The efficient solution

Beth chose her OB-GYN because he was considered one of the best in his field. But after prenatal testing resulted in a Trisomy 18 diagnosis, a condition that could seriously deform her unborn child, he began pushing for termination. Beth eventually succumbed to the pressure and had the abortion.

Later she learned that both the doctor who did the genetic testing and the doctor who performed the abortion were not only members of the National Abortion Federation but were also plaintiffs and expert witnesses in the appeal of a ban on partial birth abortions in the state of New York.

"Entirely missing from the discussion was what the baby's prognosis was as a result of this genetic defect," Beth told WORLD Virginia. "No other options were discussed other than the desired end conclusion."

Child advocacy activists across the country are claiming that there are disturbing indications that, in the face of a dire prenatal diagnosis, physicians as a rule tend to present termination of the pregnancy as not only the best option, but the only option. "Mothers report that they often feel pressured by secular doctors to solve a difficult problem with termination," Dr. Joe Decook, an OB/GYN with the American Association of Pro-Life Obstetricians & Gynecologists, wrote in an email. "Termination is an accepted norm if the baby is not perfect, and especially if there is a serious problem."

Virginia is no exception. Dr. John Bruchalski, 50 and an obstetrician, founded the Tepeyac Family Center in Fairfax, Va., a Catholic facility offering affordable healthcare for women in crisis pregnancies. "There is a professional and cultural bias not just against unwanted children, children where the parents may or may not want the child, but also there is a bias against wrongful birth," Bruchalski said in a recent interview.

"Most conversations between doctor and patient only provide the abortion option," he added, "and yet many parents have no interest in aborting their sick children." He said most doctors offer the option of "delivering early," and many stress it.

"At that point doctors begin to dehumanize the pregnancy," he continued. "They begin to stress the suffering this child would have. They talk about the most 'efficient solution' being an early delivery. Most of these diagnoses take place after there's bonding between mother and child, so they have to get through that."

Doctors will also use phrases such as, "the child is incompatible with life."

"That's a value judgment," Bruchalski said. "That's an opinion. We're in the business of diagnoses and treatment, but that and other terms are opinions based on subjective reasoning. It's not a scientific diagnosis."

The typical abortion for an unborn child with a prenatal diagnosis is indeed a kind of "induced labor." Doctors will give the mother a pill that starts the process of giving birth. Usually, since these abortions happen between 18 and 24 weeks, the child cannot survive long after birth, or is killed during the trauma of childbirth. Some obstetricians will inject saline or potassium chloride into the heart of the baby while still in the womb. Others want the baby to be born alive so the parents can spend some time with him before he dies in order to start the "healing process."

Bruchalski said that there is a rush to perform the procedure before 24 weeks, because at that point the unborn child is deemed viable, and doctors are legally required to attempt to resuscitate the child. Bruchalski has come across cases where, even after 24 weeks, if both the patients and doctor are in agreement that termination is the best option, doctors will neglect certain aspects of care, allowing the child to die.

Often, Bruchalski said, when a mother agrees to a termination, her mental image of the child has been changed drastically by what doctors have told her about deformities, conditions, and other problems the baby will have. "In the mind of the mother, this child is a monster, and there's no way she can provide for it, and it's going to ruin their lives." Bruchalski said doctors try to discourage mothers from talking to families who have been in similar situations.

Not alone

But some women are ready to share their experiences, in the hope that women who are aware of the issue will be less likely to blindly follow their doctor's advice. WORLD Virginia spoke with several mothers who described pressure from their doctors to abort. As a rule, doctors will introduce the idea of termination immediately after delivering the bad news. They are also careful to avoid any "negative" terms like "abortion." They opt instead for terms such as, "saying goodbye early," "a humane abortion," "early induction," "finishing a miscarriage," or "releasing the baby from the suffering early."

Others say that doctors made them feel selfish for wanting to carry their baby to term, asking them how it will affect their family. One mother said that after she insisted on carrying her child to term, the doctor asked, "How can you do this if you love your child?"

Some doctors simply say, "We've done this test, your baby has this condition, so we'll schedule the termination for Thursday," said Madeline Nugent, author of My Child, My Gift. She described other doctors who let patients infer that an abortion was medically necessary when it wasn't.

Mary Kellet lives in Minnesota and runs an organization called Prenatal Partners for Life, which looks to encourage women around the world as they care to term following a dire prenatal diagnosis. Doctors found disturbing signs in her unborn child that pointed to trisomy 18. Kellet said in an interview that abortion was offered constantly throughout the pregnancy, and that she was routinely informed that no trisomy 18 cases live past two weeks. Even after her son, Peter, was born, the doctors wanted to let him die rather than treat his conditions.

Three days after he was born, when Peter was still fighting for his life, a female doctor came in and sat down next to Kellet's bed. "I want to talk to you as a mother," she told her. "You need to let this baby go, because he is going to be a horrible burden on the family."

Peter is now six and a half years old. After he came home from the hospital, Kellet did some research and discovered that some with trisomy 18 live into their 30's. When she confronted her doctor, Kellet said he responded, "Well, you have to think about resources." One women was told, according to Kellet, "think of all the healthcare dollars you're saving by inducing early."

Money, Dr. Bruchalski said, is one of the primary reasons so many doctors are quick to encourage termination. The technology required to keep these children alive as long as possible is extremely expensive. In addition, doctors could face a wrongful death or malpractice lawsuit if proper care is not provided for the infant after parents have said they want to carry to term.

But beyond that, Bruchalski saw a deeper problem. "There is a move for 'designer children,' that the children that are born need to be perfect." An extremely high percentage of unborn children with disabilities are aborted. Anywhere from 90-95 percent of children with trisomy 21, commonly called Down syndrome, are never born. Some call it "prenatal eugenics for people with disabilities."

The result? A dwindling population of children born with disabilities, especially Down syndrome. Bruchalski has a cousin named Mike, who has Down syndrome. Recently, he asked Bruchalski, "Am I an endangered species?" According to the doctor, that's not far from the truth.