Other doctors said that they had seen couples terminate pregnancies for poor vision, whose effect they had witnessed on a family member, or a cleft palate, which they worried would affect the quality of their child's life.
In an extreme case, Dr. Mark Engelbert, an obstetrician/gynecologist on the Upper East Side of Manhattan, said he had performed an abortion for a woman who had three girls and wanted a boy.
"She was much more comfortable with it than I was," Engelbert said. "I told her if it was a new patient I wouldn't have done it. But my feeling as a physician was that I've accepted the responsibility of being her health care provider. She's not doing anything illegal, and it's not for me to decide."
Perhaps the hardest cases for both doctors and patients come when technology provides enough information to raise concerns about the health of a fetus but not enough to make a conclusive diagnosis. When Tom Horan and his wife learned in April that their fetus' legs were bowed and shortened, they were told that the condition could be healed through braces, growth hormones and surgical procedures in childhood.
But before they decided what to do, a closer examination by a specialist with a 3-D ultrasound machine revealed other deformities: The left arm was missing below the elbow, and the right hand was only partially developed. Moreover, sometimes such features are a sign of a neurological impairment, the doctors told them, but in this case it was impossible to tell.
"Our main concern was the quality of life that the child would have growing up with such extensive limb deformities, even in the absence of cognitive problems," Horan said. He and his wife, who have three other children, were reared Roman Catholic and had never considered terminating a pregnancy. Yet even his father, Horan said, who had long been opposed to abortion, supported their decision to end the pregnancy.
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