Amniocentesis And Genetic Counseling Health Essay

In this scrutiny of antenatal testing, two specific processs are being discussed: amniocentesis and alpha-fetoprotein. Amniocentesis is performed between 15-20 hebdomads gestation. In this process, amnionic fluid is extracted from the amnionic pouch.
Accepting Prenatal Testing
There are many grounds why female parents accept antenatal testing. First, many clinics have constructions in topographic point that dictate what constitutes appropriate antenatal attention. For case, some clinics have a pro-testing civilization, in which about all pregnant adult females are recommended to undergo a bombardment of medical trials ( Press and Browner 1997: 983 ) . Amniocentesis And Genetic Counseling Health Essay. Furthermore, antenatal testing is non ever differentiated from antenatal attention. When trials are offered, many adult females assume that they are portion of everyday antenatal scrutiny, and since antenatal attention is frequently equated with holding a healthy, normal babe, they do non decline proving. If a kid is born with a birth defect or disablement, and the female parent rejected antenatal testing, she may experience pressured to accept duty and incrimination for her kid s status. Additionally, female parents may hold to prenatal proving if they trust the purposes and the abilities of their health care practicians this is particularly of import to female parents to hold entree to, and use, public clinics ( Rapp 1993: 186 ) . Second, antenatal testing has the possible to reassure female parents. This reassurance is twofold: optimally, the showings demonstrate that there are no foetal abnormalcies, and that the female parent s antenatal behaviours were good to the foetus s development ( Landsman 2009: 44 ) .
Last, in the United States, personhood is frequently constructed prior to birth ( Landsman 1999: 134 ) . Prenatal testing is one method in which female parents begin delegating personhood to their unborn kid, because it frequently the first index of the kid s uniqueness* . Negative trial consequences are most frequently met with alleviation, and female parents determine that, most probably, their kid will be normal. Conversely, positive trial consequences

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Refusing Prenatal Testing
Amniocentesis and AFP, like about all biomedical processs, carry built-in hazards. Prior to undergoing amniocentesis in peculiar, familial counsellors present the possible complications of the process to the parents. One such complication of amniocentesis is abortion. For some parents, this is merely non a hazard that they are willing to take ; therefore, they refuse the process ( Rapp 1998: 55 ) . Additionally, for female parents who have the AFP blood trial, positive consequences are normally confirmed by amniocentesis. Consequently, they may worsen AFP, in instance they need a follow-up amniocentesis that can potentially do a abortion ( Markens et al. 1999: 361 ) .Amniocentesis And Genetic Counseling Health Essay.
Crucially, parents may decline antenatal testing because do non to the full understand what antenatal trials really screen for, even after confabulating with a familial counsellor. Parents may apologize that since they do non hold any recognizable familial conditions in their household ( such as sickle-cell anaemia or cystic fibrosis ) , their kid will non be born with one, every bit good ; therefore, there is no demand for antenatal testing. In add-on, parents may construe that antenatal showings trial for heritable, familial conditions merely. Of class, antenatal trials check for much more than that nervous tubing defects and conditions caused by nondisjuction ( such as Trisomy 18 or Down syndrome ) can be detected, as good ( Rapp 1999 ) .
Merely as female parents may accept antenatal proving to reassure themselves that their good prenatal behaviours lead to a healthy foetus, other female parents may besides reject antenatal trials because they follow the expected regimen of antenatal actions. Mothers may stress that they do non smoke or imbibe, they take antenatal vitamins, and they get regular prenatal attention ; hence, nil should be incorrect with the foetus that they are transporting. Indeed, avoiding hazardous behaviours during gestation surely increases the opportunity of holding a healthy babe. However, some disablements develop independently of a female parent s behaviour as mentioned above, conditions of nondisjuction can happen, irrespective of how rigorous a female parent followed a prescribed antenatal regimen ( Rapp 1999 ) .
Another ground that parents reject antenatal showing is an expostulation to the lone available intercession for a positive consequence abortion. Very few, if any, foetal abnormalcies can be reversed or cured, either in utero or after birth. So, if an amniocentesis or AFP returns a positive consequence, parents are presented with two immediate options: go on on with the gestation or terminate. To avoid such hard ( and in the United States, a extremely politicized ) argument, parents may choose to avoid antenatal proving wholly ( Markens et al. 1999 ) .
