Pregnant women's attitudes and knowledge in relation to access to serum-alpha-fetoprotein test

Serum-Alpha-Fetoprotein (se-AFP) screening is a controversial issue in Sweden. In some areas the test has never been offered, in others it is routinely offered to all pregnant women and there are areas where the se-AFP test has been offered but is no longer available but for very special indications. This pseudoexperimental situation was used to analyze the effects of different information environments on attitudes to and knowledge of testing procedures at the antenatal clinics, especially the se-AFP test, and anxiety of malformations. Consecutive series of pregnant women in these three areas filled in questionnaires at their first visit, in the 22nd to 24th, and the 32nd to 35th weeks of pregnancy, and after delivery. The attitudes to prenatal screening were most positive in the routine screening area and most negative in the area which previously but no longer offers the test. The level of knowledge was somewhat higher in the routine screening area at the first visit to the clinic and increased substantially, especially in the routine screening area.