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Advances in Prenatal Diagnosis Social–Psychological and Policy Issues

Published online by Cambridge University Press:  10 March 2009

Aliza Kolker
Aliza Kolker
Affiliation:
George Mason University
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Extract

Chorionic villus sampling (CVS), a new technique for prenatally diagnosing chromosomal and genetic disorders, may soon replace amniocentesis. This procedure, performed by inserting a catheter through the pregnant woman's cervix or through the abdomen and removing cells from the placenta, has the advantages of being available earlier in the pregnancy than amniocentesis (at 9 to 11 weeks gestational age) and of yielding results in a shorter time. Although the medical aspects of the procedure are being investigated, its psychosocial and policy implications have not been studied systematically. These issues include the subjective assessment of risk that prompts women to choose or to reject CVS, the implications of earlier diagnosis for feelings about abortion, the potential of negative findings (i.e., the absence of the designated disorder) for well-being during the remainder of the pregnancy, the ramifications of first trimester identification of fetal sex, equity of access to prenatal diagnosis, and the possible over- utilization of these procedures. Drawing on previous research regarding amniocentesis and more recent research concerning CVS, this article discusses the potential implications of CVS.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 5 , Issue 4 , October 1989 , pp. 601 - 617
Copyright
Copyright © Cambridge University Press 1989

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References

REFERENCES

Adler, B. & Kushnick, T.Genetic counseling in prenatally diagnosed trisomy 18 and 21: Psychosocial aspects. Pediatrics, 1982, 69, 94–99.CrossRefGoogle ScholarPubMed
Ashton, J. Amniocentesis: Safe but still ambiguous. Hastings Center Report, 1976, 6(02), 5–6.CrossRefGoogle Scholar
Bennett, N. G. (ed.). Sex selection of children. New York: Academic, 1983.CrossRefGoogle Scholar
Benderly, B. L.Thinking about abortion. Garden City, NY: Doubleday, 1984.Google Scholar
Borg, S. & Lasker, J.When pregnancy fails. Boston: Beacon, 1981.Google Scholar
Brambati, B., Simoni, G. & Fabro, S. (eds.). Chorionic villus biopsy. New York: Marcel Dekker, 1986.Google Scholar
Cadkin, A. V., Ginsberg, N. A., Pergament, E. & Verlinkski, Y.Chorionic villi sampling: A new technique for detection of genetic abnormalities in the first trimester. Radiology 1984, 151, 159-62.CrossRefGoogle ScholarPubMed
Carpenter, R. et al. Comments on Elias, “Chorionic villus sampling …” American Journal of Obstetrics and Gynecology, 1985, 152, 211–13.Google Scholar
Chervin, A. et al. ,. Amniocentesis for prenatal diagnosis: Subjective patient response. New York State Journal of Medicine, 1977, 77, 1406–08.Google ScholarPubMed
Chiswick, M. L. & James, D. K.Kielland's forceps: Association with neonatal morbidity and mortality. British Medical Journal, 1979, 1, 7–9.CrossRefGoogle ScholarPubMed
Clark, L. R. Sex preselection: The advent of the made-to-order child. The Pharos, Fall, 1985, 2–7.Google Scholar
Cohen, W. R.Influence of the duration of second stage labor on perinatal outcome and puerperal morbidity. Obstetrics and Gynecology, 1977, 49, 266–69.Google ScholarPubMed
Coombs, C.The preference for sex of children among U.S. couples. Family Planning Perspective, 1977, 9, 259–65.CrossRefGoogle ScholarPubMed
Corea, G.The mother machine: Reproductive technologies from artificial insemination to artificial wombs. New York: Harper & Row, 1985.Google Scholar
Davies, B. L. & Doran, T. A.Factors in a woman's decision to undergo genetic amniocentesis for advanced maternal age. Nursing Research, 1982, 31, 56–59.CrossRefGoogle Scholar
