The Quest for the Perfect Baby: Why Do Israeli Women Seek Rrenatal Genetic Testing?
Опубликовано на портале: 04-03-2007
Sociology of Health and Illness.
2006.
Vol. 28.
No. 1.
P. 21-53.
Тематические разделы:
Since the mid-1990s, the Israeli medical scene has witnessed a real boom in elective
prenatal testing for inherited diseases that has spread beyond risk groups to the
general Jewish population, especially of Ashkenazi (European) origin. This study
tried to identify key social influences involved in the growing range and prevalence
of prenatal genetic tests as they emerged from women's own perspective. Twenty-seven
women having blood tests for genetic mutations were interviewed at two types of genetic
clinics, and re-interviewed after getting test results. The names of 23 women who
chose not to have elective tests were obtained from testers, and these non-testers
were interviewed for comparison. Women's accounts suggest that elective genetic testing
is more acceptable, if not normative, among educated middle class Ashkenazi women,
and is more often questioned and refused by lower class Mizrahi women, as well as
religious women of any ethnic origin. The key forces that drive women's choice of
prenatal genetic diagnosis include the fear of having a sick and/or socially unfit
child in an unsupportive environment; strong endorsement of testing by gynaecologists;
popular and professional discourse on the common Ashkenazi mutations causing genetic
anxiety in this ethnic group (i.e. apprehension of multiple known and unknown dangers
hidden in its genetic makeup); and the emerging social pressure for comprehensive
prenatal screening as an indispensable part of good motherhood. Many women described
the experience of testing as frustrating because of the long wait for results and
difficulty of their interpretation and subsequent decision-making. Women who rejected
elective tests explained their decision by moral/religious objections to abortion
and/or eugenic aspects of prenatal screening, as well as by prohibitive costs and
poor understanding of the tests' meaning and implications. Yet, few informants voiced
objections to the excessive medicalisation of pregnancy as such; ethno-national motives
of reproductive decisions were also uncommon in this group. More critical reflection
is clearly needed from both providers and users of elective genetic screening before
the more widespread uptake of this practice.
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