Abstract
ObjectiveTo study women’s apprehensions, understanding and experiences of counselling concerning a screen-positive result in screening for fetal chromosomal defects.MethodsA questionnaire study including different steps of the prenatal screening process was carried out in Helsinki University Hospital. Women’s experiences concerning counselling immediately after a screen-positive result and during further examinations in the Fetal Medicine Unit (FMU) were analyzed.Results143 women filled in the questionnaire. Less than half of the women considered the primary counselling after a screen-positive result to be explicit (43.9%) and sufficient (43.1%). In the FMU, 88.3% and 89.8% of women were satisfied with the explicitness and sufficiency of counselling. Most women (75%) experienced worry before further examinations but less than half (45%) had considered their personal values concerning diagnostic tests. Half (50.5%) of women expected the worry to continue even if diagnostic tests turn out normal. Most (81%) women were aware that diagnostic tests are voluntary and were confident (85.3%) with their decision to participate.ConclusionsAfter a screen-positive result, women have unanswered questions, experience anxiety and confusion. The possibility of an abnormal screening result is not seriously considered beforehand. To enable an informed consent for prenatal screening, improvements in prescreening counselling during the first visits of antenatal care need to be made.
Highlights
Prenatal screening is part of the public health care system in Finland and available to everyone
In this study we focused on women who received a screen-positive result at any point of the screening process
In cases of other abnormalities in the first or second trimester US, a specialist in fetal medicine was consulted by a trained midwife and primary counselling and verbal information concerning the abnormality was given during the appointment
Summary
Prenatal screening is part of the public health care system in Finland and available to everyone. It is regulated by the Governmental Decree of Screening (Health Care Act 339/2011) and organized by local authorities. Screening is free of charge and voluntary [1]. The main goal of prenatal screening is to identify chromosomal and structural abnormalities in the first and second trimester of pregnancy [2]. In Finland, community-based maternal care units provide free maternal care services and are responsible for informing women about prenatal screening and screening options. During the first antenatal visit, women receive oral and written information about prenatal screening and after familiarizing themselves with it, they are expected to give an informed consent concerning participation or refusal.
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