Patients rely on early prenatal testing in light of abortion laws

WASHINGTON — Since Roe v. Wade was overturned, many health care providers say an increasing number of patients are deciding the fate of their pregnancies on whatever information they can gather before state abortion bans kick in.

But early ultrasounds show far less about the condition of a fetus than later ones. And genetic screenings may be inaccurate.

When you find out your fetus has a serious problem “you’re in crisis mode,” said doula Sabrina Fletcher.

“You’re not thinking about legal repercussions and (state) cutoff dates, and yet we’re forced to.”

About half of states ban abortion or restrict it after a certain point in pregnancy.

This leaves millions of women in roughly 14 states with no option to get follow-up diagnostic tests in time to feasibly have an abortion there if they wanted, a paper published last March in the journal Obstetrics and Gynecology found. Even more states have abortion cutoffs too early for midpregnancy ultrasounds.

“More people are trying to find these things out earlier to try to fit within the confines of laws that in my mind don’t have a place in medical practice,” said Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina.

When done at the right time, doctors said prenatal testing can identify problems and help parents decide whether to have an abortion or continue a pregnancy and prepare for a baby’s complex needs after delivery.

One of the most common tests is the 20-week ultrasound. It checks on the fetal heart, brain, spine, limbs and other parts of the body, looking for signs of congenital problems. It can detect things like brain, spine and heart abnormalities and signs of chromosomal problems such as Down syndrome. Follow-up testing may be needed to make a diagnosis.

The earlier ultrasounds, in the first trimester for example, are not standard practice because it is too soon to see many of the fetus’ limbs and organs in detail, the American College of Obstetricians and Gynecologists says.

It’s impossible to spot problems like serious heart defects much before midpregnancy because the fetus is so small, said Dr. Cara Heuser, who practices maternal-fetal medicine in Utah.