Boston Globe on Perils of 'Pro-Choice': Prenatal Tests Can Be Wrong About Birth Defects

December 16th, 2014 10:13 PM

When the topic of abortion is covered in the media, it generally tends to play into the liberal theme of “a woman’s right to choose” or circumstances where abortions may be deemed “necessary” – which makes this Sunday Boston Globe story on prenatal screening inaccuracy leading to unnecessary abortions all the more interesting.   

One of the main arguments for abortion, pro-choicers say, is to avoid severe genetic illnesses to the baby, and more so, if the mother wants to raise a disabled child.  However, as Beth Daley of the New England Center for Investigative Reporting relayed in the Globe, those prenatal screening tests that so many doctors, physicians, and women rely on, are oftentimes inaccurate. As a result, these inaccuracies are causing many women to seek abortions for babies that have no chromosomal or genetic condition.

Prenatal testing is so new, that questions on their consistency and testing methods are left unanswered, which allow the companies of these prenatal screenings to get away with a sense of false advertising. Making it even more difficult is the fact that the market is oversaturated with companies selling the test, and are not regulated by the FDA (but this past September the FDA began drafting and publishing regulations for the industry, which is expected to take at least nine years to take full effect.)

“The companies have done a very poor job of education [and] advertising this new technology, failing to make clear that it is screening testing with very good but inevitably not perfect test performance . . . and that doctors are recommending, offering, ordering a test they do not fully understand,’’ said Dr. Michael Greene, director of obstetrics at Massachusetts General Hospital and a professor at Harvard Medical School.

Studies have found that many women who have been told their baby did in fact have some sort of chromosomal abnormality based on a prenatal screening, ended up giving birth to an otherwise healthy child, while others show that those who were given a clean bill of health, gave birth to a babies with chromosomal abnormalities.

Take for instance, the story of Stacie Chapman.  From the Boston Globe:

On that spring day in 2013, Dr. Jayme Sloan had bad news for Chapman, who was nearly three months pregnant. Her unborn child had tested positive for Edwards syndrome, a genetic condition associated with severe birth defects. If her baby — a boy, the screening test had shown — was born alive, he probably would not live long.

Sloan explained that the test — MaterniT21 PLUS — has a 99 percent detection rate. Though Sloan offered additional testing to confirm the result, a distraught Chapman said she wanted to terminate the pregnancy immediately.

What she — and the doctor — did not understand, Chapman’s medical records indicate, was that there was a good chance her screening result was wrong. There is, it turns out, a huge and crucial difference between a test that can detect a potential problem and one reliable enough to diagnose a life-threatening condition for certain. The screening test only does the first… But Stacie Chapman knew nothing about these uncertainties when Dr. Sloan told her that her unborn son had screened positive for a genetic condition that was largely incompatible with life.

Hysterical with grief when she hung up, Chapman phoned her husband at a Las Vegas airport on his way home from a business trip. Together, sobbing, they concluded that their son would only suffer if he survived birth. So, that afternoon, Sloan put her in touch with a nurse who found a doctor who could do the termination the next morning.

Chapman spent the afternoon Googling the horrors of Edwards syndrome, with its heart defects, development delays, and extraordinarily high mortality. She was steeling herself for the termination when Sloan called back, urging her to wait, according to Chapman’s medical record.

Chapman had a diagnostic test and learned her son did not have Edwards syndrome. A healthy Lincoln Samuel just turned 1 and has a wide smile that reminds Chapman of her recently deceased father.

However briefly considered, their decision to abort — informed by the MaterniT21’s advertised 99 percent detection statistic — haunts them to this day.

“He is so perfect,’’ Chapman, 43, said, choking up as she watched her son play with a toy lamb. “I almost terminated him.”

There are also many concerns regarding the new generation of prenatal testing:

Two Boston-area obstetricians, with funding from a testing company, recently sent samples from two nonpregnant women to five testing companies for analysis. Three companies returned samples indicating they came from a woman who was carrying a healthy female fetus.

So just how do pregnant women decide to get an abortion based on a possible false positive or false negative prenatal screening test?  Well, doctors and physicians urge those whose tests comes back as positive for a genetic condition, to seek genetic counseling. Another way?  How about making sure those same doctors and physicians that recommend the test actually know what it’s about, or not offering the test unless otherwise specified by the woman.

Or, women can choose NOT to have the test at all.