ATTITUDES TOWARD ABORTION FOR FETAL ANOMALY IN THE 2ND VS THE 3RD TRIMESTER - A SURVEY OF PARISIAN OBSTETRICIANS

Cross-cultural differences exist in prenatal diagnosis and abortion fo r fetal anomaly, stemming from variations in laws, reimbursement polic ies, litigation, physicians' decision-making authority, and attitudes toward the prevention of handicaps. The first part of this paper discu sses such differences in France and the U.S. The second part describes a survey of practising obstetricians in Paris, designed to assess (1) their attitudes toward pregnancy termination for various conditions, (2) their concern about fetal viability, (3) their desire for diagnost ic certainty before justifying a late abortion, and (4) their perceive d role in such decision-making. Among the 64.8 per cent (N = 217) who responded, the majority supported third-trimester termination (TTT) fo r diseases such as spina bifida, trisomy 21, microcephaly, and Duchenn e muscular dystrophy; 30-59 per cent supported TTT for cystic fibrosis and sickle cell disease; and 22 29 per cent supported TTT for haemoph ilia, tetralogy of Fallot, limb amputation, and Turner and Klinefelter syndromes. Obstetricians who approved of abortion across trimesters w ere less concerned with the certainty of diagnosis than its severity, more likely to think that abortion ought to be the parents' choice, bu t more likely to report making a recommendation to the parents about w hether to abort a fetus. Such permissive abortion attitudes might impl y more permissive prenatal diagnosis and abortion practice among Paris ian obstetricians, which might lead to increased migration of patients from other E.C. countries. Cross-cultural variation in obstetric prac tice suggests that an international registry of pregnancies terminated for medical reasons, enabling further study of this issue, would be v aluable.