Imposed medical authority: orienting the decision
In some cases, medical authority is imposed without being requested by the woman/couple. This is often the case in France when women are hesitating to have a sample taken. They are often dissuaded from doing so if they are determined to keep the child they are carrying. For example, the midwife explained to a couple carrying the drepanocytosis gene: “We can make the diagnosis before birth, but we need to ask what we’re going to do. If [the foetus] is affected, are we going to terminate the pregnancy? ” Following the woman’s negative response, she continued: “the only thing we can do is an amniocentesis. But there’s a risk of miscarriage. That’s why, if you wish to keep this child, it’s better not to do [the amniocentesis]” (Midwife, France).
Finally, the practitioner’s attitude can be clearly directive when there is a strong presumption of anomaly. In France, for example, the consultant immediately told a 45-year-old woman: “As you have unfavourable blood results, with a very high level of hormones, this suggests a risk of chromosomal anomaly. It would be a good idea to rapidly have an amniocentesis to reassure you.” When facing what is considered to be a high risk, there is pressure to move fast.