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Re: Cystic fibrosisFrom: Len2976 (Len2976@aol.com)Mon May 18 20:20:41 1998
Dr. Roberts; I absolutely agree with your statements that couples often do the opposite of what they assumed they would do when faced with the prospect of a child with a genetic disorder. I have seen this many times. I have been a CNM for over 20 years. Presently I am a staff CNM in a busy private practice. Most of our counseling for prenatal diagnosis is related to AMA (advance maternal age). Many of our patients are professional women in their 30's (and sometimes 40's). Almost daily I speak to couples about genetic testing. Many of these women are well read. Quite often these couples tell me they have read that it is adequate to do the MSAFP first and then do amniocentesis only if the AFP is abnormal. I make it clear to them that the MSAFP is in no way meant to substitute for the amnio for them. The obstetrician head of our practice, who I have a great deal of respect for, often counsels patients about amnio based upon what they say they would do with the results. I advise the women about their risks for genetic disorder, risks of the procedure, and tell them that patients often change their minds when about what they thought they would do in certain situations. Then the decision is theirs. Lenora McCall, CNM
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