Perceptions of prenatal testing for birth defects among rural Latinas

Objectives To examine rural Latinas' understandings of prenatal testing, birth defects, and risk in the context of their expanded AFP (XAFP) screening decisions. Design We conducted a qualitative study using data from in-depth interviews with 33 Latina women receiving prenatal care at three clinic sites in rural areas of California. We analyzed qualitative data by identifying themes that emerged during iterative transcript readings. Quantitative data was used to generate descriptive summary statistics. Results The majority of the participants had not completed high school and had low levels of acculturation. Women in our study tended to view XAFP screening as a routine component of prenatal care that was important for the "health of the baby." Reasons for accepting the XAFP test included reassurance, emotional preparation, and desire for information. Misconceptions included a belief that a normal screening result provides a guarantee of the fetus's health. Generally, participants indicated that, regardless of the screening results, they would not undergo amniocentesis because of the potential miscarriage risk nor would they terminate a pregnancy if their fetus was found to have a chromosome problem. Numerous specific beliefs that differ substantially from medical models regarding birth defects were articulated. Conclusions XAFP screening decisions among rural Latinas are sometimes based on misconceptions of the meaning of test results and the risks associated with undergoing or foregoing testing, and therefore are frequently incongruent with personal testing philosophies and values. Educational efforts and counseling should include clear communication regarding the goals of prenatal screening programs to help these women make informed testing decisions that are reflective of their values and preferences.