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Attitudes to prenatal testing and termination of pregnancy for fetal abnormality: a comparison of white and Pakistani women in the UK

Authors: Jenny Hewison1*, Josephine M. Green2, Shenaz Ahmed3, Howard S. Cuckle3, Janet Hirst3, Clare Hucknall3
and Jim G. Thornton4

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Objectives To compare the attitudes of women from two different ethnic backgrounds to prenatal testing for
a range of conditions, and to see if “clusters” of attitudes to different conditions could be identified, for which
prenatal testing might be offered as a package.
Methods Four hundred and twenty white and Pakistani women living in the UK were surveyed about their
attitudes to prenatal testing and termination for 30 different fetal conditions. All participants had recently had
a baby.
Results Pakistani women held more favourable attitudes to prenatal testing, but less favourable attitudes to
termination than their white counterparts. Both groups were most in favour of termination for the same four
conditions: anencephaly, trisomy 13 or 18, quadriplegia, Duchenne muscular dystrophy. The rank ordering of
conditions was also similar. Only 4% of Pakistani and 2% of white women wanted no prenatal testing at all.
Fewer than a quarter of participants would consider a termination of pregnancy for 85% of the conditions,
but only 25% of Pakistani women and 6% of white women would consider termination for none of the
conditions. More advanced statistical analyses were used to measure how closely associated the 30 conditions
were in respondents’ answers. These analyses identified a principal dimension, reflecting the overall perceived
seriousness of the conditions, and a cluster of severely disabling conditions—anencephaly, trisomy 13 or 18,
quadriplegia, Duchenne muscular dystrophy, and severe learning difficulties—which stood out from the rest.
Even within this cluster there remained a considerable amount of individual variation.
Conclusion Women in the study wanted to make up their own minds about the conditions that to them
merited testing or termination. These findings have implications for obtaining informed consent