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Article

A Survey of Prenatal Testing and Pregnancy Termination Among Muslim Women in Mixed Jewish-Arab Cities Versus Predominantly Arab Cities in Israel

by
Mahdi Tarabeih
1,†,
Aliza Amiel
1 and
Wasef Na’amnih
1,2,*,†
1
School of Nursing Science, The Academic College of Tel Aviv-Yaffo, Tel Aviv 61083, Israel
2
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Women 2025, 5(3), 30; https://doi.org/10.3390/women5030030
Submission received: 11 July 2025 / Revised: 13 August 2025 / Accepted: 19 August 2025 / Published: 21 August 2025
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Abstract

Cultural and religious norms significantly influence reproductive decisions, including prenatal testing and pregnancy termination. We conducted a cross-sectional study among Muslim women living in mixed Jewish-Arab cities compared to those in predominantly Arab cities in Israel. Data for all co-variates were obtained through participants’ self-reports by an online questionnaire of 36 items for adequate content validity between July 2022 and June 2023. In total, 1081 Israeli Muslim women aged 18–49 years were enrolled. Religious affiliation has been shown to influence individuals’ attitudes toward abortion, with members of religious communities often holding more restrictive or negative views on the subject. Muslim women residing in mixed Jewish-Arab cities demonstrate significantly higher uptake of both non-invasive and invasive prenatal testing, as well as pregnancy terminations following abnormal diagnoses, compared to those in predominantly Arab cities (p < 0.001), which indicates that proximity to Jewish communities, greater availability of health services, and exposure to more permissive social norms in mixed cities may reduce religious and cultural barriers, thereby facilitating more informed reproductive decisions. Older women (≥35) in mixed cities had a higher tendency to birth a child with abnormalities in the past than Arab cities (80.9% vs. 70.0%, respectively), However, women who lived in mixed cities underwent more non-invasive (87.2% vs. 64.8%, respectively), invasive prenatal tests (85.1% vs. 69.7%, respectively), and pregnancy termination (88.3% vs. 64.1%, respectively) than those in Arab cities, p < 0.001. Our findings indicate the importance of gaining a deeper understanding of the relations between religious convictions, cultural standards, and medical practices that should contribute to reducing the prevalence of genetic disorders with their associated adverse impact on families, communities, and healthcare systems.

