Prenatal testing decisions : women's needs and well-being
Objectives: Advancements in women’s reproductive technology have resulted in women having to face the decision whether to undergo prenatal testing (PNT). This study explored the factors involved in women’s decisions around PNT and assessed the extent to which the decision making process differed between women that chose not to have PNT and those that chose to have PNT. The Self-Determination Theory (Deci & Ryan, 1985) was used as the theoretical framework. Study Methods: 30 pregnant or recently pregnant women over the age of 35 participated in semi-structured interviews and completed a brief survey. Content analyses were completed on the interview transcripts, and correlational analyses were performed on the survey data. Results: Women’s personal values, feelings of social support, and perceived competence played major roles in the decision process. Some women in this study indicated the PNT choice gave them a feeling of control and offered feelings of reassurance, while some said having to make the choice was a burden that they found difficult to bear. Women in the testing group appeared to place a great importance on the need for information, while women in the no testing group placed greater importance on the need for social support. Each testing group also appeared to differ in facets of their personal values, such as religiosity (only women in the no testing group discussed this issue) and need for a sense of control (only women in the testing group discussed this issue). The women in the no testing group showed higher levels of uncertainty and decisional conflict, and lower levels of decisional self-efficacy than women in the testing group. Conclusions: Each testing group appears to be individual in their needs during PNT decision making. The study findings suggest women should be counseled differently depending on their supports, values, and need for knowledge regarding testing. The findings suggest that women opting against PNT experience elevated decisional distress, and perceive themselves to be less competent and more conflicted over the decision than women choosing PNT. Special attention to these women during the PNT decision may improve their feelings of being socially supported during the decision.
self-determination theory, prenatal testing decision, social support
Master of Arts (M.A.)