"You will be a better mom because you are a theologian, and a better theologian because you are a mom."

Is it true? In this blog, I explore the interplay and intersection of motherhood and theologianhood.

Monday, April 26, 2010

Life...and Prenatal "Care"

(Above, Maia, at a few days old.)

My last post was on my quest for good maternity care, and I mentioned my first and last appointments at a traditional OB practice. This particular practice had a packed waiting room - one that felt like a doctor's waiting room. Like most, it was not particularly homey, and it was papered with ads and pamphlets for drugs. Of course, in this case, all of the ads and pamphlets were for various forms of birth control.

When I met with the midwife, one of the first conflicts we had was that their practice required a first trimester genetic screening. This screening would "detect" Downs Syndrome and neural tube defects... or at least it would make people paranoid of the possibility or, "risk factor" as they called it. Of course, I objected, and asked point blank if this test was offered for any purpose other than to encourage abortions. The midwife seemed offended and explained to me (as though I were a two-year old) that you'd want certain specialists available at a delivery if you knew the child had certain problems. Well, that may be true, but you wouldn't have to figure this out in your first trimester.

And the fact is that here in the United States, 9 out of 10 babies that appear to have Downs are aborted. It's a kind of sickening fact. I don't know the stats on neural tube defects, but my husband has a colleague whose son has spina bifida. At a doctor appointment for his son, the parents brought up the possibility of traveling to France, and the doctor warned them that there wouldn't be any doctors who would know how to deal with spina bifida there. Why? Because in France, there aren't any children with spina bifida.

My husband and I were both a little taken aback by the story of the doctor who aborted the "wrong" fetus. He meant to kill the Downs child and instead killed the normal child. So the mother went back and had her other child aborted too, and the doctor has lost his medical license.

It's strange here what passes for prenatal "care." My sister was a little shocked that an OB practice could require you to get the first trimester screening. Her practice, which works primarily with poor Latinas, doesn't even offer it, and they discourage the second trimester screening as well. In some ways, these Latinas get much better care than the upper-class white women here. One difference is the insurance coverage; my insurance company will pay for all these screenings (and I guess if it results in an abortion they ultimately save money, too). But this population also has a different attitude toward life; my sister says they have a beautiful saying in Spanish, which she's heard countless times when she brings up the option of the screening. It's something to the effect of, "We'll receive our child however it comes to us."

"Receive." It's an interesting word, isn't it? It implies that there's something else involved besides the two who conceived the child. It also implies that the parents didn't "choose" to have this child, so much as to accept the child as a gift from God. And who would refuse the gift as its given?


Denbeau said...

Another reason that most physicians and clinics will recommend screening is the fact that prenatal screening has been defined as the 'standard of care'. This implies that if screening isn't recommended, and if there is an 'adverse outcome' to the pregnancy, the physician and/or clinic can be sued for being responsible for a 'wrongful birth'. However, having said that, I'm still in favor of screening. It detects much more than Down Syndrome and Spina Bifida, especially if accompanied by a detailed ultrasound. Check with your larger Catholic hospitals; you might be surprised how many offer screening - not to lead to termination, but because the information leads to better care for the mother and child.

Heart and Hands said...

I think i'ts one thing to recommend screening as the standard of care, but it's quite another to tell a patient she can't receive care at your clinic if she refuses the screening, as my sister was told. That sounds more to me like forcing your agenda on the patient. If she prefers to go through her pregnancy without the addded worry of an abnormal screen which may or may not indicate a special needs child, that should be her choice. If other women want to know ahead of time so they can prepare for a special needs child, I think that should be their choice too. However, I think ultrasound is a sufficient screening, and has about the same detection rate of DS as the second trimester screen (80%). More invasive confirmatory tests carry with them the risk of miscarriage, so women who are very concerned about continuing their pregnancies usually don't consent to this testing. In general, I'm just against tests being forced on patients for legalistic or any other reasons.