Challenging the Odds

Abstract

Today, sonography allows a pregnant woman to peer into a video screen and see the fuzzy contours of her unborn child’s fingers and toes—as well as its kidney, bladder, brain, spine, and the chambers of its tiny, beating heart. Even before a mother can feel her baby’s first soft flutterings, she can watch it kick, wiggle, and somersault deep within her. Levels of serum alphafetoprotein (AFP) in the mother’s blood can indicate whether her fetus might have a neural tube defect such as spina bifida. Amniocentesis and a newer prenatal test called chorionic villus sampling (CVS) can analyze the fetus’s chromosomal makeup, revealing or ruling out many genetic birth defects. Thus, months before delivery a woman can, if she so chooses, call upon modern medical technology to learn much about her unborn child’s health and even to discover its gender.

We may think it too farfetched to believe that young couples in the future might actually choose whether to continue a pregnancy on the basis of genetic tests that predict a child’s incapacities, deficiencies or susceptibilities in the distant future. But social mores change rapidly in the face of new technology. The advent of techniques like amniocentesis and more recently chorionic villus sampling for just a limited number of chromosomal defects has led to an explosion in prenatal testing in the last decade. As a result, pregnancies are routinely terminated today for reasons that would have left previous generations aghast. Genetic counselors say it’s not unusual to encounter young couples who, for whatever reason they may formally state, are actually seeking a prenatal test solely to determine the sex of the fetus. And sociologists say younger couples today are showing an increasing tendency to expect—and demand—only ‘perfect’ children.

Jerry E. Bishop and Michael Waldholz, Genome: The Story of the Most Astonishing Scientific Adventure of Our Time— The Attempt to Map all the Genes in the Human Body (1990)