Note from Physicians to Mr. Santorum: You are Wrong on Prenatal Tests

Gentle Readers:  This note was published in the Dayton (Ohio) Daily News by five Maternal – Fetal Medicine colleagues from Miami Valley Hospital in Dayton (Ohio) as a way to ensure that the mis-statements and outright lies streaming from the mouths of our Republican “leaders to be” are corrected.
I seem to remember the Republicans worrying out loud about “government interference” in the patient – doctor relationship that would occur with “socialized medicine”.  Looks like they were right……..but it is the Republicans who are doing the interfering.  AJL

As doctors in the Greater Dayton region, we have observed many comments made recently by different presidential candidates, but when Republican candidate and former Senator Rick Santorum attacked prenatal screening as he recently did, he entered our turf and he clearly is in need of some medical facts and guidance. Therefore we have volunteered to enlighten him because he has dangerously misrepresented the realities of prenatal care.

Firstly, prenatal screening tests are offered to the expectant mother, rather than being done without her permission, whether these tests are designed to identify those patients that are at risk for a chromosomal abnormality such as Down syndrome or structural birth defects of the spine or heart.

Secondly, if the screening test places the expectant mother into the “increased risk” category, the option of an invasive test such as an amniocentesis is offered to her, rather than making the recommendation to have such a test done.

Thirdly, if an abnormality is detected, the patient is given information regarding all of her options and termination is never recommended, unless the mother’s health is at risk. At each step along the way, the patient’s autonomy regarding her healthcare decisions must be respected.

Candidate Santorum was completely incorrect to say that prenatal testing is simply a “search and destroy mission”. In reality, the recognition that the fetus has an abnormality may lead to a change in prenatal care and selection of a place of delivery that has long-term benefits. For example, a fetus that has Down syndrome is at a very high risk for having a heart defect.

Therefore, the diagnosis of Down syndrome leads to a very careful examination of the fetal heart. If a heart defect is diagnosed prenatally, the health care team is better prepared to treat the newborn baby. For those patients that elect to continue the pregnancy, prenatal diagnosis often improves the outcome. All medical knowledge should be encouraged and fully utilized and an uninformed attack on any stage of care is both ill advised and heartless in its intent.

Many of the screening tests available today, which were originally designed to improve the detection of one type of abnormality, have been found to be applicable for many others. This closer surveillance provided during prenatal care usually improves the outcome of the pregnancy and the long-term health of the newborn child.

Lastly, there are many psychological benefits to prenatal care. Many mothers feel they are much better prepared of the eventualities at the time of their children’s birth because they know in advance of the possible diagnoses.

Scientific literature is full of proof of the benefits of prenatal screening; the above is only a fraction of these. We simply suggest that It is very dangerous to trust politicians who discuss issues that they do not have the background to understand in their entirety, especially if it is done to further a narrow political agenda.

J. Sonek, MD

C. Croom, MD

M. Glover, MD

C. Kovac, MD

D. McKenna, MD

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the past approximately 10 years, until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director of Critical Care Medicine in PA. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". You are welcome to respond to him at ajlayon@gmail.com.
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