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Guest post: "I fear the eradication of Down's syndrome"

999 replies

MumsnetGuestPosts · 16/11/2015 17:29

On the day Natty was born, I wasn't sure I was up to being her mother. Ignorance took over. Everything I thought I knew about Down's syndrome was a smattering of outdated stereotypes, all of which have subsequently been proved wrong.

In eight years, we have come so far as a family, risen to challenges, endured heart surgery, made adjustments and learnt to slow our pace and live in the moment. I wouldn't change any of it. I am a better person now. The pregnant woman I was, whose heart was filled with fear at the words Down's syndrome, now shakes her head in disbelief.

I've been bleary-eyed over research for this post. And, in fact, as I rose at 5.30am, drafts of what I would write very much in my mind, there was one member of our busy household who noticed my pensiveness. Natty drew me down to her face level, looked intuitively at me and said 'It's OK Mummy.'

I held her so tight, and made a silent promise into her warm hair, a promise that I would do my best to convey her worth to the world.

Because while we praise advances in healthcare and women's control over their reproductive lives, there is an important ethical debate I fear is being overlooked.

A new non-invasive prenatal test (NIPT) could help identify women whose babies have Down's syndrome. The test involves taking a sample of blood from the mother and it uses this to detect the baby's DNA.

At the moment, the NIPT test is available privately, but it could soon be rolled out by the NHS as part of their population screening programme. The UK National Screening Committee has just ended consultation over offering it - it can only be added to the programme if there is a beneficial reason for doing so.

However, there is no health gain in diagnosing Down's syndrome during pregnancy. It cannot be treated or prevented. It simply allows parents to decide whether to continue a pregnancy to term or not.

There are ethical implications to genetic testing, but no easy answers. The UNESCO International Bioethics Committee says that genetic testing can offer women the right of choice. However, it could also become routine that ill or disabled children are not to given the choice of birth at all.

So giving women choice whilst not devaluing individuals with Down's syndrome is a fine line to tread.

We must ensure that parents are given unbiased, updated information in order to make informed choices. There can be no assumption that those with Down's syndrome are not compatible with life - or worse, that they are too costly to have a right to life.

We are promised that the new NIPT can allow parents to be prepared for their baby's arrival and that it will not increase termination rates. However, in countries where Down's syndrome screening has been standard for years, termination rates stand at almost 100%. Are these tests being sold as a kind form of early euthanasia to trusting expectant parents - and will a whole genetic group of people be targeted in the process?

The support networks we have in place simply aren't as sophisticated as the genetic tests being considered. We must explain test implications and outcomes, support those who choose a termination and give equal care to those who choose to continue their pregnancies. We need charities that aren't partnered with the test manufacturers.

If parents are rushed into terminations, or asked repeatedly if they would like to end their pregnancies, then we are certainly sending out the message that some lives are worth a great deal less than others.

We need the screening committee to welcome input from parental groups and self-advocates. We need to match up the wonderful examples of best practice by bringing committed midwives and learning disability nurses together, and we need to accept the value of difference.

Society has come a long way from the days when children with Down's syndrome were institutionalised with little or no love, educational support or quality healthcare. We hope Natty will find employment she enjoys, have a partner of her choosing, a social life fuller than ours and live a long, healthy life independently with support.

I cannot bear to think that one day I will have to explain to Natty why others think her adored life is not worth living, or even justify her very existence. But here I am, already doing just that.

And, most of all, I fear that one day I will be grieving, as others celebrate the eradication of all children like my beautiful daughter. No Natty, maybe it's not OK.

The BBC is making a documentary about Down's syndrome, which Hayley Gowleniowska is contributing to. If you are affected by the tests and interested in an initial off-the-record research chat, please contact Clare at [email protected].

OP posts:
DixieNormas · 18/11/2015 22:00

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Message withdrawn at poster's request.

Brocklady · 18/11/2015 22:01

Hoot Flowers

Owllady · 18/11/2015 22:02

Quite a few people with disabilities themselves have posted on this thread hoot

Alisvolatpropiis · 18/11/2015 22:04

I didn't read Fanjo's "it's a shame" as being judgemental and am not on the same side of the fence as her in this discussion.

5madthings · 18/11/2015 22:05

Wow this is getting a bit heated, understandably so.I guess.

My view is that if women can find out earlier in pregnancy and the tests are less invasive with less risk that is a good thing. But it has to be an informed choice to have the test and afterwards if there are any issues that require choices to be made.

Currently I would say the tests are presented as what you do. The same as a lot of things to do with pregnancy and birth tbh and women need and deserve better than that. So the medical community should be making sure women are given good unbiased information to help them make the choices they need to make.

