Discussion
In response to the question about whether NIPT should be offered by the public health service to all pregnant women regardless of age, three in four pregnant women under 35 years of age answered 'yes', 9 % answered 'no' and 15 % were unsure.
This is almost the same result as in a similar Norwegian study from 2020 (i.e. before the latest expansion of access in the Biotechnology Act) (14). In that study, pregnant women of all ages were asked about prenatal screening in general, whereas our study mainly focused on attitudes to NIPT. Furthermore, our study included participants from five university hospitals, while the 2020 study only covered the Oslo region (catchment area of Oslo University Hospital and Akershus University Hospital).
Among pregnant women in our study who indicated that religion was important to them, 26 % answered 'no' to offering NIPT to all pregnant women, compared to 12 % who said 'no' to prenatal screening in the 2020 study. The datasets are relatively small, and the studies are not directly comparable, but it can be assumed that a woman's attitude to religion is relevant to her attitude to prenatal screening in general and NIPT specifically.
Among pregnant women under 35 years of age who already had children, 12 % answered 'no' to offering NIPT to all pregnant women, compared to 7 % of nulliparous women. As multiparity is more common among women over the age of 35 years, our findings may not be representative of the overall pregnant population in Norway. However, the trend seems to be the same as before (14). Having previous experience of motherhood may influence attitudes to prenatal screening. Similarly, it is interesting that 10 % (99 out of 998) of women educated to university and college level answered 'no' to offering NIPT to all pregnant women, compared with 5 % (10 out of 200) of those with a lower level of education (Table 2).
A total of 68 % and 18 % of pregnant women under 35 years of age reported having had an ultrasound scan and/or NIPT earlier in pregnancy, respectively. For both variables, the vast majority (79 % and 95 %, respectively) thought that NIPT should be offered by the public health service.
In addition to the aforementioned study by Sitras et al. (2020), a study about attitudes to prenatal screening in Norway has been previously published (15). This was a general population study that included men and women (pregnant and not pregnant) and did not specifically focus on NIPT. A limitation of our study is that we only included pregnant women who are not currently offered NIPT through the public health service. Therefore, we cannot draw any conclusions about attitudes to this testing in the general population. However, figures from the Medical Birth Registry of Norway for 2024 show that 75 % of all women who gave birth in Norway were under 35 years of age. The variation in the counties represented ranged from 66 % in Oslo to 79 % in Trøndelag (16).
Among women who wanted NIPT to be provided, three in five women answered that this was to enable the pregnancy to be terminated if abnormalities were detected, while almost one in two women wanted the test in order to be prepared for having a child with a disability. This does not necessarily reflect what their actual decision would be if the test found abnormalities. Nonetheless, it demonstrates variations in the attitudes to prenatal screening among pregnant women in Norway. This is also reflected in what the pregnant women wanted in terms of the content of an early ultrasound scan.
A strength of the study is that it included pregnant women at university hospitals in all regions of Norway. This is in contrast to the previous study, which only included pregnant women in the Oslo area. A limitation of the study is the use of a non-validated questionnaire as no validated instrument exists for this purpose. This may have contributed to some inconsistent answers (e.g. 1188 answered that they know about NIPT, while 1200 answered the question about whether or not it should be offered on the public health service). We chose to create a questionnaire that had almost identical questions to the previous study in the Oslo area. This allowed us to compare the results from the two studies, although this was complicated by the age restriction in our recent study. Nevertheless, pregnant women under the age of 35 years represent the majority of the pregnant population in Norway.
It has been decided that pregnant women without a medical indication will be able to pay for NIPT through the public health service (17, 18). This will ensure equal access regardless of age or region of residence, but price may be a limiting factor. The policy was implemented on 1 September 2025.
Our findings indicate that the majority of younger pregnant women would like the prenatal screening on offer through the public health service to include NIPT. Many women want this test in order to have the option of terminating the pregnancy if serious fetal abnormalities are found, while others want to be prepared to care for a child with a disability. Women's autonomy is firmly upheld in modern society, and the new abortion law has further strengthened women's right to self-determination. The extent to which current biotechnology legislation and the policies being pursued reflect the society and times we live in and align with people's expectations remains open for discussion.