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Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non\u2010Western ethnic origin and 64.4% were religious.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were \u201cI would never terminate my pregnancy\u201d (57.1%) and \u201cevery child is welcome\u201d (56.2%). For 16.9% of respondents, the out\u2010of\u2010pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out\u2010of\u2010pocket costs of NIPT hinder equal access for some pregnant women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6242","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T04:39:28Z","timestamp":1663303168000},"page":"467-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT)"],"prefix":"10.1002","volume":"43","author":[{"given":"Lisanne","family":"van Prooyen Schuurman","sequence":"first","affiliation":[{"name":"Department of Clinical Genetics Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Department of Public Health Erasmus MC University Medical Center Rotterdam  Rotterdam The 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