Book Reviews The Heart and the Abyss: Preventing Abortion, Ward Biemans SJ (Ballarat, VIC: Connor Court Publishing, 2016), 390 pages. How does an expectant mother cope with receiving the results of a prenatal scan identifying that her child has Down syndrome, or spina bifida, or a cleft lip, or some other condition? How does the expectant father cope, if indeed he is informed? And how do the medical and related professionals deal with the event? Is the reaction such that the situation is problematised, perhaps by those more inclined to focus on the available options provided by the clinic than on the parents’ need for time to absorb the news and their need for support and counselling? Is abortion offered immediately as a solution? Are alternatives considered in such a way that the parents genuinely have the space and the freedom to make an informed and responsible decision? One of the many empirical studies reported in this book is a survey of 962 Dutch women entitled ‘Informed decision-making in the context of prenatal screening’, published in 2006. Matthijs van den Berg, the lead researcher and lead author of the study, outlined the three criteria applied in determining whether decision-making could be considered as ‘informed’. First, concerning the choice between accepting or declining prenatal screening, whether it was based on knowledge of the characteristics of the tested disorders, the screening test itself and the meaning of the possible results. The second criterion for an informed decision required evaluation of alternative courses of action, estimation of consequences and weighing of arguments regarding advantages and disadvantages of various options. The third criterion was that the eventual course chosen be consistent with the decision-maker’s values (p.242). The outcome of the research is that forty-nine per cent of the women ‘could not be classified as having made an informed decision: sixteen per cent due to insufficient knowledge, twenty-one per cent due to lack of deliberation and twelve per cent due to value inconsistency’ (p.242). (I reproduce the information as presented by Biemans: if there is overlap between the cases of criteria violation, then it would not be correct to sum these percentages to a total of forty-nine per cent. After all, it is likely that insufficient knowledge would be accompanied by lack of deliberation and value inconsistency. But 228 Studies • volume 106 • number 422 Summer 2017: Book Reviews I assume the statistical work is reliable and the headline figures arise from sorting instances in terms of the outstanding deficit). Other research reported on the involvement, or lack of involvement, of the male partner in the decision-making. Where the child’s father was involved, he tended to rely on the mother for information and, in the case of screening for cystic fibrosis, unsatisfactory levels of understanding were revealed in other research. Given these reports of the poor quality of the decision-making involved, it is startling to read of the comparable figures in both Britain and the Netherlands of the high percentage of decisions for abortion. Eighty per cent to ninety-five per cent opt for an abortion after the detection of Down syndrome and eighty per cent opt for abortion after the diagnosis of spina bifida (p.243). Biemans draws attention to the medicalisation of pregnancy and childbirth and to the provision of legalised abortion services through the health care systems of both countries (p.239). This raises the question of the influence brought to bear on the decision-makers, first by the availability of abortion as an option, and second by the tendency of medical personnel to think only of those courses of action which are of a medical or surgical nature. The principal focus of this book is a comparison of the implementation of legalised abortion in both the United Kingdom (except Northern Ireland) and the Netherlands. As the subtitle signals, the practical aim of the work is to prevent abortion. The concluding seventh and eighth chapters explore ways in which the demand for abortion might be reduced, and the number of abortions lessened also by the provision of other supports for pregnant women. The author takes a stand against abortion, based on...