1. Introduction

Religious and cultural contexts play a crucial role in shaping attitudes toward abortion and prenatal testing [1]; however, previous studies demonstrate that religious affiliation often influences perceptions and decision-making regarding pregnancy termination [2,3]. Few studies have explored the influence of religious factors on carrying out diagnostic tests and abortions in religiously diverse cities as compared with religiously homogenous cities [4,5,6].
However, a previous international study has shown that in neighborhoods with a higher concentration of religious individuals—such as those in the United States and Europe—women were more influenced by their surroundings and tended to align more closely with religious norms, which could affect their decisions regarding abortion [4]. Local media in cities lacking religious diversity were more inclined to reflect the dominant religious views, with a tendency towards preserving adherence to religious commandments and less support for termination of pregnancy [5]. Moreover, rural populations were more likely to oppose abortions and same-sex relationships than those not residing in rural areas [6].
Muslims disapprove of abortion more strongly than members of other religions [7]. Surveys conducted among Muslims have established that higher levels of religiosity are correlated with greater opposition to abortion [2,8,9]. Regarding the attitudes of Arab women in Israel, 35.0% would not consider a pregnancy termination even when the fetus was diagnosed with a congenital abnormality, including those of genetic origin; however, 35% would consider terminating only within the first 120 days of the pregnancy, and 22.0% reported that they would terminate in the event of a congenital abnormality [10]. The rate of induced abortions in Israel is 13.9 per 1000 women vs. 20 per 1000 in European Union countries [11]. In Israel, during 2020, 99.6% of 16,492 requests for pregnancy termination were approved, where a fifth of the requests were due to fetal abnormalities [12]. In Israel, although most abortions in 2022 were among women living in big cities, the number of abortions among women residing in rural areas increased by 3.1% compared to 2021 [13].
According to the Israel Central Bureau of Statistics, 19% of the pregnancy termination applications in 2018 were attributed to “the risk of physical or mental disability of the fetus” [14]. Intention to terminate pregnancies (e.g., due to intellectual disability) is common in Israel [15,16] and is associated with the high uptake of prenatal tests [17,18], which are considered an essential element in being responsible parents [19].
In Israel, invasive testing is covered by the Ministry of Health in cases of major fetal anomalies that are identified by using ultrasound or relevant family history, such as parental balanced chromosomal rearrangement, carrier couples for autosomal recessive diseases, or previous pregnancy with chromosomal aberration [20]. There is an underutilization of amniocentesis among Muslim Arab women at risk of Down Syndrome and eligible for amniocentesis free of charge due to advanced maternal age or other medical indications. Only 17.9% of eligible pregnant women from the Northern Triangle region of Israel underwent amniocentesis [21]. However, the average uptake of invasive testing among the 1,549,962 live births in Israel between 2011 and 2019 was 13.0% [20]. Since 2019, all invasive tests in Israel have been conducted using chromosomal microarray analysis, with a higher sensitivity than standard karyotyping [22,23].
Non-Invasive Prenatal Test (NIPT) is a safe and reliable screening method used primarily to detect common fetal aneuploidies such as trisomy 21, 18, and 13 in high-risk pregnancies and to reduce the number of invasive diagnostic procedures [24,25,26]. The American College for Obstetricians and Gynecologists (ACOG) recently recommended that NIPT be available to all pregnant women, regardless of age or previous risk [27]. However, the average uptake of NIPT in Israel was 4.3% between 2013 and 2019 [20]. NIPT is a global screening test; however, in Israel, it costs approximately 750 USD with supplementary health insurance, while an invasive test (amniocentesis or chorionic villus sampling) is needed as a diagnostic test before pregnancy termination [28].
The utilization of non-invasive prenatal screening is influenced by a variety of factors, including literacy, cultural factors, religion, ethnicity, education, knowledge, and maternal age [25,29,30,31,32,33]. Some women did not understand that the test was optional [34,35]; however, others were unaware of this or could not pay for the test [36].
Previous studies have indicated that women with low education and low-income levels were less likely to undergo fetal anomaly screening due to language and logistical barriers, accessibility and availability of tests in the residential area, inadequate knowledge, and inconsistency in counseling and information provided by healthcare professionals [25,33,37,38,39].
To date, no information exists in the literature on the differences in beliefs of Muslim women residing in mixed cities compared to those in Arab cities regarding the uptake of NIPT, invasive testing, or parental decision-making after receiving a prenatal diagnosis. To our knowledge, this is the first study to compare the uptake of prenatal testing and the acceptance of pregnancy termination following abnormal diagnoses among Muslim women residing in mixed versus predominantly Arab cities in Israel. This comparison is important because it enables us to examine how social, cultural, and regional factors—including potential barriers to access, exposure to secular norms, and the availability of healthcare services—impact women’s reproductive decisions. In mixed cities, greater access to health services and increased exposure to Jewish Israeli norms might reduce the cultural and religious constraints typically observed in more homogenous Arab cities. Therefore, identifying these differences can inform culturally sensitive genetic counseling and equitable healthcare policy. Accordingly, our main aim was to explore differences in undertaking prenatal tests and pregnancy terminations between Muslim women living in mixed and Arab cities in Israel.

