- Objective: To identify predictors of parental decision whether to terminate a pregnancy after a diagnosis of a major congenital malformation in a traditional society. Study design: The Bedouin Arabs in southern Israel are a traditional society, with a high incidence of congenital disorders. Data were abstracted from medical records of 295 families who sought counseling in the third level ultrasound clinic between 1990 and 1996. Statistical analysis included univariate and multiple logistic regression. Results: The diagnosis of a major malformation was confirmed in 64% of the cases. Pregnancy termination was a realistic option for 125 women (66.5%) as the rest were too advanced in their pregnancy. Such a delay was less common in cases of multiple malformations than in a single malformation (19.2% versus 39.0% respectively, P<0.01). Forty-nine of the 125 women (39.2%) chose to terminate their pregnancy. The only significant predictors of termination decision were earlier gestational week at diagnosis and previous uncompleted pregnancies. Conclusions: These findings indicate the importance of promoting early genetic counseling and early prenatal diagnosis, for any population where abortions are not readily acceptable.