Acceptance of screening and abortion for Down syndrome among Finnish midwives and public health nurses.

In this study we evaluated how well maternal serum screening and abortions for Down syndrome were accepted among midwives and public health nurses, and compared how those who accepted and did not accept abortions for Down syndrome differed from each other. The questionnaire was mailed in 1998 to 400 midwives and 400 public health nurses. 79 per cent responded. The majority said that all pregnant women should be offered a screening test for Down syndrome, but less than half accepted abortion for Down syndrome. Thus, the 'informative part' of the screening (serum screening itself) is supported more often than the 'operative part' (selective abortion)-or at least the 'operative part' was found to be a more difficult question. We suggest that whereas screening may be perceived as a question of more choices, information and self-determination, abortion is more clearly a moral question. The professional background characteristics and attitudes of those accepting and not accepting abortion for Down syndrome were relatively similar, but having a midwife's education, practical involvement in serum screening and having patients with Down syndrome were associated with a somewhat higher percentage of acceptance and a lower percentage of 'don't know' responses.