In an effort to identify more babies with disabilities before they are born, Canada's obstetricians and gynecologists are recommending that all pregnant women, regardless of their age, should undergo prenatal genetic screening if they choose.
Such prenatal testing in Canada is generally only offered to women aged 35 and older, when the risk of having a child with Down Syndrome and genetic abnormalities increases.
The Society of Obstetricians and Gynecologists says, however, that every pregnant woman should have access to non-invasive prenatal tests because they can reduce the need for invasive tests like amniocentesis, when a pregnancy appears to be normal. Tests that reveal disabilities, meanwhile, could help parents and hospitals be better prepared to safely deliver a baby with special needs, the SOGC notes.
But it also acknowledges that widespread screening for genetic abnormalities could result in more abortions. For that reason, the recommendations released Monday are bound to ignite passionate debate about whether more prenatal testing might be tantamount to expanding the hunt for perfect babies.
Doctors are urging prenatal screening for all pregnant women.
“The very word screening, implies that you want to keep out that which is unwanted,” said Krista J. Flint, executive director of the Canadian Down Syndrome Society.
In a position statement it had prepared, the CDSS notes that it agrees all pregnant women should have the choice to learn if they are carrying a child with genetic anomalies. But the Calgary-based charity, which represents 56 Down Syndrome support groups in Canada, worries that widespread testing will lead to more terminated pregnancies and reduce the prevalence of Down Syndrome in the population, if test results are not delivered with “neutral, fair and balanced” information.
“Families tell us that that the message is sometimes subtle, sometimes astonishingly clear...when they learn they are having a child with Down Syndrome, the message is that they shouldn't have this baby, that it will ruin their lives,” Ms. Flint said.
“The notion that my children's children will never know someone with Down Syndrome is not a world I want them to inherit.
“We have to ask ourselves what kind of human family we are building.”
In light of such concerns, even before releasing the guidelines, the SOGC had sought input from the CDSS. But The Society is stressing that offering expanding prenatal testing to women of all ages in no way implies that doctors will be instructing patients about how to proceed with a pregnancy.
“The last thing we want is the era of eugenics and a perfect population,” said Dr. Vyta Senikas, associate vice president of the SOGC.
“What is being offered is a choice to have the testing, to women of all ages,” Dr. Senikas said. “Are we to deny that choice to an individual (based on age)?”
Dr. Senikas said that the Society is instructing doctors to offer balanced and non-judgmental information with the test results so “that the patient can make the choice” of what to do next.
“That at the end of the day,” she said, “is the society that we live in.”
In the meantime, the new guidelines also mean a choice for provincial governments who must decide whether they will foot the bill to offer prenatal tests to women of all ages.
