Present to future: What the reasons for declining first-trimester combined testing tell us about accepting or declining cell-free DNA testing

What's Already Known About This Topic? Women include their attitudes towards Down syndrome and termination of pregnancy, as well as adverse test characteristics, in their considerations about participation in first-trimester combined testing (FCT). Concerns have been raised about the 'routinisation' of prenatal screening with the introduction of non-invasive prenatal screening using cell-free DNA (cfDNA). What Does This Study Add? Women who would decline FCT for test-related reasons are possibly more likely to accept the safer cfDNA test. Women who decline FCT for reasons relating to attitudes towards Down syndrome and termination of pregnancy are more likely to decline cfDNA testing as well, or to see its value in preparing for the birth of a child with a disability.