2. Results

In total, 1081 Israeli Muslim women aged 18–49 years (M = 34.9, SD = 7.9) were enrolled. Among the participants, 45.9% identified as religious, and 52.4% had completed a university-level education (bachelor’s degree or higher). Many participants had experienced pregnancies (M = 6.7, SD = 3.6, R = 0–14) and given birth to children (M = 5.0, SD = 2.8, R = 0–11). Some had experienced miscarriages [spontaneous abortions] (M = 1.1, SD = 0.7, R = 0–3) and others underwent abortions (M = 0.6, SD = 0.6, R = 0–2). Reporting on their most recent pregnancy, 47.3% reported experiencing a spontaneous conception, and 48.2% underwent NIPT.
The demographic differences (continuous variables) in the different regional groups (Mixed center, Mixed South, Mixed North, Muslim Center, Muslim South, Muslim North) are displayed in Table 1, which show significant differences in mother’s age and number of children/pregnancies/miscarriages/abortions [pregnancy terminations] following abnormal diagnoses between the different regional groups, p < 0.001 (Table 1).
Attitudes, perceptions, and beliefs regarding invasive tests and pregnancy terminations by regional groups are displayed in Table 2 (planned abortion induces anger, depression, sadness, helplessness, and guilt, the belief that religious authorities should confirm abortion if there are abnormalities with the fetus, friends’ support on planned abortion due to abnormalities, behaving in line with religious values and tradition, etc.); however, these items were significantly associated with different regional groups (Mixed center, Mixed South, Mixed North, Muslim center, Muslim South, Muslim North), p < 0.001. Women residing in Arab cities receive less genetic or medical counseling and are influenced by their strong religious beliefs (Table 2).
Significant differences were also found between the different regional groups and those who underwent invasive tests; amniocentesis (AC) or chorionic villus sampling (CVS) tests, indicating that women who lived in the center’s mixed cities (M = 5.7, SD = 1.3) underwent more AC or CVS tests than those in the center Arab cities (M = 2.3, SD = 0.9) and the other regional groups (north and south) both in mixed and Arab cities, p < 0.001 (Table 2). However, women who lived in the north (M = 6.3, SD = 1.1) and south (M = 5.7, SD = 1.2) mixed cities underwent more AC or CVS tests than those in Arab cities in the north (M = 5.5, SD = 2.0) and south (M = 3.6, SD = 1.4) regions, p < 0.001 (Table 2).
Undergoing NIPT (yes/no) was significantly associated with different regional groups, indicating that women living in the center’s mixed cities underwent more NIPT than those in the center’s Arab cities and the other regional groups (north and south) in both mixed and Arab cities. However, women who lived in the north and south regions underwent more NIPT in mixed cities than in Arab cities, p < 0.001 (Figure 1).
Pregnancy termination after a positive prenatal diagnosis for abnormalities (yes/no) was significantly associated with different regional groups, indicating that women who lived in mixed as well as in Arab cities performed pregnancy termination after a positive prenatal diagnosis for abnormalities in the center region more than women who lived in the south and north regions, p < 0.001 (Figure 2).
A significant association between age groups (<35 years [n = 418; 38.7%]/≥35 years [n = 663; 61.3%]) and a recent spontaneous conception (yes/no) in the different regional groups indicated that older participants (≥35) reported a recent spontaneous conception less frequently than younger participants (<35) both in mixed (10.9% vs. 74.5%, respectively) and Arab cities (36.6% vs. 100%, respectively), p < 0.001 (Table 3). Age groups (<35/≥35) were also significantly associated with undergoing NIPT (yes/no) in the different regional groups, indicating that older participants (≥35) tended to undergo NIPT more than younger participants (<35) both in mixed (87.2% vs. 3.4%, respectively) and Arab cities (64.8% vs. 0%, respectively), p < 0.001 (Table 3). Older women (≥35) in mixed cities were more likely than those in Arab cities to have given birth to a child with abnormalities in the past (yes/no) in mixed cities than in Arab cities (80.9% vs. 70.0%, respectively). They were also more likely to undergo prenatal AC or CVS (yes/no) (85.1% vs. 69.7%, respectively), receive genetic consultancy before a prenatal diagnosis (yes/no) (92.3% vs. 66.9%, respectively), receive physician consultancy before a prenatal diagnosis (yes/no) (95.2% vs. 78.0%, respectively), and terminate a pregnancy after a positive prenatal diagnosis for abnormalities (88.3% vs. 64.1%, respectively), p < 0.001 (Table 3).

