Prenatal paradox: an integrative review of women’s experiences with prenatal screening for fetal aneuploidy and neural tube defects

Abstract

Background: As prenatal screening for fetal aneuploidy and neural tube defects evolves technologically and becomes increasingly utilized worldwide, an evaluation of the available evidence on women’s experiences with prenatal screening is warranted.Aims: To conduct an integrative review to enhance understanding of women’s experiences with prenatal screening for fetal aneuploidy and neural tube defects.Design: Systematic literature searches from January 2005 through January 2016, using the CINAHL, PubMed, and PsychInfo electronic databases and ancestry searches of included studies were performed to identify previously published, peer-reviewed quantitative and qualitative studies.Review methods: The integrative review method as proposed by Whittemore and Knafl was selected.Results: Thirty-nine studies were included in the review. The literature reveals that prenatal screening occurs in a complex social, ethical, and political reality. A theme of paradox emerged indicating the incongruity between reported and perceived risk, the tension between informational utility and moral decisions concerning pregnancy management, and the pervasive influences of authoritative and experiential knowledge.Conclusion: There is a need for future inquiry to critically examine the interrelationships of individual, biomedical, ethical, and sociopolitical factors surrounding prenatal screening.