Dr. Hasan Abdessamad

Dr. Marjorie Greenfield shares her thoughts on a series of comments from Rick Santorum citing pre-natal testing as one of the reasons he is against President Barack Obama’s health care law.

>>> debate over prenatal testing .

>> one of the things you don’t know is they require free prenatal testing . why? because free prenatal testing ends up in more abortions and less care that has to be done because we call the ranks of the disabled in our society.

>> that was one of a series of recent comments citing prenatal testing as one of the reason he’s against the president’s health care law . the christian post has an article with the headline, ob/gob/ ob/gyn, santorum was a right. what premayal care has developed into is a search and destroy mission. joining me now is dr. marjorie greenfield from case medical center . i should note your hospital is one of leading neo natal care facilities in this nation. i don’t want to get you locked up in a political or religious battle, but i want to talk about the science here. you have a colleague who is saying that this is a search and destroy mission. what is your response to that?

>> that’s really a terrible way to frame prenatal testing . it’s much more than about abortion. i think when you narrow it down that’s way, it’s politically motivated as opposed to talking about what happens with patients.

>> what are the numbers here? rick santorum says this results ting is done. i’ve read countless articles over the last ten days or first five days when first came up with this, i have to say, i’ve not seen a clear figure here. what can you tell me.

>> the decision about what you do with abnormal result s a personal decision. when owe talk about prenatal testing . wh what are we talking about? an ultra sound is k detect fetal abnormalities. the other tests are blood tests that can be done or a sampling which are the diagnostic tests that give you the true, final answer of what’s going on with chromosones. he used the term prenatal testing which is a much broader term than that.

>> i know you’ve written about how emotional this is. some families don’t want to do testing because they don’t want to face the decision of what to do next. it is a personal and a family’s choice here. you’re in contact with people every day who decide on testing. just take me through your world and the perspective of what women are looking for when they decide to go ahead with this.

>> when i frame this with patients, i say that people fall into three groups. there’s a group that don’t want to do any of this testing or screening because they know that they would not change their behavior at all based on the results and they don’t want to be worried about this during the pregnancy. there’s another group that knows that they would terminate an abnormal pregnancy and they want the information that they can get so they can make that decision. then there’s a large group in the middle that wants to know about the health of their baby so they can make the best possible decisions. they might decide to get in contact with asupport group so that they would learn more about this condition so they could make a good decision about what to do for themselves or they might, sometimes we’re talking bt about a condition that’s not compatible with survival. sometimes we get hospice involved for people that would not terminate but want as much information as possible. these decisions are incredibly personal decisions. the other thing i want to make sure people understand is that amnio is done for anybody that’s at increased risk for finding a problem. most are carrying healthy fetuses. one thing it turns out to be reassurance for the family and the baby ent doesn’t have a problem.

>> in most cases the baby is healthy?

>> the vast majority doesn’t find a problem.

>> you’ve said that overall this is commonly accepted and one of quotes is that this is like not covering an ultra sound . the ideas that are coming from rick santorumin that he would not want insurance to cover the prenatal testing .

>> right. you can do an ultrasound and find a very severe problem on a fetus that would not be detected by amnio. it’s an anatomical problem that could be severe and not compatible with survival or quality of life that family would go forward with. would that mean that the doctor would be not supposed to tell the family that this abnormal finding was there because the family might make a decision for abortion. you end up going down a path that really interferes with the doctors ability to take care of the patients and the family’s independence.

>> it’s a rejection for some of science here. this is science used to, as you pointed out, help with the mother to have a healthier child in the end here. if insurance cover it, that would mean on the wealthy perhaps would have the ability to have this testing done. i would imagine it’s quite expensive.

>> i looked into it. there’s quite a range of charges across the country but we’re talking about $2,000. that’s really going to be unreachable for a lot of people.

>> if you’re rich, you’d be able to do it and have this testing but obviously the other 99%, as we like to say, would not.

>> right. what you could end up having, for instance, i can give you an example of a patient that has a routine ultrasound, they see shotgun that makes it likely you find a problem and the family would have to make a decision, are they going to spend the money for the amnio or just be terrified for the rest of the pregnancy when it could be just fine.

>> we greatly appreciate it. we have been trying to get you on for two days. i’m glad you were able to make it. thank you so much.

>> happy to be here. thank you.