'This is just what you do when you are pregnant': a qualitative study of prospective parents in Iceland who accept nuchal translucency screening

Background: nuchal translucency (NT) screening, mainly for Down's syndrome, in the first trimester of pregnancy is becoming an established practice in many countries. However, very little is known about parents' knowledge and beliefs prior to undergoing screening. Such information is essential to form guidelines regarding informed decision making. Objectives: to explore the influences on prospective parents' decision-making in relation to NT screening in early pregnancy, and to gain insight into how the views of prospective mothers and fathers towards the benefits and implications of screening may differ. Design: a qualitative study using framework analysis based on a grounded theory approach. Participants: 10 couples, who had decided to have NT screening, were recruited from four community health centres in Iceland. All pregnancies were defined as 'low risk' for fetal anomaly. Data collection: semi-structured interviews were conducted separately with each prospective mother and father at 7-11 weeks and again at 20-24 weeks of gestation. In total, 40 interviews were conducted. Findings: the majority of prospective mothers in this study had already decided to accept NT screening before they entered the public antenatal care system. The decision to accept screening seemed to lie with the prospective mother and had hardly been discussed by the couple. Differences between prospective mothers and fathers were observed in relation to the expression of expectations towards the benefits of screening and the perception of disability, which is of interest in the context of information provided to prospective parents. Conclusions and implications: the findings from this study are of interest to clinicians and policy makers forming future guidelines for antenatal care both in Iceland and further a field. It highlights the need for information for prospective parents to be in the public domain prior to their contact with maternity services. Additionally, findings add to knowledge of prospective fathers in early pregnancy regarding how their perceptions of disability may contribute to the couple's decision to accept screening. (C) 2008 Elsevier Ltd. All rights reserved.