The role of religion in decision-making on antenatal screening of congenital anomalies: A qualitative study amongst Muslim Turkish origin immigrants

Wal, Janneke T. Gitsels-van der; Manniën, Judith; Ghaly, Mohammed; Verhoeven, Pieternel; Hutton, Eileen K.; Reinders, Hans S.

doi:10.1016/j.midw.2013.04.001

Cited by 40 publications

(42 citation statements)

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“…Religious women, for example, are more likely to accept a child with Down syndrome and less likely to terminate their pregnancy [30]. As in previous studies, we found a strong association between religious background and declining the CT [10–18]. An additional finding in our study is that the influence of religious background is faith-specific.…”

Section: Discussionsupporting

confidence: 85%

Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study

Wal

Verhoeven

Manniën

et al. 2014

BMC Pregnancy Childbirth

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BackgroundTwo prenatal screening tests for congenital anomalies are offered to all pregnant women in the Netherlands on an opt-in basis: the Combined Test (CT) for Down syndrome at twelve weeks, and the Fetal Anomaly Scan (FAS) at around twenty weeks. The CT is free for women who are 36 or older; the FAS is free for all women. We investigated factors associated with the CT and FAS uptake.MethodThis study is part of the DELIVER study that evaluated primary care midwifery in the Netherlands. Associations between the women’s characteristics and the CT and FAS uptake were measured using multivariate and multilevel logistic regression analyses.ResultsOf 5216 participants, 23% had the CT and 90% had the FAS, with uptake rates ranging from 4% to 48% and 62% to 98% respectively between practices. Age (OR: 2.71), income (OR: 1.38), ethnicity (OR: 1.37), being Protestant (OR: 0.25), multiparous (OR: 0.64) and living in the east of the country (OR: 0.31) were associated with CT uptake; education (OR: 1.26), income (OR: 1.66), being Protestant (OR: 0.37) or Muslim (OR: 0.31) and being multiparous (OR: 0.74) were associated with FAS uptake. Among western women with a non-Dutch background, first generation (OR: 2.91), age (OR: 2.00), income (OR: 1.97), being Protestant (OR: 0.32) and living in the east (OR: 0.44) were associated with CT uptake; being Catholic (OR: 0.27), Protestant (OR: 0.13) were associated with FAS uptake. Among non- western women with a non-Dutch background, age (OR: 1.73), income (OR: 1.97) and lacking proficiency in Dutch (OR: 2.18) were associated with CT uptake; higher education (OR: 1.47), being Muslim (OR: 0.37) and first generation (OR: 0.27) were associated with FAS uptake.ConclusionThe uptake of the CT and FAS varied widely between practices. Income, parity and being Protestant were associated with uptake of both tests; ethnicity, age and living in the east were associated with CT uptake, and education and being Muslim with FAS uptake. These findings help to explain some differences between women choosing or declining early and late screening, but not the large variation in test uptake among practices, nor between the Netherlands and other countries.

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Section: Discussionsupporting

confidence: 85%

Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study

Wal

Verhoeven

Manniën

et al. 2014

BMC Pregnancy Childbirth

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“…This means that, for a Muslim woman living in the Netherlands who is guided by her religious beliefs regarding the moment of ensoulment (120 days after conception) information indicating a serious anomaly resulting from routine second-trimester ultrasound screening will be received too late to inform her choice regarding continuation of the pregnancy. Similarly, previous studies showed that not all pregnant Muslim women themselves have sufficient knowledge of the rulings of their own specific tradition on termination in the case of a congenital anomaly [18,35]. Neter et al observed similar findings and argued that midwives, in their role as counselors, are expected to inform Muslim women about prenatal screening tests and to discuss the possibility of termination if it comes to a fetus with serious anomalies [37].…”

Section: Discussionmentioning

confidence: 84%

“…The MIMES model identified a number of factors that are relevant in test uptake decisions, including not only well-known factors such as age, parity, family life and personal experience, but also ‘identity markers’ such as ethnicity and religion [10-14]. It is acknowledged that the difficult questions that confront clients in decision-making may be influenced by their religious convictions [15-18]. As the shared decision-making approach prescribes taking the client’s perspective into account, the question arises as to whether asking about client’s religious convictions should also be part of the counseling process.…”

