In the wake of the US Supreme Court lifting federal protections for abortion and Wisconsin’s Ban on Nearly All Abortions come into effect, some people have wondered what implications that would have on genetic testing.
In particular, people have contacted Wisconsin Public Radios WHYconsin ask what options pregnant people have now when genetic testing reveals abnormalities in a fetus, including those that prevent a child from surviving outside the womb.
A Wisconsin woman was nine weeks pregnant when she contacted them and asked about it. WHYsconsin does not use her name because she is afraid she will be shamed or criminalized for asking these questions.
“I am currently 9 weeks pregnant with a very much wanted child,” she wrote. “Since I will be 35 when I go into labor, I will undergo genetic testing on the advice of my doctor to make sure the baby is healthy and viable. If I find out that this is not the case, what my options are “Would I be forced to wait until my life is on the line before abortion is considered an option?”
In the United States, it’s common for health care providers to offer and discuss genetic testing as part of prenatal care, according to medical professionals interviewed by WPR. Some screening can be done pre-conception, when people consider having a child. During pregnancy, testing done during the first and second trimester provide information about the fetus, including whether the fetus could be born with certain genetic conditions and if the fetus is incompatible with life, meaning the baby will not survive outside the womb.
The Wisconsin mom, who also has a 2-year-old, and her husband are overjoyed to have another child, but she’s worried about how the recent legal changes are affecting her pregnancy.
“I’m so excited to have another baby,” she said in a follow-up interview. “But I’m just afraid if something happened to our baby, what our options would be. If it’s not viable, if there’s just crazy birth defects or things that would make it incompatible with life, would I be forced to to wear Or if something were to happen, maybe not a miscarriage per se, but if there is no heartbeat, would I again be forced to wait until my life is in danger before any medical intervention would be available to me here now ?”
In Wisconsin, the ability to undergo genetic testing has not changed; it is the ability to act on the information obtained from these tests.
“These tests aren’t really affected,” says Dr. James Linn, an OB-GYN with Ascension Wisconsin in Milwaukee and member of American Association of Pro-Life OB-GYNs. He said he has not heard from anyone who has questioned the legality of genetic testing and said he does not think providers have stopped offering or discussing genetic testing since the state ban took place.
“The intent of the law is not to allow abortion of an unborn child,” he said.
The 1849 ban makes abortion illegal in Wisconsin unless a pregnant person’s life is in danger. That means every genetic abnormalities found in a fetus through genetic testing are not a legal reason for an abortion in Wisconsin. If a person wants to terminate a pregnancy, they must go to a state where it is legal or wait until a medical emergency requires the procedure to save a patient’s life, said Dr. Wendy Molaska, President of the Wisconsin Medical Society.
That is also the understanding of UW Health.
“In the absence of maternal disease, genetic abnormalities in the fetus — including those that prevent the fetus from surviving outside the womb — do not pose a life-threatening condition to the mother,” Dr. Lisa Barroilhet, interim chair of the Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, in a written statement. “Since the abortion is not performed to save the mother’s life, it would not be legal in Wisconsin under the 1849 statute.”
Across the country carriers are trying to understand laws with exceptions like this, exceptions which some feel are not well defined.
Molaska has been practicing family medicine in Wisconsin for more than 20 years. She runs her own practice, Dedicated Family Care, in Fitchburg.
A physician who has worked as an OB-GYN in rural areas, Molaska has seen patients struggle with the news that their child will be born with major birth defects such as anencephalywhen a baby is born without parts of the brain or skull, or trisomy 18when a baby is faced with heart defects and infections that can lead to death.
She has had heated discussions with her patients about test results and has had patients who have gone both ways: terminating the pregnancy or carrying it to term.
“I think this really comes down to the conversation having to be a conversation between a (patient) and her healthcare provider,” Molaska said. “…I believe the physician should be able to talk to their patient about all the options…all the evidence we have available and that the patient and her family should make that decision about what their values are and what they see as what they want to do.”
Since reaching out, the Wisconsin mom has completed genetic testing in the first trimester. Her husband is adopted and they don’t know much about the medical history of his biological parents, so they decided to have genetic testing during both pregnancies.
Family history and wanting to know if the child may have genetic abnormalities are common reasons for testing and can help make decisions, said Dr. Kara Goldman, a professor of obstetrics and gynecology at Northwestern University.
“I think it’s important to know that a lot of people screen because they want to prepare for whatever is going to happen to their families,” Goldman said. “And so if it becomes a chromosomally abnormal pregnancy, patients can decide, ‘This is important for me to know so that I can prepare our relatives so that we have resources so that we can go to the right doctors.’ “So it’s really not just about using the information to terminate, but it’s really important to have that information so that patients have that choice.”
Another reason genetic testing is done is to help determine what resources and assistance parents and families need for the birth, child and family, Linn and Goldman said.
“These are optional tests that some parents want so they can prepare for the birth of a child who may have an abnormality,” Linn said. “Sometimes they’ve had a previous child with a problem and they just want to know how to prepare for the next baby. Or they want to be reassured that there’s nothing to suspect another abnormality. So sometimes it’s just to getting ready to get everything ready, get their household ready and make plans for the new baby. Another reason is just to relieve anxiety.”
If a health care provider performs an illegal abortion in Wisconsin, can face a crime. Patients are not prosecuted. Wisconsin Attorney General Josh Kaul has said he… does not intend to enforce the 1849 prohibition, although local law enforcement might. Government Tony Evers said he would pardon those persecuted under the ban. The limitation period is longer than the period of Kaul and Evers.
This story arose from a question as part of the WHYsconsin project. If you have a question about abortion and reproductive rights access, post your question below or at wpr.org/WHYsconsin and we may answer it in a future story.