Ethnicity, bioethics, and prenatal diagnosis: the amniocentesis decisions of Mexican-origin women and their partners.

Abstract

Bioethical standards and counseling techniques that regulate prenatal diagnosis in the United States were developed at a time when the principal constituency for fetal testing was a self-selected group of White, well-informed, middle-class women. The routine use of alpha-fetoprotein (AFP) testing, which has become widespread since the mid-1980s, introduced new constituencies to prenatal diagnosis. These new constituencies include ethnic minority women, who, with the exception of women from certain Asian groups, refuse amniocentesis at significantly higher rates than others. This study examines the considerations taken into account by a group of Mexican-origin women who had screened positive for AFP and were deciding whether to undergo amniocentesis. We reviewed 379 charts and interviewed 147 women and 120 partners to test a number of factors that might explain why some women accept amniocentesis and some refuse. A woman's attitudes toward doctors, medicine, and prenatal care and her assessment of the risk and uncertainty associated with the procedure were found to be most significant. Case summaries demonstrate the indeterminacy of the decision-making process. We concluded that established bioethical principles and counseling techniques need to be more sensitive to the way ethnic minority clients make their amniocentesis choices.

Knowledge and Attitudes towards Prenatal Diagnostic Procedures among Pregnant Women in Greece

“…In addition, in our study, women who read the popular press and were aware of smoking consequences during pregnancy also had a better knowledge. Therefore, this study confirms the importance of nationality, education and socioeconomic status as predictors of adequate knowledge of prenatal diagnostic procedures as has been shown in previous studies [11,19,28,29] . Our results also indicate that women from minority ethnic groups and low socioeconomical status did not have negative attitudes towards genetic testing, but rather lower rates of informed choice, as has been previously reported [14,30,31] .…”

Knowledge, attitudes and decision-making in Czech women with atypical results of prenatal screening tests for the most common chromosomal and morphological congenital defects in the fetus: Selected questionnaire results

“…Similar conclusions were reached by Mulley and Wallace 3 , Comerford et al 25 and Dahl et al 5,26 . Compared to studies related to screening programmes, there are significantly fewer published studies on patient awareness, decision making, and the need for support before amniocentesis 6,7,10,[27][28][29][30] . These studies agree on the insufficient knowledge of women regarding amniocentesis; their expectations related to this test are often unrealistic 31 .…”

Strategies for Motivating Latino Couples' Participation in Qualitative Health Research and Their Effects on Sample Construction

“…Our study of the amniocentesis decisions of Latino couples 28 makes a revealing test case because it posed a combination of obstacles to recruitment. We were trying to enroll an immigrant group that customarily has low participation rates in social research; we were trying to recruit couples, not just individuals; and we were approaching them at a sensitive time, in a medical setting, without offering any medical benefits.…”