WASHINGTON — First birth control, now prenatal testing? Once again a fact of life for many American women has become a jarring issue in the presidential race.
Republican candidate Rick Santorum is making free screenings for birth defects part of his attack on President Barack Obama's health care law. Santorum, who has a young daughter with a serious genetic disorder, said rules requiring insurers to cover prenatal tests are designed to encourage more women to have abortions that will "cull the ranks of the disabled in our society."
Obama re-election campaign spokeswoman Lis Smith called Santorum's remarks "misinformed and dangerous." She said the tests are for the health of mothers and babies and help bring about safer deliveries.
Federal health officials and the nation's obstetricians recommend that all pregnant women be offered blood tests and an ultrasound exam that assess the risk of having a baby with various birth defects or genetic disorders, including Down syndrome. If the screening raises concern, a woman may choose further testing, such as amniocentesis.
How did these commonplace tests spark so much controversy?
_Some women don't want the tests because they know they wouldn't abort their fetus no matter what the results. Others who wouldn't consider an abortion still want the tests – seeking reassurance that all is well or, if not, the chance to adjust emotionally and prepare for a disabled baby's more complicated care. Babies with Down syndrome can need specialized attention at delivery that affects hospital selection.
_Some women avoid amniocentesis, which involves withdrawing amniotic fluid through a needle, because of the small chance it could cause a miscarriage. There are less invasive tests available, however, and newer ones on the way.
_As Santorum noted, studies show that in the vast majority of cases where amniocentesis reveals Down syndrome, women decide on abortion.
_Advocates for the disabled, including many parents of Down syndrome children, worry that couples are choosing abortion without considering that their child could lead a happy, fulfilling life. About one in 800 babies is born with Down syndrome, a condition in which having an extra chromosome causes mental retardation, a characteristic broad, flat face and, often, serious heart defects.
The prenatal testing issues have been debated by abortion foes and obstetricians and wrestled with by prospective parents. But the ethical quandaries and painful emotional decisions received scant public attention before the politically charged remarks from Santorum, who also opposes the government requiring birth control coverage for employees of religiously affiliated organizations.
Until now, perhaps the best-known personal reflections on the prenatal testing decision came from two well-known conservatives, each the parent of a Down syndrome child. They saw the issue differently:
_"I was grateful to have all those months to prepare. I can't imagine the moms that are surprised at the end. I think they have it a lot harder," Sarah Palin, the 2008 Republican vice presidential nominee, said about the amniocentesis results she received before her son Trig was born.
_"What is antiseptically called `screening' for Down syndrome is, much more often than not, a search-and-destroy mission: At least 85 percent of pregnancies in which Down syndrome is diagnosed are ended by abortions," columnist George Will wrote in a 2007 column about his grown son Jon and the recommendation by the American College of Obstetricians and Gynecologists that all pregnant women be screened.
Santorum, whose daughter Bella has a different genetic disorder, Trisomy 18, said in a CBS interview on Sunday: "Almost 100 percent of Trisomy 18 children are encouraged to be aborted, so I know what I'm talking about here."
Santorum is outspoken on matters of sex. Here are some of his past statements:
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On Contraception
"It's not okay. It's a license to do things in a sexual realm that is counter to how things are supposed to be."
<a href="http://thinkprogress.org/health/2011/10/19/348007/rick-santorum-pledges-to-defund-contraception-its-not-okay-its-a-license-to-do-things/" target="_hplink">Think Progress, 2011</a>
On The Definition Of Marriage
"Marriage is what marriage is. Marriage was around before government said what it was. It's like going out and saying, 'That tree is a car.' Well, the tree's not a car. A tree's a tree. Marriage is marriage."
"It's like handing up this and saying this glass of water is a glass of beer. Well you can call it a glass of beer, it's not a glass of beer, it's a glass of water. And water is what water is. Marriage is what marriage is."
"I can call this napkin a paper towel, but it is a napkin. Why? Because it is, what it is."
<a href="http://iowaindependent.com/60602/santorum-qa-marriage-for-gays-threatens-religious-freedom" target="_hplink">Iowa Independant, 2011</a>
<a href="http://www.youtube.com/watch?feature=player_embedded&v=fLbAFNbVSEE
http://thinkprogress.org/lgbt/2011/08/09/292121/santorum-marriage-is-like-water-not-beer/" target="_hplink">Think Progress, 2011</a>
<a href="http://www.youtube.com/watch?v=U394HKpak1s" target="_hplink">MSNBC, 2011</a>
On Sex In The Military
"I -- I would say, any type of sexual activity has absolutely no place in the military. And the fact that they're making a point to include it as a provision within the military that we are going to recognize a group of people and give them a special privilege to -- to -- and removing 'don't ask, don't tell' I think tries to inject social policy into the military. And the military's job is to do one thing, and that is to defend our country."
