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Why is it that people are so obsessed with testing for Downs syndrome, when there are so many other disabilities which cannot be tested for, that are far, far worse?

1005 replies

wannaBe · 15/09/2008 16:50

It baffles me.

When we fall pregnant we are offered tests, and scans, most, although not all of which relate to the detection of Downs Syndrome.

At 12 weeks we are offered a nuchal fold scan to determine the likelyhood of the baby having downs, and women over 35 are routinely offered anmio to detect whether the baby has downs.

92% of pregnancies where Downs is detected are terminated .

And yet there are lots of other disabilities, such as cerebral palsy, autism, other disabilities which cause learning difficulties, which cannot be detected in utero, but which can be much, much worse than downs.

So what is it about Downs that is so scary?

Or would people have far more stressful pregnancies if all disabilities could be tested for, and would they feel that they had to be sure their baby would be perfect?

OP posts:
fivecandles · 17/09/2008 13:04

YOUR experience again riven.

And if I had said that having a teenager is like having a child with severe disabiltiies for life then 1001 people would have jumped down my thoat (and in my view rightly so).

sarah293 · 17/09/2008 13:06

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FioFio · 17/09/2008 13:06

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pagwatch · 17/09/2008 13:07

Everyone posts from their own experience 5 - why is Riven not allowed to.

You wouldn't have got away with the teenager comment as we all know Riven is being funny.
You don't do funny

silverfrog · 17/09/2008 13:08

Thankyou, Littlemydancing, for answering the question. I am sorry for your loss.

I do not think anyone would take issue with a well-researched decision (whichever way the decision goes). But, in most cases, the reasons for testing, and the implications of testing are not fully explained.

In my own case, my midwife tried to scare me into having the triple test when i was pregnant with dd2. Lots of "oh, surely you'll want to know what you'll be facing?" questions, and even on one particualrly memorable occasion, "I bet you'd love to be able to test for autism (dd1's condition)" - said in front of dd1.

I didn't get as far as asking her why she thought I'd want to be able to, I was absolutely speechless, but i'm not sure that the answer would have been a positive one.

She kept on badgering me, as i had been unable to take any folic acid/vitamins (due to hyperemesis) and just kept repeating that there was a higher chance that something might be "wrong" because of this, and that, due to already having one disabled child, I would not be able to cope with another.

That is the type of "information" that was available to me. I researched on my own (as I had with dd1), talked it over with dh, asked any questions we had, and tried to sift through the blatantly biased answers. I am, surely, not the only woman this has happened to. It was scaremongering, pure and simply.

If i had not had the time, or inclination, or even ability, to do my own research, the person that I should have been trusting to be impartial would have been influencing me in very obvious ways. And that si wrong, and leads back to the OP - just what, exactly, is so scary about down's anyway?

sarah293 · 17/09/2008 13:08

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eidsvold · 17/09/2008 13:10

I'm with you wannaBe - do not understand why there is the obsession with down syndrome??

I can understand top for conditions that are incompatible for life. I can understand that it must be a very difficult decision to make However have read stories of woman who have chosen to have their babies and enjoy their lives as brief as that life may be. Not sure I could do it - easy to hypothesise from the outside.

I have faced the very real situation of being told your child has a very serious heart defect that if they survive through the first year of life and the three or more surgeries they would face and make it to teenage years - they will need a heart transplant - hopefully they would be able to have it and survive beyond that. That was a difficult day - dh and I came home and read and waited for a fetal cardiologist appt for a fetal cardiac scan. He is the one who diagnosed dd1's very serious but entirely operable heart defect and told us that if she was born without ds than it would be very very rare indeed. Actually even though dh and I had decided that dd1 would be born and we would deal with each day as it came - I was not scared about the down syndrome. I was more apprehensive about the heart defect BUT knew that we could deal with it.

Funnily enough when we were in London whilst dd1 was having her first open heart surgery at 8 weeks old - we were able to talk with a mother whose little one had the original condition they thought dd1 had. It was just interesting to see her positivity and her ability to reach out to me and put me at ease when I full well knew what she was experiencing was far more serious and life limiting that we would face with dd1 who had down syndrome and a heart defect.

Handing my child over to surgeons twice within 5 days for two open heart surgeries is the hardest thing I have ever had to do in terms of raising dd1.

How ironic - as I type this the closing ceremony of the paralympics is beginning.

fivecandles · 17/09/2008 13:17

Yes, riven, but I don't draw conclusions from my experinence and apply them to other people. And then make judgements about others because their lives are not like mine.

