Prenatal screening and testing is offered to virtually all pregnant women as standard prenatal care. Many women accept all or some of the tests offered, though they are not always well informed about what purpose the screening and testing will serve. Some will enter into the screening process with a lot of ambivalence but take on the assumption that the benefit of proceeding will outweigh their reservations. They are not always informed that from a medical perspective, the primary purpose of this prenatal screening has less to do with improving or ensuring health of baby, and more to do with identifying babies at higher risk of syndromes or congenital malformations as early as possible.

Medicine cannot “cure” chromosomal syndromes, nor some of the most serious defects. Of course, some children survive and do well because their birth defects were detected or even treated in-utero, and still others benefit from the medical planning parents were able to put in place before delivery – these are good and therapeutic reasons to pursue testing. Yet the process of prenatal testing and diagnosis is, in practice problematic. Waiting for results, some mothers feel their pregnancy has been put on hold. Some mothers experience feeling alienated from baby. The looming possibility of bad results can change a mother’s perception of reality because a baby that already is may suddenly become a baby who will not be. Some begin to suppress their maternal instincts, which appears to be a necessary prelude to termination.

Recently, University of St Thomas Professor of Law and a mother intimately familiar with prenatal diagnosis, Elizabeth Schiltz noted in an interview titled, “Down Syndrome and the Pressure to Abort”, that, “The real problem is using the results of these tests as part of a crude "cost-benefit" analysis — of balancing the "benefit" of giving birth to a child with Down syndrome against the "cost" to the mother and the broader society.” Any baby perceived from the lens of “cost” over “benefit” will be at risk of abortion. What Schiltz has described and what has been reported by many women is nothing less than an institutionalized presumption in favor of abortion; imperfect babies are burdensome and should be aborted, it is best for all involved. Medicine might not be able to take away baby’s problems, but it can identify and take away an “affected fetus”.

Termination is presented, if not as a good in itself, then something “good enough” by far too many medical professionals. Yes, they may sincerely believe they are offering a compassionate choice. Certainly we can see that the language of compassion has been adopted by many professionals to shield hurting parents from the frankness of the phrase, “elective abortion”. However, to speak of abortion as the merciful way out, to offer one tragedy for another, only intensifies the pressure put upon the mothers to terminate after a prenatal diagnosis. If parents are not directed to life-affirming and hope-filled sources of support, it is easy to understand why most feel they must abort.

Thankfully, there is now a great deal of support for families investigating all their options after a diagnosis. Some of this support is easily accessible online. Other support is imbedded within larger organizations, such as churches and hospitals. Those of us who want to help families stand up against the presumption for abortion have learned very much from women who have carried to term as well as those who have aborted. All of us can report that many women were pressured to consider termination, whether they ultimately chose it, or not.

Mary Kellett, foundress of Prenatal Partners for Life , an internet-based support organization shares, “Parents are frightened into thinking they are doing their child a favor by not allowing it to be born. They are often given worst case scenarios, inaccurate and incomplete information so they are led to the conclusion that aborting their baby is the best solution.”

Jane Lebak, webmistress of Carrying to Term Pages, a website which offers practical support to women who carry to term babies with fatal diagnoses believes that even well-meaning doctors can be a source of pressure after a diagnosis, “Physicians all offer to terminate the pregnancy, and that's generally the first option they offer to the parents, who are still shocked by the diagnosis. Because it is the only medical "treatment" they can offer, they may come across as pushy even when they're not intending to be. It's just the case of when you're a hammer, the whole world looks like a nail.”

On our BeNotAfraid outreach, many parents have written about the pressure they experienced, alarmingly overt and directive in nature. It is a theme that stands out, story after story. What follows are only a few selections which should demonstrate what is undeniably “pressure” to terminate.

* Kelly, “I was advised that this was our time to ‘get out of a bad situation’ and that ‘we don’t know what were getting ourselves into’.

* Michelle, “Most of the doctors we saw were telling us we should go for a late term abortion. They told us that with the heart defects, the baby would never sustain life. They told us that she would most likely be still born. When the amnio came back normal, they told us that if she were born alive she would suffer. They said that she would probably never take a breath, and if she did, she would be a shell of a baby.

* JoAnne, “We told my doctor that we would not terminate the pregnancy, and he insisted that I speak to a counselor. He gave me a phone number which I called- I figured the more people I talked to and the more information I gathered the better prepared I would be. I called the number and began to tell my story to a counselor named Patty. I had no idea that Patty was a counselor for an abortion clinic.”

* Renee, “The doctors kept reminding us that it wasn’t too late to terminate the pregnancy. One doctor even called me on the telephone and told me he’d like for me to reconsider my decision not to terminate. He said my son may always have to live in a children’s hospital and his life may be miserable and full of pain. He said that if I don’t terminate the pregnancy, I may feel guilty later on because I could have spared my son such a miserable life.”

To acknowledge that there exists an institutional presumption in favor of abortion – and the power of it – is not to shift blame to someone else, or try to take away any responsibility for the decision from the parents. No, to acknowledge the presumption is to help parents understand, very simply, they were not the sole participants in the decision made. They were to some degree caught up within a process driven by powerful, entrenched presumptions. We hope that parents can first, accept healing and forgiveness for a decision they regret and, importantly, that they will pray for a change of heart among those who continue to presume that termination is a “good enough” outcome. It is necessary to pray as well for the mothers who will receive their own “bad news” today, tomorrow, and the days after.

Monica Rafie, founder and administrator of BeNotAfraid.Net