The Newcastle area of New Brunswick has the distinction of having one of the world’s most comprehensive programmes of parental screening for spina bifida. According to one source at the Miramichi Hospital, a blood test, called the Maternal Serum Alpha-Fetoprotein Test (MSAFP) is “routine” for all prenatals. In 1983 this test was used in 695 maternity-related cases in New Brunswick.

The MSAFP test was developed in 1972 when Dr. David Brock of Scotland discovered that a serum protein (designated alpha-fetoprotein) is normally produced only during fetal-life. He also determined that if a neural tube defect (such as spina bifida) is present, there is more AFP found in the fluid surrounding the baby and also in the mother’s blood. The amniotic fluid can be tested for AFP levels through a procedure called amniocentesis. This procedure is expensive and carries “risk of fetal loss,” so is generally used only in high risk cases. The MSAFP test, which looks for elevated AFP in the maternal blood, is cheap, and safe, but much less accurate and produces a large number of false “positive” results.

The screening process is complex, but various programmes follow the same general course. The first full interview and physical examination usually takes place about ten weeks of gestation. The pregnancy is dated as accurately as possible and the concept of screening is introduced. In the United States, legal considerations require that “full informed consent be secured from the pregnant patient before she submits to the screening process.” To meet this requirement, supplementary literature describing the screening programme is produced with every test kit.

Eugenic abortion

The next doctor appointment is scheduled between 16 and 18 weeks’ gestation, at which time the patient is given the opportunity to ask questions. If she so consents, a blood sample is taken which will then be tested for elevated levels of AFP. Of 1,000 women tested, it is expected that 50 will have elevated AFP levels. Of these 50, only one will be found to have an open neural tube defect such as spina bifida.

If the first serum screening is positive, the patient is notified, counseling is given, and a second test is scheduled for between one and two weeks later. If the results of the second sample remain elevated, ultrasound is performed to determine fetal age, to check for twins (elevated levels of AFP can also indicate the presence of twins, not necessarily with defects) and anencephaly. If the elevated MSAFP values cannot be explained, more counseling is in order and the patient is typically scheduled for amniocentesis.

Remember, of 1,000 women screened, it is probable that only one open neural tube defect will be detected, but about 20 of these women will eventually be channeled to undergo amniocentesis. This procedure is left until last because it carries certain known risks, including a 2 per cent risk of miscarriage. Amniocentesis involves the testing of fluid withdrawn from the amniotic sac. If the results are positive, or inconclusive, it is often repeated a week or ten days later.

If these test results are also positive, the woman will be offered an abortion. After more counseling by those who support eugenic abortion, the decision is most often made to abort the baby. Because the baby would now be over 20 weeks old – just the edge of fetal viability – and now quite large, the preferred method of abortion is that of saline poisoning. It can be expected that 12 per cent of those babies aborted under this programme will be found to have been normal. A much greater number are found to have been only slightly handicapped.

Almost all the literature on parental screening for spina bifida is consistent in calling for “full informed consent” before any testing should begin. Why is this necessary if the first step involves only a “harmless” blood test?

Search and destroy

Perhaps the most obvious reason for the need for consent is in the very purpose for which such testing is carried out. It used to be a legitimate assumption that medical tests were undertaken to diagnose disease so that the proper treatment could be given to help towards healing the afflcted patient. In MSAFP testing the aim is to diagnose disease with a completely opposite objective, namely to facilitate an early death for the one who might be so afflicted. This is why MSAFP testing has been called a “search and destroy” technology.

MSAFP screening represents a revolutionary new medical ethic and a significant and fundamental change in the purposes and goals of out health-care system. Without the element of informed consent (which is sometimes absent from the counseling in the Newcastle area), such screening would be reminiscent of the eugenics programmes imposed by the Nazi regime in the 30s.

It has been interesting to follow the reports of the New Brunswick task force which recommended that MSAFP screening be implemented in the province. Their first report indicated that, after diagnosis, a woman could “elect” to have an abortion. When they were challenged with the fact that this was contrary to Canadian law which does not allow abortion for eugenic reasons, they altered the wording in the second report.

The task force position was clearly presented at their news conference last year. One member referred to the great emotional and psychological stress that would result from a woman being told that she was carrying a defective child. The stress factor, therefore, for them becomes sufficient reason to approve abortion. This is in spite of the fact that later abortion has been shown to cause women greater depression than stillbirth. The resulting saline abortion is considerably more dangerous to women than is a full-term delivery. The conspiracy of deception comes full circle when we realize that it was the anxiety of prenatal testing and retesting and counseling by those who support eugenic abortion that caused that level of stress in the first place.

Aggressive early treatment of spina bifida is carried out with the idea that your afflicted child is worthy of such a complex, expensive and surprisingly successful medical technology. On the other hand, prenatal MSAFP screening and late abortion is done with the notion that the unborn child is a piece of meat, to be inspected for quality and discarded at will.

Tax money is used to provide these screening/abortion programmes and it is money which should have been used to upgrade the intensive treatment of afflicted children at birth. As more money is put into screening, less will be used to find the real causes and cures for spina bifida. This is already true, in spite of the fact that vitamin supplements (with folic acid) taken before conception, have already shown promising results in reducing the incidence of spina bifida by as much as 80 per cent.

Kent Smith, executive director of the Spina Bifida Association of America, recently questioned in a letter to a Chicago newspaper where the hullabaloo about birth defects was coming from. “Is it from the disabled population themselves – or more probably from those with clouded vision and perceptions, who appear normal to the world but wear their handicap internally?” Commenting on the use of MSAFP testing, coupled with abortion, as a way of dealing with spina bifida, Smith said, “As a ‘normal,’ whatever that means, adult, with no visible handicaps, I would prefer to live in a world where we care for those who may not be as physically strong as the rest rather than obliterate or hide anyone who doesn’t quite measure up to the accepted norms.”

George Gilmore is a member of the Miramichi chapter of New Brunswick Right to Life and the New Brunswick Coalition for Life.