3. Discussion

We examined differences in performing prenatal tests and pregnancy terminations by comparing Muslim women living in mixed communities with those living in Arab cities in Israel. It is well known that pregnancy termination is not permitted in Islam after the first 120 days following conception, except in special cases, such as to save the mother’s life [40,41]. Indeed, studies focusing on Muslim women from Western countries have highlighted the possible effects of cultural and religious factors that play a role in their decisions, i.e., as to whether to undergo prenatal testing. Specifically, undergoing NIPT, which is widely used by the general population, decreased among Muslim women more than in other populations [25,26,40,41,42,43,44,45]. Previous studies from the Netherlands, Australia, the United Kingdom, and the United States demonstrate significant associations between residential areas with socioeconomic disparities and prenatal screening for fetal anomalies [25,26,38,46,47,48,49,50].
A study conducted in Israel among Arab Muslim women whose fetuses had been diagnosed with congenital anomalies focused on the subjects’ decision-making process as to whether to undergo a pregnancy termination and found that physicians only consider the social and religious factors that may affect the woman’s decision-making process when communicating with their patients [10]. Israeli Muslim women are at an increased risk of delivering malformed newborns due to the high frequency of consanguinity [31,45]. Furthermore, the acceptance level of prenatal testing was found to be relatively low owing to their “religious opposition” in terminating their pregnancy, based on receiving guidance from health professionals [50].
According to our results, women residing in Arab cities receive less genetic or medical counseling and are influenced by their strong religious beliefs. The influence of religious beliefs, cultural norms, and access to healthcare on decision-making has been validated in other international contexts. For example, studies conducted among Muslim populations in the Netherlands and Australia have similarly demonstrated how religious beliefs and minority status influence the uptake of prenatal testing and decisions regarding pregnancy termination, especially in socioeconomically disadvantaged or ethnically concentrated neighborhoods [31,45]. Thus, our study might inform clinical practice, counseling approaches, and health policy in other diverse or segregated societies where religious norms intersect with reproductive decision-making. However, previous studies [2,9,18,51] have shown that most of the women who refused to undergo prenatal testing and/or to undergo pregnancy termination were religious, concurring with our study’s findings.
A Dutch study published in 2014 revealed that religious conviction played a role in prenatal screening decisions among pregnant Muslim women of Turkish origin who would not consider pregnancy termination even when the fetus was found to have an abnormality [31]. Several studies have examined the effects of ethnic differences on the numerous prenatal tests chosen by pregnant women [48,52,53]. For example, in England, Pakistani women chose not to undergo invasive tests following abnormal test results due to the risk of abortion and the difficulties in pregnancy termination [54]. In Israel, a study focusing on the Muslim woman’s decision-making process regarding termination of pregnancy in cases of diagnosed congenital anomalies examined the effect of the physician-patient relationship on the woman’s decision, while considering social and religious pressures not to terminate the pregnancy under any circumstances [10]. The authors concluded that, to address the issue, physicians must consider social and religious pressures when engaging with their patients. Physicians must understand the emotional elements of risk communication, both in creating an empathetic interaction with the women and in respecting the women’s feelings [10]. However, despite the high frequency of consanguineous marriages among the Muslim Arab population in Israel, there is a relatively low level of acceptance of prenatal testing because of their “religious opposition” to pregnancy termination [50]. This finding is supported by previous Israeli studies comparing Jewish versus Muslim women’s decisions to terminate a pregnancy [2,55,56]. It was also supported by an Australian study conducted with a Muslim population [45].
An Egyptian study investigating the changes in attitude towards pregnancy termination found a declaration from the High Islamic Council Fatwa that, in the case of in-depth counseling and a prenatal diagnosis of fetal abnormality, abortion is permissible if performed up to 120 days of pregnancy. The Fatwa, issued by the Islamic Jurisprudence Council of the World Islamic League during its 12th session (15–22 Rajab 1410H/10–17 February 1990G) in Makkah Al-Mukarama, reached a consensus by a majority vote to permit abortion under specific conditions [57].
Our study highlights that Muslim women residing in mixed Jewish-Arab cities demonstrate significantly higher uptake of both non-invasive and invasive prenatal testing, as well as pregnancy terminations following abnormal diagnoses, compared to those in predominantly Arab cities. This indicates that proximity to Jewish communities, greater availability of health services, and exposure to more permissive social norms in mixed cities may reduce religious and cultural barriers, thereby facilitating more informed reproductive decisions. This finding underscores the potential impact of sociocultural integration on medical decision-making in diverse communities. Significant differences were also found between the different regional groups and those who underwent invasive tests; AC or CVS tests, indicating that women who lived in the center’s mixed cities underwent more AC or CVS tests than in the center Arab cities and the other regional groups (north and south), both in mixed and Arab cities. However, women who lived in mixed cities in the north and south underwent more AC or CVS tests than those in Arab cities in the north and south regions. These distinctions reflect meaningful cultural, religious, and healthcare access differences that are essential to the interpretation of our findings.
Our findings also showed that older women (≥35) in mixed cities had a higher tendency to give birth to fetuses with abnormalities in the past than those in Arab cities, as well as to undergo prenatal AC or CVS, receive genetic consultancy before a prenatal diagnosis, receive physician consultancy before a prenatal diagnosis, and undergo pregnancy termination after a positive prenatal diagnosis for abnormalities. The self-report for births with abnormalities in the past likely reflects past pregnancies that occurred before the broader uptake of prenatal testing and pregnancy termination. However, they demonstrated higher current uptake of diagnostic testing and pregnancy terminations, suggesting a shift toward greater acceptance of prenatal interventions in recent years. We assume that due to advanced maternal age and increased risk of abnormalities and spontaneous abortions, women from the southern and central regions received more medical and genetic counseling and underwent more prenatal tests and pregnancy termination compared to those in the north of the country, which is consistent with findings from other studies [58,59,60,61].
Only a few studies have examined the influence of religious factors in mixed versus non-mixed cities regarding performing diagnostic tests and women’s attitudes toward abortion. A USA study [4] reporting on Catholic women who live in religious neighborhoods found that proximity can have a formative effect on shaping behavior, opinions, attitudes, and decision-making regarding abortion. In religious environments, i.e., neighborhoods with a higher concentration of religious people, the women are more likely to develop relationships with other religious people, which may influence their behavior and opinions. In addition, in non-mixed cities, the local media tend to reflect dominant religious views with a propensity to promote religious observance and lessen the support for abortion [5].
We believe that the same issues are in play in decision-making regarding prenatal tests/pregnancy termination in mixed cities in Israel, where Jewish and Muslim populations live in proximity to each other. The Jewish and Muslim populations in a mixed city, especially in the center of the country, use the same health services, including genetic counseling. Furthermore, the secular Jewish population’s influence on Muslim attitudes and decision-making about undergoing prenatal tests and pregnancy termination was reflected in the mixed cities. Accordingly, although prenatal tests and pregnancy termination are performed all over the country, it appears that in the center, more tests/pregnancy terminations are performed due to the greater availability of genetic counseling and health services there.
The main strengths of our study are a large sample size and that it is the first study in Israel that compares the attitudes toward prenatal tests and abortion of Muslim women living in mixed and Arab cities in Israel.
The limitations of the current study center around the need for a further understanding of the real reasons why women go for prenatal and genetic counseling. Moreover, it was important to ask the participants who lived in Arab cities whether they would have preferred to live in one of the mixed cities to benefit from the improved and more accessible medical services. We used a convenience sample, which may have introduced selection bias; thus, the generalizability of our findings might be limited. We also used self-reports, which might have resulted in reporting bias.

