During a pregnancy, women are offered prenatal genetic screening and diagnostic testing to determine whether a fetus is healthy or has certain genetic disorders or anomalies.
This information can help patients and their doctors prepare for the pregnancy. But some opt out of such testing, believing that babies should be born regardless of potential abnormalities.
For those who do choose to undergo such testing, maternal-fetal medicine specialists and genetic counselors usually work closely with the pregnant person or couple to explain in detail what the results mean for a birth, for mother and child, if a genetic disorder or fetal anomaly is detected. These health care providers can also provide the pregnant person or couple with guidance on what options are available to them after a diagnosis, which can include aborting apregnancy. That option, however, is limited or no longer available to women in many U.S. states.
Prenatal tests cant diagnose a genetic condition before 6 weeks
Without the protection of Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwideand was overturnedin June, the procedure has become illegal or heavily restricted in at least 14 states. Six states Mississippi, Missouri, Tennessee, North Dakota, South Dakota and Ohio prohibit abortions when the fetus may have a genetic anomaly, and infive of those states, its now nearly impossible, because it is banned at about six weeks. This is so early in a pregnancy that many women at that point dont even know they are carrying a child.
A person's first [doctors] appointment in pregnancy doesn't usually happen until eight or 10 weeks, so never mind the rest of the story. That's when obstetric care begins, said Philip D. Connors, lead genetic counselor at Boston Medical Center.
Three [percent] to 4% of all pregnancies are going to be affected by some sort of complication related to a difference in fetal or embryonic development, a genetic condition. And essentially none of those can be screened for or diagnosed until after the gestational age limits that are being placed by some of these really discriminatory laws, Connors added.
Story continues
Dr. Tani Malhotra, a maternal-fetal medicine specialist in Cleveland,Ohio, a state where abortions are now illegal after six weeks and where there are no exceptions for cases of rape, incest or fatal fetal anomalies, said it is impossible to assess whether there are any issues with the fetus at such an early point in pregnancy.
The size of the embryo at six weeks is somewhere between 6 to 7 millimeters. It's less than 1 centimeter, and that centimeter is like the size of my finger, right? So it's just impossible for us to be able to detect abnormal findings on an ultrasound at that point, Malhotra said.
KatieSagaser, director of genetic counseling at Juno Diagnostics, a women's health company, told Yahoo News: Theres no genetic testing or screening that can be done prior to six weeks.
One method of testing which she said has revolutionized the landscape of prenatal chromosome screening and is mostly used today is a noninvasive prenatal screening technology known as NIPT or NIPS. This can detect genetic variations as early as nine weeks into pregnancy, using a blood sample from the mother. But the test, Sagaser said, can only indicate if there is a potential problem, and does not replace diagnostic testing, such as chorionic villus sampling (CVS) or amniocentesis, which study the cells from the fetus or placenta and can confirm a diagnosis.
The earliest a CVS diagnostic test can be performed is at the 10th week of pregnancy. Amniocentesisis usually conducted at between 15 and 20 weeks of pregnancy, but can technically be done up until a person gives birth, according to the American College of Obstetricians and Gynecologists.
WASHINGTON, DC - JUNE 24: Abortion-rights activists gather in front of the Supreme Court building following the announcement to the Dobbs v Jackson Women's Health Organization ruling on June 24, 2022 in Washington, DC. (Photo by Nathan Howard/Getty Images)
Aborting a pregnancy because of genetic anomalies
As prenatal screening testing like NIPS has become more common, selective terminations involving genetic conditions have too. Some studies have shown that parents often decide to terminate a pregnancy, even after finding a mild form of a genetic condition, including Turner and Klinefelter syndromes.
Down syndrome is the most common chromosomal disorder in the U.S., and about 6,000 babies are born with it in the U.S. each year, according to the Centers for Disease Control and Prevention.
A published review of studies, which included 24 publications studying pregnancy terminations after a prenatal diagnosis of Down syndrome in the U.S., found that 67% ofthose pregnancies end in abortion.
Terminating a pregnancy after the 2nd trimester because of medical complications
Its notable, however, that the majority of abortions in the U.S.(91%) occur at or before 13 weeks of gestation. Abortions late in pregnancy are rare,butMalhotra said some of the main reasons why they do happen include delays and other barriers in obtaining abortion care, or after discovering medical complications. Those complications often include the discovery of lethal fetal anomalies, which can be detected during a fetal anatomy scan that is usually performed at around 20 weeks of pregnancy. Terminations at this stage, Malhotra said, are difficult and traumatic, because these pregnancies are often desired.
