Black parents’ views and understanding of prenatal genetic testing: a cross-sectional survey of attitudes, knowledge and trust in UK healthcare

Abstract Black women in the UK experience disproportionately poor maternal outcomes yet remain underrepresented in research on prenatal screening and diagnostic genetic testing (prenatal testing). We therefore know little about how Black parents feel and what they understand about these tests. Using a cross-sectional online survey, we assessed attitudes towards prenatal tests, knowledge of genetic terms and prenatal tests, and mistrust amongst Black and mixed Black heritage parents in the UK who had been pregnant in the last five years. 110 parents completed the survey (95% female). Screening was valued by most (89%), although only half (50%) reported willingness to undergo invasive diagnostic testing. Preparing for a child with a genetic condition or disability were key motivators for testing, whilst opposition to termination and concerns about miscarriage risk drove refusal. Healthcare professionals (HCPs) were the main source of information when discussing prenatal testing, though mistrust in healthcare systems was high and associated with lower reported uptake of both screening and diagnostic tests. Nearly three-quarters valued speaking to an HCP who shared their ethnic background. Misconceptions about sickle cell were common, with 40% believing it affects only African and Caribbean populations. While most parents recognised the term ‘DNA’, only 28% understood the term ‘genome’. Our findings highlight support for prenatal testing but reveal knowledge gaps and high mistrust that may undermine informed choice. Addressing misconceptions - particularly around sickle cell and available prenatal tests - alongside culturally responsive counselling and community-based education is essential to achieving equitable prenatal care for Black parents.