LittleMyDancing · 17/09/2008 13:20

pagwatch thank you for your post - it made very interesting reading.

and it does chime with my experience, that when we were first told the diagnosis for our son (he had hypoplastic left heart syndrome, where the left ventricle does not develop properly) we were both terrified. And all we could contemplate initially was the fear of having a child who needed so much care, so many trips to hospital, and who might die at any moment from something as minor as an infection or a blood clot.

But then we did our research into what it actually meant, and talked to people living with it. And what swung it for us in the end wasn't about whether we were up to being parents to this child (although we were still worried about that) - it was whether we had the right to put our child and our family through the pain and suffering of the amount of serious surgeries (three open heart surgeries minimum, one within days of birth) that this condition required, with very uncertain outcomes. Our fears about whether we would be up to the job receded, the more information we acquired.

Unfortunately, the more information we acquired, the more we became convinced that we couldn't do it to our child, or to our existing DS.

What might seem like very minor things came into it, such as the fact that they don't do these heart surgeries in the city where we live, so within hours of giving birth, I would have had to go to London with the baby, and stay there for six weeks minimum expressing and feeding for the baby, who would have at least one open heart surgery almost immediately and then be in NICU.

This would have caused so much pain not only to the baby, who could easily have died in that first surgery, but to our family - to our DS whose Mummy would suddenly have vanished to London; to DP who runs his own business, but would suddenly have to do all the childcare for DS for six weeks, while trying to keep the business afloat so that we could support our two children.

I'm sure we could have done it, as you say, it's not about being worthy but about doing what has to be done. But the outcomes for this condition remain very uncertain, with survival rates very difficult to gauge beyond the teenage years, and we didn't feel it added up. Another factor, for us, was that babies with this condition will certainly die within days of birth without massive medical intervention. There are no survival possibilities without open heart surgery - so it wasn't about terminating a viable baby with problems, iyswim, but about deciding whether to intervene on such a massive scale.

Sorry, have gone on a bit there, but just wanted to get across that I agree - more information really helps to allay people's fears. And until you're faced with it, as you say, you just don't know how you're going to feel or react or what factors are going to come into it. I always thought I would have no problem with termination for disability. Having gone through the agony of deciding whether to terminate our second son, I'm not so sure any more.

But I would defend to the death people's right to make their own choices, and I think we have to trust people to make those choices in an informed way, while lobbying society to provide the right, balanced, accurate information. And it's a shame that in the case of Down's Syndrome, much of that information is out of date, and based on a 'handed down' fear.

iyswim.

pagwatch · 17/09/2008 13:20

No you don't. You form your own views based on your experience and then expect everyone to agree with them.
And if they don't you go on and on and on and on and on and on......

fivecandles · 17/09/2008 13:21

Along the lines of this is what I chose, this is how I cope, this is how I feel so you must be the same.

And no, I didn't spot the humour in riven's post about the scars her teenager had left her with. Sorry.

fivecandles · 17/09/2008 13:24

'You form your own views based on your experience and then expect everyone to agree with them'

I have said many times that my views are NOT just based on my personal experience and I certainly do not expect everyone to agree with them.

Another crucial difference is that I am respecing everyone's right to make their own choices however different they may be and very much including riven.

Whereas there are people here who clearly do not respect others' choices or even the principle of choice.

pagwatch, hate to point it out to you, but if you don't like this discussion you could always go elsewhere...

pagwatch · 17/09/2008 13:25

LittleMyDancing

no - you haven't gone on at all.
Your post too is interesting to me. The issues you had to face were so different from mine. My DS2 has no health issues at all.

That must have been such a difficult time - I can't imagine. Thank you for sharing your experience. I hope it hasn't been painful to discuss here.

Thank you.

pagwatch · 17/09/2008 13:27

fivecandles
I love discussion
You don't discuss - you just lecture. Endlessly.

And that is the second time you have told people to go away when they don't agree with you.

eidsvold · 17/09/2008 13:27

wannaBe actually statistically where there is real life experience of down syndrome - people who are given an antenatal diagnosis - 66% more likely to keep the baby.

silverfrog when have a nuchal translucency screening as it is called here - I had a genetic counsellor sit in front of me - with dd1 and 2 in the room and try to tell me what it was like to have a child with ds - like dd1 was invisible and the last 4 years of our life was nothing. She then phoned me with my results - we had 1 in 962 chance of having a child with any number of conditions indicated by the nts. She told me that if that was not acceptable than I could book an amnio with her then and there. I had gone from 1 in 52 - due to age and history to 1 in 962. I just laughed and put the phone down on her. Even more angering was the assumption - that result was 'high risk' protocol for that hospital was that 'high risk" I prefer term chance - results would be phoned through to patients - low results would be put in a letter and mailed. So even though as a 38/9 yo woman I got the result of a 26yo - that was clearly still 'high' risk enough in this woman's opinion to warrant a phone call.