Section: Introductionmentioning

confidence: 99%

“…An explanation of the flexible concept of a ‘serious’ anomaly is given by Rispler-Chaim: "the fetus is defective to a degree that it will never develop to live in a dignified normal life" [30]. Down’s syndrome, for example, ranges from mild to very serious forms and most women in our previous study among pregnant Muslim women from Turkish origin did not consider Down’s syndrome in general as severe enough to terminate a pregnancy [18]. …”

Section: Introductionmentioning

confidence: 99%

“…In the same study, Muslim women who were interviewed said it would be helpful if midwives knew about the Islamic perspective on the meaning of life when giving prenatal counseling [18]. This view is supported by international literature showing that professional knowledge of religious and cultural backgrounds of their clients is important, but insufficient [8,33,36-38].…”

Section: Introductionmentioning

confidence: 99%

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Prenatal screening for congenital anomalies: exploring midwives’ perceptions of counseling clients with religious backgrounds

Wal

Manniën

Gitsels

et al. 2014

BMC Pregnancy Childbirth

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BackgroundIn the Netherlands, prenatal screening follows an opting in system and comprises two non-invasive tests: the combined test to screen for trisomy 21 at 12 weeks of gestation and the fetal anomaly scan to detect structural anomalies at 20 weeks. Midwives counsel about prenatal screening tests for congenital anomalies and they are increasingly having to counsel women from religious backgrounds beyond their experience. This study assessed midwives’ perceptions and practices regarding taking client’s religious backgrounds into account during counseling. As Islam is the commonest non-western religion, we were particularly interested in midwives’ knowledge of whether pregnancy termination is allowed in Islam.MethodsThis exploratory study is part of the DELIVER study, which evaluated primary care midwifery in the Netherlands between September 2009 and January 2011. A questionnaire was sent to all 108 midwives of the twenty practices participating in the study.ResultsOf 98 respondents (response rate 92%), 68 (69%) said they took account of the client’s religion. The two main reasons for not doing so were that religion was considered irrelevant in the decision-making process and that it should be up to clients to initiate such discussions. Midwives’ own religious backgrounds were independent of whether they paid attention to the clients’ religious backgrounds. Eighty midwives (82%) said they did not counsel Muslim women differently from other women. Although midwives with relatively many Muslim clients had more knowledge of Islamic attitudes to terminating pregnancy in general than midwives with relatively fewer Muslim clients, the specific knowledge of termination regarding trisomy 21 and other congenital anomalies was limited in both groups.ConclusionWhile many midwives took client’s religion into account, few knew much about Islamic beliefs on prenatal screening for congenital anomalies. Midwives identified a need for additional education. To meet the needs of the changing client population, counselors need more knowledge of religious opinions about the termination of pregnancy and the skills to approach religious issues with clients.

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Hinduism and reproductive decision‐making:Karma,Samsara,and the in‐between

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Conway

2020

Journal of Genetic Counseling

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Investigations of the role of religious philosophy in reproductive decision‐making has exclusively focused on Abrahamic traditions. However, those who practice Eastern religions, such as Hinduism, represent an increasing proportion of the population in the United States and may present for prenatal care. Here, we consider tenets of Hindu philosophy as they may pertain to decision‐making surrounding women’s pregnancy termination. Such tenets include the cycle of rebirth (samsara), karma, dharma, Hindu writing, and the multivalent nature of Hindu philosophy. Through this brief communication we hope to present a starting point for further exploration which will increase cultural competency of genetic counselors while enhancing awareness of variations of religious beliefs patients may hold.

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The role of religion in decision-making on antenatal screening of congenital anomalies: A qualitative study amongst Muslim Turkish origin immigrants

Abstract: counsellors should be aware of the role of religious beliefs in the decision-making process on antenatal screening tests.

Cited by 40 publications

References 17 publications

Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study

Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study

Prenatal screening for congenital anomalies: exploring midwives’ perceptions of counseling clients with religious backgrounds

Hinduism and reproductive decision‐making:Karma,Samsara,and the in‐between

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