It's really tragic, as you're telling these patients who have been continuing their pregnancy. They're at 20 weeks. They're excited about the pregnancy. They're planning their baby showers. They come to that ultrasound hoping to be able to find out the sex of the baby and you tell them this devastating news, that there is an abnormality that is either not compatible with life, or is going to have significant impact on the quality of life after birth, the Ohio doctor said.
Malhotra told Yahoo News that Ohios new abortion law has made her job even tougher, because she also has to tell patients in these situations who wish to terminate the pregnancy that they cannot receive such care in their state.
It is just horrible, because not only are you giving them this tragic, heartbreaking news, but you're stigmatizing their care, because you're saying, Oh, this thing is illegal here, but you could go to another state. So they have to travel to another state to do something that's illegal, which is a part of medical care, Malhotra said. If they're not able to go out of the state, then we're asking them to take on risks associated with a pregnancy, which we know inherently, pregnancy is not risk-free.
In addition, she explained, she needs to inform these patients that they must act rapidly. Abortions later in a pregnancy are more complex and also more expensive. Medication abortion, which can be taken at home, can only be safely used in the first 70 days, or 10 weeks of pregnancy. After that, women need a surgical abortion, which typically takes about two days and requires inpatient care. A patient who needs to go out of state to receive care must therefore also take into account additional costs related to travel and lodging.
Because of the abortion bans that have gone into effect in the Midwest, surrounding states where the procedure is protected have seen an increase in patients, Malhotra said. They are really backed up, currently complicating the scheduling of an abortion, she said.
Another important reason to act quickly in these situations, according to Malhotra, is because most states do not permit abortions after 24 weeks when a fetus has reached viability and can survive outside the uterus. According to the Guttmacher Institute, a research group focused on reproductive health, 17 states impose a ban at viability.
Little research has been conducted on what happens to women who are unable to terminate a pregnancy because of a fetal genetic condition or anomaly. However, one study conducted by the University of California, San Francisco, that tracked 1,000 women unable to get an abortion because they had passed the gestational limits, found they were more likely to fall into poverty, as well as have worse financial, health and family outcomes, than those who had terminated their pregnancies.
Opponents of abortions conducted as a result of screening for disabilities believe that such procedures are unjust, because all human beings have inherent value from the moment of conception. Malhotra, on the other hand, told Yahoo News that she finds it absolutely horrible to put patients in a position where they dont have a choice anymore.
There are multiple reasons women may choose to terminate a pregnancy because of a genetic condition or anomaly, ranging from the emotional and financial cost of raising a disabled child to the effect that this may have on the existing children in a family, as well as the feeling that it is cruel to give birth to a child who may need a lifetime of constant medical intervention.
Connors said that terminations due to genetic or fetal anomalies are comparatively rare, but are often emphasized unduly in conversations on abortion and abortion care. It inadvertently leads to a narrative about what makes a good or a bad abortion, he said.
Sagaser agreed, saying:There's no benefit to us as a society to say, Oh, there's this one population that really needs access to abortion care more so than other people.'
Everyone deserves to be able to make the choices that are right for them and their family in that unique situation, she added.
