During this time, they experienced uncertainty that forced them to confront both their and the foetus’ vulnerability – ‘a high-risk woman with the chance to have an abnormal foetus’. Marteau et al. (1989) noted that expectant mothers are better able to tolerate the balance of the pregnancy when results are normal. In this study, even women with normal results awaiting the birth of their child expressed some uncertainty. The feelings of relief from a normal result varied depending on the quality of procedure-related information and the woman’s state of mind as well as her understanding of the test and her expectation of having a child.
Davies and Doan (1982) investigated influences on women of advanced maternal age undergoing amniocentesis and identified three contributors: (1) perception of a miscarriage,
(2) understanding the need for amniocentesis and (3) concerns regarding harm to the foetus. In this study, many women expressed fear that they are at higher than average risk for foetal loss. A concern that individual personal risk is higher than the overall figure of pregnancies is common
(Tercyak et al. 2001). Discussion of factors that affect risk may clarify matters for both professionals and their patients ( Papantoniou et al. 2001, Hsu et al. 2004). Concurrent ultrasound guidance has proved to reduce loss rate and direct-needle injury to the foetus (Seeds 2004). Sharing such
information and accompanying the pregnancy women, while reflecting on the baby’s health during the procedure may reassure many women. In this study, several women also expressed how important it was for them to touch the foetus or see foetal movement on the ultrasound screen. The meaning of this contact with the foetus was not only about making sure that their baby was safe but also conveyed some sense of the parental role and contributed to the attachment they felt toward the new life within them. Maternal–foetal bonding was established and it is well known that bonding begins before conception for a planned pregnancy and becomes stronger with gestational ageing (Mercer & Ferketich 1990). During the first trimester, the foetus can be primarily an abstract concept, but movement during the second trimester leads to the perception of a foetus as an individual (Salisbury et al. 2003). It was found that the degree of bonding may decrease significantly during the period just preceding amniocentesis up to receipt of the test results (Heidrich & Cranley 1989). Furthermore, anxiety-related issues, including delay in publicly announcing the pregnancy, may be more pronounced in women who have positive attitudes toward elective abortion and those who perceive a high degree of risk for foetal defect (Silvestre & Fresco 1980, Tercyak et al. 2001).
Comparing amniocentesis between Eastern and Western countries, most routine steps of the procedure are similar. In general, it takes approximately 2–4 weeks for sufficient cells to allow for completing chromosome analysis. However ,most agencies in Taiwan would not disclose the results of prenatal genetic testing until routine outpatient department follow-up, four weeks following the test. Despite the results of the test being abnormal, health staff informed the test recipient actively two weeks after the test. Most people are frightened to receive the telephone call during the two to four weeks after the test and most staff console the woman that if they do not receive the information earlier, it means the results are normal, which is according to the rule of ‘no news is good news’. However, shortening the time to inform the result can be significant for the women to decrease their uncertainty. As with any decision a woman makes that affects another,
there are not only internal influences on the decision-making process but also external ones. It is important for health care providers to understand the timing and context within which a woman’s decisions are made to support a routine medical procedure that is correct for the individual