4. Materials and Methods

4.1. The Study Design and Population

We conducted a cross-sectional study among Israeli Muslim women aged 18–49 years residing in mixed cities and Arab cities in different regions (North, Center, and South) in Israel. In our study, mixed cities are defined according to the Israel Central Bureau of Statistics as municipalities where both Jews and Arabs reside in significant proportions, often with a Jewish population of 70% or higher and an Arab population of 30% or lower. This includes cities such as Haifa, Lod, Ramla, and Tel Aviv-Yaffo, where there is daily interaction between Jewish and Muslim populations and shared access to healthcare services. Arab cities were defined as municipalities with a predominantly Muslim population (above 90.0%) [13]. We established contact with 1192 women using the Qualtrics method and snowball sampling, specifically addressing the online questionnaire to them via a link through social networks, mother and child clinics (Tipat Chalav), and family health nurses, of whom 1081 (91.0%) completed the questionnaire between July 2022 and June 2023. According to the Central Bureau of Statistics, the population of Israel comprises 74% Jewish, 21% Arab, and 5% other groups [61]. The Arab population in Israel had lower socioeconomic status and educational levels compared to the Jewish population [62]. Of this population, 1,682,300 citizens lived in Arab cities and 460,900 in mixed cities [61].

4.2. Data Collection and Definition of the Study Variables

Five experienced professionals in the fields of genetics, nursing, epidemiology, pediatrics, and public health collaborated in developing and verifying the study questionnaire to ensure adequate content validity. The online questionnaire was created using the Qualtrics method and specifically promoted via social networks, mother and child clinics (Tipat Chalav), and family health nurses. The questionnaire was also circulated using snowball sampling, where each participant was asked to pass on the questionnaire to other people they knew who fit the study criteria, allowing access to populations that are otherwise difficult to locate. There was no remuneration for participating in the study.
The questionnaire was originally written in Hebrew and translated into Arabic, then translated back into Arabic and checked by translators specializing in the language of the questionnaire to ensure ease of understanding. It included 36 items: sociodemographic characteristics (i.e., age, place of residence, religiosity, education level, and number of children/pregnancies/miscarriages and number of abortions due to a diagnosis of fetal malformation or aneuploidy); questions regarding receiving genetic or medical consultancy, consulting with a religious authority to consider invasive tests, spontaneous conception, performing prenatal tests (invasive tests [amniocentesis or chorionic villus sampling] and non-invasive tests [NIPT, Alpha-fetoprotein screening, and Nuchal Translucency]), and pregnancy terminations; questions regarding attitudes, perceptions, beliefs and potential factors for prenatal tests and pregnancy terminations (Planned abortion induces anger, depression, sadness, helplessness, and guilt), the belief that religious authorities should confirm abortion if there are abnormalities with the fetus. Other items related to friends’ support on planned abortion due to abnormalities, and behaving in line with religious values and tradition. Data for all covariates were obtained through women’s self-reports via the online questionnaire.

