An exploration of midwives' and obstetricians' knowledge of genetic screening in pregnancy and their perception of appropriate counselling

Abstract

Objective: to describe levels of knowledge relevant to genetic screening in a sample of midwives and obstetricians in the late 1990s, and to compare these with those found by Smith et al. in London and Wales, and reported in 1994; to describe health professionals' perceptions of an appropriate counselling process relating to genetic screening in comparison with recognised good practice; and to consider links between knowledge and perceptions of the counselling process.

Design: a questionnaire study, including responses to a counselling scenario.

Participants and setting: responses were obtained from 81 midwives and obstetricians from maternity services in the North West of England.

Findings: knowledge about procedures was very good, but knowledge about the probability of genetic abnormality was relatively poor, and respondents overestimated the efficacy and usefulness of tests. These findings were similar to those of Smith et al. (1994), suggesting that they are a good reflection of the national picture. In terms of reported information-giving and counselling practice, there were some respondents who would not check the woman's understanding of her baby's risk of a genetic abnormality, or the risk of a false result. Some respondents would give information based on their own (necessarily limited) experience, rather than national statistics, and give advice based on the choices they themselves would make. These findings reflect earlier, basic research on people's understanding of probabilistic information.

Implications: the findings of this study, together with those of earlier work cited, suggest a need for education and training which includes a specific focus on biases in understanding this type of probabilistic information. They also raise the question as to why tests which provide probabilistic data have been introduced without consideration of the known problems in understanding such information.