Dixon, R. D. & Levy, D. E.Sex of children: A community analysis of preferences and predetermination attitudes. Sociological Quarterly, 1985, 26, 251–71.CrossRefGoogle Scholar
Ekwo, E. E. et al. , Factors which influence subjects' acceptance or rejection of amniocentesis. Research proposal submitted to the National Institute of Child Health and Human Development (NIH), Grant #NCJ 190457–03–0, 1981.Google Scholar
Ekwo, E. E. et al. , Factors influencing maternal estimates of genetic risk. American Journal of Medical Genetics, 1985, 20, 497–504.Google Scholar
Elias, S., Simpson, J. L., Martin, A. O. et al. , Chorionic villus sampling for first-trimester prenatal diagnosis: Northwestern University program. American Journal of Obstetrics and Gynecology, 1985, 152, 204–13.CrossRefGoogle ScholarPubMed
Elias, S., Simpson, J. L., Martin, A. O. et al. ,. Chorionic villus sampling in continuing pregnancies: Low fetal loss rates in initial 109 cases. American Journal of Obstetrics and Gynecology, 1986, 154, 1349–52.CrossRefGoogle ScholarPubMed
Etzioni, A.Genetic fix. New York: Harper & Row, 1973.Google Scholar
Farrant, W. Who's for amniocentesis? The politics of prenatal screening. In Homans, H. (ed.), The sexual politics of reproduction. England: Gower Publishing, 1985, 96–123.Google Scholar
Fischhoff, B., Lichtenstein, S., Slovic, P. et al. ,. Acceptable risk. Cambridge: Cambridge University Press, 1981.Google Scholar
Fletcher, J. C.Coping with genetic disorders. New York: Harper & Row, 1982.Google Scholar
Fletcher, J. C. Ethics and public policy: Should sex choice be discouraged? In Bennett, N. G. (ed.), Sex selection of children. New York: Academic, 1983, 213–52.CrossRefGoogle Scholar
Fletcher, J. C. & Schulman, J. D.Fetal research: The state of the question. Hastings Center Report, 1985, 15(04), 2, 6–12.Google Scholar
Fraccaro, M., Simoni, G. & Brambati, B. (eds.). First trimester fetal diagnosis. Berlin: Springer-Verlag, 1985.CrossRefGoogle Scholar
Gilroy, F. & Steibacher, R.Preselection of child's sex: Technological utilization and feminism. Psychological Reports, 1983, 53, 671–76.Google Scholar
Golbus, M. S. et al. ,. Prenatal diagnosis in 3000 amniocenteses. The New England Journal of Medicine, 1979, 300, 157–63.CrossRefGoogle ScholarPubMed
Green, J. E., Dorfmann, A., Jones, S. L. et al. ,. Chorionic villus biopsy: Experience with an initial 940 cases. Obstetrics and Gynecology, 1988, 71, 208–12.Google Scholar
Griffiths, D. M. & Gough, M. Dilemmas after ultrasonic diagnosis of fetal abnormality. Lancet, 1985, 623–25.CrossRefGoogle Scholar
Grimes, D. A. Second-trimester abortions in the United States. Family Planning Perspectives, 1984, 16(11–12), 260–65.CrossRefGoogle Scholar
Grimes, D. A. & Schulz, K. F. The comparative safety of second-trimester abortion methods. In Ciba Foundation Symposium 115, A bortiow Medical progress and social implications. London: Pitman, 1985, 83–102.Google Scholar
Harris, R. E.An evaluation of the median episiotomy. American Journal of Obstetrics and Gynecology, 1970, 106, 660–65.CrossRefGoogle ScholarPubMed
Hartley, S. F. & Petraczyk, L. M.Preselecting the sex of offspring: Technologies, attitudes, and implications. Social Biology, 1979, 26, 232–46.Google Scholar
Hayward, R. A., Shapiro, M. F., Freeman, H. E. & Corey, C. R.Inequities in health services among insured Americans. The New England Journal of Medicine, 1988, 318, 1507–12.Google Scholar
Hern, W. M.Abortion practice. Philadelphia, PA: J. B. Lippincott, 1984.Google Scholar
Hern, W. M. & Corrigan, B.What about us? Staff reactions to D & E. Advances in Planned Parenthood, vol. 15. Rpt. in Excerpta Medica, 1980.Google Scholar
