A growing number of expectant mothers are requesting early ultrasounds and genetic testing to help them make informed decisions about their pregnancies as more states enact strict abortion laws.
Prenatal genetic screening and other diagnostic tests are frequently used to detect abnormalities and health risks to the fetus and help doctors and patients plan for a safer pregnancy and delivery.
They also provide women with information that may influence their desire to terminate a pregnancy.
Many of these tests cannot be done until the woman is at least 10 weeks pregnant. However, more than a dozen states have laws that ban abortions entirely or restrict them to before six weeks, meaning that by the time a person receives prenatal test results, it is often too late to terminate. a pregnancy.
Prenatal genetic screening and other diagnostic tests are frequently used to detect abnormalities and health risks to the fetus.
There are multiple prenatal tests that a woman can undergo to obtain health information about her baby.
Some screening tests include an amniocentesis, which is done between weeks 16 and 20 of pregnancy to test the fluid surrounding the fetus for certain health conditions, chorionic villus sampling, which is done between weeks 10 and 13 to test a fragment of the placenta for genetic disorders, and non-invasive prenatal testing. , a blood test performed at 10 weeks to analyze fetal DNA present in the mother’s blood.
These tests detect conditions including Down syndrome and spina bifida, as well as more serious and deadly abnormalities such as Edwards disease and Tay-Sachs disease.
Some women may choose to terminate their pregnancy if prenatal testing reveals that the fetus has a life-threatening birth defect that can lead to death soon after delivery or if the pregnancy is not viable.
The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that reproductive health professionals offer prenatal screening to all pregnant patients.
Researchers in 2023 study in the journal Obstetrics and Gynecology said: “Although many factors influence a patient’s decision to abort, fetal genetic abnormalities are a common reason, particularly for abortions after the first trimester.”
Citing a 2012 systematic review, the researchers also said that when faced with a Down syndrome diagnosis, up to 67 percent of patients in the United States chose to terminate their pregnancies.
The study noted that the data has remained consistent.
Sabrina Fletcher, a doula who has counseled pregnant patients in these situations, said According to the Associated Press, when women discover that their fetus has a serious health problem, “you’re in crisis mode.”
He added: “We’re not thinking about the legal repercussions or the (state) deadlines, and yet we’re forced to do it.”
After the overturning of Roe vs. Wade by the Supreme Court in June 2022, 14 states ban abortion at all stages of pregnancy, meaning diagnostic testing of a fetus cannot be performed before limits based on gestational age.
While there are no definitive statistics on how many women seek early testing, anecdotally, health care providers say they have noticed an increase.
However, experts worry that women will rush to make decisions about whether to continue or terminate their pregnancies based on any information they can obtain before a state abortion ban takes effect.
But early tests are not always 100 percent correct and can provide only limited information.
Ultrasounds in early pregnancy reveal much less about the fetus than scans done in later weeks, and genetic tests can be inaccurate.
Dr. Clayton Alfonso, an obstetrician and gynecologist at Duke University, told the AP: “More and more people are trying to find out these things earlier to try to fit within the confines of laws that, in my opinion, have no place.” in medical practice.”
The types of tests and ultrasounds a pregnant woman receives, and when she receives them, can vary depending on each individual’s health and risk factors, as well as the equipment and tests available at a medical clinic.
While some women can have an ultrasound in the first 12 weeks of pregnancy, to estimate birth or check for multiple fetuses, it is not standard because it is too early to see limbs and organs in detail, ACOG said.
It is also difficult to find major birth defects before the middle of 20 weeks gestation.
A common prenatal test at 20 weeks — after the abortion deadline in more than a dozen states — is an ultrasound commonly known as an anatomical scan.
This scan examines the heart, brain, spine, and limbs of the fetus to look for congenital problems and can detect problems and abnormalities that may lead to further testing and a possible diagnosis.
But since Roe v. Wade was overturned, OB-GYN Dr. Cara Heuser of Utah, where abortion is allowed up to 18 weeks, said more patients are undergoing ultrasounds between weeks 10 and 13 to give themselves time to abort. if necessary.
However, Missouri genetic counselor Chelsea Wagner said early scans do not provide a complete picture of a pregnancy and doctors cannot give a definitive diagnosis from scans or other screening tests early in pregnancy.
She said: “You can’t give someone an ‘everything looks good’ or a clean bill of health with an ultrasound at 10 weeks.”
Additionally, when it comes to genetic testing, the accuracy of the tests varies depending on the disorder, but no test is considered definitively diagnostic and false positives are possible.
And in 2022, the Food and Drug Administration issued a warning about certain screening tests, reminding patients and doctors that results need further confirmation.