Who declines from antenatal serum alpha-fetoprotein screening--and why?

One hundred women who declined a voluntary alpha-fetoprotein screening test during early pregnancy and one hundred women who accepted the test were investigated by means of semistructured interviews with particular reference to background factors which could have influenced upon the decision making. Those who declined were, as expected, overrepresented among those opposed to legal abortion and they often showed an ambivalent or negative attitude towards prenatal diagnosis as such. These women were also more frequently legally married and active members of various religious denominations. Otherwise there were no socioeconomic, psychologic or other background factors specially associated with women who declined. The paramount individual reason given for abstaining from the test was the feeling that the test was 'unreliable'. The personal ethical attitude, together with the current reputation of the test in society, seem to be major factors affecting the rate of participation in an AFP-screening program.