Continue reading here:
Restrictive abortion laws are limiting the options parents have after receiving genetic test results, experts say - Yahoo News
- CRISPR: A game-changing genetic engineering technique - January 4th, 2023
- Genetic Counseling Online Course - School of Medicine Columbia ... - January 4th, 2023
- Genetics & Medicine - Site Guide - NCBI - National Center for ... - December 27th, 2022
- Lilly, ProQR to expand genetic medicine development agreement - December 27th, 2022
- Central Dogma and Genetic Medicine - HHMI BioInteractive - November 24th, 2022
- Social, Environmental, Cognitive, and Genetic Influences on the Use of ... - November 24th, 2022
- Genetically modified food controversies - Wikipedia - October 29th, 2022
- BSGM - The British Society for Genetic Medicine - October 13th, 2022
- Genetic and Genomic Medicine - Nationwide Children's Hospital - October 13th, 2022
- Carrier Screening for Genetic Conditions | ACOG - October 13th, 2022
- New NHS genetic testing service could save thousands of children in England - The Guardian - October 13th, 2022
- Vertex, after setbacks, moves forward with second-generation rare disease drug - BioPharma Dive - October 13th, 2022
- Passage Bio Announces Appointment of William Chou, M.D. as Chief Executive Officer - Yahoo Finance - October 13th, 2022
- Metagenomi Announces Participation in October Investor and Industry Conferences - Business Wire - October 4th, 2022
- NovaSeq X machines will make genetic analysis even faster and cheaper - Mezha.Media - October 4th, 2022
- ORYZON to Give Updates on Corporate Progress in October - BioSpace - October 4th, 2022
- e-therapeutics: Fundraise of 13.5 million - BioSpace - October 4th, 2022
- The inheritance of hope curing genetic heart disease now within grasp - British Heart Foundation - October 4th, 2022
- MS Genetic Counseling | Ohio State College of Medicine - September 16th, 2022
- Genetic Counselor - Mayo Clinic College of Medicine & Science - September 16th, 2022
- UCLA researcher awarded National Academy of Medicine prize for work on genetics of autism - Newswise - September 16th, 2022
- Medical research doesn't serve everyone. This effort hopes to build one of the most diverse health databases ever - Colorado Public Radio - September 16th, 2022
- Precision Medicine Offers Hope for More Targeted Rash Diagnosis and Treatment - Dermatology Times - September 16th, 2022
- Redmond firefighters to 'Fill the Boot' for Muscular Dystrophy Association - KTVZ - September 16th, 2022
- Why Monkeypox Wasnt Another COVID-19 - FiveThirtyEight - September 16th, 2022
- Endometriosis Researchers One Step Closer to Diagnosing Condition With Menstrual Blood - Business Wire - September 16th, 2022
- The Biggest CGT Breakthroughs Through the Eyes of Our 2022 Power List - The Medicine Maker - September 16th, 2022
- Humans evolved with their microbiomes like genes, your gut microbes pass from one generation to the next - The Conversation - September 16th, 2022
- When to Use Targeted Therapy for Iodine-Refractory Thyroid Cancer - Targeted Oncology - September 16th, 2022
- Gracell Biotechnologies to Participate in Three Upcoming Investor Conferences - PR Newswire - September 16th, 2022
- CRISPR is 10: A decade of gene editing refinements presents new ways to address agricultural diseases thought to be incurable - Genetic Literacy... - September 16th, 2022
- Sarepta Therapeutics Announces Recipients of Route 79, The Duchenne Scholarship Program, for ... - The Bakersfield Californian - September 8th, 2022
- 'Record' Gains in Bringing Research Closer to the Patient - Applied Clinical Trials Online - September 8th, 2022
- Metagenomi Announces Participation in September Investor and Industry Conferences - Business Wire - September 8th, 2022
- Sarepta Therapeutics Announces That FDA has Lifted its Clinical Hold on SRP-5051 for the Treatment of Duchenne Muscular Dystrophy - Yahoo Finance - September 8th, 2022
- Studies Reveal Aggressive Prostate Cancer Linked to Ancestral Heritage - DocWire News - September 8th, 2022
- Lonza and Touchlight collaboration will expands customer's access to DNA - Labiotech.eu - September 8th, 2022
- Genetic variants in miR-145 gene are associated with the risk of asthma in Taiwan | Scientific Reports - Nature.com - September 8th, 2022
- Elderly are more affected by COVID brain fog, but 'cognitive rehab' could be an effective treatment - Genetic Literacy Project - September 8th, 2022
- A therapy found to improve cognitive function in patients with Down syndrome - EurekAlert - September 8th, 2022
- Ovid turns to gene therapy startup to restock drug pipeline - BioPharma Dive - August 30th, 2022
- Morris Animal Foundation Golden Retriever Lifetime Study Celebrates 10 Years - PR Newswire - August 30th, 2022