Last, antenatal trials may be declined due to the historical context of a peculiar civilization or society. Rayna Rapp, in Refusing Prenatal Diagnosis: The Meanings of Bioscience in a Multicultural World, portions the experience of an African American twosome who decide to reject an amniocentesis, based on information given to them by their familial counsellor. Amniocentesis And Genetic Counseling Health Essay. The familial counsellor explained that after analysing the amnionic fluid, any excess fluid could potentially be used in farther familial research. Medical experimentation is a unquestionably outstanding issue among African Americans, as the horrors of experiments such as the Tuskegee survey remain embedded in African American cultural cognition ( Rapp 1998: 48-50 ) .
Who makes the ultimate determination as to whether a female parent will undergo antenatal proving? C.H. Browner explores this complex inquiry in her survey of Mexican immigrants in the United States who are sing antenatal showings. Browner determines that so, the determination to accept antenatal testing is non ever the exclusive determination of the female parent ; alternatively, in some structural contexts, her spouse may to a great extent rock the concluding determination. Browner points to two state of affairss that are non reciprocally sole in which this is mostly the instance: foremost, if the female parent is dependent on her spouse for income, or 2nd, if the spouse is inexorable that they do non desire to raise a kid with a disablement ( 2001: 780-781 ) . Importantly, decision-making about antenatal testing is seldom an independent act by an person ; alternatively, many histrions and societal contexts integrate in either accepting or rejecting antenatal showings. Regardless of parents determination to accept or reject antenatal testing, they are similar in their belief that their determination was best for the babe and that God would assist them, irrespective of the result ( Browner et al. 1999: 1661 ) .
A Closer Expression: The Ashley Treatment
One alone illustration of how parents can act upon their handicapped kid s personhood is clearly illustrated in the instance of Ashley. Ashley is a kid with permeant, planetary disablements. Harmonizing to the web log written by her parents, Ashley can non maintain her caput up, axial rotation or alter her sleeping places, hold a plaything, or sit up by herself, and she is fed through a stomachic tubing ( The Ashley Treatment 2007 ) . Her parents coined the term Pillow Angels in mention to kids with terrible disablements ( including their girl Ashley ) who require round-the-clock attention, and will most likely ne’er develop accomplishments beyond that of a six-month old baby ( The Ashley Treatment 2007 ) . Amniocentesis And Genetic Counseling Health Essay. In order to supply her the best attention they perchance could, Ashley s parents pursued a broad assortment of medical processs that, basically, stunted her growing. Get downing at age six, Ashley had her chest buds removed ; later, Ashley s physicians performed a hysterectomy and assorted growing fading processs ( Battles and Manderson 2008 ) . This specific set of processs became widely known as the Ashley Treatment, and other parents of Pillow Angels began bespeaking such intervention for their kids, every bit good. Removing the primary and secondary sex features, along with growing fading, ensures that the kid remains little and easier to take attention of in the place or, as the term Pillow Angels implies, ensures that the kid will be able to remain on a soft pillow for most of the twenty-four hours ( Battles and Manderson 2008: 220 ) .
Ashley s instance is instead alone among parents of kids with disablements Ashley s parents embraced biotechnology in order to, in a sense, maintain her handicapped organic structure in a manageable signifier.
After a kid with a disablement is born, female parents must voyage non merely the personhood of their new babe, but besides their ain changing constructs of what it means to be a female parent. In American society, new female parents may meet mother-blame ( which may be external or internal ) , and view the birth of a handicapped kid as a penalty for behaviours or actions during the antenatal period ( Groce and Zola 1993 ) . Mothers may look back at their gestation with sorrow, even if they followed everything by the book, and justice any errors, even minor 1s ( for case, burying to take a folic acid addendum one forenoon or imbibing one cup of java ) . In this manner, antenatal behaviours and actions are assumed to straight act upon a kid s result ( Landsman 1999: 137-139 ) . Mothers, sometimes every bit early as instantly after birth, must face the impression that disabled infant organic structures challenge the all-or-nothing-ness quality [ that has been ] associated with North American personhood ; they besides challenge the conflation of either construct or biological birth with societal personhood ( Landsman 2009: 58 ) . For illustration, Gail Landsman, in Reconstructing Motherhood and Disability in the Age of Perfect Babies, portions the narrative of one female parent who called her household after the birth of her girl to denote her safe and happy reaching.Amniocentesis And Genetic Counseling Health Essay.  However, after her physician confirmed that her kid had Down syndrome, she called everyone back, stating, Well, we did hold a babe, but things didn t go harmonizing to program ( 2009: 57 ) . In this peculiar case, non merely is the female parent denying her babe personhood, but besides disputing her ain maternity.
