Would you rather have a child said to be SS or abort?

Specialties Ob/Gyn

Published

This is a question one of my patients had asked me.Very difficult one. She had gone to a genetic counsellor as her doctor ordered but feels she doesn't want to keep the baby because of associated risks. She also tells me she feels so bad aborting the little thing in her. she kind of have a mixed feling since everyone now knows she is almost 5 months pregnant. I just empathized with her but remained silent throughout. Anyone?

Specializes in ER/Nuero/PHN/LTC/Skilled/Alzheimer's.

For those of you reading this, I am in no way suggesting a pro-life or pro-choice standpoint. I am just giving opinions and suggestions.

As far as Sickle cell anemia goes, everyone is correct. It is a farily maintainable illness with variable outcomes. If your pt is not able to care for the child with this or any other illness due to socio-economic, religious, or insurance reasons, then instead of aborting perhaps an open adoption could work for her.

Everyone is also correct on the accuracy of prenatal testing however there is a reason these tests are done. If there is an indication of a problem with the fetus, then it is still a variable to be considered. I personally feel that telling her or any pt accounts of how these tests are wrong will influence them in refusing these tests and set them up for disaster if a complication that is easily fixable is not identified in future pregnancies.

As for caring for any child "normal" or otherwise, it will have to be an individual decision and as nurses our job is to present every option, no matter what our personal feelings on the matter is. And sometimes that means offering options we personally may not prefer. The coice is ultimately hers and her partner's. Best of luck.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

What i personally would rather have is support for whatever i decided was best.

Specializes in OB.

At 5 months, the baby is almost viable, depends on how many weeks. I think this plays a huge role it the decision. As far as what would I do if this was my pt....I would listen to her concerns make sure she has all the correct information about both sides, and make sure she has discussed this with ther partner. I would offer her to talk with a specialist, and encourage her to get a second oppinion. Whatever her decision she should have support from everyone involved.

tough situation, I think this discussion could apply to any situation in which a pt asks our oppinion about a ethical decision.

I hope she realizes that she carries the Sickle Cell trait and that the child's father has the trait as well. As a result, any child that she has will have an at least 50% chance of having Sickle Cell and an even higher risk of carrying the gene. Therefore, terminating this pregnancy may seem like a way of ending the situation. However, she may have to face this situation again in subsequent pregnancies.

Good point.

Specializes in Emergency.
What i personally would rather have is support for whatever i decided was best.

Very well said.

This is a difficult choice only she can make. Until we walk in her shoes, we can't truly speak.

Specializes in OB/GYN,L&D,FP office,LTC.

There are a few things about this situation that really bother me.

I wonder if she really is as informed as she should be?

I also wonder if she may be depressed? I am not judging her in any way,I feel that she needs more information before she makes a decision.I feel like as nurses it is up to us to support our pts,I just don't feel she has all the information she needs to make that decision. Is there a way she could talk to a therapist?

I agree with the idea that she needs a second opinion. I can't believe that she is being encouraged to abort for sickle cell anemia. And at 5 months.

I had genetic counseling when I was pregnant with my son at 42 years old. Most of the weight of the blood tests is on age of the mother, which really tells you nothing about the true condition of the baby. I had a regular sono, a more detailed sono, genetic counseling by UC Davis, and I agreed to an amnio even though we would not have aborted. In hindsight I gave in to hammering I got from the "experts". Which I regret. My son is fine.

steph

Specializes in OB, M/S, HH, Medical Imaging RN.

Abort for sickle cell? That is truely sad. Why does every baby have to be perfect? As we all know, those tests carry a high rate of false positives. They scare the h*** out of pregnant women. Sickle cell can be dealt with. What about when your child turns out to be a drug addict, an alcoholic or sexually promiscuous as a teen or young adult? Do we go around thinking "gee I should of had an abortion"? Where will this nonsense end? :cry:

I don't know if this will make a difference, but the doctor told my mother I would not be able to move from the neck down and she should put me to sleep, when I was an infant. My father told the doctor he would take care of me the rest of his life if that's what it took. I wish you could see me now; I'm 42 years old and I'm studying to be a nurse. I didn't have any problems growing up. I was an honor student and very active in the sporting arena. Food for thought, just because a person has M.D. behind their name doesn't mean they're God. Only God knows what the outcome will be and he will not put no more on us that we can bear. Glad to be still here to contribute to the world.

I would abort. While SSA is survivable, it is painful. Besides, I see no reason to keep the gene available for reproduction.

Specializes in acute medical.

The decision to abort is not yours to make and it is very unfair of this person to ask such a question of you. I would suggest that the person be given information about the condition from reliable sources, perhaps make contact with self help groups of either ppl with the condition / families caring for children with the condition, and allow her to make her own decision. In other words, the decision needs to be "informed".

I hope she realizes that she carries the Sickle Cell trait and that the child's father has the trait as well. As a result, any child that she has will have an at least 50% chance of having Sickle Cell and an even higher risk of carrying the gene. Therefore, terminating this pregnancy may seem like a way of ending the situation. However, she may have to face this situation again in subsequent pregnancies.

The risk is lower than that. Sickle Cell is recessive. She has a 25% chance of having another child with it with the same father. She has a 50% chance of having the child carry the sickle cell trait, but not be sick, ie. the child would be like her. She has a 25% chance that the child will not carry the trait at all.

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