Impact of prenatal screening on maternity services - Finnish physicians' opinions

Background. The purpose of this survey was to find out whether Finnish phys icians had thought about or had observed resource or organizational effects due to the offering of prenatal screening. Methods. A mailed questionnaire survey sent in 1996-1997 in Finland to all leading Finnish obstetrician-gynecologists, to a random sample of obstetric ian-gynecologists providing prenatal care, to general practitioners providi ng maternity care, and to other general practitioners. The number of respon dents was 322 (response rate 70%). Results. Most physicians supported the screening programs currently in wide use in Finland (serum screening for Down's syndrome and ultrasound for mal formations), and over a third wanted to introduce the two genetic carrier s creenings asked about. Most thought Down's screening took up resources, but they did not consider this to be important. The impact of screening on pub lic or customer images of prenatal care was not an important issue. Instead , a diversity of opinions was expressed on whether the increasing numbers o f prenatal screenings require organizational changes in current prenatal ca re provided within primary care, or whether a shift to hospital clinics is necessary to achieve more specialized care. Conclusions. Most physicians were not concerned by the potential organizati onal and resource implications of prenatal screening, and apparently they j udge screening more from a health and individual patient point of view.