[Experiences of women who decided to continue the pregnancy after diagnosis of Down's syndrome]. / Ervaringen van vrouwen die besloten de zwangerschap uit te dragen na de diagnose 'Down-syndroom'.

OBJECTIVE: To gain insight into the motives and experiences of women who had decided to continue with the pregnancy after Down's syndrome had been diagnosed in the foetus. DESIGN: In-depth interviews. METHOD: In ten women who had decided to continue her pregnancy after Down's syndrome had been diagnosed in the foetus, qualitative in-depth interviews were held. Four women were pregnant at the time of the interview, the other six were parent of a Down's syndrome child already. One of the women was in her first pregnancy, the other nine had been pregnant once or several times. Four women had problems in their history (subfertility, miscarriage, in-vitro fertilisation). RESULTS: Many pregnant women were confronted with an increased risk as the result of maternal serum testing or nuchal translucency. They hoped to reduce the uncertainty which had arisen by submitting to an amniocentesis or a chorionic villus sampling. The result of this diagnostic test put those concerned in the position of having to make a difficult decision. They had to make the choice between having to bring up a child with intellectual limitations or allowing the termination of an already well-advanced pregnancy. For the ten respondents, the latter proved to be unacceptable. Initially, little understanding was shown for the parent's decision by some social and medical workers; however, sufficient help and support were usually given. The respondents received a lot of support from members of their family, friends and acquaintances, but there were also negative and disapproving reactions. Only one woman regretted the examination. CONCLUSION: As the technological possibilities for determining individual risks during pregnancy increase, it will occur more often that women hesitate to have their pregnancy terminated after diagnostic testing has identified Down's syndrome. Whatever decision is made, those involved should be treated with understanding.

[End of life and termination of life: opinions of elderly persons with health problems]. / Levenseinde en levensbeëindiging: meningen van ouderen met gezondheidsproblemen.

OBJECTIVE: To determine the views of elderly persons with physical limitations about a number of aspects of the end stage of life and termination of life. DESIGN: Enquiry. SETTING: University of Groningen, the Netherlands. METHOD: An enquiry was conducted in 1995 among 575 elderly (429 females, 146 males; age 57-99 years; 281 living alone) with physical restrictions (mostly heart disease, hypertension, rheumatism or other articular diseases). The group had been selected from the 'Groningen longitudinal aging study'. The respondents were asked (a) what they thought about euthanasia, (b) whether they worried about the end stage of life, (c) whether they were afraid of death and how much they were 'preoccupied with death'. For the last-mentioned two questions a visual analogue scale was used. RESULTS: Almost one-third of the elderly were not preoccupied with death and over half were not afraid of death. Very few scored high on these scales. Respondents' views about the acceptability of active termination of life varied greatly: almost half were of the opinion that their life had to be terminated once they themselves had developed complete dementia. Regarding the end stage of life, respondents mostly worried about being a burden to others, being completely dependent on others, having to say goodbye to their loved ones and having to suffer greatly. Elderly persons with poorer health were more preoccupied with death and worried more about the problems of the end stage of life. CONCLUSION: Most of those interviewed were not greatly preoccupied with or afraid of death. They did worry, however, about the problems that might be associated with the end stage of life.

[Opinion of primiparae on the possibility of sex selection]. / Oordeel van primiparae over de mogelijkheid van sekseselectie.

Recent medical-technological developments such as chorionic villi sampling and in vitro fertilization make sex selection in principle possible. The literature and our own experiences suggest an increasing demand for it. We interviewed a selected group of 180 women regarding sex selection, of whom 127 responded. More than 80% of these rejected a selection based on sex. The legitimacy of withholding information about the sex of the foetus is questionable. The existence of a demand, however small, should prompt professionals to take a stand about its acceptability.

[Women's opinion concerning oocyte donation for pre-embryonic studies]. / Meningen van vrouwen over eiceldonatie voor pre-embryo-onderzoek.

For the benefit of pre-embryonal research, women requesting sterilization may be asked whether they are prepared to donate egg cells. Recently, a questionnaire was sent to 144 women who had given birth to their second or third child at the University Hospital Groningen, asking them how they felt about egg cell donation: 68 (47%) of the questionnaires was returned. Of the respondents 45 (66%) felt that a request for donation could be made to women who were admitted to hospital for sterilization. 22 (32%) of the respondents said they would be willing to donate an egg cell themselves. Of these women, 10 said they would be willing to use hormone preparations for this purpose.

[Liver transplantation: patients' experiences]. / Levertransplantatie: ervaringen van getransplanteerden.

The Dutch orthotopic liver transplant programme was evaluated recently. This article focuses on the physical functioning, the pattern of activities, the social functioning and the level of wellbeing of 31 transplant patients. Data were generated by means of questionnaires and interviews. The majority of the patients look upon themselves as 'healthy'. Their physical potential has greatly improved. Three-quarters of the patient group think they are able to go back to work. However, from the interviews it appears that one third of the patient group suffered from more or less serious psychological problems following transplantation.

[Attitudes of pregnant women concerning testing for HIV infection]. / De houding van zwangeren ten aanzien van het onderzoek op HIV-infectie.

Since July 1987 pregnant women who attend the outpatient clinic of the University Hospital in Groningen are tested for HIV-infection after informed consent. Their opinion of this policy was examined by means of a questionnaire. This questionnaire was answered by a group of women who had delivered and by a group tested recently. Of these 95.9% and 89.8%, respectively, felt it would be desirable to test all pregnant women; 30% felt obliged to be tested. Informed consent was of importance according to 58.8%; 84.8% were worried about a risk of 1:10,000 of acquiring HIV-infection; 16.6% would still feel very anxious if this risk were 1:1,000,000. Many of the women were prepared to pay for testing, if this would reduce these risks. The results show a positive attitude to screening for HIV-infection. However, a restrained policy remains advisable as the prevalence is still low and screening is considered more or less obligatory by the women involved.