Question about medical ethics/morality, miscarriages, and Down syndrome

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I had a question about medical ethics as it relates to downs syndrome and miscarriage. This question has bothered me for a while, and I simply don’t know the answer to it or what the Catholic position is at all. It is not my area. I’ve attached an article about downs syndrome and miscarriage.

Constructive thoughts are appreciated. Relevant links and suggested reading is appreciated. Note this thread is not about abortion. I am pro-life.


To quote the article
It’s estimated that between an amniocentesis (done between 15 to 20 weeks of pregnancy) and delivery, up to 30 percent of Down syndrome pregnancies that are not terminated result in miscarriage or stillbirth.
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If you have learned that your pregnancy is affected by Down syndrome, you do face an increased risk of pregnancy loss. You may be referred to a high-risk pregnancy specialist for increased monitoring for the duration of your pregnancy.
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My questions is this. If you have learned your pregnancy is affected by Down Syndrome, why would take additional precautions to make sure the baby is successfully delivered? Is the miscarriage perhaps the natural outcome? Why would we change the natural outcome of a situation? Also, is it best not to do the Down Syndrome test in the first place?

I’ve never faced such a situation. I don’t have a point of view; however, I’d like to learn more. I’d like to know the Catholic position or thoughts on the subject.

No easy questions today… 😐
 
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I’m not sure that preventing a miscarriage is possible in many cases.

Moms of babies with Down’s syndrome should receive appropriate prenatal care. Prenatal care can’t always prevent a miscarriage.
 
Why change the “natural outcome” of a possible miscarriage? I would ask, why change the “natural outcome” of cardiac arrest, or any other possibly fatal medical condition?

Miscarriage, as a medical complication, is no different from any other in that its prevention should be sought.
 
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Thom18 said:
I would ask, why change the “natural outcome” of cardiac arrest, or any other possibly fatal medical condition?

Miscarriage, as a medical complication, is no different from any other in that its prevention should be sought.
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The response is that that from what I understand the Catholic position on certain procedures is far from simple. Below is a link to the National Catholic Bioethics center about end of life decisions.

https://www.ncbcenter.org/publications/end-life-guide/

They say…
One of the most important moral distinctions for end-of-life decisions is that between what is morally obligatory and what is morally optional.
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A Down Syndrome child in danger of miscarriage isn’t an “end of life case”, so there’s no purpose in bringing it up.
 
“Additional monitoring” is only monitoring. Until the end of pregnancy, when sometimes early labor can be halted or slowed, or a c-section can be performed with a hope the baby will survive, there is little-to-nothing doctors can do to prevent pregnancy loss in most cases. It is, however, important to know that a loss has occurred, so that decisions about delivering the deceased baby can be made and the mother’s health can be protected throughout the process.

In two pregnancies now, my husband and I have declined all genetic testing. It can be inaccurate (often causing unnecessary worry), does not change outcomes, and wouldn’t change our decisions. Each of our children will live out every moment God has ordained for him or her, few though those moments may be.

Since genetic testing does not change outcomes, I’m also deeply concerned that its only accomplishment (purpose?) is to feed the abortion machine. No, thank you.

The standard, non-invasive anatomical ultrasound at 18-20 weeks will generally reveal any gross (large/detectable) physical abnormalities that may require surgery or intervention after birth, and I have other health concerns that mean an echo-cardiogram a few weeks later will be done as a matter of course. With our current understanding and circumstances, Husband and I don’t see any real need or positive purpose for genetic testing.
 
Some people like to prepare for the outcome, like finding doctors with experience, or getting appropriate therapists be it speech or physical therapists.

We have friends whose daughter has Down’s syndrome. They actually moved to a better school district that had more services for their daughter.
 
@MrsAngelala Thanks for the interesting and helpful response.
MrsAngelala said:
Since genetic testing does not change outcomes, I’m also deeply concerned that its only accomplishment (purpose?) is to feed the abortion machine. No, thank you.
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Are families under pressure these days to do genetic testing on their unborn children? I can understand a non-evasive ultrasound, but it seems like I would be hesitant at doing genetic testing. What is the point?..aside from pain and worry if something is not quite right. I mean perhaps moving school districts may be a good idea like @F_Marturana mentioned.

