The American Congress of Obstetricians and Gynecologists now recommends that doctors offer all pregnant women prenatal testing, which can detect chromosomal conditions like Down syndrome before their babies are born. As a result, they all face a decision, or a series of decisions, on what to do.
Although there is no one right answer for how women should approach these tests, women can inform themselves and consider the test's limitations and possibilities before making a final decision in a doctor's office. Prenatal tests were designed to provide women with the option of selective abortion, but not all women choose testing with abortion in mind. Taking the time to think through the ethical and practical questions these tests raise will not only prepare women for a conversation about testing but also for receiving whatever child they have been given.
Until recently, the only definitive way to identify Down syndrome or other trisomies (the presence of a third copy of a chromosome instead of the typical pair) came via amniocentesis or corionic villus sampling, called CVS. Both tests require invasive procedures and carry a small risk of miscarriage. Many women didn't choose these tests unless a second trimester screening indicated an elevated risk of a chromosomal condition. As a result, a diagnosis often came in the mid or late second trimester, making abortion both physically and legally more complicated than if discovered earlier.
Still, both amniocentesis and CVS were designed to offer the option of abortion. In Testing Women, Testing the Fetus, New York University anthropologist Rayna Rapp, who had an abortion after a prenatal diagnosis of Down syndrome and then went on to study the ways amniocentesis has changed our society, writes, "The technology of prenatal diagnosis was developed explicitly to allow the selective abortion of fetuses facing serious disabilities because of atypical chromosomes and genes."