Furthermore, if a disablement or developmental hold is discovered after the kid s birth ( for illustration, assorted upsets on the autism spectrum ) , personhood may be yanked off by healthcare practicians. Doctors are speedy to indicate out abnormalcies and how much a kid is delayed ( normally given in units of months or old ages ) . It is at this point that parents are introduced to the medical theoretical account of disablement, in which a disablement is presented as a job residing within the organic structure or head of an person ( Landsman 2005: 125 ) .1 While many female parents do non needfully differ with a physician s specific diagnosing, they may impeach the physician of merely concentrating on how the disablement negatively affects their kid, instead than admiting the kid s advancement and singularity. Indeed, female parents may seek to counter the hegemony of the medical theoretical account by proudly indicating out the achievements of their kid, in an attempt to reframe the diagnostic label ( Landsman 2005: 127 ) . Harmonizing to Bill Rocque, female parents perform a proxy-selfhood for their kids, and frequently do so by warranting or apologizing their kid s behaviour ( 2010: 486 ) . For case, manus flutter, a stereotypic behaviour associated with autism, may be reframed as early efforts at mark linguistic communication ( Rocque 2010: 492-483 ) .
Constructing narrations about a kid s life besides allows parents to reframe their kid s disablement, particularly in footings of the kid s individuality. As Prussing et Al. articulately province, a kid s disablement disrupts [ the ] conventional cultural narrations of parenting, presenting menaces to the personhood of both kids and parents ( 2005: 588 ) . One manner to resituate a kid s disablement is to negociate the descriptive linguistic communication of disablement. For case, words such as mental deceleration and upset describe, possibly, a permanence to a kid s status. Amniocentesis And Genetic Counseling Health Essay. As one female parent explained to Gail Landsman,

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Peoples don Ts like to utilize the phrase mentally retarded. Now, I personally
feel that it s a instead accurate description. It merely means mentally slow,
and developmentally delayed, to me, is a euphemism because I kind of
feel when you say your plane is delayed, you know that it s finally
traveling to come in. Well, Daniel s plane International Relations and Security Network T finally traveling to come
in, in a batch of ways ( 2003: 1957 ) .
However, some parents take comfort in the phrase developmentally delayed, as it connotes that their kid s battles are merely impermanent, that the kid will react to intercession, and that, at some point, the kid will acquire back on the normal path of development. Parents use such dual discourses to admit the kid s unsure developmental flight, while at the same clip staying optimistic and hopeful for the hereafter ( Rapp 2000: 197 ) .
Frequently, subsequently in a kid s life, parents become familiar with the societal theoretical account of disablement. The societal theoretical account locates the hindrances to a high quality of life non within the organic structure of a handicapped individual but instead within the society that discriminates against individuals with disablements ( Landsman 2005: 131-132 ) . This challenges the impression that people with disablements need to be cured, treated, or fixed ; alternatively, policies should be enacted and enforced so they can populate a life with fewer barriers. An interesting displacement in paradigms is presently afoot: while a important figure of female parents are still undergoing antenatal trials to test for inborn abnormalcies, parents of kids with disablements are forcing for integrating, instead than exclusion from, their communities ( Prussing et al. 2005 ) . Amniocentesis And Genetic Counseling Health Essay. Frequently, one of the first major chances for integrating for kids with disablements is traveling to school. In the United States, kids with disablements are guaranteed a free appropriate public instruction under the Individuals with Disabilities Education Act ( IDEA ) . However, securing such an instruction, and guaranting that schools comply with the authorizations laid out by IDEA, remains hard for many parents. Parents of kids with disablements point to structural barriers within school territories, such as deficiency of support and human resources, which in bend inhibit their kid s instruction and show an obstruction to their kid s development ( Rapp and Ginsburg 2001 ) .
1 If the kid is traveling to take part in early intercession plans, a diagnostic label is required. For First Steps, which is Indiana s statewide early intercession plan, an ICD codification must be provided by the kid s physician before developing a service program can even get down. This, of class, may change from province to province. Amniocentesis And Genetic Counseling Health Essay.