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Jewish World Review May 31, 2001 / 9 Sivan, 5761

Betsy Hart

Betsy Hart
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Consumer Reports

Parents-to-be looking for guarantees -- AS readers of this column may know by now, I'm soon expecting baby Number Four. What many also might have surmised is that I'm in the so-called "advanced maternal age" category. (Let's just leave it that I'm over 35.) What that means, according to the experts, is that I should have had a battery of genetic tests to determine the health of this baby. From the simple alpha feta protein (AFP) blood test, which looks for markers for Down's Syndrome and other conditions, to the invasive amniocentesis in which amniotic fluid is extracted and examined, such tests are as routine for pregnant women my age as is getting our blood pressure taken.

Routine --- except for me and moms like me. I said "no" to all genetic testing, and I have the rare obstetrician who backed me up in that decision.

My reasons for rejecting these standard tests were simple. A sonogram, which I did have, is a harmless "picture" of the baby taken with sound waves which can allow certain problems -- for instance growth retardation -- to be addressed in utero. In other cases it provides information for making the birth of the baby safer for mother and child. (Plus it's wonderful to "see" the little one before it makes its entrance into the world.)

But any additional information turned up via routine first or second trimester genetic testing is almost always useless in this regard. Instead such tests are, it seems, most commonly done to help the prospective parents decide whether or not to abort, depending on the baby's health. As the well known reference book "Your Pregnancy Week by Week" puts it, doing amniocentesis at 16 to 18 weeks of pregnancy "allows the woman enough time to make a decision about terminating the pregnancy, if that is what she desires."

I find such thinking tragic. Not only because I would refuse to abort for any reason, but because it suggests these parents-to-be are looking for guarantees. Sure, maybe they can find out their odds of carrying a healthy baby (though amniocentesis can only detect about 10 percent of known genetic abnormalities anyway). But there are no promises to be given about whether or not the baby will be born safely, or will be healthy and active at six months, two years or 20.

If there were a genetic test to determine the child in the womb would suffer from leukemia at age 5 or a car accident at age 10 - what would the prospective parents do with that information? Life is fraught with wonder - and uncertainty. And no test can promise us that we as parents will be protected from heartache.

The simple truth is that to become a mom or dad is to become vulnerable as never before. Of course many moms who would never consider ending their pregnancies do a standard course of invasive testing anyway so they can "be prepared" if the baby is born with a genetic problem. Now I'm all for being informed - but at what risk are these moms getting their information, information they can't change and that they'll have in a few months anyway?

Amniocentesis, even done by the most skilled of hands, causes a miscarriage in about one in 200 procedures according to the established medical literature. Chorionic villus sampling, a newer test in which tissue is taken from the placenta, is even more dangerous. Even the simple AFP blood test presents problems. It's commonly offered to pregnant women regardless of their age, but it's notorious for returning false positives for Down's Syndrome, often causing anxious moms to then undergo invasive and dangerous testing.

In any event, no loving parents would subject their child to a one-in-200 chance of a deadly car crash just to go on a sight-seeing trip. So why take those odds with routine, invasive genetic testing? It seems to me that with such prenatal tests these certainly well-intentioned parents who just want to "be prepared" are also, in the end, looking for a promise at some level from somebody, anybody, that all will always be well with their little one.

Like all expectant moms and dads, my husband and I hope and pray that the baby I'm carrying is born safe and healthy. But this child will be precious to us and to our family no matter what. Anyway, what's true for us is true for all parents regardless of what any testing says - our children just don't come with guarantees, and maybe that's one of the things that makes them so breathtakingly special to us.

JWR contributor Betsy Hart, a frequent commentator on CNN and the Fox News Channel, can be reached by clicking here.


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© 2001, Scripps Howard News Service