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Ethnic differences in informed decision-making about prenatal screening for Down's syndrome
  1. Mirjam P Fransen1,2,
  2. Marie-Louise Essink-Bot1,3,
  3. Ineke Vogel1,
  4. Johan P Mackenbach1,
  5. Eric A P Steegers2,
  6. Hajo I J Wildschut2
  1. 1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, CA Rotterdam, The Netherlands
  2. 2Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center Rotterdam, The Netherlands
  3. 3Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Mirjam Fransen, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands; m.fransen{at}erasmusmc.nl

Abstract

Background The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables.

Methods Pregnant women of Dutch, Turkish and Surinamese origin were recruited between 2006 and 2008 from community midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed 3 weeks (mean) after booking for prenatal care. Knowledge, attitude and participation in prenatal screening were assessed following the ‘Multidimensional Measure of Informed Choice’ that has been developed and applied in the UK.

Results In total, 71% of the Dutch women were classified as informed decision-makers, compared with 5% of the Turkish and 26% of the Surinamese women. Differences between Surinamese and Dutch women could largely be attributed to differences in educational level and age. Differences between Dutch and Turkish women could mainly be attributed to differences in language skills and gender emancipation.

Conclusion Women from ethnic minority groups less often made an informed decision whether or not to participate in prenatal screening. Interventions to decrease these ethnic differences should first of all be aimed at overcoming language barriers and increasing comprehension among women with a low education level. To further develop diversity-sensitive strategies for counselling, it should be investigated how women from different ethnic backgrounds value informed decision-making in prenatal screening, what decision-relevant knowledge they need and what they take into account when considering participation in prenatal screening.

  • Decision-making PR
  • ethnic differences
  • ethnic minorities SI
  • ethnicity
  • informed choice
  • informed decision-making
  • pregnancy
  • prenatal screening

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Footnotes

  • Funding This work was supported by Erasmus MC Zorgonderzoek (FED 1059).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Medical Ethics Research Committee Erasmus MC (MEC 238.848/2004/11).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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