Table 1 Summary of the contextual background for Quebec and Lebanon^a

Structure of the healthcare system

Public; meaning that the State and therefore the provincial government being the principal administrator of healthcare services.

Private and public; meaning that the provision of healthcare services includes payers and providers from both the public and the private sectors with the latter being the main provider of healthcare services in the country [20].

Coverage of prenatal tests

Prenatal tests are covered by the healthcare system for pregnant women if medically indicated and prescribed by the physician.

As for NIPT, it is covered in few Canadian provinces such as Ontario and British Colombia for women with high-risk pregnancies.

However, in Quebec, the decision has been made to cover it for high-risk pregnancies but has not yet entered into effect.

Prenatal tests are generally not covered unless one benefits from a public or a private coverage.

Regarding NIPT, it is not yet reimbursed by any form of coverage and is paid for privately.

The legal status of abortion

Abortion in Quebec is legal at any point during pregnancy with late term abortions e.i. after 24 weeks, performed in few clinical cases and in restricted number of institutions [21].

Abortion in Lebanon is illegal at any point in time except if the mother’s life is in danger. Nevertheless, the law is not enforced and it’s being clinically practiced in a clandestine manner in clinics or in hospital operation rooms [22].