Are counsellors' attitudes influencing pregnant women's attitudes and decisions on prenatal screening?
OBJECTIVE
It is generally recognised that choices concerning treatment or screening should be people's own, autonomous decisions. However, in the context of genetic counselling, many studies found that counsellors deviate from nondirectiveness, or that subjective norm influences behaviour. The present study aimed to investigate whether prenatal counsellors (midwives, gynaecologists) influence pregnant women's decisions and their attitudes regarding prenatal screening. It was hypothesised that uptake rates and attitudes would be associated with the counsellor's attitude toward prenatal screening.


METHODS
Pregnant women attending their midwifery or gynaecology practice were asked to fill out postal questionnaires before and after they were offered prenatal screening for Down syndrome. Their prenatal counsellors also filled in a questionnaire. These questionnaires assessed attitudes toward prenatal screening and background variables. The study sample consisted of 945 pregnant women, being guided by 97 prenatal counsellors.


RESULTS
Multilevel regression analyses revealed that neither uptake rates, nor attitude toward prenatal screening were significantly predicted by counsellors' attitudes toward prenatal screening.


CONCLUSIONS
It is suggested that the advice these pregnant women were reported to have received, should rather be interpreted as an indication of shared decision-making and social support than of social pressure and undesired influence.
van den Berg
Matthijs
M
EMGO Institute, Department of Public and Occupational Health, VU University Medical Centre, Amsterdam, The Netherlands. m.vandenberg@vumc.nl
Timmermans
Danielle R M
DR
Kleinveld
Johanna H
JH
van Eijk
Jacques Th M
JT
Knol
Dirk L
DL
van der Wal
Gerrit
G
van Vugt
John M G
JM
D000328:Adult; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D009426:Netherlands; D011247:Pregnancy / Q000523:psychology; D011296:Prenatal Diagnosis / Q000523:psychology*