4.3. Statistical Methods

The Kolmogorov–Smirnov test was performed to examine the normal distribution, which indicated a normal distribution for the continuous variables in our study. Means (M), standard deviations (SD), and ranges (R) were reported for the continuous variables. Comparisons between groups were made using chi-squared and Fisher’s exact tests for categorical variables, while Student’s t-tests or one-way ANOVA were used for continuous variables. Data analyses were carried out using Statistical Package for the Social Sciences (SPSS) version 28 (IBM, Armonk, NY, USA) with a significance threshold of p < 0.05, which was considered to reflect statistical significance.

4.4. Ethical Aspects

All procedures performed in our study involving human participants followed the ethical standards of the Institutional Review Board (IRB) at the Academic College of Tel Aviv-Yaffo (Protocol number 2022-1083). Respondents signed informed consent forms to participate in the study.

5. Conclusions

More prenatal tests and pregnancy terminations are performed among Muslim women who live in mixed cities compared to Arab cities and in the central region than in the northern and southern regions of Israel; However, the influence of mixed communities may partly explain the higher rates of prenatal test uptake and pregnancy termination observed among Muslim women in these areas, pointing to the role of cultural integration, religion, and shared healthcare systems. This may be attributed to more genetic counseling and the influence of Jewish society. Religious scholars, such as imams and muftis, are needed to address some of the misconceptions regarding prenatal tests and abortions, in addition to more health professionals, including genetic counselors, to provide services to the Arab cities, particularly those in the northern and southern regions of Israel. Our findings indicate the importance of gaining a deeper understanding of the relations between religious convictions, cultural standards, and medical practices that should contribute to reducing the prevalence of genetic disorders with their associated adverse impact on families, communities, and healthcare systems.

Author Contributions

Conceptualization, M.T., A.A. and W.N.; methodology, M.T. and W.N.; formal analysis, M.T., A.A. and W.N.; investigation, M.T., A.A. and W.N.; writing—original draft preparation, M.T., A.A. and W.N.; writing—review and editing, M.T. and W.N. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The Institutional Review Board (IRB) approved the study protocol at the Academic College of Tel Aviv-Yaffo (Protocol number 2022-1083); all procedures followed local guidelines and regulations.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study. The participants were given a detailed explanation of the study in their native language (Arabic) and were asked online to provide an informed consent form.

Data Availability Statement

Due to legal and ethical restrictions, individual-level data cannot be publicly available. Aggregative data might be provided upon reasonable request to the corresponding author.

Conflicts of Interest

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Abbreviations

The following abbreviations are used in this manuscript:
ACOGAmerican College for Obstetricians and Gynecologists
ACAmniocentesis
CVSChorionic villus sampling
IRBInstitutional Review Board
MMeans
NIPTNon-Invasive Prenatal Test
RRanges
SDStandard deviations
SPSSStatistical Package for the Social Science

