Prenatal Diagnosis



All pregnant women are offered prenatal diagnosis. Actually it is intended as an offer, but in real life you will quickly be questioned if you deselect it. And even when you have opted out, you will be invited to a scanning to determine the age of the baby, where the typical commentary from the sonographer is: "If I find something wrong, I will have to tell you!"



I know a mother, whose midwife was pushing to scan for fetal errors. The future mother said she would not have an abortion no matter what the baby might fail. The midwifes immediate response was: "What if the baby has no brain?"

What a message to give to an expectant mother! With such messages if you choose to opt out, one might as well make the investigations mandatory. But in Denmark, this is not the Board of Health's intention: The mothers shall be able to choose between having prenatal diagnosis or not.

This is because even if the prenatal diagnosis shows nothing wrong, it is not an assurance that the parents will have a healthy baby. All parents have a risk of 2% of having a child with serious malformations. If the prenatal diagnosis shows no signs that something is wrong, their risk is reduced to 1%. There is still a risk because not all the abnormalities are detected with the available examinations of today. You can also turn the figures around and say that the chance of having a healthy child is 98% before and 99% after the examinations have not shown any signs of abnormalities.



Prenatal diagnosis consists of a blood test –the so-called double test- and a nuchal translucency scan. Combined with the age of the mother, this serves as the foundation for a risk assessment. If the risk of having a baby with a birth defect -most commonly Down’s syndrome- is greater than 1:250, you are offered to proceed with so-called invasive fetal tests. Now you have to have a sample from the fetus itself, either through an amniocentesis, or a placenta biopsy. This way you can usually tell whether the child has a congenital disorder or not.



The invasive tests, however, carry themselves a risk of spontaneous miscarriage of 1%. The final outcome is that for every third child with Down’s syndrome that is spotted and killed, a totally healthy baby dies ,too.


In addition, all the women with an increased risk of fetal malformations without anything actually being wrong with the baby, are troubled with unnecessary anxiety during their pregnancy. Not to mention the dilemma they are faced with when something wrong is found, and they are to decide what is going to happen. Most people choose to kill their child. But there are examples of parents who are aware of their responsibilities, and who, despite a positive test, choose to keep their baby.


This is looked down upon in today’s society: "Something must have gone wrong!" To say this is the same as standing right in front of the child, and telling them "You are a mistake!" This stigmatization definitely contributes to why so few parents choose to keep a child with a congenital disorder. Because of their opinions, many are thus guilty of the death of innocent children.


In the near future we will have the opportunity to examine for many more diseases in order to remove those whom we do not want. Where are we going? Do we want a society that consists only of "perfect" people? And what kind of society are we becoming, when people consciously kill their own children because they have a cleft lip and palate, or have the wrong gender?