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Prenatal genetic counseling: future parents prefer to make decisions together, using professional advice.

Martin, L., Dulmen, S. van, Spelten, E., Hutton, E. Prenatal genetic counseling: future parents prefer to make decisions together, using professional advice. Prenatal Diagnosis: 2012, 32(suppl.1), p. 105. Abstract: 16th International Conference on Prenatal Diagnosis and Therapy, 3-6 june 2012, Miami.
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OBJECTIVES: Counseling about prenatal testing for congenital abnormalities has become an increasing part of obstetric care in the Netherlands (Wiegers and Hingstman, 2008). During the past decade many changes have taken place in medical-technical and social-cultural areas as well as in health care policy. These developments have affected content, range and communication style of prenatal genetic counseling. For a long period prenatal genetic counseling was supposed to be done in a non-directive way (Williams et al, 2002). Recently some authors argue that shared decision making may be more appropriate in prenatal genetic counseling (Van Staveren, 2011). However, to date, insight is lacking into future parents’ preference regarding prenatal counseling. Insight in parents’ preferences may improve prenatal genetic counseling, because the provision of tailored information is associated with more effective care (Silverman et al, 2006). The aim of our study was to examine future parents’ needs regarding prenatal counseling in general, and prenatal decision making in particular. METHOD: A questionnaire study was set up to explore clients’ preferences regarding prenatal counseling, their knowledge about this topic and preferred decision making model. In 17 primary midwifery care practices in the Netherlands, pregnant women and their partners were asked to complete: 1) the 59, 4 Likertscaled items Quality of care through patients’ eyes (QUOTE prenatal) questionnaire, 2) a 15 item Knowledge questionnaire, and 3) a one item decision making questionnaire containing six closed answers. These questionnaires were completed before prenatal counseling about genetic tests. RESULTS: 941 counselees (538 clients and 403 partners) completed the questionnaires. Preliminary results show that pregnant women and their partners had comparable needs regarding prenatal genetic counseling with respect to both communication and content aspects, comparable knowledge about prenatal tests for congenital abnormalities. In addition, the majority of couples preferred to make their decision about prenatal tests, together, as a couple, after receiving advice from their midwife. CONCLUSIONS: The results of our study suggest that pregnant women and their partners have comparable needs regarding genetic counseling, comparable pre-counseling knowledge and comparable views on participating in decision making. As a consequence, it is not likely that differences in pre-visit knowledge, needs and preferred way of decision making will complicate the interaction. On the contrary, our findings suggest that counselees are likely to benefit from paired prenatal genetic counseling; that way both their (individual) counseling needs can be met and couples can benefit from both receiving the same information and counseling in making their decisions towards prenatal genetic tests. (aut. ref.)