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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 Everything I thought I knew about Down's syndrome was a smattering of outdated stereotypes, all of which have subsequently been proved wrong.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:
CoteDAzur · 28/11/2015 22:19

I didn't mean to offend you or anyone else, Dixie. I am sorry if you thought that is what I was doing.

DixieNormas · 28/11/2015 22:30

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zzzzz · 28/11/2015 22:36

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CoteDAzur · 28/11/2015 22:49

As I said, if some terms I used caused upset to some people here, that wasn't my intention and I apologise.

This is not the SN board, where you might reasonably berate people for not using exact terminology and knowing every detail of each disability, or ask "Why are you here?". This is a thread where I expected to talk about the issues around abortion of fetuses with DS.

DixieNormas · 28/11/2015 22:52

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CoteDAzur · 28/11/2015 23:01

"you think the world would be better if they [people with disabilities] hadn't been born."

I don't, actually. I don't think the world is a worse place because there are people with disabilities in it, and some of them (like Stephen Hawking) have contributed significantly to it. So no, you are wrong.

However, I would not knowingly continue with a pregnancy where the fetus has a serious chromosomal abnormality such as Down's Syndrome or Edwards' Syndrome. That is because I don't see the fetus as a baby and would prefer to abort and try again. Generalising this and assuming every fetus with DS is diagnosed prenatally and every pregnant woman agrees with me on this, then DS would presumably be eradicated (as in the OP), and I don't see the problem with this, either. This doesn't mean I believe the world would be a better place if all people with DS currently alive suddenly disappeared. Not at all.

CoteDAzur · 28/11/2015 23:07

"It's a guest post, so a women on here who is talking about her child who has ds. I would expect some sensitivity even when talking about abortion."

The guest post itself talks about abortion. I'm sorry but what is the point of a guest post if not to start a discussion?

This is not a support thread. I didn't barge into the SN board and start talking about abortion on a thread started by a parent looking for support. If someone finds talk of abortion upsetting, they really should not be following a thread titled Guest post: "I fear the eradication of Down's syndrome" that is clearly going to be about aborting fetuses with DS.

DixieNormas · 28/11/2015 23:15

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zzzzz · 28/11/2015 23:30

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Devilishpyjamas · 28/11/2015 23:37

Edward's & Down's are hardly the same kettle of fish. Which is why I was banging on about the difference between MLD & SLD earlier. There seems to be this assumption that people with DS are terribly intellectually disabled, whereas within the world of learning disabilities -that's rarely the case. They're often - relative to others with LD's - very able.

Someone with Edward's would have profound and multiple learning disabilities (PMLD). They're really facing a very different (& in the case of Edward's, much shorter) life than someone with DS. I don't suppose the OP was really thinking about Edward's when talking about DS.

Devilishpyjamas · 28/11/2015 23:42

I think if you (one) lump DS in with conditions that cause profound and multiple learning disabilities (to be clear I am using PMLD in its official sense) you're doing everyone a disservice really. People need to make such a difficult decision on accurate information and that includes being clear on the difference between mild LD's/MLD/SLD/PMLD. Otherwise you risk finding out you made the wrong decision for you too late.

CoteDAzur · 29/11/2015 08:32

"you do realise that most people find out at 20 weeks at the earliest"

I don't know how these things happen on the NHS, but in France I had amnio at 18 weeks and received the preliminary results (of T18 and T21) in a few days. That was 10 years ago. Unless technology has regressed in the past decade, I wouldn't expect to wait until 20 weeks.

No doubt it would be a traumatic experience but the decision itself was not that difficult for us. DH and I had decided beforehand that is what we would do and it was a "discussion" that took about a second to settle.

fanjoforthemammaries7850 · 29/11/2015 08:41

Well I think that explains your reluctance to listen to people explaining that DS doesn't necessarily mean a very low IQ and lack of a fulfilling life maybe. As you made your decision based on those facts?

fanjoforthemammaries7850 · 29/11/2015 08:41

This is not an attack but an observation

CoteDAzur · 29/11/2015 08:51

Devilish - Clearly I didn't equate T18 with T21 and do know that they have very different outcomes and prognosis. I said I would terminate for not only T21 but also for other serious genetic disorders that severely limit a child's prospects. Not that they are all the same thing.

I don't know know why you would think saying so is a disservice to others or why you feel my priority while making such an important personal decision would be service/disservice to strangers who should & would inform themselves for the same personal decision.

fanjoforthemammaries7850 · 29/11/2015 08:56

Sorry I missed the additional T21 diagnosis there. Which changes things

But I assume that it been just T18 you'd have made same decision. Entirely your choice but I could see why you then wouldn't want to read about it not being very life limiting.

fanjoforthemammaries7850 · 29/11/2015 08:57

Sorry..just T21. Got my Ts mixed up. Am unwell today.

CoteDAzur · 29/11/2015 09:05

"people explaining that DS doesn't necessarily mean a very low IQ"

I doubt if anyone actually said that. The expected IQ of 50-60 of people with DS is called "extremely low" in IQ classification.

fanjoforthemammaries7850 · 29/11/2015 09:08

OK you hang on to that

fanjoforthemammaries7850 · 29/11/2015 09:09

People have explained why it's not as simple but obviously there is no point.

Devilishpyjamas · 29/11/2015 09:37

Oh right it's just the way they were mentioned in the same breath as if they were equivalents.

Never mind, each to their own.

Stillwishihadabs · 29/11/2015 09:45

Someone who scores 70 on today's IQ tests would have scored 100 in 1910 and 85 in 1940 - google the Flynn effect. Disabily is subjective.

BishopBrennansArse · 29/11/2015 09:53

Oh right. So it's a given that an individual with Downs is going to have a specific iq within a 20 point range then?

Um.... No.

It's a given they'll have cardiac issues?

Nope again.

DS has a very broad spectrum of associated issues. Where there is spectrum you find multiple variants on each issue.

There is no typical person who has Downs. Just like there's no typical person who has ASD.

Problem is I don't think that's highlighted anywhere near enough. I think the common perception is of the worst case scenario - when it comes to time to choose - and no many parents probably wouldn't choose the worst case scenario for their child.

Before I had kids a friend of mine had a child with autism. I didn't know how she did it, knew there was no way I could cope with that.

All three of my children have autism. Yes life is difficult due to the monetary side and societal expectation but I will never, ever regret my children.

If I'd known antenatally maybe my preconceptions about what autism is would have meant my children wouldn't have been born. That now horrifies me. Because our lives as a family are happy, it's outside the home the problem lies.

fanjoforthemammaries7850 · 29/11/2015 09:56

Also there is the fact that even if someone DOES have a very low IQ that is not an indicator of their quality of life.

DixieNormas · 29/11/2015 09:57

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Message withdrawn at poster's request.