We had a patient recently who tried for over a year to become pregnant and was ecstatic to get through the first trimester. When her early prenatal testing revealed a diagnosis of Down Syndrome, she decided to continue the pregnancy. However, further testing revealed a heart defect associated with the condition—one that would have significant consequences after birth. At this point, she decided that the most loving thing she could do was have an abortion. Our patient was able to make this complex combination of decisions because she could have honest discussions with her providers throughout the course of her pregnancy. Passing the Down Syndrome ban in Pennsylvania would interfere with the caring, open dialogue she was able to have with all of us.