Prenatal genetic testing: Content of discussions between obstetric providers and pregnant women

Barbara A. Bernhardt, Gail Geller, Teresa Doksum, Susan M Larson, Debra Roter, Neil A. Holtzman

Research output: Contribution to journalArticle

Abstract

Objective: To document the content and accuracy of discussions about prenatal genetic testing between obstetric providers and pregnant women. Methods: The first prenatal visits of 169 pregnant women with 21 obstetricians and 19 certified nurse-midwives were audiotaped and analyzed for whether a discussion of family history or genetic testing took place and if so, its length, content, and accuracy. Results: Family history was discussed in 60% of visits, maternal serum marker screening in 60%, second- trimester ultrasonography for fetal anomalies in 34%, and for women at least 35 years old, amniocentesis or chorionic villus sampling (CVS) in 98%. The length of discussions of genetic testing averaged 2.5 minutes for women younger than 35 years of age and 6.9 minutes for older women. Topics discussed most often were the practical details of testing, the purpose of testing, and the fact that testing is voluntary. Discussions seldom were comprehensive. Obstetricians were more likely to make a recommendation about testing than were nurse-midwives and were less likely to indicate that testing is voluntary. Most women were satisfied with the amount of information, and the majority of women of advanced maternal age had made a decision about amniocentesis or CVS by the end of the visit. Conclusion: The information about genetic testing provided in the first prenatal visit is inadequate for ensuring informed autonomous decision-making. Guidelines addressing the content of these discussions should be developed with input from obstetricians, nurse-midwives, genetic counselors, and pregnant women.

Original languageEnglish (US)
Pages (from-to)648-655
Number of pages8
JournalObstetrics and Gynecology
Volume91
Issue number5 I
DOIs
StatePublished - May 1998

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Genetic Testing
Obstetrics
Pregnant Women
Nurse Midwives
Chorionic Villi Sampling
Amniocentesis
Prenatal Ultrasonography
Maternal Age
Second Pregnancy Trimester
Decision Making
Biomarkers
Mothers
Guidelines

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Prenatal genetic testing : Content of discussions between obstetric providers and pregnant women. / Bernhardt, Barbara A.; Geller, Gail; Doksum, Teresa; Larson, Susan M; Roter, Debra; Holtzman, Neil A.

In: Obstetrics and Gynecology, Vol. 91, No. 5 I, 05.1998, p. 648-655.

Research output: Contribution to journalArticle

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