Legislating to preserve women's autonomy during pregnancy

Women are often excluded from the process of medical decision making during pregnancy, even though medical decisions that are made by health care professionals affect them personally and affect the future well-being of the unborn. Women in general and pregnant women in particular, will feel the impact of new genetic tests and technologies, designed to predict and even treat certain genetic problems during pregnancy, through prenatal diagnosis, foetal surgery and foetal gene therapy. This may be the first of several implications that new genetics technologies will hold for women's autonomy during pregnancy. Does genetic testing of a foetus empower women or pose an unanticipated threat to autonomy? To address these issues, there is a need to articulate a feminist perspective on genetic testing and possibly to legislate protection of women's rights during prenatal care. This article raises, but does not answer, several important issues regarding the implications of new developments in genetic testing that will affect pregnant women's autonomy in medical decision making. The article concludes that, although there are United States constitutional protections for the right to abortion and in turn, therapeutic abortion, an unfavourable chain of precedents regarding women's autonomy during pregnancy makes it imperative that there be strong legislation providing assurances that information will be given to pregnant women about the genetic testing process; that women will be made aware of their right to refuse treatment; that the law will require health care professionals to give adequate information to pregnant women regarding possible treatment outcomes in order to make an informed choice; and that there will be adequate protection for the right to confidentiality of information regarding prenatal prognosis, in order to safeguard autonomous decision making during pregnancy.