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Comment by sudhirj | Hacker News Reader

The pre-natal tests are routine even here in India - I'm quite surprised they're not in the US.

There are various levels of screening tests available (but not required) like ultrasounds, but the more definitive diagnostic tests (like amniocentesis) are more invasive and carry some risk to the fetus.

If you aren't sure that you'd abort the fetus if a genetic abnormality were detected, you'd probably be less likely to take a screening test that poses even a minor risk to the fetus. (of course, there are other reasons to know, like if you are considering a home birth versus hospital birth, you'd want to know if the baby will have any special needs at birth)

Screening generally doesn't affect the fetus and can help make a decision about whether or not to do a more invasive test in the absence of other risk factors. Most screening is also before the timeframe that you're able to perform something like amniocentesis. Thinking PGD (for IVF), NIPT, NT ultrasound, serum screening, other such things...

I don't know a lot of people that refuse the noninvasive prenatal screening offered by California... even if you don't act on the information you receive.

Yes, screening is non-invasive (and also is not definitive), but is optional and some people refuse even non-invasive screening because nothing will change their mind about continuing the pregnancy "for as long as god intends it".

Your quotation marks seem like you disagree. There are other reasons not to do screening, for example not be faced with the decision to abort or not to abort. Here in Germany, at least in my circles, people tend to avoid such screenings not because of religiousness.

Pre-natal tests are routine, and even free, in California. The state pays for testing that would identify Downs, including NIPT. Unfortunately, you have to do older tests first to be considered high risk and to qualify for NIPT or amniocentesis.

CA's screening program is not free. It costs $220 to participate, although insurance may cover that cost so it is free to the patient. Any followup care for people with fetuses at high risk of a birth defect is covered by the state though.

Back from when I was pregnant, I also recall that my insurer (Kaiser) would cover the cost of NIPT for anyone 35+ or in certain high-risk cases without having to go through the state. They also covered the cost of carrier testing.

edit: I thought maybe you might be thinking of newborn screening which is also very much a Thing in CA, but it turns out that is also not free - $130, also covered by most insurance. Good to have though!

Thanks for the details. Not free, but certainly routine. I’d be surprised if MediCal and other govt programs didn’t entirely cover this.

There are many pre-natal tests available. I was specifically referring to nipt, which is usually priced around $200-600, and can spot Down and other DNA issues with great accuracy.

NIPT is a relatively new test, and at least in the UK, most people haven't even heard of it. It's very rarely offered on the NHS, and only in some areas. It can be had privately for around £200 though.

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