress the importance of admitting ignorance rather than trying to conceal it by guessing. There is a complicated picture of relationships between attitudes, knowledge and ethical values of the midwives responsible for information in an AFP screening procedure. These results give some indications for a rational improvement in this part of the screening.