[First-trimester-test--support-tool for the individual decision or screening-tool for public health planning?]

International studies about women's knowledge of the first-trimester-test show that they are quite often not sufficiently informed for their personal decision-making: The information needed is not given in an understandable way; they are not informed that the test is only a risk assessment and not a diagnosis; and they often don't understand the concept of false positive and false negative results. Other studies show, that this sophisticated and complex information about the first-trimester-test can be given in an understandable way. But even with adequate information most women are unable to make an informed choice as long as the test is presented as a routine for screening. However, for an informed and free choice, an individual decision-making-process has to take place. For this reason a counseling concept has been developed in Switzerland. It introduces the first-trimester-test not as a screening-tool for the public health planning but as a support-tool for the individual decision. It consists of an information brochure for the pregnant woman and her partner, a counseling framework for the physicians and a two days training program. The counseling concept has been evaluated by a research project of the Swiss National Science Foundation and has been adopted as an official counseling standard by the Swiss Society of Obstetrics and Gynaecology. Recommendations for the communication skills together with a short time training program were added, such that the concept can serve as an integrative tool for decision-making support concerning first-trimester tests.