Midwives' perceptions of their role as facilitators of informed choice in antenatal screening

Abstract

Objective: to explore midwives' perceptions of their role as facilitators of informed choice in antenatal screening.

Design: qualitative.

Setting: community midwives, Yorkshire and Humber region, UK.

Participants: community midwives offering antenatal screening (n=15).

Method: semi-structured interviews analysed using Thematic Analysis.

Findings: to facilitate informed choice, midwives highlighted both the importance and challenges of engaging in discussion with women, remaining non-directive, within tight timeframes, sometimes with women unable to communicate in English or with complex social needs.

Conclusion: midwives varied in the degree to which they believed it was their role to (1) discuss rather than just provide information and (2) to check women's understanding of the information provided. Midwives were concerned about the constraints imposed by first trimester combined screening in terms of the limited time in which they had to facilitate informed choice and the women had to make a decision about screening. To ensure that women understand the options available to them and are able to exercise an informed choice, clinical guidelines are needed that set out how midwives can actively facilitate informed screening choices without compromising patient autonomy. This is especially important given the small 'window of opportunity' within which combined first trimester screening is a viable option.