This paper examines the intersection of prenatal testing and abortion decision-making. It outlines the four primary methods of prenatal diagnosis — ultrasonography, Maternal Serum Alpha Fetoprotein Screening, amniocentesis, and Chorionic Villi Sampling — describing the purpose, timing, and risks of each. The paper then addresses the cognitive dissonance between parents and healthcare providers regarding the purpose of prenatal testing, explaining why parents are often unprepared for abnormal results. Finally, it discusses the emotional consequences of genetic abortion, including prolonged grief, guilt, shame, and distress, drawing on clinical evidence to illustrate the psychological burden carried by parents following termination for fetal abnormality.
Prenatal testing offers expectant parents and healthcare providers critical information about fetal development and potential chromosomal or structural abnormalities. There are four primary methods of prenatal diagnosis currently available to women, each varying in timing, invasiveness, and diagnostic scope.
The first and most commonly known method is ultrasonography, colloquially referred to as "ultrasound." A picture of the fetus is produced through the use of sound waves. Ultrasound is used to identify abnormalities that are physically apparent, such as deformed limbs or a defective chest and heart. During the fourteenth to sixteenth week of pregnancy, neural tube defects can also be detected (Cassidy & Gentles, 2002). Additional uses include detecting multiple fetuses and measuring fetal growth.
The second method is Maternal Serum Alpha Fetoprotein Screening (MSAFP). Its primary purpose is to detect neural tube defects by measuring alpha fetoprotein levels in the mother's blood. Elevated levels of alpha fetoprotein can indicate neural tube defects in the fetus. This exam is typically administered during the fifteenth to seventeenth week of gestation (Cassidy & Gentles, 2002).
Amniocentesis, the third method, is an invasive procedure that involves inserting a needle through the mother's abdominal wall and into the amniotic sac, from which fluid is withdrawn. The amniotic fluid is then tested for chromosomal abnormalities such as Down syndrome, Edwards syndrome, and Turner syndrome (Yashon & Cummings, 2012). There is a risk of miscarriage associated with amniocentesis; however, that risk is minimal.
The newest procedure used for prenatal diagnosis is Chorionic Villi Sampling (CVS). This test can be administered in the first trimester and uses the villi to provide fetal chromosomal information. CVS is not as precise as amniocentesis because placental material, rather than amniotic fluid, is analyzed. CVS also carries a higher risk of miscarriage and fetal damage than the other testing methods described above (Cassidy & Gentles, 2002).
There is a cognitive dissonance between parents and healthcare providers regarding the purpose of prenatal testing. Parents typically pursue prenatal testing as a means of reassuring themselves that their baby is healthy, while doctors administer the tests to identify fetal abnormalities early enough to inform decisions about whether to continue the pregnancy (Cassidy & Gentles, 2002). In other words, parents approach these tests hoping for positive outcomes, while healthcare providers are specifically looking for negative ones. As a result, parents react adversely when presented with anything other than an optimistic result.
"Grief, guilt, and shame following genetic abortion"
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