Perspectives of women who receive an increased chance result on non-invasive prenatal testing or combined first trimester screening: a qualitative study

BACKGROUND: Non-invasive prenatal testing (NIPT) is increasingly used by expectant parents. Data are lacking on the perspectives and needs of expectant parents around NIPT after receiving an increased chance screening result. AIM: To explore the experiences and views of people who had undergone NIPT who received increased chance screening results (on any prenatal screening test), and perceptions of the potential benefits and harms of NIPT. METHOD: We interviewed 16 Australian women who received an increased-chance prenatal screening result and conducted a reflexive thematic analysis. FINDINGS: The overarching theme of these finding is that NIPT, and the processes that surround it, both facilitates and hinders women's ability to make informed decisions. Subthemes included 1) the desire to arm oneself with maximal information from the "best" screening test; 2) lack of pre-/post-test support to enable informed decision-making; 3) negative psychosocial consequences of an increased chance NIPT result; 4) NIPT as a choice available to the "fortunate," and 5) women's perspectives on what prenatal screening decisions they would make if they had their choice again, and what things may have improved their experience with prenatal screening. CONCLUSION: In this group of Australian women who received an increased chance NIPT result, there was support for increased access to the test through public subsidy. Women voiced a need for improved pre-and post-test counselling and support for those offered a test, and for better knowledge on the tests and conditions by requesting clinicians.