Abstract
Objective We aimed to conduct an analysis of the associations between the information provision procedure of prenatal screening for Down’s syndrome and congenital anomalies and the intention to participate in prenatal screening (PS) of ethnicity groups and Dutch language proficiency groups. Design Using a prospective web-based registration form, we asked counselors (midwives, general practitioners, nurses and gynecologists) to report whether and how they offered information about PS to pregnant women. Duration The study was conducted from 2008 to 2010. Participants We collected data on the characteristics of the women who received an information offer about PS from counselors. Measurements Measures included socio-demographic and language proficiency level (LPL) characteristics, key elements of the provision procedure of PS, and intentional participation in PS. Findings The dataset represents 37% of the total population in the study area. Women with a non-native Dutch background and/or insufficient Dutch LPL received fewer information offers about PS, faced a reduced chance of receiving counseling, and showed lower intentional participation rates for PS. Key Conclusions Women with a non-native Dutch background and/or with an insufficient LPL are underserved in the Dutch PS program. These findings present evidence indicating that the fundamental principle of the Dutch Population Screening Act, namely, equal access to PS for all pregnant women, is not being realized. Implications for Practice Therefore, the study findings are important for national and international healthcare, policy makers and governmental professionals to allow ethnic and LPL-related differences in the provision and intentional uptake of PS.
Highlights
Since 2007, a nationwide prenatal screening program was introduced in the Netherlands
What does this study add? This study shows that pregnant women with a non-native Dutch background and/or with insufficient Dutch language proficiency (LPL) are underserved more often within the Dutch prenatal screening (PS) program
Several studies show that language barriers are a threat to the effective provision and actual use of health services, which is in line with the positive association between the demand for counseling for the combined test (CT) and the fetal anomaly scan (FAS) and Dutch language proficiency found in Information offer Counseling desired Information offer Counseling desired Counseling CT
Summary
Since 2007, a nationwide prenatal screening program was introduced in the Netherlands. The program is supported by a legislative framework (the Population Screening Act), providing standards for regional and nationwide coordination and quality assessment of prenatal screening (Health Council of the Netherlands 2007). The Screening Act calls for equal access to the program for all pregnant women. According to this act, pregnant women who indicate that they require information should be counseled on the first trimester combined test (CT) for Down’s syndrome and the second trimester fetal anomaly scan (FAS) for congenital anomalies (Health Council of the Netherlands 2007; Wald and Hackshaw 1997; Bricker et al 2000). For an overview of the Dutch prenatal screening program, see Fig. 1
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