Genetic Prenatal Testing

Advances in genetic prenatal testing since the 1970s have given parents the option of learning their unborn baby's gender, as well as other characteristics, early in the pregnancy. This technology is of concern because it gives the parents the option of aborting a fetus that has unwanted characteristics. Although aborting a fetus of an unwanted sex is widely condemned, choosing to abort for other reasons is still contested. This entry will start by describing genetic prenatal testing and sex selection. Second, the implications of prenatal testing for selection based on race and sexual orientation will be discussed. Third, the emerging arguments of the disability rights community will be explained. And fourth, a variety of other concerns regarding genetic prenatal testing will be covered.

The term genetic prenatal testing includes a variety of genetic tests that look at chromosomes, genes, or proteins and are usually done to diagnose a range of genetic disorders. The most common prenatal test is amniocentesis. In this procedure, the health care provider uses ultrasound as a guide and inserts a thin needle through the mother's abdomen and uterus. A small amount of amniotic fluid (the fluid that surrounds the baby) is removed and tested. Amniocentesis can detect chromosomal disorders such as Down syndrome, structural defects such as spina bifida (open spine, where the vertebrae fail to close), and many rare, inherited metabolic disorders. The procedure is usually done between 15 and 20 weeks of pregnancy. Many parents and medical professionals are concerned with the small increase in the risk of unintentional miscarriage (approximately 1 in 200) that is associated with amniocentesis.

Ever since the technology became available to allow for prenatal sex testing, scholars have been worried that this procedure would be followed by sex-selective abortions (where the fetus is aborted if it is not the parent's desired sex). This is especially a concern in those countries that show a strong preference for sons over daughters, such as China, Korea, and Taiwan. Although there already are concerns in some countries about infant femicide (the killing of female babies), the worry is that the use of sex-selective abortions would lead to even more unequal sex ratios. In developed countries, such as the United States, son-preference is weaker and the idea of family balancing (having one boy and one girl) is usually behind parental gender preference.

Genetic testing and prenatal sex selection are also used by parents who conceive through the use of what is often called “assisted” reproduction. This includes an assortment of reproductive technologies, including in vitro fertilization where the egg and [Page 389]sperm are combined in a Petri dish and selected embryos are then transferred to the mother's uterus (or in the case of surrogacy, the uterus of another woman). Although some parents may be unwilling to abort a fetus that is already growing in a mother's uterus because of its sex, more parents are willing to engage in prenatal sex-selection when the sex of the fetus can be selected before the woman is ever actually “pregnant.”

Concerns about the use of genetic prenatal testing, whether in concert with either abortion or reproductive technologies that allows potential parents to “choose” their offspring, are not limited only to the topic of gender. As more knowledge about genetic makeup is discovered, worries that parents may choose not to have offspring who are either darker in skin color (racial discrimination) or who carry the so-called gay gene have increased. The arguments surrounding whether this type of prenatal genetic selection is morally acceptable become murky because, although some parents may make decisions based on prejudice, other parents claim to have the well-being of their children in mind. These latter parents claim to be basing their preferences on their understanding (but not their endorsement) that lighter-skinned or heterosexual children may be better off because of the current levels of racism and homophobia.

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