Decisions about prenatal testing for chromosomal disorders: Perceptions ofa diverse group of pregnant women

We conducted a study to elucidate factors influencing women's decisions reg arding prenatal genetic screening for and diagnosis of chromosomal disorder s and to learn about their experiences with these tests and with the medica l system. Using focus group interviews and questionnaire assessments, we ob tained detailed impressions of a diverse group of 75 pregnant women. Partic ipants varied with respect to race/ethnicity, religious background, and rep roductive history, as well as in their decisions about use of prenatal scre ening and diagnostic testing. Substantial variation surfaced in attitudes t oward testing. Factors influencing women's views included available resourc es, feelings about having a child with Down syndrome, moral beliefs, family and social influences, perceptions of one's own health, the difficulty of becoming pregnant, and willingness to put the fetus at elevated miscarriage risk. Such findings indicate that age-based policies regarding access to p renatal diagnoses that, among other reasons, are based on the balance of ri sks between bearing a child with a chromosomal abnormality versus procedure -related loss are incompatible with the range of concerns that women bring to this decision and the weight individual women may assign to the outcomes .