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After anonymization and transcription, interviews were coded inductively using thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our interviews showed the complexity of the decision making environment regarding prenatal screening funding. Participants agreed that NIPT is superior to maternal serum screening as a first\u2010tier test, but they also recognized that first\u2010tier NIPT has limits and barriers. They described the following conditions for its responsible implementation: (1) need for time and evidence; (2) taking stakeholders' perspectives into account; (3) limit costs for the healthcare system; (4) ensure appropriate logistical conditions and harmonize the test offer; (5) ensure appropriate clinical services; (6) ensure informed consent; (7) ensure the test is presented as an individual choice to avoid eugenic concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multiple barriers and issues need to be addressed before moving NIPT from second\u2010 to first\u2010tier. Decision makers' perspectives should be contrasted with those of other important stakeholders, including pregnant people, disability advocates and healthcare professionals.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6753","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T04:40:55Z","timestamp":1738384855000},"page":"453-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Towards a Responsible Implementation of NIPT as a First\u2010Tier Test in Canada: Decision\u2010Makers\u2019 Perspectives"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1803-4079","authenticated-orcid":false,"given":"Marie\u2010Christine","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Social and Preventive Medicine School of Public Health University of Montreal  Montreal 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