Also, I was under the impression that a high-risk pregnancy specialist could actually do things to prevent miscarriage. Is there really nothing they can do in the case of a down syndrome pregnancy to prevent miscarriage?
 
I don’t know how much pressure most people are under. I am very blessed to be with an OB/GYN who runs a Catholic practice within a Catholic hospital, to the extent that at your first GYN visit you sign a document stating you understand she will not prescribe chemical birth control or perform abortions. Within that environment, when I later became pregnant and was asked if I wanted genetic testing, I said, “Can you do anything if you find anything?” “No.” Then, no." That was the extent of the pressure to which I was subjected. I was warned that I would have to be firm when I saw an MFM, but we didn’t get that far.

That pregnancy was also high-risk, so I was under extensive monitoring from the beginning and on a pregnancy-supporting medication commonly given in an NFP environment, yet it ended in a late miscarriage. To the best of my knowledge and in my recent experience, there is nothing that can be done to prevent miscarriage.
 
MrsAngelala said:
I was under extensive monitoring from the beginning and on a pregnancy-supporting medication commonly given in an NFP environment,
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First, perhaps a dumb question…, but what is a NFP environment? (I’m guessing Natural Family Planning environment)

They could give a pregnancy-supporting medication though. Would that medication be prescribed to all woman?
 
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Yes, Natural Family Planning.

The medication isn’t given to all pregnant women, only those who require the support. Unfortunately however, it only addresses one concern and there are so many other things that can go wrong.
 
maryjk said:
And these medications are only given in an NFL environment?
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That is a good question. Are these medications only given in a Natural Family Planning environment. Would treatment for a high risk pregnancy be any different in a Non Natural Family Planning environment?
 
All I know is that this particular medication is given much more liberally in an NFP environment. I’ve been blessed that I haven’t been through a pregnancy with a non-NFP doctor, so I’m sorry, but I can’t offer any other comparisons.
 
MrsAngelala said:
All I know is that this particular medication is given much more liberally in an NFP environment. I’ve been blessed that I haven’t been through a pregnancy with a non-NFP doctor, so I’m sorry, but I can’t offer any other comparisons.
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But since you have never delivered in a non-NFP setting, you really have no idea what is or is not done.
 
Except that my doctor, who is trained in the traditional medical establishment, as all board-certified doctors must be, told me this.

Good heavens, there are reasons I rarely participate on these boards. I’ve been generous in sharing my painful personal experience, and careful not to say anything I can’t back up. Since you’re going to snipe, I’m done.
 
If the medication she is referring to is progesterone, she is correct in my experience. I had an NFP trained Dr who prescribed it, when I had to switch to a non-NFP physician he would not prescribe it, he had me wean off and refused further blood tests.
 
When I had a baby at age 38, my doc asked if I wanted to do amnio tests, etc. He looked at me significantly and said “if you wouldn’t do anything, then probably there’s no point in doing the testing”. So I didn’t do the testing.
He was a good doc, but now I have an even better Catholic OB-GYN (now that I’m too old to probably need one for OB stuff!). 😆
 
MrsAngelala said:
Except that my doctor, who is trained in the traditional medical establishment, as all board-certified doctors must be , told me this.
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I understand. But, sorry to say, essentially, an NFP doctor said, “NFP doctors are better.” Or at least they are better at giving the right/good medication.

Look, doctors all have things that they do or don’t do.

But it seems disingenuous to somehow indicate that doctors that aren’t “NFP only” are somehow not doing all that they can for their patients.

I’ve seen both. My NFP doctor was wonderful. She was kind and caring. But my mainstream OB was also wonderful. He did all he could to bring my baby to term, and then when I delivered early, even called the NICU regularly to check on the baby that wasn’t his patient.

He also offered various, non invasive testing. Why? So, he could have “all hands on deck” if they anticipated a problem. He equated it as it is better to know that you have cancer than to not know that you have cancer.
 
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