The Story: Recent analysis by the New York Times finds that prenatal tests are usually wrong when they warn of rare disorders—which increases the number of abortions.
The Background: For pregnant women in the United States, noninvasive prenatal screening (NIPS) for fetal chromosome abnormalities has become a routine practice. While such tests have been effective at identifying Down syndrome and spina bifida, they are much less effective for rarer conditions.
The New York Times analyzed the results for five conditions— DiGeorge syndrome, 1p36 deletion, cri du chat syndrome, Wolf-Hirschhorn syndrome, and Prader-Willi and Angelman syndromes. They found the chance of delivering a wrong positive result ranged from 81 to 93 percent. The article observes that some experts have concluded that “the blood screenings that look for the rarest conditions are good for little more than bolstering testing companies’ bottom lines.”
“It’s a little like running mammograms on kids,” said Mary Norton, an obstetrician and geneticist at the University of California, San Francisco. “The chance of breast cancer is so low, so why are you doing it? I think it’s purely a marketing thing.”
Why It Matters: In her book Woman and the New Race, Margaret Sanger, founder of Planned Parenthood, included a chapter to answer the question, “When Should a Woman Avoid Having Children?” Included in her list is the admonition, “No more children should be born when the parents, though healthy themselves, find that their children are physically or mentally defective.”
Sanger, like many Americans in the early 20th century, was a proponent of eugenics, an attempt to improve the human race by limiting or excluding the types of hereditary traits that can be passed on through procreation. She was primarily concerned with the effect on the larger population. The “defective stock” of humans with disabilities, advocates of eugenics believed, harmed the overall fitness of the population and put a drain on public resources.
That type of public-oriented eugenics fell out of favor after the Nazi eugenics program exposed the horror of the movement. But later in the century, it was replaced by a more personal form of eugenics that was more concerned with the strain it put on the individual family.
Today, the most common and widely accepted form of eugenics in America is the aborting of children who have genetic defects, especially Down syndrome. Approximately 67 percent of prenatal diagnoses for Down syndrome result in an abortion, according to estimated pregnancy termination rates from 1995 to 2011. More recent research suggests that abortion after prenatal diagnosis has reduced the population of individuals living with Down syndrome in the United States by approximately 30 percent.
In some countries, such as Iceland and Denmark, the choice of individual parents is leading to a result only dreamed of by Sanger and other eugenicists—the elimination of children with “undesirable” conditions.
Today, the most common and widely accepted form of eugenics in America is the aborting of children who have genetic defects.
This is the context by which we must evaluate the use of prenatal genetic screening. The implication of the New York Times article is that because of the high false positive rate of the tests, women are choosing to abort babies who likely would have been born “healthy.” As the article points out, a study from 2014 found that 6 percent of women whose babies screened positive obtained an abortion without getting another test to confirm the result.
The true horror, however, is that such prenatal tests are more often leading to the killing of children than to improving the health of babies. After all, the only actual “treatment” available for most prenatal genetic conditions is abortion.
Some pro-life Christians justify the use of prenatal tests because it helps them be better prepared for complications, either during birth or after the child is born. As Kathyrn Butler explained in an article for TGC, “The aim of prenatal screening is to help families prepare, both practically and emotionally, for terminal illness or disability in an unborn baby. The abnormalities in trisomy 13 and 18 are so severe and pervasive that most of these children die in utero.” If our reason for using such a test is preparation, then we could ask doctors to only report the results of noninvasive prenatal testing if the results are actionable.
But we should carefully weigh our motives and consider if such testing is truly prudent. Even when abortion is not an option, knowing an unborn child has a genetic condition can make us less rather than more prepared. Knowing a child has an incurable condition can lead parents to distance themselves emotionally from a child during the pregnancy, the time when the bonding process should occur. As Christian bioethicist Gilbert Meilaender says about prenatal testing, “we deceive ourselves if we suppose that, as a routine feature of medical practice, it can simply assist a couple to prepare themselves for their child’s birth. It does exactly the opposite. It sets our foot on a path that is difficult to exit.”