- Immortal jellyfish genes identified that may explain their long lives - New Scientist - August 30th, 2022
- Walk Again Or Stop Blindness. How Gene Therapy Is Revolutionizing Medicine - Nation World News - August 30th, 2022
- ElevateBio and the University of Pittsburgh Announce Creation of Pitt BioForge BioManufacturing Center at Hazelwood Green to Accelerate Cell and Gene... - August 30th, 2022
- Therapeutic Effects of Tretinoin | JIR - Dove Medical Press - August 30th, 2022
- Physical Activity May Have a Stronger Role than Genes in Longevity - Newswise - August 30th, 2022
- BridgeBio, Baylor College of Medicine to Collaborate on Genetic Disease ... - August 22nd, 2022
- New $2.8-million gene therapy becomes most expensive medicine in history - New Atlas - August 22nd, 2022
- Molecular Map Reveals Insights Into the Genetic Drivers of CLL - The ASCO Post - August 22nd, 2022
- Biopharmaceutical Company Expands Clinical Trials On Texas A&M-Developed Angelman Syndrome Treatment - Texas A&M University Today - August 22nd, 2022
- Marketing and Industry Trends Influencing Precision Medicine in 2022 - Healthcare Tech Outlook - August 22nd, 2022
- expert reaction to study investigating use of genetic risk score for prostate cancer in men with lower urinary tract symptoms to predict diagnosis -... - August 22nd, 2022
- As the Smithsonian wraps a genome exhibit, leaders in the field reflect - STAT - August 22nd, 2022
- Why some people suffer more from COVID-19 than others - EurekAlert - August 22nd, 2022
- Q3 2022 Earnings Forecast for LogicBio Therapeutics, Inc. Issued By William Blair (NASDAQ:LOGC) - Defense World - August 22nd, 2022
- Next generation patient avatars: Expanding the possibilities with MicroOrganospheres - EurekAlert - August 22nd, 2022
- Masters Program in Genetic Counseling - Perelman School of Medicine at ... - August 14th, 2022
- Admissions | Master's Program in Human Genetics & Genetic Counseling ... - August 14th, 2022
- The Silver Lining Of Innovation in Genetic Medicine - Pharmaceutical Executive - August 14th, 2022
- Genetics Team Serves as Go-to for Mom of Son With Extremely Rare Disorder - Stanford Medicine Children's Health Blog - Stanford Children's Health - August 14th, 2022
- UI professor receives grant from National Institutes of Health - Iowa Now - August 14th, 2022
- Lilly's Taltz (ixekizumab) Now Available in New, Citrate-Free Formulation to Reduce Injection Site Pain for Improved Patient Experience - PR Newswire - August 14th, 2022
- Research Roundup: 21 Genes Linked to Increased Risk of Alzheimer's and More - BioSpace - August 14th, 2022
- Personalised medicine made in hospitals can revolutionise the way diseases are treated the challenge now will be implementing it - The Conversation... - August 14th, 2022
- Beyond Paxlovid for covid-19: The hunt for better covid medications - Grid - August 14th, 2022
- PVM to Play Role in Research on New Patent-pending Method to Mass-produce Antitumor Cells to Treat Blood Diseases and Cancer - Purdue University - August 14th, 2022
- Analyzing Kiromic BioPharma (NASDAQ:KRBP) and LogicBio Therapeutics (NASDAQ:LOGC) - Defense World - August 14th, 2022
- Corporate America's Abortion Radicalism - The American Conservative - August 14th, 2022
- A team of Oxford and Mexican researchers want to diversify genomic databases. Can they end 'parachute science,' too? - STAT - August 14th, 2022
- The aging heart accumulates mutations while losing the ability to repair them - EurekAlert - August 14th, 2022
- Generation Bio Reports Business Highlights and Second Quarter 2022 Financial Results - GuruFocus.com - August 5th, 2022
- Population Genetic Testing: Save Lives And Money, While Avoiding Financial Toxicity - Forbes - August 5th, 2022
- Genetic Counselors Scramble Post- Roe to Provide Routine Pregnancy Services without Being Accused of a Crime - Scientific American - August 5th, 2022
- GENERATION BIO CO. Management's Discussion and Analysis of Financial Condition and Results of Operations. (form 10-Q) - Marketscreener.com - August 5th, 2022
- Sangamo Therapeutics Reports Recent Business Highlights and Second Quarter 2022 Financial Results - Yahoo Finance - August 5th, 2022
- Researchers discover one of the largest known bacteria-to-animal gene transfer inside a fruit fly - EurekAlert - August 5th, 2022
- Intellia Therapeutics Announces Second Quarter 2022 Financial Results and Highlights Recent Company Progress - Yahoo Finance - August 5th, 2022
- Medical Student's Crime In Cipolletti: They Found A Man's DNA Under The Victim's Thumb - Nation World News - August 5th, 2022
- A new era: After winding path and safety scares, gene therapy enters the clinic - Sydney Morning Herald - August 5th, 2022