Prenatal care has gradually moved away from paternalism, to a state where patient autonomy and information is vital. It is known from other health care settings that the way information is presented affects understanding.The objective is to summarize current knowledge on aspects of informing pregnant women about prenatal examinations. Women's knowledge, decisional conflict, satisfaction and anxiety will be explored as compared with different ways and different groups of health professionals providing information. To what extent information empowers informed decision making will be explored as well.The review is based on systematic search strategy in the electronic databases Medline and Science Citation. Additional studies were identified through reference lists of individual papers obtained. Improving knowledge scores and reducing decisional conflict can be obtained by group counselling, individual sessions and by way of written materials. None of the interventions leads to a raise in anxiety scores or influence up-take rates. Satisfaction with information provided is found unrelated to level of knowledge, but associated with having expectations for information met. Information does not seem to empower women making an informed consent. Information on Down syndrome is often confined and limitations of screenings tests rarely mentioned. Understanding is better achieved by presenting the risk estimate as a numerical probability compared to a verbal explanation. Rates are better understood than proportions. Using medical words or lay terms can significantly alter risk perception. The way information is presented affects understanding. Information can increase knowledge level and reduce decisional conflict, without raising anxiety scores. A clarification of the women's expectations seems paramount.
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Congress of the Nordic Federation of Societies of Obstetrics and Gynecology (NFOG), 2006