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Women 05 00030 g001
Figure 1. Distribution of Non-Invasive Prenatal Testing (NIPT) by regional groups.
Figure 1. Distribution of Non-Invasive Prenatal Testing (NIPT) by regional groups.
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Women 05 00030 g002
Figure 2. Distribution of pregnancy termination after prenatal diagnosis by regional groups. Note. The number in brackets is the number of women who had undergone pregnancy termination in each regional group.
Figure 2. Distribution of pregnancy termination after prenatal diagnosis by regional groups. Note. The number in brackets is the number of women who had undergone pregnancy termination in each regional group.
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Table 1. Differences in demographic characteristics for pregnancy/abortion by regional groups.
Table 1. Differences in demographic characteristics for pregnancy/abortion by regional groups.
RegionCriterionMSDCriterionMSD
Mixed CenterAge39.72.3Number of miscarriages1.70.5
Mixed SouthF = 143.9 *, ω2 = 0.435.95.6F = 103.0 *, ω2 = 0.31.20.8
Mixed North 29.69.8 0.80.9
Muslim Center 40.02.1 1.00.1
Muslim South 37.14.5 1.10.2
Muslim North 27.58.2 0.60.6
Mixed CenterNumber of children5.11.4Number of abortions following abnormal diagnosis of the child1.00.4
Mixed SouthF = 164.1 *, ω2 = 0.44.32.10.50.6
Mixed North 2.72.7F = 43.8 *, ω2 = 0.20.50.7
Muslim Center 8.11.3 0.80.6
Muslim South 6.71.3 0.50.7
Muslim North 3.52.9 0.30.6
Mixed CenterNumber of pregnancies7.91.7
Mixed SouthF = 115.4 *, ω2 = 0.46.03.1
Mixed North 4.14.1
Muslim Center 9.81.6
Muslim South 8.22.0
Muslim North 4.33.8
Note. * The F-test is used to determine whether there are significant differences between group means; however, an F value > 1 indicates a statistically significant difference between at least two groups. Omega squared (ω2) is an effect size measure, indicating the proportion of variance that the independent variable explained in the dependent variable and providing a sense of how meaningful the group differences are beyond just statistical significance (Large effect is ≥0.14), p < 0.001. M = mean. SD = standard deviation. Group sizes are as follows: (1) Mixed Center, n = 244; (2) Mixed South, n = 148; (3) Mixed North, n = 192; (4) Muslim Center, n = 185; (5) Muslim South, n = 116; (6) Muslim North, n = 196.
Table 2. Differences in attitudes, perceptions, and beliefs regarding invasive tests and pregnancy terminations by regional groups.
Table 2. Differences in attitudes, perceptions, and beliefs regarding invasive tests and pregnancy terminations by regional groups.
RegionCriterionMSDCriterionMSD
Mixed CenterInvasive tests for diagnosing5.71.3Planned abortion induces anger4.02.0
Mixed Southabnormality5.71.2F = 160.1 *, ω2 = 0.43.41.8
Mixed NorthF = 238.5 *, ω2 = 0.56.31.1 2.71.8
Muslim Center 2.30.9 6.80.5
Muslim South 3.61.4 5.71.2
Muslim North 5.52.0 3.81.7
Mixed CenterConsulting with a religious authority/figure to consider invasive tests3.52.0Planned abortion induces depression3.92.0
Mixed South2.91.8F = 163.3 *, ω2 = 0.43.41.8
Mixed North2.31.9 2.71.8
Muslim CenterF = 113.3 *, ω2 = 0.36.31.2 6.80.4
Muslim South 4.62.0 5.61.2
Muslim North 3.12.1 3.91.7
Mixed CenterBelief in religious values and4.12.3Planned abortion induces sadness4.02.0
Mixed Southmorals4.22.1F = 164.4 *, ω2 = 0.43.41.7
Mixed NorthF = 113.1 *, ω2 = 0.33.31.9 2.71.8
Muslim Center 6.80.4 6.80.4
Muslim South 6.30.6 5.61.2
Muslim North 4.91.2 3.91.7
Mixed CenterBehaving in line with religious4.22.3Planned abortion induces helplessness4.02.0
Mixed Southvalues and tradition4.22.1F = 164.9 *, ω2 = 0.43.41.7
Mixed NorthF = 11.6 *, ω2 = 0.33.41.9 2.71.8
Muslim Center 6.80.4 6.80.4
Muslim South 6.30.6 5.61.2
Muslim North 5.01.2 3.91.7
Mixed CenterPlanned abortion induces guilt4.22.3Planned abortion when fetus has4.71.7
