This study aimed to examine whether pregnant women made informed decisions
based on an accurate understanding of the antenatal screening process and t
o explore their attitude to screening and termination of a Down syndrome fe
tus. Women's aspirations were the keystone that informed the development of
the first strategy for antenatal screening for congenital anomalies. Semi-
structured interviews were carried out with a sample of pregnant women in S
outh Wales in 1995. A total of 34 women aged less than 35 years, who were 2
0 weeks pregnant, were interviewed. These women were selected because the s
creening policy differed between hospitals for this age group. The majority
of women were not aware that screening tests were voluntary: tests were pr
esented as routine. About half of the sample were not well informed to make
decisions. Only five out of a sampling frame of 101 women refused screenin
g; they tended to be better educated and of higher social class. All women
wanted to be given the choice whether to be screened. Seven out of 34 would
not terminate an affected fetus. Staff communication skills, especially in
delivering risk estimate, were criticized. The survey findings supported t
he view that women required an information package tailored to their indivi
dual needs. Copyright (C) 2000 John Wiley & Sons, Ltd.