‘Let’s have it tested first’: choice and circumstances in decision‐making following positive antenatal screening in Hong Kong

Abstract

There now exists a considerable body of sociological work examining antenatal screening for fetal abnormalities. A common theme emerging from this literature is that pregnant women report not feeling able to exercise choice freely, experiencing constraints both from medical professionals and their perceived expectations of the sociocultures in which they live. This study adds to existing literature in three ways. Firstly, in contrast to the existing body of interview-based research, the study uses video recordings of actual consultations, in order to capture the interactional processes through which choice and constraints are established, negotiated and contested. Secondly, it explores the next stage in the process of antenatal screening, by focusing on women who are offered invasive diagnostic testing as a result of 'high risk' screening results, and who have been the subject of little research. Thirdly, the study site in Hong Kong provides a particularly interesting location, given limited research on antenatal screening in that part of the world, and Hong Kong's cosmopolitan environment that is reflected in the diversity of client population undergoing antenatal screening. Using conversation analysis we examine how aspects of the clients' diverse socioeconomic backgrounds and circumstances are interactionally managed in this setting, and how this might impact on decision-making.

Delivering patient choice in clinical practice: a conversation analytic study of communication practices used in neurology clinics to involve patients in decision-making

“…For example, in the context of decision-making -in Hong Kong -around whether or not to undergo further testing for Down syndrome following a preliminary high-risk result, Pilnick and Zayts 52 showed that doctors could be 'quite directive . .…”

Paramedical risk framing during field referral of acute stroke and S–T elevation myocardial infarction patients

“…The framing of risk can be a major influence in patients’ understanding of clinical options and subsequent decision making 18 19. For professionals, this part of their practice is often nuanced and calls for situational-specific judgements.…”

Psychosocial factors affecting uptake of prenatal genetic testing: a pilot study

“…Hypothesis Attitude towards termination of pregnancy predicts the decision to take a prenatal genetic test. Previous researches have found a positive association between attitude towards abortion and the tendency to undergo prenatal (genetic) testing …”

“…Available researches on the determinants of PGTs have looked at (1) the attitudes of women and their partners, (2) religious beliefs and women's attitudes towards termination of pregnancy, and (3) women's racial‐ethnic background …”