The influence of women’s cognitive status on their understanding of Down syndrome screening information and midwife communication

Aims: To establish whether women’s cognitive status influenced their understanding of Down syndrome screening information and to determine whether midwives offer the same oral explanation of Down syndrome screening to all women or if information was tailored to each woman based on their cognitive status.
Methods: Midwives (n=16) and women (n=100) were recruited from a regional National Health Service (NHS) unit in the United Kingdom (UK). A mixed methods design encompassed two components; audio-recorded antenatal consultations and quantitative surveys to assess women’s cognitive status and their understanding of Down syndrome screening information.
Findings: Whilst women with abstract reasoning skills and high Need for Cognition could understand information sufficiently, women with more concrete skills and low Need for Cognition require further explanation from the midwife to reach an informed decision.
Conclusions: Midwives did not tailor their communication based on women’s cognitive status, however if they had, all women should have left appointments well informed. This has implications for midwifery education programmes to train midwives to communicate Down syndrome screening information effectively.