Factors affecting Thai pregnant women's decisions concerning prenatal diagnosis and termination of pregnancy for β-thalassemia

Abstract

Aim: To investigate the factors influencing decisions concerning prenatal diagnosis (PND) and termination of pregnancy for β-thalassemia in Thai pregnant women. Methods: A total of 142 Thai Buddhist pregnant women waiting for PND were asked to undertake semi-structured interviews regarding their reasons for PND and their decisions and reasoning concerning pregnancy if the fetus was found to be affected. The interviews were analyzed using a thematic content approach. Results: Thai pregnant women accepted PND for three reasons: to know whether their pregnancies were affected, to confirm that their pregnancies were unaffected and to terminate if their pregnancies were affected. Three decisions identified among the women were to terminate the pregnancy, to continue the pregnancy and undecided. The interview analysis identified five themes and nine sub-themes affecting pregnancy-related decision-making: (i) quality of life (suffering or no disability); (ii) burden (difficulty or acceptability); (iii) sense of motherhood (the best way for the child or I cannot hurt my child); (iv) significant others (support to terminate, support to continue or support to wait for the test result) and (v) conflict in deciding. Conclusion: An acceptance of PND in Thai pregnant women was not always associated with pregnancy termination. Multiple factors influenced the decision to terminate, but not their religious affiliation.