This genetic counsellor also told me I was completely wrong when I challenged her on her information regarding nts only screening for down syndrome and that a raised nuchal fold does not indicate any other conditions. Blatantly wrong.

So if you are not internet savvy or you belong to a group that thinks professionals because of some higher education to you know it all - still more common than you would think - then this is the sort of information you are being given.

I was also pissed off with the assumption because I had dd1 I obviously did not know before she was born BUT would definitely want to know prior to having dd2 or 3.

Again - when first pregnant with dd2 - dd1 in the consultation with me - doc wants to send me for fetal cardiac scans, book me a triple test and a CVS thank you very much - because I want to know. Amazed that a Gp that has never seen me or dd1 thinks I want all sorts of testing as I want to know. I asked him what is was that I wanted to know.

See everyone is making assumptions - supposedly educated ( but hey we know that does not me not ignorant) people are making huge leaps - sharing dodgy information SUCH as again GP telling me that my information with regards to the 48% accuracy of the triple test was wrong.

Again - we assume that people do a lot of research and read up about things because that is what we would do - you know what - not true actually. Most people are more than ready to take the word of professionals.

LittleMyDancing · 17/09/2008 13:27

eidsvold - cross posts - just wanted to say I remember you from my threads back when we were going through this, and you were unfailingly helpful and supportive, so thank you.

We took a different route to you and I hope you can respect our choice, but your posts helped us immensely, as did all those who were kind enough to contribute.

pagwatch · 17/09/2008 13:28

Of course you didn't spot Rivens humour.
You don't do humour.

eidsvold · 17/09/2008 13:29

little my dancing was it a HPLH that your child was diagnosed with?? That is what dd1 was originally suspected to have.

LittleMyDancing · 17/09/2008 13:33

Yes it was, unfortunately.

I'm now pregnant again, and about to have our OSCAR scan next week, so a little jumpy. Our chances of another heart problem are around 25/1000 instead of 8/1000, which is the norm for the average woman. And I honestly don't know whether we'd do the same thing again, or what we'd do for other conditions.

Only time will tell.

eidsvold · 17/09/2008 13:34

I personally do not see down syndrome itself as a reason for termination. I have simply been trying to show why it is not something to be feared and despite laying our family life open to the scrutiny of others - NO ONE has answered wannaBE's question or mine as to exactly what it is about ds that is so scary??

pagwatch · 17/09/2008 13:35

eidsvold
I totally agree. We are so quick to assume that our mediacl professionals are absoloutely giving you correct information and that simply isn't true.
When I first took DS2 to the Doctors I suggested that he could be developing autism. The GP told me that the signs of autism would have been picked up when DS2 had his 18 month check so it definately wasn't autism but
" if you keep talking about autism you will make him autistic"

DS2 was diganosed with severe regressive autism about four months later

SixSpotBurnet · 17/09/2008 13:36

eidsvold, I can only think that it is prejudice and ignorance. DS is a visible form of disability, unlike autism, and I think that people make judgements on that basis.

eidsvold · 17/09/2008 13:36

Little - then I know a little of what you struggled with.

FWIW - we have since learnt that my husband has a congenital heart defect and a heart condition that may mean cardiac surgery eventually - only discovered at around 40 yo. That means dd2 and dd3 had a 1 in 50 chance of also having the same congenital heart defect. Dd2 has been given the all clear. Dd3 is not old enough for the best view in order to rule it out.

pagwatch · 17/09/2008 13:37

LMD
congratualtions and good luck with your pregnancy

Eidsvold.
I can't answer as I have no idea.

silverfrog · 17/09/2008 13:38

Littlemydancing - I crossed posts with you on my last post. thankyou for sharing your experience, and thought process with us. I can only echo pagwatch and say that i hope it wasn't painful or distressing to do so.

I do wish that we could have more threads with open discussing of issues such as yours and eidsvolds - times where information is mch needed, but is not neceassarily being shared by professionals involved with your case (or, indeed, sometimes where the professional's info is not accurate - that is, i agree, eidsvold, a very scary notion).

I don't think that anyone on this thread actually wanted it to become a debate on whether termination for disability is right or wrong. Only the people involved in each case can ever know the answer to that. and sometimes it is right for one person where it would be wrong for another, and vice versa.

But, i do think that the thread spiralled off in the direction it did because there were a lot of generalisations early on on how having a disability would destroy family life, without much honesty from the people who were saying this. Thankyou Littlemydancing for your clarity and honesty (don't think i mean that, but can't think of the word I do mean) in talking to us about this.

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