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Negotiating severity behind the scenes: prenatal testing in Germany.

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Area of Science:

  • Reproductive Health
  • Medical Ethics
  • Sociology of Medicine

Background:

  • Foetal-related severity influences reproductive technology and abortion policies globally, but not in Germany.
  • German law does not recognize foetal clinical findings severity as grounds for population-wide prenatal screening or legal abortion.
  • This disconnect creates challenges in navigating reproductive decisions within the German context.

Purpose of the Study:

  • To explore how 'severity' of foetal conditions is understood and negotiated by women undergoing prenatal testing and healthcare professionals in Germany.
  • To assess whether the current legal and regulatory framework adequately addresses concerns and needs in reproductive decision-making.
  • To investigate the socio-cultural and legal factors influencing the perception of foetal anomaly severity.

Main Methods:

  • Semi-structured interviews were conducted with women undergoing prenatal testing and healthcare professionals (n=27).
  • Qualitative analysis explored participants' framing of severity in foetal clinical findings.
  • The study examined the interplay between personal interpretations and the legal/regulatory landscape.

Main Results:

  • Women and professionals negotiate 'severity' implicitly, despite its legal exclusion as a justification for screening or termination.
  • Interpretations of severity are context-dependent, integrating clinical, social, and familial factors.
  • Perceptions of severity significantly influence pregnancy management and decision-making processes.

Conclusions:

  • Acknowledging the personal and contextual nature of severity assessment is crucial.
  • Integrating foetal anomaly as a legitimate factor in professional and legal guidance could support better pregnancy management.
  • Current frameworks may not fully accommodate the lived experiences and decision-making needs of individuals facing prenatal testing in Germany.