OBJECTIVE: All pregnant women in Denmark are offered risk assessment for Down syndrome. The aim of this study was to investigate whether women and partners make an informed choice about first trimester risk assessment, and their satisfaction with the choice. METHODS: A survey using multiple measure of informed choice at 12 weeks and decision regret scale at 30 weeks, among pregnant women and partners, planning to deliver at Copenhagen University Hospital, Rigshospitalet. RESULTS: Five hundred thirty-one women (99.6%) out of 534 women chose to have risk assessment. Most women and men had high degree of knowledge (82% and 81%) and positive attitudes regarding risk assessment (97% and 98%), leading to 79% and 80% making an informed choice. Education predicted knowledge for women (odds ratio 3.42; 95% confidence interval 1.63-7.18) and partners (odds ratio 2.97; 95% confidence interval 1.37-6.45), country of origin predicted knowledge, attitude and informed choice among women. Three hundred thirty-two women (99%) and all partners were satisfied with having chosen risk assessment. CONCLUSIONS: Although 80% of pregnant women and partners make an informed choice about undergoing first trimester risk assessment for Down syndrome, as many as 20% do not. At 30 weeks nearly all women and partners were satisfied to have had a risk assessment performed. © 2012 John Wiley & Sons, Ltd.