The mere mention of an “amnio” has the power to evoke fear in the heart of every new mother. A positive test leads to the hardest of choices: continue with the pregnancy or arrange an abortion. Because of this, the test itself has come under fire for even bringing up this dilemma. But what is an “amnio”, or amniocentesis as it is officially known, and why is it so controversial?

Amniocentesis is a genetic test conducted four months into pregnancy to determine whether the fetus has any genetic, chromosomal or neural tube abnormalities. The test is usually offered to pregnant women over the age of 35 or with risk factors such as elevated levels of AFP, hCG, or Estriol. It involves the collection of amniotic fluid from the amniotic sac via a needle guided by ultrasound. Most commonly, the results of the amniocentesis are thankfully negative and these women continue to plan for their healthy baby. However, in some cases, the test comes back with a positive result that is 98-99% accurate[1]. The test most frequently diagnoses Down Syndrome, but it could also indicate other types of diseases like Spina Bifida or Cystic Fibrosis. While there are further tests that can be done to determine the severity of these diseases, every woman who receives a positive amniocentesis result has the option to abort the fetus.

Many people have an immediate negative reaction to this idea. Even for those who are pro-choice, it sounds unethical – aborting a baby simply because they might not be “ideal”. Some would even argue that aborting after an amniocentesis is “selective” abortion, which means to terminate a pregnancy when the fetus has so-called “undesirable” characteristics. As one prominent bioethical book mentioned on the topic of amniocentesis, “selective abortion on these grounds is neither therapeutic nor preventive…it is simply a form of euthanasia”[2]. Additionally, many take offensive to the implication that any baby born with these diseases is automatically inferior. However, in reality, people with Downs Syndrome, Spina Bifida, and Cystic Fibrosis can go on to live long and fulfilling lives and many do. So, although a potential mother might feel as though her future fulfillment is at risk, these families are not necessarily defined by the disease and many of them feel as though terminating a pregnancy after a positive amniocentesis result suggests just that. In fact, the amniocentesis test doesn’t even give any information on the severity of the disease[3]. Therefore, a positive result could simply mean a mild form of the disorder, which while still chronic, would not significantly lower the child’s quality of life, one of the fears for many prospective mothers who have been given a positive result. Lastly, the amniocentesis test is administered very late in the pregnancy, during the second trimester. At this point the fetus is already the size of an apple and has been moving for a couple weeks. Since abortion is legal in most states until viability, these abortions are still technically allowed but some consider them to be past the point of an ethical abortion. For all this, there are people who are trying to get rid of the amniocentesis test altogether.

However, for every one of those against the amniocentesis test, there is someone who strongly believes in the benefits of the test.

However, for every one of those against the amniocentesis test, there is someone who strongly believes in the benefits of the test. First and foremost, the test itself does not always lead to an abortion even if the results are positive. While women are given the option to terminate the pregnancy, there are many mothers who choose to keep their fetus. However, armed with this knowledge, they now can prepare in advance for the challenges that they and their child will face in the future. The test gives women the information they need to make educated decisions about their child. As one such mother said, “I fear that genetic testing is becoming a polarizing issue like abortion…when it’s really just another moment to make sure women have access to compassionate care and comprehensive information”[4]. Amniocentesis should not be viewed through the lens of the abortion it can sometimes cause but rather for the important information it can give to prospective parents about the health of their child so that should they choose to continue their pregnancy, they can be prepared. On top of that, some people argue that it is simply more merciful to terminate the pregnancy early. If the disorder is very serious, it is possible that the quality of life for the child would be extremely poor. Some believe that this is a good enough reason to end the pregnancy here, much like hospice. Finally, some insurance companies can consider the amniocentesis results as prior knowledge, which would make the disease a pre-existing condition[5]. Though this issue was somewhat combated with the Affordable Care Act, in some cases, they could still refuse to take the child on as a patient, forcing the parents to deal with the astronomical health costs that they undoubtedly will face. To this end, many people believe that the amniocentesis test itself is simply another way to get information about the baby, something which can only help parents make educated decisions. Good or bad, as of right now the amniocentesis test is a real possibility for all pregnant women as they go through their prenatal testing and so definitely deserves serious ethical consideration.

[1] “Amniocentesis – American Pregnancy Association.” American Pregnancy Association. 02 Sept. 2016. Web. 26 Oct. 2016.

[2] Morrison, Eileen E., and John F. Monagle. Health Care Ethics: Critical Issues for the 21st Century. Sudbury, MA: Jones and Bartlett, 2009. Print.

[3] “Amniocentesis – American Pregnancy Association.” American Pregnancy Association. 02 Sept. 2016. Web. 26 Oct. 2016.

[4] Morton, Jacqui. “Women Have the Right to Prenatal Genetic Testing – and to Choose Abortion | Jacqui Morton.” The Guardian. Guardian News and Media, 26 Mar. 2015. Web. 26 Oct. 2016.

[5] Lewis, Megan. “The Ethical Problems of Amniocentesis.” The MedSchool Project:. Web. 25 Oct. 2016.