Responding to parental concerns after a prenatal diagnosis of trisomy 21.

CASE Jane and Luke were excited after hearing that Jane was pregnant. They had been married for ten years and had a healthy six year old daughter. Because of her age (36 years old), they chose to have a genetic amniocentesis at 16 weeks gestation. A trisomy 21 fetus was discovered through standard karyotyping. They described their marriage as strong. Luke managed a small shoe store and Jane was an elementary school teacher. Their daughter’s growth and development was uncomplicated; she adapted to kindergarten very well. Social support, both family and friends, was an important part of family life. Jane’s younger sister had a significant learning disability and was always in special education. When informed about the genetic diagnosis of a trisomy 21 fetus and presented with the options of either continuing the pregnancy or elective termination, the parents asked the following questions: “What is it like to raise a child who is not normal, especially a child with Down syndrome?” “How will the child do in school?”“How will our six year old daughter respond to her?”“Can we still keep our jobs and raise such a child?”