Last Monday, CBS News ran a report on Down syndrome in Iceland. There, since screening tests for pregnant women became available in the early aughts, nearly 100 percent of women who found out their fetuses probably had the chromosomal abnormality terminated their pregnancies. Only one or two babies are born with Down syndrome each year, usually to women who got an inaccurate test or were one of the 15 percent or so who opt not to be screened. The U.S. rate of Down syndrome births is three to six times higher.
Social attitudes toward abortion and toward the disability itself certainly play a role in differing rates of Down-related terminations. The CBS News segment quoted one medical counselor—an employee at the Reykjavik hospital where 7 in 10 Icelandic children are born—who said that these parents have “ended a possible life that may have had a huge complication…preventing suffering for the child and for the family,” a characterization most disability-rights advocates would dispute. In one sense, abortions sought after a positive Down screening could be part of a self-perpetuating cycle: If Icelanders meet few to no people with Down syndrome in their lives, they may be less confident about raising a child with a condition that’s unknown to them, leading to more Down-related abortions and fewer people with Down syndrome for future parents to meet. Advocates contend that a society that encourages women to terminate fetuses with Down syndrome is one that ascribes less value to a child with Down syndrome, which leads to discrimination against people living with the condition.
In the U.S., anti-abortion leaders are hijacking this rhetoric of the disability rights movement to argue against women’s rights to choose their own future for their families and bodies. On Tuesday, the Ohio Senate had a second hearing for a bill that would charge doctors with fourth-degree felonies if they performed abortions on women who sought the procedure because their fetuses had a high probability of Down syndrome. Physicians would have to fill out “abortion reports” after each procedure, certifying that they had no idea whether or not the patient wanted to terminate her pregnancy due to a Down screening. Supporters of the bill have likened Down-related abortions to “eugenics,” saying women who choose abortion after a positive Down screening are engaging in discrimination.
Laws that try to prohibit women from accessing a constitutionally protected medical procedure because of their reasons for wanting to access it are notoriously difficult to enforce. Several states have passed sex-selective abortion bans, which are based on a racist myth that Asian-Americans are aborting their female fetuses at unconscionable rates, but there’s no good way to elicit proof of why a woman is seeking an abortion. That should be a clear sign that the reasons shouldn’t matter: For abortion-rights advocates, there’s no acceptable reason to deny a woman the right to bodily autonomy; for abortion-rights opponents, if abortion truly is murder, as they claim, there should be no acceptable reason to allow it. It’s the same for politicians who boast of their anti-abortion bona fides, then allow for exceptions in cases of rape and incest. If their arguments were consistent, they’d allow for no such concessions—but they know most Americans support such exemptions, so they sacrifice intellectual and moral purity for the popular vote.
Jeanne Mancini, the president of the March for Life, laid out her argument against Down-related abortions in a Washington Post opinion piece on Thursday. In it, she claims a medical student told her that his professor taught that doctors have a “responsibility” to encourage abortion after a parent’s prenatal Down diagnosis. She cites surveys that have shown that people with Down syndrome generally report high life satisfaction, and that their families report high levels of “personal fulfillment.” “Not only are people with Down syndrome happy, but they also bring a great deal of happiness to their friends and family members,” Mancini writes. “Indeed, the survey found that 88 percent of siblings of children with Down syndrome feel that they are better people for having had their brothers and sisters.”
Reducing the life purpose of a person with Down syndrome to a learning opportunity for her siblings is just as damaging as assuming that people living with Down are “suffering,” as the Icelandic doctor put it. There is no inherent moral good in increasing the number of people with a given genetic condition, just as there is no inherent moral good in eliminating that condition from the population. Doctors should never press women one way or another on abortion—a fact as applicable to Down-screening counseling as the dozens of state laws that force physicians to tell their patients flat-out lies to discourage them from terminating their pregnancies. The sponsors of the Ohio bill had parents of kids with Down syndrome testify at Tuesday’s hearing, as if the existence of their happy, healthy children justified the curtailing of women’s constitutional rights.
A study of studies conducted between 1995 and 2011 found that between 50 and 85 percent of people who receive a positive prenatal Down screening terminate their pregnancies. For the most part, in other words, the happy lives Mancini describes in her piece are the lives of people who chose to carry their pregnancies to term, especially if Down-related abortions are as pushed upon women as she claims. These are not people who, faced with unwanted pregnancies, are forced to carry them to term against their will. Studies have shown that women denied abortions that they want are more likely to be in poverty, more likely to stay with abusive intimate partners, and more likely to have neutral or negative future outlooks than women who get the abortions they seek. Women turned away from abortion care are also less likely to have “aspirational one-year plans,” an important indicator of hope and confidence, than those who were successfully able to terminate their unwanted pregnancies.
Bills like Ohio’s would introduce a veil of suspicion into the doctor’s office, making medical providers second-guess their patients’ motives instead of giving them non-judgmental care. Women’s rights and disability rights are not mutually exclusive movements; they intersect and inform one another in important ways. Anti-abortion activists are stoking fear in advocates of the latter in hopes that they’ll join an assault on the former.