Mixed SouthF = 113.4 *, ω2 = 0.34.22.1abnormalities5.21.6
Mixed North 3.41.9F = 122.1 *, ω2 = 0.45.81.7
Muslim Center 6.90.4 2.01.2
Muslim South 6.40.6 3.81.7
Muslim North 5.01.2 5.42.0
Mixed CenterReligious authorities should3.52.0Friends’ support on planned3.82.4
Mixed Southconfirm abortion (if there are2.91.8abortion (due to abnormalities)4.42.1
Mixed Northabnormalities with the fetus)2.42.0F = 145.2 *, ω2 = 0.45.72.0
Muslim CenterF = 98.4 *, ω2 = 0.36.11.2 1.10.3
Muslim South
Muslim North		 4.31.9 2.01.3
2.62.2 5.02.3
Note. * The F-test is used to determine whether there are significant differences between group means; however, an F value > 1 indicates a statistically significant difference between at least two groups. Omega squared (ω2) is an effect size measure, indicating the proportion of variance that the independent variable explained in the dependent variable and providing a sense of how meaningful the group differences are beyond just statistical significance (Large effect is ≥0.14), p < 0.001. M = mean. SD = standard deviation. Note: All criteria are measured on a 7-point Likert-type scale ranging from 1 (not at all/very unlikely) to 7 (very much/highly likely). Values in the table represent mean scores (M) and standard deviations (SD) for each item. Group sizes are as follows: (1) Mixed Center, n = 244; (2) Mixed South, n = 148; (3) Mixed North, n = 192; (4) Muslim Center, n = 185; (5) Muslim South, n = 116; (6) Muslim North, n = 196.
Table 3. Factors associated with age group (<35/≥35) and regional groups.
Table 3. Factors associated with age group (<35/≥35) and regional groups.
VariableMixed Cities Arab Citiesp Value
Age(<35)
N = 208
n (%)		Age(≥35)
N = 376
n (%)		Age(<35)
N = 210
n (%)		Age(≥35)
N = 287
n (%)
Had a spontaneous conception <0.001
Yes155 (74.5%)41 (10.9%)210 (100%)105 (36.6%)
No53 (25.5%)335 (89.1%)0 (0.0%)182 (63.4%)
Doing a Non-Invasive Prenatal Test <0.001
Yes7 (3.4%)328 (87.2%)0 (0.0%)186 (64.8%)
No201 (96.6%)48 (12.8%)210 (100.0%)101 (35.2%)
Birth of an abnormal child in the past <0.001
Yes0 (0.0%)304 (80.9%)0 (0.0%)201 (70.0%)
No208 (100.0%)72 (19.1%)210 (100.0%)86 (30.0%)
Prenatal amniocentesis/chorionic villus sampling <0.001
Yes0 (0.0%)320 (85.1%)0 (0.0%)200 (69.7%)
No208 (100.0%)56 (14.9%)210 (100.0%)87 (30.3%)
Received genetic consultancy before prenatal diagnosis <0.001
Yes42 (20.2%)347 (92.3%)0 (0.0%)192 (66.9%)
No166 (79.8%)29 (7.7%)210 (100.0%)95 (33.1%)
Received physician consultancy before prenatal diagnosis <0.001
Yes59 (28.4%)358 (95.2%)0 (0.0%)224 (78.0%)
No149 (71.6%)18 (4.8%)210 (100.0%)63 (22.0%)
Pregnancy termination (after a positive prenatal diagnosis for abnormalities) <0.001
Yes13 (6.3%)332 (88.3%)0 (0.0%)184 (64.1%)
No195 (93.7%)44 (11.7%)210 (100.0%)103 (35.9%)
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Tarabeih, M.; Amiel, A.; Na’amnih, W. A Survey of Prenatal Testing and Pregnancy Termination Among Muslim Women in Mixed Jewish-Arab Cities Versus Predominantly Arab Cities in Israel. Women 2025, 5, 30. https://doi.org/10.3390/women5030030

AMA Style

Tarabeih M, Amiel A, Na’amnih W. A Survey of Prenatal Testing and Pregnancy Termination Among Muslim Women in Mixed Jewish-Arab Cities Versus Predominantly Arab Cities in Israel. Women. 2025; 5(3):30. https://doi.org/10.3390/women5030030

Chicago/Turabian Style

Tarabeih, Mahdi, Aliza Amiel, and Wasef Na’amnih. 2025. "A Survey of Prenatal Testing and Pregnancy Termination Among Muslim Women in Mixed Jewish-Arab Cities Versus Predominantly Arab Cities in Israel" Women 5, no. 3: 30. https://doi.org/10.3390/women5030030

APA Style

Tarabeih, M., Amiel, A., & Na’amnih, W. (2025). A Survey of Prenatal Testing and Pregnancy Termination Among Muslim Women in Mixed Jewish-Arab Cities Versus Predominantly Arab Cities in Israel. Women, 5(3), 30. https://doi.org/10.3390/women5030030

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