Friday, January 31, 2020

unsound ultrasound

From time to time I have faced a challenging situation, in which the report from a prenatal ultrasound leaves the pregnant woman and her husband with more questions than answers.  Prior to the ultrasound scan, there was a tiny person inside her womb, growing, constantly taking nutrition from her blood, and causing the nausea and other physical effects that come with hormonal changes.

They looked forward to the scan.

... an opportunity to confirm life and wellness.

... their child; welcome and already loved.

Then a phone call.  "You need to make an appointment to talk to the doctor about the scan."

The science behind prenatal diagnosis is significant, and developing constantly.  Risk assessment, especially for Down (or Down's) Syndrome is fairly standard in today's maternity care.  This includes measurement of the translucency or thickness of the nuchal fold, and identification of soft markers.  Most women (or couples) undergoing ultrasound scans in early pregnancy have no idea that they may be expected to make the chilling decision to abort or not.

Ultrasound is not essential to maternity care.  If a pregnant woman knows she does not want ultrasound she can decline the test.  But most would say that they want to 'see' their baby.

Our world today does not acknowledge the Judeo-Christian principles about the sanctity of human life.  When I see  the familiar images from ultrasound screening I see a person who is created in God's image.  A person for whom the 'You shall not kill' principle of the Ten Commandments applies.

When unprepared women attend ultrasound screening they love to see the movements, especially before the time of quickening, around 17-20 weeks, when they can feel movements.  They love to see the tiny thumb going into their baby's mouth.  The heart beats rhythmically, and the rate is recorded. 

The technician makes other routine measurements, and notes them down.  She or he is looking for anomalies: the unusual or abnormal.  These matters then become reasons for further testing, and, frequently, reasons for terminating the pregnancy.

Ultrasound is a serious medical test.  It has been used for protecting the life of a baby who would otherwise have died.  It can be the beginning of an unpredictable and unplanned journey through new terrain.  For example:

  • The baby's heart had not formed properly.  He had an under-developed Right atrium.  He probably will not survive, and if he does, he will need open heart surgery.  The parents are advised to abort their baby at 22 weeks.
  • The measurement of the baby's head is small.  She will probably have microcephaly, and brain damage.  Subsequent ultrasound measurements lead to confusion about the baby's condition.

Many women today in our society are entering motherhood for the first time at an age when the risk of Down Syndrome is already increased, before they consider the results of ultrasound scans.  A woman is told that at 40 her risk of conceiving a baby with Down Syndrome is *high*, at 1:100.  Then she is told that there is a *small* 1% risk of spontaneously aborting following amniocentesis.  1% is also 1:100.

Our world is subject to disorder, disease, and corruption - even down to the genes that we carry and pass on to our children.  

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