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Video recording to improve the quality of prenatal genetic counselling.

Spelten, E., Gitsels, J., Pereboom, M., Martin, L., Hutton, E., Dulmen, S. van. Video recording to improve the quality of prenatal genetic counselling. 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: Counselling on prenatal testing has become an increasing part of obstetric care in the Netherlands. The majority of Dutch women (>70%) are counselled by midwives on prenatal testing (Wiegers and Hingstman, 2008). Prenatal screening on congenital abnormalities is not routinely done and pregnant women have a choice to participate. Testing includes two non-invasive tests: the combined test at ca.12 weeks and the second trimester ultrasound at ca. 20 weeks. The overall uptake for the combined test is low: around 23% (Gitsels, 2012).For most practicing midwives, prenatal counselling was new, when it was introduced in 2007. They received additional training on counselling for prenatal testing on congenital abnormalities. There is to date very little information on actual counselling practices. For the present study videotapes were made of consecutive, real-life consultations between clients and midwives. Here the use of video recordings as a tool for research and education is discussed. METHOD: This study was conducted as part of the Deliver study (, the first nationwide study to evaluate the quality and provision of primary midwifery care in the Netherlands. Twenty primary care midwifery practices in the Netherlands and their nearly 8000 clients participate in this study. In a smaller subsample, video recordings were made of the first prenatal consultation. Intake consultations were taped. Twenty-two midwives out of six practices were involved; ten to twenty recordings were made of the same midwife. In total just over 300 recordings were made. Both for midwives and clients, video recording was a completely novel experience and we were not sure how this method was going to be accepted (van der Stouwe 2011). RESULTS: Attention is paid to the benefits and drawbacks of this tool. We assume that the results of this study may be generalised to other environments.The results show some resistance from midwives about the recording, purportedly to protect their clients. Clients themselves, however, were happy to contribute to the education of health professionals in this manner. Midwives in the end were also positive about being recorded. As one midwife put it, ‘‘I learned a lot already from just being taped and reflecting on my own skills.’’ CONCLUSIONS: The study showed that video recording, although new, was accepted both by midwives and clients as a tool to improve the quality of prenatal genetic counselling. (aut. ref.)