I am pro choice, as early as possible, as late as necessary. I am uncomfortable that abortion laws do discriminate against disabilities but I would just remove the 24wks limit and allow abortion for any reason after that point, so there is then the sane rule for all fetuses. I understand that late term abortion is a sensitive subject and makes peoole uncomfortable but I believe in a woman's right to bodily autonomy.

I chose to have nuchal scans etc and today had my twenty week scan knowing if it showed any issues we would have had further testing. What choice I would have made with the information I got I can't tell you as we have been fortunate not to have to go down that path.

I do however have a son with asc and other health issues, his life is absolutely worth living of course, he brings me huge joy and is amazing. But do I hate seeing him struggle? Absolutely and he is high functioning and his health issues, related to hypermobility and some stuff as yet undiagnosed are mild in the big scheme of things. But he does suffer and if I could click my fingers and take thst away I absolutely would. I struggle as some aspects of his asc are kind of part of who he is... But god I wish I could make life easier for him.

Really I support women having choices, having good informed ante natal care and then everyone having a good supportive society to live in. I hate the fight and it's a daily fight, to make sure my son gets his needs met at school. I hate that despite reading and learning and educating myself I still feel like I fuck up and get it wrong some days. There are plenty of ways society needs to change and improve, removing choices for women is not one of those ways.

Devilishpyjamas · 18/11/2015 22:06

We didn't make a choice either. I'm not sure what you're saying hoot. Should we have killed my son at 2 when we found out he was disabled? Or at 5 when we discovered that disability was severe?

Tbh until the last year his life has been very good despite his severe disabilities. This last year his disability has made him very miserable indeed. Through the support of those around him we've managed to get some aspects of his life back on a more rewarding level - I hope he's back to looking forward to some parts of it now & we keep trying to do the same for the rest of his life. I'm not sure what else we can do.

zzzzz · 18/11/2015 22:06

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fanjoforthemammaries7850 · 18/11/2015 22:09

Argh I need sleep.

But I am not on a side of the fence.

I have said repeatedly I am pro choice.

So are you not pro choice then Alys?

Ridiculous misinterpretation of my posts.

Now better hide the thread or will be defending self all night .

Devilishpyjamas · 18/11/2015 22:10

Although we did have ds3 knowing he was at higher risk of a severe disability we couldn't test for (he's fine) - so I guess we made a choice there.

fanjoforthemammaries7850 · 18/11/2015 22:10

Sorry..Alis not Alys

5madthings · 18/11/2015 22:15

And of course there are things we can't test for and peoole can become disabled at any point in their lives, we had no idea ds2 would have asc or develop the health issues he has done as a teen. Yes we cope, we have to do. But no I wouldn't choose this life for my son if I had a choice. I wouldn't want to have not had him, he is bloody amazing but god I wish things didn't have to be difficult for him. And they are difficult FOR Him. I may find it frustrating and feel emotional, upset, exhausted etc. But he is the one living with his asc, he doesn't know any different. But he does know he is different and thst he struggles... If society were more accepting he would struggle less but the sensory issues he has etc would still annoy and anger him.

I don't see ridding the world of some things as a bad thing, vaccinations have removed illness. I would bloody love a cure for cancer or parkinsons and cystic fibrosis and any number of other conditions that make peoole suffer. I don't have enough personal experience of down syndrome to comment but there are plenty of things I would rid humanity of if I could. That doesn't mean I would get rid of living peoole with those conditions but if you could treat them in utero or do gene therapy etc hell yes. Sadly we can't yet, but we can test for some conditions and we have to allow women the choice.

Arabidopsis · 18/11/2015 22:28

I find it astonishing that people talk about wanting people to be better informed about things such as downs syndrome but only share stories at the most positive end of the spectrum. Happy children who can grow up to leave a semi independent life. No mention that many cases of T21 will not result in a live birth, many more will not make it past a year old due to complex heart defects or other co-morbidities. In a lot of cases a diganosis of T21 IS a diagnosis that is incompatible with life. It is not always a mild disability.

Devilishpyjamas · 18/11/2015 22:33

I think that's a rather out of date view Arab. The very low life expectancy was because heart problems didn't used to be treated in people with DS. Remember Craig the big brother winner donating his winnings so his friend could get heart surgery in the States - that is now treated here, but that shows you how recent that change is. People with learning disabilities didn't even have a right to education until the 80's.

FWIW my son is less able to access life than anyone I have met to date with DS. I'm not talking about the positive end of any spectrum - he is what I thought my worst nightmare was.

HootOnTheBeach · 18/11/2015 22:35

My reply was aimed at the blog/OP as I only read up to page 3 before my blood started boiling. Apologies if that was not clear.

Of course once the baby is here most just get on with it. But those who know and choose to carry on with the pregnancy like to argue that they will love the baby no matter what. And that's lovely. But having lived through decades of pain and misery I am telling you that it's not enough. It is a selfish choice which to me seems to only placate your conscience. It ignores me and my experience. It ignores the experience of thousands of disabled people who suffer needlessly.

