The Tentative Pregnancy: Then and Now

Rothman, Barbara Katz

doi:10.1159/000263873

Cited by 55 publications

(61 citation statements)

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“…[30][31][32][33] This detachment or 'tentative pregnancy' is likely to be a psychological defense strategy enabling the woman to cope with the knowledge that the pregnancy might end in termination. 30 This phenomenon was observed in a number of women in this study for whom invasive testing was an option. It is possible that these women were delaying maternal attachment for this reason and might help us to understand why the experience of the ultrasound during invasive testing was distressing.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

et al. 2012

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Prenatal fetal sex determination is clinically indicated for women who are at risk of having a child with a serious genetic disorder affecting a particular sex. Ultrasound has been the traditional method used, but early fetal sex determination using non-invasive prenatal diagnosis (NIPD) can now be performed using cell-free fetal DNA in maternal plasma. The study aim was to assess the views and experiences of service users who had used NIPD for fetal sex determination. In this paper, we report on the perceived benefits and disadvantages. A qualitative approach using semi-structured interviews was used. A total of 44 participants (38 women and 6 partners of participating women) were recruited. Participants' views and experiences of NIPD were overwhelmingly positive. Concerning benefits over traditional methods, three themes emerged: (1) technical aspects of technology; (2) timing; and (3) enhanced decision-making. Practical advantages of NIPD included avoiding miscarriage, and there were a number of psychological advantages associated with timing such as perceived control, early re-engagement, normalization of pregnancy and peace of mind. Participants also valued NIPD as it enabled a stepwise approach to decisionmaking. A number of disadvantages were discussed including concerns about social sexing and increased bonding at a time in pregnancy when miscarriage risk is high. However, participants felt these were fairly minor in comparison with the advantages of NIPD. Until definitive genetic diagnosis using NIPD is available, NIPD for fetal sex determination is perceived as a good interim measure with a number of notable advantages over traditional methods.

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Section: Discussionmentioning

confidence: 99%

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

et al. 2012

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“…[1][2][3][4][5][6] Avoidance of prenatal tests has been related to high commitment to pregnancy or refusal to recognize the possibility of fetal aberration. [7][8][9][10][11] Factors associated with the use of amniocentesis were higher education and occupational level, more knowledge about prenatal diagnostics procedures, 10,12 social pressure, spousal attitudes, 13 willingness to terminate pregnancy based on test results, 7,12 and higher levels of anxiety and pessimistic thoughts about the anticipated child. 14,15 Previous studies thus suggested that the use of prenatal diagnostics is related to both rational variables, such as knowledge, and emotional variables, such as social pressure and levels of anxiety.…”

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confidence: 99%

Elective amniocentesis in low-risk pregnancies: decision making in the era of information and uncertainty

Lesser

Rabinowitz²

2001

Am J Public Health

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A B S T R A C TObjectives. Rational choice theory was applied to explain women's use of amniocentesis. Variables included knowledge about prenatal diagnostics, attitudes, and emotional preferences.Methods. Using structured instruments at 9 to 14 and at 29 to 34 weeks' gestation, we interviewed 232 Israeli women who had low-risk pregnancies.Results. Women who had elective amniocentesis (n=39) were more knowledgeable about prenatal diagnostics, risks of invasive procedures, and probability of fetal abnormality in high maternal age; had fewer children; and had less favorable attitudes toward parenthood than those who had medically indicated amniocentesis (n = 57) and those who did not have amniocentesis (n = 136).Conclusions. The use and possible overuse of amniocentesis were associated with having more information about prenatal diagnostics and definite emotional preferences. (Am J Public Health. 2001;91:639-641)

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Section: Ethical Analysismentioning

confidence: 99%

“…This means that, by a standard information provision before pregnancy, the right not-to-know would have been disregarded. In addition, focusing on the possibility of becoming pregnant with a child having Down syndrome, the risk appears that this unwanted information spoils the (unconcerned) process of getting pregnant [Katz Rothman, 1986].Con: a perceived directive. In addition to individual preferences, informed decision-making is dependent upon the availability and accessibility of choices and alternatives [Guadagnoli and Ward, 1998;Goldberg, 2009].…”

mentioning

confidence: 99%

Informing on prenatal screening for Down syndrome prior to conception. An empirical and ethical perspective

Schoonen

Zee

Wildschut

et al. 2012

American J of Med Genetics Pt A

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In most Western countries, information on prenatal screening for Down syndrome is provided in the first-trimester of pregnancy. The purpose of this study was to examine whether this information should additionally be provided before pregnancy to improve the informed decision-making process. In an empirical study, we obtained data from pregnant women with respect to their preferences regarding information on prenatal screening preconceptionally. Questionnaire data (n ¼ 510) showed that 55.7% of responding women considered participating in prenatal screening for Down syndrome before pregnancy. 28.0% of women possessed information on prenatal screening preconceptionally. 84.6% preferred not to receive information preconceptionally in retrospect. In an ethical analysis, we elaborated on these preferences by weighing pros and cons. We considered two arguments against the provision of information on prenatal screening preconceptionally: women's preference to receive information in a step-by-step manner, and the risk of providing a directive message. We identified three reasons supporting its provision preconceptionally: the likelihood of making an informed decision could, firstly, be increased by ''unchaining'' the initial information from possible subsequent decisions, and, secondly, by providing women sufficient time to deliberate. Thirdly, the probability of equal access to prenatal screening may increase. To conclude with, we propose to incorporate an information offer on prenatal screening for Down syndrome in preconception care consultations. By offering information, instead of providing information, prospective parents are enabled to either accept or decline the information, which respects both their right to know and their right not-to-know. Key words: information on prenatal screening; down syndrome; preconception care consultation; informed decision-making; medical ethics; right not-to-know INTRODUCTIONPreconception care is a set of primary interventions that identify and modify biomedical, behavioral, and social risks to a woman's health and future pregnancies [Centers for Disease Control and Prevention (CDC). National Center on Birth Defects and Developmental Disabilities, 2006] Preconception care aims to optimize the health of the future child and to improve maternal health 485 [Health Council of the Netherlands, 2007b]. Information on prenatal screening for Down syndrome is commonly provided after conception, during the first-trimester of pregnancy. Many Western countries have policies or recommendations for prenatal screening for Down syndrome, in which either women of advanced age are offered invasive diagnostic testing (chorionic villus sampling or amniocentesis), or in which women, irrespective of their age, are offered non-invasive risk-assessment tests in the firsttrimester of pregnancy (nuchal scan, often combined with maternal serum evaluation) [Boyd et al., 2008;EUROCAT, 2010]. The latter screening tests provide an individual risk estimate of carrying a child with Down syndrome, and may be foll...

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The Tentative Pregnancy: Then and Now

Abstract: This paper examines the ways in which prenatal diagnosis changes women’s experiences of pregnancy. The paper explores the role of patriarchal ideology in the development and use of prenatal diagnostic technology.

Cited by 55 publications

References 0 publications

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users’ perspective

Elective amniocentesis in low-risk pregnancies: decision making in the era of information and uncertainty

Informing on prenatal screening for Down syndrome prior to conception. An empirical and ethical perspective

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