<a href="http://www.foxnews.com/politics/2011/09/22/fox-news-google-gop-2012-presidential-debate/" target="_hplink">Fox News, 2011</a>
On Gays In The Military
"The problem is that sexual activity with people who you are in close quarters with who happen to be of the same sex is different than being open about your sexuality ... They're in close quarters, they live with people, they obviously shower with people."
<a href="http://www.huffingtonpost.com/2011/10/09/rick-santorum-gay-soldiers-shower-dadt_n_1002244.html" target="_hplink">HuffPost, 2011</a>
On Polygamy, Bigamy, Adultery ...
"If the Supreme Court says that you have the right to consensual sex within your home, then you have the right to bigamy, you have the right to polygamy, you have the right to incest, you have the right to adultery. You have the right to anything."
<a href="http://articles.cnn.com/2003-04-22/politics/santorum.gays_1_statement-on-individual-lifestyles-senator-santorum-bigamy-and-adultery?_s=PM:ALLPOLITICS" target="_hplink">Associated Press, 2003</a>
On The Difference Between Being Black And Being Gay
"You are black by the color of your skin. You are not homosexual, necessarily -- obviously, by the color of your skin. [...] The idea that being black and being gay is the same is simply not true."
<a href="http://politics.foxnews.mobi/quickPage.html?page=23681&content=58208053&pageNum=-1" target="_hplink">Fox News, 2011</a>
On Candidates' Sex Lives
"When you look at someone to determine whether they'd be the right person for public office, look at who they lay down with at night and what they believe in."
<a href="http://2012.talkingpointsmemo.com/2011/10/rick-santorum-when-selecting-candidate-look-at-who-they-lay-down-with-at-night.php" target="_hplink">Talking Points Memo, 2011</a>
On 'Man On Dog'
"In every society, the definition of marriage has not ever to my knowledge included homosexuality. That's not to pick on homosexuality. It's not, you know, man on child, man on dog, or whatever the case may be. It is one thing."
<a href="http://www.usatoday.com/news/washington/2003-04-23-santorum-excerpt_x.htm" target="_hplink">Associated Press, 2003</a>
On Sodomy, etc..
"Whether it's polygamy, whether it's adultery, whether it's sodomy, all of those things, are antithetical to a healthy, stable, traditional family."
<a href="http://www.usatoday.com/news/washington/2003-04-23-santorum-excerpt_x.htm" target="_hplink">Associated Press, 2003</a>
On The Government Getting Up In Your Sex Life
"The idea is that the state doesn't have rights to limit individuals' wants and passions -- I disagree with that. I think we absolutely have rights because there are consequences to letting people live out whatever wants or passions they desire. And we're seeing it in our society."
<a href="http://www.usatoday.com/news/washington/2003-04-23-santorum-excerpt_x.htm" target="_hplink">Associated Press, 2003</a>
On Gay Marriage
"This is an issue just like 9/11 ... We didn't decide we wanted to fight the war on terrorism because we wanted to. It was brought to us. And if not now, when?"
"The battle we're engaged in right now on same-sex marriage, ultimately that is the very foundation of our country, the family, what the family structure is going to look like. I'll die on that hill fighting."
<a href="http://articles.mcall.com/2004-02-25/news/3521981_1_gay-marriage-defense-of-marriage-act-amendment-process" target="_hplink">The Morning Call, 2004</a>
<a href="http://thinkprogress.org/lgbt/2011/10/19/348059/rick-santorum-pledges-to-die-on-the-hill-fighting-against-same-sex-marriage/" target="_hplink">Think Progress, 2011 </a>
On Being A Hater
"You can say I'm a hater. But I would argue I'm a lover. I'm a lover of traditional families and of the right of children to have a mother and father. ... Isn't that the ultimate homeland security, standing up and defending marriage?"
<a href="http://www.post-gazette.com/pg/04197/346633-84.stm" target="_hplink">Pittsburg Post Gazette, 2011</a>
On The Gay Jihad
"So the gay community said, 'He's comparing gay sex to incest and polygamy, how dare he do this,' and they have gone out on a, I would argue, jihad against Rick Santorum since then."
<a href="http://thehill.com/blogs/blog-briefing-room/news/178543-santorum-gay-community-on-jihad-against-me-for-stance-on-marriage?utm_campaign=briefingroom&utm_source=twitterfeed&utm_medium=twitterfeed" target="_hplink">The Hill, 2011</a>
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CONNIE CASS 02/22/12 03:56 PM ET Associated Press