“There are not yet universal standards for genetic testing, but a narrow consensus has emerged around specific conditions. The first prenatal diagnosis for Down syndrome was made in 1968. Since then, screenings have become routine for pregnant women in many parts of the world…But people in societies where abortion has been illegal or discouraged have also created local norms, in which decisions are made earlier in the process of family formation, and often more communally...Both of these examples were enacted in relatively small, homogenous communities. But it’s hard to closely follow either playbook in a massive, multiethnic democracy like Nigeria. Instead, over the past half- century, Nigerians have forged their own notions of genetic responsibility.”

“Most Nigerian medical professionals don’t see their goal as zero future SCD cases, but somewhat fewer of them, and a much higher quality of life for those born with the condition.”

“In the United States today, pregnant women can find out whether their unborn child has cystic fibrosis, fragile X syndrome, spinal muscular atrophy, or many other conditions. Prospective parents can quickly determine their carrier status for hundreds of disorders, from primary congenital glaucoma to maple syrup urine disease to a bone disease that increases the likelihood of fractures. People with no thoughts of parenthood, too, can get a basic genetic profile in a matter of weeks; for about two hundred dollars, 23andMe can detect one’s carrier status for over two dozen conditions— and also estimate the likelihood of someday developing breast cancer or Alzheimer’s. Without public health initiatives, it’s unlikely that these advancements will dramatically reduce the prevalence of any particular condition. They will, however, put more people in positions like that of Nkechi and Subomi: having genetic information in the back of their minds while dating, falling in love, and starting a family— and deciding whether they’re willing to intervene on the basis of that information.”

Read more in Harper’s.