In April, Karla Renée got a surprise positive on a pregnancy test. She and her husband Sam had tried unsuccessfully to get pregnant before and had expected they'd need fertility treatments.
"For it to just happen naturally felt like a miracle," she says. "We were ecstatic."
By the time she found a doctor in her insurance network near where she lived outside of Raleigh, N.C., and got in for her first appointment, she was eight weeks pregnant.
"The doctor noted that since I'll be 35 when the baby was due, I should take a screening test for genetic anomalies," she says. "We agreed to do the test and we scheduled our next appointment for a month out."
For those few weeks, they were just "blissfully pregnant," she says.
At the 12-week appointment, the doctor noticed something callen the ultrasound. This happens when extra fluid accumulates behind the neck of a fetus. "We'd never heard [of] that before," says Karla. "She explained that lots of babies have this and they can recover on their own, but it could be an indication of something more serious."
The first genetic screening results, from blood tests, came in — they were negative for several common genetic conditions. That test also told them they were having a girl. "We felt relief and we felt hope, and we started to call hmore comprehensive genetic test – amniocentesis – to see if there was a cause for the fluid accumulation she'd observed on the ultrasound. It's often done when there's a family history of certain genetic conditions, or the patient is over 35, or the doctor wants to follow up on an unusual result from a previous test.
That test involved waiting several more weeks until cells could be gathered, cultured and analyzed.
The results, which Karla finally got at week 18 of her pregnancy, showed their fetus had a condition in which all or part of the short arm of chromosome 18 is missing. Their doctors told them their daughter would likely have severe intellectual and physical disabilities, and could potentially need medical interventions as soon as she was born.
Karla and Sam were in shock but they didn't have much time to process. They needed to make an enormous decision: whether to continue or terminate their pregnancy.
They received the test results on June 27 – three days after Roe v. Wade was overturned. North Carolina had a 20-week abortion ban on the books that was blocked by the courts. That law was expected to go into effect imminently, so Karla said that hospitals were "taking no chances with legal liability." She was told if she decided to terminate the pregnancy, she needed to get in before 20 weeks, or she would have to travel out of state.
North Carolina also has a 72-hour waiting period for abortions, meaning if they did decide to terminate, they would have to wait at least three days before getting the procedure.
They only had a few days to determine the course of the rest of their lives.
The situation: 18 weeks into her pregnancy, Karla Renée learned the baby she was carrying had a serious genetic anomaly that could lead to severe physical and mental disabilities, miscarriage or stillbirth.
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