Access to Prenatal Testing and Ethically Informed Counselling in Germany, Poland and Russia.

Marcin Orzechowski,Alexandr Zinovievich Lichtshangof,Florian Steger,Galina Lvovna Mikirtichan,Cristian Timmermann,Katarzyna Woniak,Oxana Kosenko

doi:10.3390/jpm11090937

Abstract

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. Visible in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level.

Highlights

The development of reproductive technologies allows us to reduce risks related to late-term births, expanding reproductive choices
Interviews focused on three themes: (i) attitudes on current legal regulation of prenatal diagnostics in the country; (ii) views on issues of patient information and access to adequate counselling in prenatal diagnostics; (iii) opinions on access to novel methods of prenatal testing and use of prenatal diagnostics
They rather arise from structural factors such as imprecise and prohibitive regulations, political and social pressure on patients and physicians, lack of resources or deficient organization of healthcare services

Summary

Introduction

The development of reproductive technologies allows us to reduce risks related to late-term births, expanding reproductive choices. Giving birth to the first child at a later age is a worldwide trend. According to the statistics for 2019, women’s mean age for their first child is 31.2 years for Germany, 29.7 years for Poland [1] and 27 years for Russia [2]. Due to changes in the labor market and insufficient regulations to accommodate a balance between work and family life, there is an increasing percentage of women who have children at an older age [3]. This carries additional considerations that need to be evaluated for both the expectant mother and the fetus [4]. Care activities disproportionally burden women and may oblige them to abandon their careers, hindering progress in achieving equality of opportunities [5]

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