CMDA's The Point

Discussing Difficult Cases

January 8, 2024

by Steven A. Foley, MD

If we believe that all human life is made in God’s image (Imago Dei), then it is time to discuss the present worldview that urges young mothers to terminate their pregnancies once complications or handicaps are found. In the state of Texas, a soon-to-be mother named Kate Cox discovered that her unborn baby had Trisomy 18, a detrimental disease with a high mortality rate for the baby and the certainty of disability and medical complications throughout the baby’s life. Discussing cases like Ms. Cox’s are always difficult, but we need to be knowledgeable of the facts, and we also need to affirm our Christian worldview that every person carries the Imago Dei.


It is important to remember that prenatal diagnosis is not risk free. The typical cell-free DNA procedure to determine the diagnosis only holds an 80 percent accuracy rate and needs to be followed with a CVS or amino test that has a 1/200 risk of pregnancy loss. Once babies are diagnosed with Trisomy 18, they have varying degrees of neurological and anatomical defects. The American College of Obstetricians and Gynecologists (ACOG) believe this is a fatal condition. This study from the National Institutes of Health and this article out of Switzerland, however, would disagree with that assumption. If the baby survives the first week, which a high percentage do not, it will have a 70 percent chance of living to one year and a 14 percent survival rate at five years. These numbers have significantly improved since the apnea seen in babies with Trisomy 18 is obstructive apnea, not central apnea as previously thought. It is correct that there is a high mortality rate, but this is not always a fatal condition. It is just another example of ACOG ableism and their prejudice toward handicapped people, especially the unborn.


ACOG infers that all 60,000 members believe as they do. This is not the case. At least 7,000 members of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) do not agree with ACOG on numerous things when it comes to the value of life and the value of the handicapped. ACOG strongly supported the recent bill passed in Ohio allowing abortion throughout pregnancy with no restrictions. In addition, the Society of Maternal-Fetal Medicine states they “believe that all patients are entitled to prompt, complete and unbiased care that is medically and scientifically sound.”


There is no evidence that a mother with an unborn child diagnosed with Trisomy 18 will have an increased risk of infertility, nor that their own health would deteriorate if the pregnancy went to full term.


There is no discussion of the maternal mortality associated with abortion. Abortion is not a risk-free procedure, as ACOG would want you to believe. They fail to mention the risk of pre-term birth and mental health disorders that are well documented.


All patients that are pregnant have risk involved, but there is no increased risk for a patient with a handicapped baby versus a non-handicapped baby. Placenta acreta, injury to bowel and bladder and hysterectomy are risks of all pregnancies, not risks of pregnancies with a handicapped baby. Terminating a pregnancy is certainly medically indicated when the life of the mother is a stake. ACOG would have you think that pro-life physicians do not believe this. They also would have you think that state laws are confusing regarding this, but they are not. Cases where the life of the mother is at risk involve previable delivery, not abortion.


I do not want to belittle how difficult this case is; however, handicapped, unborn children need our protection. Their moms and families need our support. There are organizations well equipped to support these families who find themselves facing exceedingly difficult circumstances.


As Christians in healthcare, we must hold fast to the belief that all life holds value, and all human beings are made in the Imago Dei. To veer from that belief is to allow room for the lie that some lives are not worth living.


  1. Avatar Mrs. Malcolm Oliver on January 11, 2024 at 1:42 pm

    I am sitting with our daughter in Arkansas as she waits for a miscarriage. Her water broke just shy of 18 weeks pregnant. There is still a fetal heartbeat of 150, 3 days later. Due to laws doctors say we must just wait for labor to start naturally or the baby’s heart to stop so they can induce her. Never done anything so hard as to wait for this process to happen while she cries over losing her baby.

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