Hogge, W. A., Schonberg, S. A. & Golbus, M. S.Chorionic villus sampling: Experience of the first 1000 cases. American Journal of Obstetrics and Gynecology, 1986, 154, 1249–52.Google Scholar
Hughey, M. J., McElin, T. W. & Lussky, R.Forceps operations in perspective. Journal of Reproductive Medicine, 1978, 20, 253–59.Google Scholar
Hutson, J. M., McNay, M. B., MacKenzie, J. R. et al. ,. Antenatal diagnosis of surgical disorders by ultrasonography. Lancet, 1985, 621–22.CrossRefGoogle Scholar
Jackson, L. G. First-trimester diagnosis of fetal genetic disorders. Hospital Practice, 1985, 39–48.CrossRefGoogle Scholar
Jackson, L. G. Chorion villus sampling. Jefferson Alumni Bulletin, 1985 (Spring), 2–7.Google Scholar
Jackson, L. G.CVS Newsletter. 07 26, 1985.Google Scholar
Jackson, L. G. & Warner, R. J.Risks of chorion villus sampling. Bailliere's Clinical Obstetrics and Gynaecology, 1987, 1, 513–31.Google Scholar
Jeffery, R., Jeffery, P. & Lyon, A.Female infanticide and amniocentesis. Social Science and Medicine, 1984, 19, 1207–12.CrossRefGoogle ScholarPubMed
Kahenman, D. & Tversky, A.The psychology of preference. Scientific American, 1982, 246, 160–71.CrossRefGoogle Scholar
Kasper, A. S.Maternal serum alpha fetoprotein testing: Some public policy considerations. Women and Health, 1981, 6, 147–53.Google ScholarPubMed
Kazazian, H. H.Prenatal diagnosis for sex choice: A medical review. Hastings Center Report, 1980, 10, 17–18.Google Scholar
Kitzinger, S.Women as mothers. Fontana, 1978.Google Scholar
Keyfitz, N. Foreword. In Bennett, N. G. (ed.), Sex selection of children. New York: Academic, 1983, xi–xiii.Google Scholar
Kolata, G.First trimester prenatal diagnosis. Science, 1983, 221, 1031–32.CrossRefGoogle ScholarPubMed
Kolker, A.Abortion following afinding of abnormality with prenatal diagnosis. What difference does timing make? Paper presented at the Meetings of the Eastern Sociological Society, 03, 1988.Google Scholar
Kolker, A. & Burke, B. M.Amniocentesis and the social construction of pregnancy. Journal of Marriage and Family Review, 1987, 11, 95–116.CrossRefGoogle Scholar
Kolkem, A., Phillips, J., Jones, S. & Schulman, J.CVS Preliminary findings. Paper presented at the Meetings of the Society for the Study of Social Problems, 08, 1988.Google Scholar
Lancet. A time to be born [editorial]. 1974, ii, 1183–84.Google Scholar
Lilford, R. J.Chorion villus biopsy. Archives of Disease in Childhood, 1985, 60, 897–99.Google Scholar
Lindsten, J., Marsk, L. & Mikkelsen, M. Role of chorion villi biopsy in prenatal diagnosis of genetic disorders. In Berg, K. (ed.) Medical genetics. Past, present, future. New York: A. R. Liss, 1985, 195–212.Google Scholar
Lippman-Hand, A. & Fraser, F. C.Genetic counseling – the post-counseling period: Parents' perceptions of uncertainty. American Journal of Medical Genetics, 1979, 4, 51–71.Google Scholar
Luker, K.Taking chances: Abortion and the decision not to contracept. Berkeley: The University of California Press, 1976.Google Scholar
Markle, G. E.Sex ratio at birth: Values, variance and some determinants. Demography, 1974, 11, 131–42.CrossRefGoogle ScholarPubMed
Markle, G. E. & Nam, C. B.Sex predetermination: Its impact on fertility. Social Biology, 1971, 18, 73–83.Google Scholar
Martin, A. O., Simpson, J. L., Rosinsky, B. J. & Elias, S.Chorionic villus sampling in continuing pregnancies: Cytogenic reliability. American Journal of Obstetrics and Gynecology, 1986, 154, 1353–62.CrossRefGoogle Scholar
Mechanic, D.From advocacy to allocation: The evolving American health care system. New York: Free Press, 1986.Google Scholar
Milunski, A.Know your genes. Boston: Houghton-Mifflin, 1977.Google Scholar
Milunski, A. (ed.). Genetic disorders and the fetus: Diagnosis, prevention, and treatment. New York: Plenum, 1979.CrossRefGoogle Scholar
