Roe’s Fall Will Limit Screening for Fatal Congenital Conditions


Jennifer knew it her pregnancy at 37 was full of risks, so she was more excited to expect twins. However, detailed ultrasound images at 12 weeks showed significant complications. Both fetuses lacked limbs and fluid accumulated in the brain cavities. An additional ultrasound and a more invasive test, where a tissue sample was taken from the mother’s amniotic fluid, confirmed a diagnosis of trisomy 18 (where someone has an additional copy of chromosome 18) three weeks later.

While these tests were being performed, one of the children died in the womb, and the chances of the second fetus surviving seemed slimmer. “They saw her heart beating, but she was missing a camera,” says Jennifer, who now faces several potential scenarios, all difficult. There was the possibility of a dead body, and Jennifer’s bleeding, as she had done four years earlier when her daughter was born. Even if the fetus was carried out, it is likely to die from its condition shortly after birth.

In the end, Jennifer and her husband were able to make a decision with their doctor and end the pregnancy at 17 weeks. But that was in 2018; today they would not have that option. In the US state of Oklahoma, where they lived at the time, a new law came into force in April banning abortions after the sixth week, well before the point where congenital conditions such as trisomy were detected. The law makes an exception only to save the life of a pregnant woman in a “medical emergency.” Anyone who has an abortion after the sixth week of pregnancy can be prosecuted.

Very soon, these restrictions could be much more widespread in the United States. According to a leaked Supreme Court opinion, Roe against Wade—The 1973 case that ruled that the right to abortion in the U.S. is constitutionally protected — could be overturned this summer, allowing each state to draft and enforce its own abortion laws. Yes Roe It is repealed, it is likely that 26 states will reduce the legal deadlines for abortion or ban them altogether, depriving families like Jennifer’s of the ability to make medical decisions for their own health and that of their unborn children.

According to an analysis by the Guttmacher Institute, an abortion rights advocacy and advocacy group, nine states have approved six-week bans like the one in Oklahoma, but have not yet enforced them, and state courts consider individually the laws in contravention of Roe against Wade. (Texas is also enforcing a six-week ban.) Thirteen states have strict anti-abortion laws that will be “activated” to take effect immediately if Roe no longer applies. In some states, existing blocked bans and new activating laws are imminent.

Details of incoming activation laws vary from state to state. Most completely forbid medical or surgical abortions, with limited exceptions for cases of rape or incest or to prevent death or serious injury to the patient. Only a few states want to allow exceptions for fetuses that have congenital conditions with low chances of survival, while six states already explicitly ban abortions due to genetic conditions.

Although optional, genetic screening is a common part of prenatal care and is usually performed between the 10th and 13th week of pregnancy, along with an ultrasound examination. Doctors look for fetal DNA floating in the mother’s blood that can be used to detect brain and spinal problems or chromosomal conditions. If a blood test shows positive results, doctors will use a needle to take a small sample of amniotic fluid or placenta into the uterus to confirm a diagnosis. Abortion of fetuses diagnosed with a non-fatal condition such as Down syndrome raises moral and ethical issues, but doctors also examine conditions such as trisomy 18 and trisomy 13, both of which cause miscarriages, miscarriages, or infants who die shortly. after birth.

About 1 in 5,000 babies is diagnosed with trisomy 18, also known as Edwards Syndrome, and about 1 in 16,000 with trisomy 13, also known as Patau Syndrome. Due to heart problems and other life-limiting conditions, most of these newborns die within the first few days or weeks. Between 5 and 10 percent survive the first year.

“If she could have given birth and he had died naturally, it could have been an option for us,” Jennifer says of her unborn child with trisomy 18. But the knowledge that doctors would have tried to keep the baby alive despite his condition also influenced his decision, he says. There is no cure for the extra chromosome that causes Edwards syndrome; Treatment, ranging from blood pressure medications to fans and feeding tubes, focuses only on the symptoms that newborns have.



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