23 Duke J. Gender L. & Pol'y 1 (2015-2016)

handle is hein.journals/djglp23 and id is 1 raw text is: 










                           Backdoor to Eugenics?
       The Risks of Prenatal Diagnosis for Poor, Black Women

                                   BRET D. ASBURY*

      This article is situated at the intersection of three of the conference's stated subject
areas: Race and Healthcare, Reproductive Rights, and Race and the Family. My recent
research has focused on the manner in which pregnant women who learn of fetal genetic
abnormalities prenatally receive counseling as they decide whether to terminate or bring
their fetuses to term. The decision whether to terminate on genetic grounds is
particularly vexing because it often turns on speculative medical information, and it can
result in elevated rates of grief, depression, and post-traumatic stress. Though the
prenatal genetic counseling offered to expectant women learning of a fetal abnormality
exists ostensibly to provide them with objective information rather than to encourage or
discourage pregnancy terminations, the reality is that such counseling is often coercive in
the direction of aborting genetic anomalous fetuses. Because genetic counseling tends to
consider family factors such as wealth and perceived preparedness to raise a child with a
persistent medical condition or disability -and because the vast majority of genetic
counselors are highly educated white women - the pro-termination norms of prenatal
genetic counseling disproportionately impact nonwhite, non-affluent pregnancies. This
observation is consistent with prior state and private practices aimed at controlling black
reproduction. Because the detection of prenatal genetic abnormalities will soon rise
sharply due to advances in technology and increased access to prenatal genetic analysis
under the Patent Protection and Affordable Care Act, far more poor, black pregnant
women will receive genetic counseling that will make them more likely to abort their
fetuses in future years. This article describes the scale and scope of this potentially far-
reaching problem and offers suggestions for how to eliminate racial and class bias in
prenatal genetic counseling.












Copyright  2015 by Bret D. Asbury
    *   Associate Professor, Drexel University Thomas R. Kline School of Law. A.B., Princeton
University, J.D. Yale Law School. Thanks to Connor Hackert and Lauren McGinley for superb
research assistance, Kevin Woodson for helpful comments, and Christine Inkyung Kim and her
fellow Duke Journal of Gender Law and Policy editors for outstanding editorial assistance in the
preparation of this article.

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