Reproductive Justice, Late Term Abortions, and Genetic Counselors' Obligation to Speak Up

By Madison Granier · Aug 2021

Abortion access is once again making headlines, but why is abortion access important to the field of genetic counseling?

On May 13, a genetic counselor, Jordan Brown, wrote about her experiences with the National Society of Genetic Counselors (NSGC) and the organization's position statement on abortion. In the article, "Not Ready to Make Nice: Juggling unabashed advocacy and NSGC's insidious culture of 'nice'," Brown calls out the NSGC's lack of response and leadership for abortion access: "As a genetic counselor who has had an abortion, our organization's continued silence stings. I have no negative feelings or regrets about having had an abortion, however NSGC's lack of response on the essential nature of access to abortion care is hurtful. I cannot be the only one feeling this way."

Brown's article gained a lot of attention on #GCChat Twitter with many genetic counselors chiming in and expressing their support. The NSGC president-elect also responded publicly. A few months after Jordan's blog post, the NSGC announced the newly formed NSGC Task Force on Reproductive Freedom, Access and Justice, with the objective of developing recommendations for key messages, resources and long-term strategy considerations for NSGC and member advocacy around genetic counseling and reproductive justice.

Why is abortion important to the field of genetic counseling?

Genetic counselors are uniquely qualified as healthcare professionals to speak up for access to abortions, reproductive justice, and healthcare for patients in general.

On May 17, 2021 the U.S. Supreme Court announced they will review the Mississippi ban on abortions after 15 weeks of pregnancy. In the last several months there have been waves of state laws aimed at limiting access to abortions, challenging the court ruling of 1973 Roe v. Wade. According to the Guttmacher Institute, "2021 will end up as the most damaging antiabortion state legislative session in a decade."

An abortion is a safe and legal way to end a pregnancy. 4 out of 10 women will get an abortion during their life. Less than 1% of all abortions occurred at 21 weeks or greater. 92.2% of abortions occurred at 13 weeks or less. However many people do not find out they are pregnant until late in the pregnancy. Often this will severely limit access to later term abortions due to state restrictions.

In a minority of cases, people might seek later term abortions due to fetal abnormalities, congenital defects, or health risk to the pregnant person. These complications will sometimes not be discovered until very late in a pregnancy.

This is where abortion access and the profession of genetic counseling collide. On the Patient Stories podcast, Erika and Garin discuss how their pregnancy began with a normal first trimester, with the CVS showing normal results. It wasn't until early in the third trimester that they were told something was seriously wrong, and they ultimately flew to Colorado to end the pregnancy after reaching a point where abortion was no longer legally available in New York.

On the Genotypecast podcast, Jordan Brown highlights how delays in prenatal testing or a diagnosis can jeopardize a person's choice to have an abortion: "It's really important because genetic counselors all know there are time sensitive aspects of genetic testing. But then there's also the possibility that in some cases it just takes longer to get results or that different features are not noted until later on in a pregnancy. And at that point, a lot of women are past the time in their state where they would be able to have a legal abortion."

What's Next?

The field of genetic counseling is rapidly growing and changing. More genetic counselors are speaking out about disparities and inequality in the healthcare system and genetics. Part of the growing conversation centers around reproductive justice—how socioeconomic status, gender, and race can affect reproductive healthcare—and abortion access.

Abortion is a very important healthcare option and healthcare providers should be providing patients with all their options, even if talking about abortion may be uncomfortable. Genetics professionals need to address abortion access, reproductive justice, and healthcare disparities. Healthcare providers have a platform, and we need to use it to advocate for our patients.