Had my mum had tests or (were tests sophisticated enough been available) I wish she had aborted me and spared me all of this.

I know it's not fair to blame her but this is where my frustration has been directed for as long as I can remember. I might have picked up on how much she struggled and how hard she pushed me to have a 'normal' life and do 'normal' things even when I did not want to or was not able to.

I don't tend to be so vocal about my views in real life because it makes people uncomfortable. They don't want to know that I am in pain, that I am uncomfortable, that I am having a particularly bad day - physically or mentally - because there is nothing they can do to help and I'm not about to commit suicide to escape this.

But if being this frank can make even one person consider the life their disabled foetus would lead...

Devilishpyjamas · 18/11/2015 22:46

Well there's a whole discussion around whether healthy people with learning disabilities 'suffer'.

My son had suffered on account of his learning disabilities in this last year. But he'd had 15 years prior to that when he really didn't.

I really don't think living in constant pain is the same as living with a learning disability. That doesn't mean that people with LD's can't suffer due to their LD (see what I said about my son) - but the LD bit is not really comparable to being in pain.

Arabidopsis · 18/11/2015 22:46

No, not out of date. While it is true that life expectancy has increased for those children born with what are now repairable heart defects the sad reality is that the majority of T21 cases will not result in a live birth. Circa 70% iirc.

DixieNormas · 18/11/2015 22:46

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DixieNormas · 18/11/2015 22:47

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Devilishpyjamas · 18/11/2015 22:48

I personally (not passing judgment on anyone else) would be far more likely to terminate for reasons of health than reasons of learning disability or sensory impairment. Well I know I wouldn't terminate for LD or VI or deafness, but I can't be as certain about health. They're different issues to me.

Devilishpyjamas · 18/11/2015 22:53

Arab - I was talking about life expectancy (which has increased from around 25 to around 60 since the 1980's - mainly due to treatimg heart defects). It's true that many t21 foetuses will spontaneously abort - but usually very early on in pregnancy. I had an 8 week miscarriage, I've always assumed it may well have been some sort of chromosomal abnormality.

LyndaNotLinda · 18/11/2015 23:03

Hoot is saying what I said earlier when talking about my DS and what another disabled poster Cintia69 also said. That being the person with the disability isn't always very fun. That the 'lovely community' of people you get to meet as a parent of a disabled child actually might mean jackshit to the person who's actually disabled.

And while I know that in all these cases, these aren't disabilities that could have been tested for in utero, that's what we're talking about - testing for disability in utero. And the discussion has widened out far beyond DS so I think it's really poor form to dismiss Hoot's post. I also think it's very poor to dismiss the voice of one of the very few disabled people who've posted on this thread.

I think my DS is amazing and he brings a lot of people a lot of joy because he has such a unique take on the world. But it's not about me or the other people. He's fucking miserable a lot of the time because of his disability. People with his disability have very poor life outcomes. They are much more likely to have depression and addiction issues. They find self-care and finding meaningful paid employment difficult. They are very unlikely to form meaningful relationships. The future could be very bleak for him.

I know that if he could medicate his disability away, he would. But he can't and he's stuck with it. And he resents me for it. Of course he does! I'm his mother.

Incidentally, I had no antenatal tests because I would not have terminated for a disability. Ironically, he has really given me a different perspective.

DixieNormas · 18/11/2015 23:10

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Devilishpyjamas · 18/11/2015 23:12

Maybe it's about viewpoints. My son will never have a job, will never get married, needs 24 hour 2:1 care, he'll never walk down the street alone. That doesn't make his life automatically awful. Until the last year it's been very good indeed.

I see his life a fiercely worth living. Yes he's had a bloody awful year - but his NT brothers aren't protected from bloody awful years either (actually ds3 has had an awful year as well).

For me it just comes down to value. Terminate if you want to (as I said I support termination to birth for any reason) - you don't have to justify it to anyone - but don't give the 'all encompassing awfulness of life with LD's' as your reason because that does pass judgment of the lives of those with LD's. I know people with DS who live very good lives indeed & I know people without disablities or health issues who have a dreadful time. Sometimes it's the luck of the draw & nothing to do with the challenges faced.

LyndaNotLinda · 18/11/2015 23:14

Are you talking to me Dixie? It's something that DevilishPyjamas said. About the loveliness of the SN community.

There have been a lot of positive posts on this thread about the benefits for the family of having a child with a disability. That seems massively wrong-headed to me

LyndaNotLinda · 18/11/2015 23:17

And what's going to happen to him when you're dead Devilish? Who's going to look after him?

My DS is okay at the moment because I fight for him. But I'm not going to be around for ever. Who's going to fight his corner then?

We do not live in a kind world.