Uptake of a Prenatal Screening Test: The Role of Healthcare Professionals??? Attitudes Towards the Test

Abstract

Healthcare professionals generally feel positive about prenatal screening for Down syndrome, but obstetricians reportedly are more positive than midwives. This study examined the association, if any, between professional attitudes and screening uptake. Attitudinal studies were carried out on 71 midwives and 18 obstetricians at 2 hospitals in the United Kingdom with very different uptake rates of Down syndrome screening: 26% and 61%. Attitudes were assessed using a scale designed to study midwives' attitudes toward prenatal HIV testing. Screening uptake rates were estimated from laboratory records. In general, healthcare professionals expressed positive attitudes toward Down syndrome screening. Professionals from the hospital with the higher uptake had more positive attitudes than those from the lower-uptake hospital. When data from both hospitals were pooled, obstetricians were found to have more positive attitudes toward screening than did midwives. Uptake rates for 70 healthcare professionals who had offered screening to 10 or more women ranged from 15% to 89%. Attitudes did not correlate significantly with screening uptake in women who had discussed screening with a single healthcare professional. An association between healthcare professionals' attitudes toward Down syndrome screening and uptake rates by hospitals leads to the question of whether professionals' attitudes might affect women's behavior through existing systems of care rather than by influencing only communication between individual professionals and the pregnant women who consult them.