Women???s Experience of Maternal Serum Screening

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Abstract
Maternal serum screening (MSS) is an increasingly popular measure for detecting Down syndrome, trisomy 18, and open neural tube defects antenatally. Several studies, however, have demonstrated that women in general do not know much about the disorders being screened for or the meaning of the results. Therefore, focus groups were conducted at six sites across the province of Ontario, Canada; sites included northern, rural, urban, suburban, and inner-city communities. Each group comprised 10 women (on average), who were interviewed using a semistructured guide to explore their ideas, feelings, and views about MSS. The 60 participants, who were 16 to 44 years old, had recently given birth but were not currently pregnant. They had an average of two children and, with two exceptions, were married. More than half of the women had completed some type of postsecondary education. Some women had a definite need to be reassured about their infants’ well-being, whereas others were willing to “let nature take its course” and confront the outcome. Views about abortion and the ethics of prenatal genetic testing varied widely. Some women believed it was wrong to bring disabled children into the world. Others were concerned about intolerance of an “imperfect” child. Decisions were influenced by the woman’s or her partner’s perceived ability to cope with a child who has Down syndrome. Personal values aside, women depended on their sources of social support (partners, relatives, and friends) for help in making decisions. Participants wished to receive information primarily from their physicians and in an accurate and unbiased manner. They wanted to receive information on genetic screening as early as possible during their prenatal care, preferably at the fist or second visit. They wanted to know what the test could tell them, the positive and negative aspects of testing, how to interpret the results, and all options available, including abortion. Women wanted their physicians to convey the test results, whether positive or negative, in an accurate and timely manner. Women were opposed to being contacted only if the results were abnormal.

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