This study focused on decision-making on terminating pregnancy for Arab Muslim women in Israel who were pregnant with fetuses diagnosed with congenital anomalies. It examined the impact of the doctor-patient interaction on the women’s decision, especially in light of social and religious pressures not to terminate under any circumstances. Our goal was to identify perceptions and attitudes of Muslim Arab women who choose to continue their pregnancy following the detection of congenital anomalies in prenatal tests. Specific objectives included (1) To examine the Muslim Arab women’s perceptions on genetic testing, and ascertain the reasons for their decision to continue the pregnancy following the detection of a congenital anomaly in the fetus; and (2) To examine risk communication of gynecologists regarding genetic testing and abortions, and regarding the decision of continuing or terminating a pregnancy following detection of a congenital anomaly.
The research framework used the constructivist classical qualitative method to understand the experience of women at high risk for congenital anomalies and their experience of how doctors communicate the risk.
It showed that the emotional element is no less dominant than religious and social elements. The findings emphasized the disparities between doctors and women regarding emotional involvement (non-directive counselling). The women interviewees (N = 24) felt that this expressed insensitivity. As far as we know, the emotional component has not been raised in previous studies of Muslim women at high risk for congenital defects in their fetus, and therefore comprises a significant contribution of the present study.
To mitigate gaps, doctors should take affect into consideration in their communication with patients. It is important for doctors to understand the emotional element in risk communication, both in how they respect women’s emotions and in creating an emotional interaction between themselves and the women.
Rauch ER, Smulian JC, DePrince K, Ananth CV, Marcella SW. New Jersey Fetal Abnormalities R. Pregnancy interruption after second trimester diagnosis of fetal structural anomalies: the New Jersey Fetal Abnormalities Registry. Am J Obstet Gynecol. 2005;193(4):1492–7. doi: 10.1016/j.ajog.2005.02.099. CrossRefPubMed
WHO. Congenital anomalies. 2016. http://www.who.int/mediacentre/factsheets/fs370/en/. Accessed 15 Mar 2017.
Zlotogora J, Haklai Z, Rotem N, Georgi M, Rubin L. The impact of prenatal diagnosis and termination of pregnancy on the relative incidence of malformations at birth among Jews and Muslim Arabs in Israel. Isr Med Assoc J. 2010;12(9):539–42. PubMed
Jaber L, Dolfin T, Shohat T, Halpern GJ, Reish O, Fejgin M. Prenatal diagnosis for detecting congenital malformations: acceptance among Israeli Arab women. Isr Med Assoc J. 2000;2(5):346–50. PubMed
Lewando-Hundt G. Evaluation and improvement of maternal and child health services for Palestinians in Gaza and Bedouin in the Negev. Final report on CT93AV12-031. Brussels: European Commission, DGXII1999.
Lewando-Hundt G, Forman MR. Autonomy access and care: a study of Palestinian Bedouin of the Negev in Israel. Soc Sci Health. 1997;3(2):96–112.
Gitsels-van der Wal JT, Mannien J, Ghaly MM, Verhoeven PS, Hutton EK, Reinders HS. The role of religion in decision-making on antenatal screening of congenital anomalies: a qualitative study amongst Muslim Turkish origin immigrants. Midwifery. 2014;30(3):297–302. doi: 10.1016/j.midw.2013.04.001. CrossRefPubMed
Weitzman D, Shoham-Vardi I, Elbedour K, Belmaker I, Siton Y, Carmi R. Factors affecting the use of prenatal testing for fetal anomalities in a traditional society. Community Genet. 2000;3(2):61–70.
Jaber L, Halpern G, Samara S. Prenatal testing and termination of future pregnancies in Arab mothers of children with severe defects: impact of Moslem cleric or physician on the decision making. Open J Genet. 2011;1:54–9. http://dx.doi.org/10.4236/ojgen.2011.13010. CrossRef
Winnicott DW. The capacity to be alone. Int J Psychoanal. 1958;39(5):416–20. PubMed
Raphael-Leff J. Healthy maternal ambivalence. Stud Matern. 2010;2(1):1–16. http://doi.org/10.16995/sim.97.
Cohen LJ, Slade A. The psychology and psychopathology of pregnancy: reorganization and transformation. In: Zeanah Jr CH, editor. Handbook of infant mental health. 2nd ed. New York: The Guilford Press; 2000. p. 20–36.
Harper P, Clarke A. Genetics, Society and Clinical Practice. Oxford: BIOS Scientific Publishers; 1997.
Halamish-Shani A. Medicine, law and communication. Med Law J. 2001;24:3–5.
Ulin PR, Robinson ET, Tolley EE. Qualitative methods in public health: a field guide for applied research. Med Sci Sports Exerc. 2005;37(7):1249. CrossRef
Krueger RA, Casey MA. Focus groups: a practical guide for applied research. 3rd ed. Thousand Oaks, CA: Sage Publications; 2000.
Strauss A, Corbin J. Basics of qualitative research, techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks: Sage Publications; 1998.
Charmaz K. Grounded Theory: Objectivist and Constructivist Methods. In: Denzin NK, Lincoln YS, editors. Handbook of Qualitative Research. 2nd ed. Thousand Oaks, Ca: Sage; 2000. p. 509–35.
Atkin K, Ahmed S, Hewison J, Green JM. Decision-making and ante-natal screening for sickle cell and thalassaemia disorders: to what extent do faith and religious identity mediate choice? Curr Sociol. 2008;56(1):77–98. CrossRef
Ahmed S, Hewison J, Green JM, Cuckle HS, Hirst J, Thornton JG. Decisions about testing and termination of pregnancy for different fetal conditions: a qualitative study of European white and Pakistani mothers of affected children. J Genet Couns. 2008;17(6):560–72. doi: 10.1007/s10897-008-9176-x. CrossRefPubMed
Moghadam VM. Women, structure, and agency in the Middle East: introduction and overview to feminist formations’ special issue on women in the Middle East. Fem Form. 2010;22(3):1–9. CrossRef
Charrad M. Kinship, Islam, or oil: culprits of gender inequality? Polit Gend. 2009;5(4):546–53. CrossRef
Hall JA, Harrigan JA, Rosenthal R. Nonverbal behavior in clinician—patient interaction. Appl Prev Psychol. 1995;4(1):21–37. http://dx.doi.org/10.1016/S0962-1849(05)80049-6. CrossRef
Buckman R. Breaking bad news: why is it still so difficult? Br Med J (Clin Res Ed). 1984;288(6430):1597–9. CrossRef
- Decision-making on terminating pregnancy for Muslim Arab women pregnant with fetuses with congenital anomalies: maternal affect and doctor-patient communication
Nour Abed Elhadi Shahbari
- BioMed Central
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