WASHINGTON (AP) — First birth control, now prenatal testing? Once again a fact of life for many American women has become a jarring issue in the presidential race.
Republican candidate Rick Santorum is making free screenings for birth defects part of his attack on President Barack Obama's health care law. Santorum charges that the law requiring insurers to cover the tests is a way to encourage more women to have abortions that will "cull the ranks of the disabled in our society."
Obama re-election campaign spokeswoman Lis Smith called Santorum's remarks "misinformed and dangerous." She said the tests help bring about safer deliveries for mothers and babies.
Federal health officials and doctors recommend that all pregnant women be offered blood tests and an ultrasound exam that assess the risk of having a baby with a birth defect or genetic disorder, including Down syndrome. If a screening test raises concern, a woman may choose further testing, such as amniocentesis.
How did these commonplace tests spark so much controversy?
—Some women don't want the tests because they know they wouldn't abort their fetus no matter what the results. Others who wouldn't consider an abortion still want the tests, so they can be emotionally prepared and plan for a disabled baby's more complicated care. Babies with Down syndrome can need specialized care at delivery that affects hospital selection.
—Some women avoid amniocentesis, which involves withdrawing amniotic fluid with a needle, because of the small chance it could cause a miscarriage. There are less invasive tests available and newer ones on the way.
—As Santorum noted, studies show that in the vast majority of cases where amniocentesis reveals Down syndrome, women decide on abortion.
—Advocates for the disabled, including many parents of Down syndrome children, worry that couples are choosing abortion without fully considering that their child could lead a happy, fulfilling life. About one in 800 babies has Down syndrome, a condition in which having an extra chromosome causes mental retardation, a characteristic broad, flat face and, often, serious heart defects.
The prenatal testing issues have been debated by abortion foes and obstetricians and wrestled with by prospective parents. But the ethical quandaries and painful emotional decisions received scant public attention before the politically charged remarks from Santorum, who also opposes the government requiring birth control coverage for employees of religiously affiliated organizations.
Until now, perhaps the best-known public reflections on the prenatal testing issue came from two well-known conservatives, each the parent of a Down syndrome child, who reached different conclusions about prenatal screening:
—"I was grateful to have all those months to prepare. I can't imagine the moms that are surprised at the end. I think they have it a lot harder," Sarah Palin said during her 2008 campaign for the vice presidency about the amniocentesis results she received before her son, Trig, was born.
—"What is antiseptically called 'screening' for Down syndrome is, much more often than not, a search-and-destroy mission: At least 85 percent of pregnancies in which Down syndrome is diagnosed are ended by abortions," columnist George Will wrote in a highly personal 2007 column about his grown son, Jon.
Santorum, whose youngest daughter has a different genetic disorder, Trisomy 18, said in a CBS interview on Sunday, "Almost 100 percent of Trisomy 18 children are encouraged to be aborted, so I know what I'm talking about here."
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