The controversial plan to eliminate mandatory prenatal screening was approved by the Islamic Consultative Assembly in July of this year and was sent to the Guardian Council for review, despite being initially rejected by Hossein-Ali Shahriari, the head of the Parliament’s Health Commission. This plan was passed as part of the “Youth and Family Support” plan in the Parliament. According to this plan, pregnant mothers will no longer be forced to undergo prenatal screening and various diagnostic tests by the national health network. Instead, voluntary mothers can choose to undergo different tests at a free rate to determine the health of their fetus. According to health experts, the elimination of mandatory screening and the increase in test costs will discourage many mothers from voluntarily undergoing these tests. Many women living in remote and underprivileged areas of the country will also lose access to basic healthcare services during pregnancy. Ultimately, the plan that was passed with the aim of supporting families increases the likelihood of giving birth to a disabled or sick child in a family.

Cancellation of supervision after two decades

The fetal health screening program became mandatory in the country since 2001. Screening and diagnostic tests are performed in the first trimester of pregnancy to detect fetal congenital defects. First trimester screening includes NT ultrasound (measurement of the thickness of the fetal neck skin) and blood tests. These tests are usually done between weeks 11 and 13 of pregnancy. Screening tests determine the likelihood of the fetus having a chromosomal or genetic disorder; for example, abnormal thickness of the neck skin can indicate congenital defects such as Down syndrome. By performing a blood test, the presence of low or high levels of two substances, protein A and hormone hCG, can indicate certain congenital defects. This screening can also determine the likelihood of the fetus having diseases such as Down syndrome, trisomy 18, and 13. Diseases such as trisomy 18 and 13 can lead to involuntary abortion, but without screening, there is a chance of giving birth to a baby with Down

Deletion under the pretext of reducing abortion

Prenatal screening with early detection of diseases provides the possibility of legally terminating the fetus for the patient. Failure to perform timely screening also complicates the possibility of legally terminating the fetus. Khalil Ali Mohammadzadeh, head of the Health Policy Research Center, said in an interview with Tasnim in May of this year: “The government is seeking to reduce the number of healthy fetuses that are mistakenly diagnosed during screening.” But what percentage of pregnant women mistakenly undergo abortion? Ali Asghar Anabestani, a member of the Social Commission of the Islamic Consultative Assembly, also reported in May of this year that more than 300,000 illegal abortions occur annually in Iran; however, no official statistics have been published by the Ministry of Health and Medical Education regarding legal and illegal abortions in the country. According to Anabestani, “About 12,000 requests for legal abortion are sent to legal physicians annually. While the share of legal abortions, based on legal medical

Cost of option

With the availability of pregnancy screening tests, the measurement of fetal health is no longer covered by supplementary insurance and is calculated independently. According to the 1400 tariff, a pregnant mother pays one million and one hundred thousand tomans for a complete ultrasound. Genetic testing costs more than five million tomans. It is obvious that the high cost of these tests discourages many women from voluntarily undergoing them, an option that is emphasized after the removal of screening. In fact, pregnancy health tests have become a luxury service that only a certain segment of society can access. The head of the Center for Health Policy and Economic Research believes that screening for specific diseases is not necessary without a family history and a doctor’s recommendation. According to Mohammadzadeh, undergoing tests is mandatory for mothers over the age of thirty-five, but a mother can choose to opt out. In this case, the mandatory screening for pregnant women over the age of thirty-five is not actually carried out.

Reduced supervision, increased damage

“Alireza Zali,” the president of “Shahid Beheshti University of Medical Sciences” in Tehran, announced in February 2020 that there were 30,000 newborns with birth defects in the country. According to him, about 50 to 90 percent of infant deaths and 45 percent of fetal deaths are caused by genetic abnormalities. He also mentioned a significant number of infants with genetic problems, ranging from three to five out of every hundred births in the country. He attributed the decrease in neural defects among newborns to preconception interventions. While the prenatal screening program is being eliminated, there is no alternative preventive program in place. Despite the mandatory nature of prenatal screening in the past, obstetricians, gynecologists, and health officials report that many pregnant women are not seeking medical care during the COVID-19 pandemic. It is not clear if the fear of contracting the virus, staying at home, and not seeking medical care for prenatal screening has led