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Terminating a Desired Pregnancy for Medical Reasons or Poor Prognosis

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Updated December 09, 2009

Pros

When parents decide to terminate for medical reasons, the decision may have a number of factors. In nonfatal conditions, parents may feel they are ill equipped to handle a child with lifelong special needs, such as a baby with Down syndrome.

Sometimes the decision to terminate involves concern for the baby's suffering. In the event of a condition like trisomy 18 that involves potentially severe medical problems as well as a very short life expectancy, parents may want to avoid putting the child through unnecessary pain when there is no hope for a good outcome. These parents may feel that termination is the lesser of two evils.

Terminating for medical indications may involve concerns for the mother's physical and emotional health. When receiving the news of a devastating medical diagnosis, moms may not want to face additional months of pregnancy only to see the much-wanted baby die in the hospital. They may need the physical process over with so that they can begin grieving and move on.

Finally, some situations may involve serious risk to a mother's life, such as the rare condition of a twin pregnancy involving one normal fetus and one hydatidiform mole (in which the mother faces a 60% risk of developing malignant gestational trophoblastic disease by the end of the pregnancy if she opts to continue). In these cases, the mother's life and health may be protected by the termination -- even if the baby was very much wanted.

Cons

For diagnoses of nonfatal conditions, such as Down syndrome, parents may decide that they are ready and willing to accept a child with special needs.

In situations with a poor prognosis, some parents may opt against termination because of religious convictions or deep philosophical convictions against abortion.

Other parents prefer not end the pregnancy through medical or surgical intervention when the condition does not threaten the mother's life. Some of these parents may make every effort to avoid medical interventions when possible because of philosophical or religious beliefs, especially invasive procedures.

Still other parents may feel solace in letting nature take its course and in having a chance to hold the baby before it passes away, perhaps not being able to bear the idea of terminating a baby that is alive.

A few parents may continue a pregnancy because of a slim hope that the diagnosis was wrong and that everything will turn out fine. (Diagnostic errors are extremely rare for conditions that would raise the question of medically based termination; chromosomal studies obtained through amniocentesis, for example, have 100% accuracy barring the also rare case of lab error.)

Where It Stands

The decision of whether or not to terminate a pregnancy affected by a serious medical condition is highly personal. Some parents take a middle ground, opting to terminate if the condition is one that would be fatal at birth or shortly thereafter, but choosing to continue pregnancies in which the baby is expected to have a physical or developmental condition but also a reasonable life expectancy.

Some states do have laws on the books that can make a termination difficult if the condition does not threaten the mother's life, in which case women may be forced to travel a long distance for the procedure or to continue the pregnancy.

Second-trimester terminations for medical reasons usually involve a D & E or a D & X (dilation and extraction) procedure -- often with an injection beforehand to stop the baby's heartbeat. The D & X procedure, which is used for some of these terminations, is highly controversial. Legislators have targeted this procedure, known as "partial-birth abortion" in mass media, in recent years and the future of the procedure remains uncertain.

Sources:

National Institute of Neurological Disorders and Stroke, "Anencephaly Information Page." 13 Nov 2007. Accessed 7 Feb 2008.

University of Virginia Health System, "Trisomy 18 and 13." Medical Genetics. 28 Jan 2008. Accessed 3 Feb 2008.

Wertz, D.C. "How parents of affected children view selective abortion." Issues in Reproductive Technology I: An Anthology Garland Publishing, 1992. New York. Accessed 7 Feb 2008.

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