'Let's have it tested first': Choice and circumstances in decision-making following positive antenatal screening in Hong Kong

Abstract

There now exists a considerable body of sociological work examining antenatal screening for fetal abnormalities. A common theme emerging from this literature is that pregnant women report not feeling able to exercise choice freely, experiencing constraints both from medical professionals and their perceived expectations of the sociocultures in which they live. This study adds to existing literature in three ways. Firstly, in contrast to the existing body of interview-based research, the study uses video recordings of actual consultations, in order to capture the interactional processes through which choice and constraints are established, negotiated and contested. Secondly, it explores the next stage in the process of antenatal screening, by focusing on women who are offered invasive diagnostic testing as a result of 'high risk' screening results, and who have been the subject of little research. Thirdly, the study site in Hong Kong provides a particularly interesting location, given limited research on antenatal screening in that part of the world, and Hong Kong's cosmopolitan environment that is reflected in the diversity of client population undergoing antenatal screening. Using conversation analysis we examine how aspects of the clients' diverse socioeconomic backgrounds and circumstances are interactionally managed in this setting, and how this might impact on decision-making. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.