A reader writes:

I am a maternal fetal medicine specialist (high risk obstetrics) working in the midwest. Talking to women about why they make their decision to have amniocentesis and continue the pregnancy there are some common reasons put forward:-

1.) Many months of anxiety and concern are avoided by a certain diagnosis now rather than certain diagnosis at delivery. Many women say they could not enjoy any aspect of their remaining pregnancy without knowing the diagnosis.

2.) Family, friends and support mechanisms can be prepared

3.) The woman assumes some control over her situation and knows what she has to deal with

From the medical perspective the pregnancy may be managed differently. For example some Downs babies develop a bowel blockage that is usually not seen until 28 weeks. Many Downs babies have heart defects and abnormalities of growth. Such factors may well lead to delivery in a specialised unit rather than a small town.

On the face of it Sarah Palin's actions may appear contradictory, in my experience many women who would not dream of terminating a Downs fetus do exactly the same thing. 

I'm grateful for the input. But again: no inherent risk to the life of the mother and an increased risk to the unborn child. And if all of this is designed to prepare for labor in a specialized unit, why did Sarah Palin not seek one? There was one right nearby in Texas where her water broke at 4 am. It's the Children's Medical Center:

Children's is accredited by the Joint Commission, and both U.S.News & World Report and Child magazine have named Children's as one of the nation's top pediatric providers.

So if the main reason for amniocentesis is to prepare for a grueling labor, how do you explain the bizarre behavior of Sarah Palin in the 24 hours after her water broke and she felt contractions?

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