7.3.2 Pregnant women’s decision-making with regard to antenatal screening for down syndrome: a meta-synthesis (178)

Bernie Reid, PhD Student, Institute of Nursing Research, University of Ulster, Derry, United Kingdom Co authors: Marlene Sinclair, Owen Barr, Frank Dobbs & Grainne Crealey reid-b@ulster.ac.uk

Abstract:

Background:

The diffusion of antenatal screening programmes for Down syndrome has triggered much discussion about their powerful potential to enhance pregnant women’s autonomy and reproductive choices. Simultaneously, considerable debate has been engendered by concerns that such programmes may directly contribute to the emergence of new and complex ethical, legal and social dilemmas for women. Given such discussion and debate, an examination of women’s decision-making within the context of antenatal screening for Down syndrome is timely.

Aim:

To examine the factors influencing decisions to accept or decline antenatal screening for Down syndrome from the perspective of pregnant women.

Methods:

A meta-synthesis was undertaken based on the method of Noblit and Hare (1988). Ten electronic health and social science databases were searched together with a hand-search of ten journals for papers published in English between 1999 and 2007, using predefined search terms; inclusion and exclusion criteria; and a quality appraisal framework (Walsh and Downe 2006).

Findings:

Nine papers met the criteria for this meta-synthesis, providing an international perspective on pregnant women’s decision-making. Ten sub-themes were identified by consensus and combined into four main themes. These main themes were anticipating the future; perceiving risk; maternal-fetal relatedness and privacy.

Discussion & conclusion:

These themes provide new insight into pregnant women’s complex decision-making processes with regard to antenatal screening for Down syndrome and they support Mercer’s (2004) theory of ‘becoming a mother’. However, further research is necessary to determine whether or not the development of a model of decision making may empower pregnant women in making choices about screening.

Biography:

Bernie Reid is a registered nurse, midwife and public health nurse. She has practiced midwifery for more than a decade in Northern Ireland. She has worked as a designated Public Health Nurse for Traveller Health in the Republic of Ireland. She is a founding member of the Cross-Border network of Public Health Nurses and Health Visitors working with Travellers. More recently she worked as a Lecturer in Midwifery at the University of Dundee. She is presently undertaking a full-time PhD at the University of Ulster.