Mittenthal, S. Amniocentesis: On the increase. The New York Times, 08 22, 1984, p. Cl.Google Scholar
Oakley, A.Women confined: Toward a sociology of childbirth. New York: Shocken Books, 1980.Google Scholar
O'Sullivan, M. J., Fumia, F., Holsinger, K. & McLeod, A. G.Vaginal delivery after cesarean section. Clinics in Perinatology, 1981, 8, 131–43.CrossRefGoogle ScholarPubMed
Ott, W. J.Primary cesarean section: Factors related to postpartum infection. Obstetrics and Gynecology, 1981, 57, 171–76.Google ScholarPubMed
Perry, T. B., Vekemans, M. J. J., Lippman, A. et al. ,. Chorionic villi sampling: Clinical experience, immediate complications, and patient attitudes. American Journal of Obstetrics and Gynecology, 1985, 151, 161–66.Google Scholar
Powledge, T. M. Toward a moral policy for sex choice. In Bennett, N. G. (ed.), Sex Selection of Children, New York: Academic, 1983, 201–13.Google Scholar
Powledge, T. M.The last taboo: Genetic manipulation and eugenics. Boston: Houghton-Mifflin, 1984.Google Scholar
Rice, N. & Doherty, R.Reflections on prenatal diagnosis: The consumers' views. Social Work in Health Care, 1982, 8, 47–57.Google Scholar
Rogers, E. M. & Shoemaker, F. F.Communication of innovations. New York: Free Press, 1971.Google Scholar
Rothman, B. K.In labor. Women and power in the birthplace. New York: W. W. Norton, 1982.Google Scholar
Rothman, B. K.The tentative pregnancy. New York: Viking, 1986.Google Scholar
Rothman, B. K.Reflections: On hard work. Qualitative Sociology, 1986, 9, 48–53.CrossRefGoogle Scholar
Rubin, J., Provenzano, F. & Luria, Z.The eye of the beholder: Parents' views on sex of newborns. American Journal of Orthopsychiatry, 1974, 44, 47–55.Google Scholar
Schulman, J. D.Prenatal treatment of biochemical disorders. Seminars in Perinatology, 07, 1985, 9, 75–77.Google Scholar
Schwartz, H. D.Dominant issues in medical sociology, 2nd edition. New York: Random House, 1987.Google Scholar
Seals, B., Williamson, R., Hanson, J. & Ekwo, E.Moral and religious influences on the amniocentesis decision. Social Biology, 1985, 32, 12, 13–20.Google ScholarPubMed
Seals, B. et al. ,. State-wide evaluation of MSAFP screening. Research proposal submitted to the National Institute of Child Health and Human Development, NIH, 1985.Google Scholar
Seibel, M. M.A new era in reproductive technology. The New England Journal of Medicine, 1988, 318, 828–34.Google Scholar
Simoni, G., Brambati, B., Danesino, C. et al. ,. Diagnostic applications of first trimester trophoblast sampling in 100 pregnancies. Human Genetics, 1984, 66, 252.CrossRefGoogle ScholarPubMed
Wertz, D. C. & Sorenson, J. R.Genetic counseling and reproductive uncertainty. American Journal of Medical Genetics, 1984, 18, 79–88.CrossRefGoogle ScholarPubMed
Wertz, D. C., Sorenson, J. R. & Heeren, T. C.Clients' interpretation of risks provided in genetic counseling. American Journal of Human Genetics, 1986, 39, 253–64.Google Scholar
Wertz, D. C. & Wertz, R. W.Lying-in: A history of childbirth in America. New York: The Free Press, 1977.Google Scholar
Westoff, C. F. & Rindfuss, R. R.Sex preselection in the United States: Some implications. Science, 1974, 184, 633–36.CrossRefGoogle ScholarPubMed
Wilcox, A. J., Weinberg, C. R., O'Connor, J. F. et al. ,. Incidence of early loss of pregnancy. The New England Journal of Medicine, 1988, 319, 189–94.Google Scholar
Williamson, N. E.Sons or daughters. A cross-cultural survey of parental preferences. Beverly Hills, CA: Sage, 1976.Google Scholar
Williamson, N. E., Lean, T. H. & Vendgadasalam, D.Evaluation of an unsuccessful sex preselection clinic in Singapore. Journal of Biosocial Science, 1978, 10, 375–88.Google Scholar
Williamson, N. E. Parental sex preferences and sex selection. In Bennet, N. G. (ed.), Sex selection of children. New York: Academic, 1983, 129–151.Google Scholar