by Grattan Brown, STD, and Elizabeth Nelson, MD
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Dr. Elizabeth Nelson and her mother were both physicians. Between the two of them, they saw the rise of elective abortion paired with various technologies to detect disabilities and pressure to eliminate the disabled before they are born.
After the legalization of elective abortion, for example, many people noticed that there were fewer and fewer people living with Down’s Syndrome. Dr. Nelson saw the process at work. And the process was more a mindset shift than a series of procedures.
Here is Dr. Nelson’s story in her own voice.
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During 44 years as an OB/GYN in private practice, I never performed an elective abortion. My mother was a physician as well, graduating from Harvard Medical School in 1952. I grew up in an open home where topics were discussed and explained and where truths were acknowledged and became convictions. Probably from early education and training, I always knew life began at conception. I understood that there is evil in the world and that I should reject it and try to find better options.
I have seen technology increase pressure on women to terminate a pregnancy whenever the child might have an abnormality. The logic is to not use resources to care for a child who will be severely handicapped or die early; terminate the pregnancy and save the resources.
Medicine Before Prenatal Diagnosis
When I began practicing medicine in 1977, ultrasound, amniocentesis and prenatal diagnosis were not widely available. I delivered children with life-limiting, genetic abnormalities that could not be diagnosed until after birth. We treated those babies the same as any other child.
When ultrasound came along, it showed the head and body and, finally, limbs. Once ultrasound developed enough to use for prenatal screening, it was offered only to women at high risk. Today, prenatal screening is offered, and encouraged, for all women, with elective abortion as an option.
Before ultrasound became widespread, amniocentesis was much riskier and was reserved for special circumstances, such as checking fetal lung maturity at term. Now it is always performed with ultrasound and is much safer, but the increased safety has brought a new problem. Amniocentesis is offered if there are mere suspicions of a disabling or life-limiting condition, and is used much more often. The risk of amniocentesis causing fetal death may be 1 in 100 to 200, but as more and more doctors recommended amniocentesis, that risk affected more pregnancies, and more healthy babies died because of it. So, I would always ask patients how they would feel if they lost a normal pregnancy due to the testing.
The Quiet Pressure to Abort
In my early practice, I had a petite young woman who started to measure small for dates in her pregnancy. I asked myself, “Was this due to her size and genetics with a small baby or was there a problem?” The only way to know was to deliver and evaluate the infant. Should she have a Cesarean, which would commit her to Cesarean delivery for all subsequent pregnancies?
We discussed the risks, and she consented to have a Cesarean delivery if needed. At birth, it was apparent the baby had anomalies. The pediatrician ordered chromosomal studies and found a life-limiting condition. The mother chose comfort care and had her baby baptized; the child lived only a few days.
Today, the mother could have had prenatal blood testing and amniocentesis, capable of revealing abnormalities with greater precision. Virtually everyone now gets an ultrasound, capable of showing fingers, profiles, and much greater detail of the organs. Even with more advanced technology, her diagnosis would have led many doctors to the same recommendation and many women to the same action: an elective abortion.
For the woman, the typical reason is to prevent the suffering of the baby and allow the woman to recover from that pregnancy and become pregnant again more quickly, if she so chose. These reasons are understandable, but in my experience, elective abortion is not the best solution for pregnant mothers. They do better psychologically if they carry the pregnancy to term and meet their child, whether alive or stillborn.
Elizabeth Nelson, MD is a retired OB/GYN and maintains an active Florida medical license in order to volunteer in clinics and pregnancy centers. She is currently responsible for the abortion pill reversal program at the Choices Women's Clinic in Orlando, FL.
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