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A meta-synthesis of pregnant women’s decision-making processes with regard to antenatal screening for Down syndrome

Reid, Bernie, Sinclair, Marlene, Barr, Owen, Dobbs, Frank and Crealey, Grainne (2009) A meta-synthesis of pregnant women’s decision-making processes with regard to antenatal screening for Down syndrome. Social Science and Medicine, 69 (11). pp. 1561-1573. [Journal article]

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URL: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-4X9SC9R-2&_user=126978&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000010438&_version=1&_urlVersion=0&_userid=126978&md5=baa72990f5d433b5b105b1b774cd32b4

DOI: 10.1016/j.socscimed.2009.09.006


The diffusion of antenatal screening programmes for Down syndrome has triggered much discussionabout their powerful potential to enhance pregnant women’s autonomy and reproductive choices.Simultaneously, considerable debate has been engendered by concerns that such programmes maydirectly contribute to the emergence of new and complex ethical, legal and social dilemmas for women.Given such discussion and debate, an examination of women’s decision-making within the context ofantenatal screening for Down syndrome is timely. This paper aims to undertake a meta-synthesis ofqualitative studies examining the factors influencing pregnant women’s decisions to accept or declineantenatal screening for Down syndrome. The meta-synthesis aims to create more comprehensiveunderstandings and to develop theory which might enable midwives and other healthcare professionalsto better meet the needs of pregnant women as they make their screening decisions. Ten electronichealth and social science databases were searched together with a hand-search of eleven journals forpapers published in English between 1999 and 2008, using predefined search terms, inclusion andexclusion criteria, and a quality appraisal framework. Nine papers met the criteria for this metasynthesis,providing an international perspective on pregnant women’s decision-making. Twelve themeswere identified by consensus and combined into five core concepts. These core concepts were: destinationunknown; to choose or not to choose; risk is rarely pure and never simple; treading on dreams,and betwixt and between. A conceptual framework is proposed which incorporates these themes andcore concepts, and provides a new insight into pregnant women’s complex decision-making processeswith regard to antenatal screening for Down syndrome. However, further research is necessary todetermine whether or not the development of a model of decision-making may empower pregnantwomen in making choices about screening.

Item Type:Journal article
Keywords:Meta-synthesis Antenatal screening Down syndrome Women Decision-making Pregnancy
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Nursing
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Centre for Maternal, Fetal and Infant Research
Institute of Nursing and Health Research > Centre for Intellectual and Developmental Disabilities
ID Code:2673
Deposited By: Professor Marlene Sinclair
Deposited On:15 Dec 2009 16:10
Last Modified:13 Oct 2014 12:45

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