This is a special addition/edition to the 2.13.24 issue of Abortion, Every Day. Keep an eye on your inbox for the full daily report.
For months, I’ve been tracking the anti-abortion movement’s quiet campaign to force women to carry nonviable pregnancies to term. Their plan includes changing legislation and medical guidelines, forcing doctors to lie to women about their pregnancies, and requiring that women meet with anti-abortion “counselors” before ending a doomed pregnancy.
These days, though, I’m keeping a close eye on another part of that broader strategy: attacks on prenatal testing. And this piece from Associated Press is a good reminder of why, exactly, conservatives are going after women’s ability to find out as much as possible about their pregnancies.
The AP piece looks at how important prenatal testing has become in post-Roe America, and how women—especially those in states with bans—are increasingly relying on early testing. Doctors say more and more patients are asking for early ultrasounds and more genetic screenings; the hope, obviously, is to catch any issues as quickly as possible.
The article gets into the various kinds of prenatal testing and ultrasounds that patients receive—and the massive problem of timing. Many of these tests aren’t done until after some states’ legal limit for abortion care. With ultrasounds, for example, you can’t see details of the fetus until a certain, later, point in pregnancy. Still, patients are asking for those ultrasounds at 10 to 13 weeks so they can have abortions under the wire if necessary.
The other issue is that genetic testing results can sometimes take weeks to come back—that’s time that patients don’t have when they live in a state with an abortion ban. North Carolina OBGYN Dr. Clayton Alfonso said, “More people are trying to find these things out earlier to try to fit within the confines of laws that in my mind don’t have a place in medical practice.”
To find out more about the anti-abortion movement’s campaign to force women to carry nonviable pregnancies to term, read Part I of my series below. Part II is here.
The anti-abortion movement knew that all of this would happen after Roe was overturned—they knew that women would be desperate to get prenatal tests, and that the timing would be a big issue. That’s why prenatal testing is such a huge part of their campaign.
The short version is that the anti-abortion movement simply doesn’t want women to know what’s going on with their pregnancies. They’re ready to “counsel” those who get devastating diagnoses, but it’s even better for them if a pregnant person never finds out that there’s a problem to begin with.
That’s why anti-abortion activists are ramping up claims that prenatal tests are inaccurate, that the “testing industry” is corrupt, and that women need to be protected from genetic tests and ultrasounds. As such, their plan includes a few tactics:
Passing legislation that would require doctors to tell patients that “no test is 100% accurate” or that they might be ending a healthy pregnancy. (The cruelty is the point.)
Requiring that hospitals direct patients who are given fatal fetal diagnoses to anti-abortion “prenatal counselors” and groups, who will then give those patients fake or misleading information about the reliability of prenatal testing.
Spreading scare-tactics about prenatal tests to shame women out of taking them, using the language of “informed consent.” The idea is to dissuade patients who have gotten initial test results (like from bloodwork) from further testing. They’ll highlight the possible risk of miscarriage, and use language that suggests ‘responsible’ parents would never agree to tests like an amniocentesis.
In addition to all of these truly horrific policies, Republicans are also going to be pushing the FDA to reconsider the approval of some of prenatal tests. Mark my words. In the same way that they’ve been going after the FDA to repeal mifepristone approval, they are absolutely going to target prenatal tests.
Remember, it wasn’t so long ago that nearly 100 Republican lawmakers sent a letter to the FDA asking about the labeling requirements and regulatory measures around the tests. Sen. Steve Daines said, “It is unacceptable that the FDA is not conducting proper oversight on these inconsistent prenatal tests that often pressure women into making a life-ending decision for their baby.”
The Associated Press reports, in fact, that the FDA is going to be releasing a new regulatory framework this Spring around requirements for prenatal tests—so it’s something we’re going to have to keep a close eye on.
I’ve said it many times, but it’s worth repeating: make sure your legislators are on the lookout for Republican-proposed bills that contain language about prenatal tests and counseling, perinatal hospice care, or nonviable pregnancies. They’re banking on us not noticing—or being too afraid of taking on legislation they say is pro-women or pro-family. We can’t let that happen.
I had the AFP blood test in 1995 while pregnant with my first baby. I was 26 and the results said my chances of having a baby with Downs' were the same as for a 39-year old woman. Those chances are still low, but I was freaked out and they rushed me in for an ultrasound to confirm my dates. The AFP is more likely to be accurate if you are exactly 16 weeks pregnant. I had the ultrasound and they said my dates were correct and recommended an amnio. I got the amnio the next day and had to wait 10 days for the results. I was a basket case that entire time and we didn't tell anybody because we weren't sure what we would do if the results weren't what we were hoping for. Well, maybe we knew what we'd do and that was why we didn't want people to know. I didn't know that the AFP test could be unreliable, but the amnio is 100% reliable. We found out our baby did not have Downs' and that she was a she. The ultrasound tech said it looked like a boy. With my third pregnancy at age 35, the AFP results were again off. I had an ultrasound and the technology with ultrasounds had changed enough that they could examine several parts of the baby to look for signs of Downs' and they didn't find any and we also talked to a genetic counselor and decided not to have the amnio even though I was older. He did not have Downs'. Shouldn't giving inaccurate information about tests be considered malpractice? Also, referring a woman with a baby that won't live to an anti-abortion counselor is just cruel.
My initial prenatal screen came back concerning so my high risk OBGYN physician (Maternal Fetal Medicine aka MFM) recommended an amniocentesis. Found out I'm a carrier for a fatal neurological disease but husband is not so fetus was not affected. Those 3 weeks waiting for results, when we knew it could end in termination, were some of the most isolating for us. My mother, who worked at a CPC (which hurts my soul as a Family Medicine physician), called us repeatedly to tell us our "baby was precious, regardless of the results" and "wouldn't you rather give up your life for your child, __, than give up your child's life?"
I ended up very ill and had to deliver in an emergency at 28 weeks. The OBGYN asked me who to save, if it came to that, and without hesitation my husband yelled "save my wife" so that she understood and everyone in the room heard it.
Both of us survived, barely.
I love our child but, if those amnio results had been positive, we would've left Texas and come back after. I am lucky to know doctors that would've gotten me in as fast as possible.
It's hard being the only pro-choice people in your family and even harder when you're a physician who provides these much needed services in a state that hates women.