Empowering women's choice in the new era of non-invasive prenatal testing methods: Opting for routine perinatal care information over routine screening.

Routine prenatal screening programmes are often heralded as ways to empower women’s autonomous decision-making around pregnancy. The introduction of non-invasive prenatal testing (NIPT) is seen as enhancing the aim of empowering
women by making screening and testing easier, more accurate, and safer. However, the possibility of a systematic (routine) offer of NIPT has been linked with risk to women’s autonomous decision-making as the method’s ease is feared to impair deliberate and voluntary choice. In this landscape of conflicting views, NIPT is increasingly adopted globally. Technological advancements in the field increase the likelihood of systematically offering NIPT to all pregnant women and expanding its use to include more foetal conditions alongside common aneuploidies. In this paper, I argue that autonomous decision-making amidst the challenges of new screening and testing methods requires more than providing accurate, balanced, and non-directive information. To truly empower pregnant women with choice in this era, we need to move away from entrenched ideas of routinised screening and take a new approach. My suggestion is that only by routinely offering high-quality perinatal counselling followed by an option to choose to test for genetic conditions are we likely to come anywhere near our goal of enhancing women’s choice.