A. Wanted Fetuses Diagnosed with Grave
Anomalies in the Second Trimester.
One of the tragic realities of second-trimester abortions
is that many women who obtain them are carrying pregnancies
that were entirely wanted. As many of the women note,
tests to assess whether certain grave conditions or disorders
affect a pregnancy cannot be administered prior to the
second trimester.11 As a result, a woman whose fetus is critically
9 In their accounts, individual women self-identified as Baptist,
Catholic, “conservative Christian,” Jehovah’s Witnesses, Jewish,
Muslim, Presbyterian, atheist, and “spiritual.” Individual women
identified as members of different racial and ethnic groups, including
African-American, Asian-American, Caucasian, and Latina. The women
who submitted their stories are from more than half of the States,
including, inter alia, Alaska, Arizona, California, Colorado, Connecticut,
Florida, Georgia, Idaho, Illinois, Louisiana, Maryland, New York, New
Jersey, Ohio, Oregon, Pennsylvania, Virginia, and Washington.
10 While two of the women’s stories make clear they obtained D&X
procedures, some of the women’s testimonials refer alternatively to having
obtained a D&E and a D&X procedure, suggesting that more than two of the
women who submitted stories may have obtained a D&X procedure.
11 Amniocentesis is the most common and accurate prenatal test used
to diagnose serious birth defects. It is generally not available before the
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impaired will often not learn that fact until well into the second
trimester of her pregnancy. Often women learn, only for the first
time in the second-trimester, of mortally serious conditions and
disorders such as Trisomy 18 or Patau’s syndrome;
12 Trisomy 18or Edward’s syndrome;13 Cat Eye syndrome or chromosome 22
disorder;14 congenital CMV;15 or Turner Syndrome.16
fifteenth week of pregnancy. “Chorionic villus sampling,” or CVS, is a test
available starting at ten to thirteen weeks in pregnancy but is useful to
identify a limited subset of abnormalities identifiable by amniocentesis.
See F. GARY CUNNINGHAM, ET AL., WILLIAMS OBSTETRICS 329-30 (22d ed. 2005).
12 Median survival rate for infants born with Trisomy 13 is seven
days. Only 10% of infants with the chromosomal disorder will celebrate
their first birthday. Eighty to 90% of infants with Trisomy 13 will suffer
from cardiac defects, and 70% will suffer from a spectrum of significant
cranio-facial malformations. See WILLIAMS, supra n.11, at 291; see also
Support for the Trisomy 13, and Related Disorders, Trisomy 13 Facts,
www.trisomy.org/html/trisomy_13_facts.htm (visited Aug. 9, 2006).
13 Most infants born with Trisomy 18 die within fourteen days of birth
and only 10% survive more than one year. Those who survive are profoundly
retarded and 95% have cardiac defects. WILLIAMS, supra n.11, at 290; see also
Support for the Trisomy 18, and Related Disorders, Trisomy 18 Facts,
www.trisomy.org/html/trisomy_18_facts.htm (visited Aug. 9, 2006).
14 Cat Eye syndrome typically results in the grotesque malformation
of a fetus’s skull and facial features. Additional conditions associated
with the chromosomal disorder include malformations of the heart,
kidneys, and intestinal and anal systems. See Nat’l Inst. of Health,
Nat’l Library of Med., avail. at
www.nlm.nih.gov/cgi/jablonski/syndrome_
cgi?index=93 (visited Aug. 9, 2006); see also Nat’l Org. for Rare Disorders,
Cat Eye Syndrome, avail. at
www.rarediseases.org/search/rdb
detail_abstract.html (visited Aug. 9, 2006).
15 In 90% of infants born that show no symptoms of CMV at birth,
15% will develop one or more neurological abnormalities, usually in the
first two years of life. Of the 10% that show symptoms at birth, up to
20% will die and about 90% of the survivors suffer from serious
neurological defects. See WILLIAMS, supra n.11, at 1282-84; see also March of
Dimes, Cytomegalovirus Infection in Pregnancy, avail. at
www.marchofdimes.
com/professionals/681_1195.asp (visited Aug. 9, 2006).
16 The majority of fetuses with Turner Syndrome that survive until
the second trimester have major cardiac malformations. It is also
common for these fetuses to have “cystic hygromas” or sacs of fluid that
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As the women describe, not only are some of the
initial diagnostic tests administered only in the second
trimester, but confirmatory tests – essential to the woman
making an informed decision – take additional time.
Erin, a 35-year-old woman from the West Coast,
describes her life as “pretty ‘apple pie’.” She explained the
timing involved in receiving a diagnosis for her pregnancy:
In addition to the terrible news about the probability
of the baby having a serious problem came another
nasty surprise: We would not be able to
confirm if there was a problem or make any decision
about how to proceed for quite some time. . . .
Waiting to get the amnio was one of the most
stressful, heart-rending, agonizing times of my
life. My belly was growing, and my pregnancy
was no longer a private matter because of that. I
wanted to be upbeat, but I was terrified. The
more research I did on Trisomy 13 and 18, the
more terrified I got. . . .
The amnio date finally arrived in the middle of
my 15th week of pregnancy. During the amnio,
they discovered that I also had a complete placenta
previa – a condition where the placenta
implants over the cervix. They felt my case was
unlikely to resolve itself, which meant I would be
at risk for severe bleeding as the pregnancy progressed.
. . . [W]e tried to remain hopeful that the
amnio results would show that the baby at least
didn’t have a fatal trisomy. . . . But unfortunately,
the amnio results came back confirming our baby
form from the neck and may be the size of or larger than the fetal head.
WILLIAMS, supra n.11, at 395. Less than 2% of fetuses with Turner Syndrome
survive pregnancy. See id. at 291. Of those infants who survive, 98% will be
infertile and some will have heart, kidney, and neurological problems. See
also Nat’l Inst. of Health, Turner Unit, avail. at
Turner Syndrome - Home
ClinFrTables.html (visited Aug. 9, 2006).
9
had trisomy 18. At this point I was 16 weeks
along and had begun feeling the baby kick. It
should have been sweet, but instead the kicks
were torture. We were utterly crushed.
Erin, submitted by e-mail, May 11, 2006, at 62-63.
Cara, a married Catholic woman with an almostthree-
year-old son, has “always dreamed of having a big
family.” She described the time it took to obtain information
needed about her pregnancy:
I was about 17 weeks pregnant at the time. . . .
[T]hey scheduled us for our Level II ultrasound a
few weeks early so they could look in more detail
at the baby. . . .
A few days [after the ultrasound], we received
the news that would change our lives forever.
Our son was infected with CMV (cytomegalovirus).
This was the worst possible scenario (of the
possibilities we were given). . . .
Although I have always been pro-choice, I had
winced at the thought of late-term abortions or
“partial birth” abortions, thinking that it was
just inhumane or irresponsible. Now I know differently.
In my case, we were not able to confirm
our diagnosis until 19 or 20 weeks gestation. I
terminated at 22 weeks. . . . I was completely
heartbroken. . . .
Cara, submitted by e-mail, May 11, 2006, at 42-43.17