- Paul Stark
Is abortion justified after an adverse prenatal diagnosis?
Sometimes, in the course of pregnancy, testing reveals a genetic or developmental problem with the unborn child—a "defect," "abnormality," "anomaly," "deformity," or condition "incompatible with life" (an odd way of saying "fatal").
These revelations can be gut-wrenching. Many people think abortion is justified. In fact, medical professionals have frequently presented abortion to parents as the only or default option.
In a speech earlier this year on the floor of the U.S. Senate, Sen. Elizabeth Warren pointed to such "devastating stories" as a reason to oppose any legal limit on abortion late in pregnancy. Denying abortion would be "cruel," she said.
Is she right?
A disability, disease, or deformity doesn't justify killing
An unexpected prenatal diagnosis often isn't fatal. Non-terminal conditions range from cleft palate and Down syndrome to heart defects and sickle-cell disease.
These diagnoses pose real challenges to families. But is abortion an appropriate response? Not if the unborn child is a valuable human being.
Parents may not kill their toddler if they learn that she will be less intellectually capable than other children. They may not execute a 10-year-old with spina bifida because they think she would be better off dead. They may not terminate a Down syndrome teenager because raising her has become too burdensome.
If unborn human beings have a right to life, like toddlers, 10-year-olds, and teenagers, then killing them because of a disability or disease is equally unjustified.
Of course, some people think that unborn humans (whether or not they are sick or disabled) do not have the same value and right to life as older human beings. But this is only a different form of wrongful discrimination. Just as ability and health are irrelevant to human rights, so too are age, size, location, and the desires and decisions of others.
All human beings are equal by virtue of their shared humanity. That's why killing disabled, sick, or deformed people, whether in the womb or out, is unjust.
The fears that drive abortion, moreover, are often unfounded. Many parents worry about the difficulties of raising a child with special needs. But caring for sick or disabled children, though hard, is enriching and rewarding, as many parents and caregivers attest.
Researchers at Boston Children's Hospital found that 79 percent of parents of children with Down syndrome say their child has given them a better outlook on life. Only 4 percent regret having their child in the first place.
"[T]he experience of Down syndrome is a positive one for most parents, siblings, and people with Down syndrome themselves," the researchers conclude.
Some parents express concern about their child's future "quality of life." Yet people with disabilities or medical limitations live meaningful and often happy and fulfilling lives. A major study published in the American Journal of Medical Genetics, for example, found that 99 percent of people with Down syndrome are happy.
"In our [survey], people with Down syndrome encouraged parents to love their babies with Down syndrome, mentioning that their own lives were good," the researchers note. "They further encouraged healthcare professionals to value them, emphasizing that they share similar hopes and dreams as people without Down syndrome."
Frank Stephens, a man with Down syndrome, testified last year before a congressional committee. "[People with Down syndrome] are the canary in the eugenics coal mine," he said. "We are giving the world a chance to think about the ethics of choosing which humans get a chance at life."
Everyone deserves that chance.
A life-limiting condition doesn't justify killing
What about when a child in the womb is diagnosed with a lethal condition, such as anencephaly, Trisomy 18, or Potter's syndrome? She will likely die before, during, or shortly after birth. Surely, many people think, a pregnant woman should not have to endure such a traumatic pregnancy.
But the fact that someone will soon die is no justification for killing her. We may not kill terminal patients in the cancer ward or elderly grandparents in the nursing home. Indeed, all of us will die at some point in the future, but we ought to be treated with dignity and respect in the present.
Natural death (by disease) doesn't make unnatural death (intentional killing) okay.
Nor is the alleviation of trauma a good reason for killing. Imagine a father whose 5-year-old daughter is dying of leukemia. This is an agonizing experience for him. May he end her life to "get it over with," avoid painful conversations when someone asks about his family, and "move on" to his next child? Of course not.
If unborn human beings really matter—like cancer patients, grandparents, and 5-year-old daughters—then they likewise may not be killed on account of a terminal condition.
Moreover, abortion in these circumstances does not actually serve the emotional and psychological health of pregnant women. Research suggests that it does precisely the opposite.
A study in the Journal of Psychosomatic Obstetrics and Gynecology, for example, concludes that abortion after a terminal diagnosis is a "traumatic event" that "entails the risk of severe and complicated grieving." A 2016 Swedish study found that "women who terminate a pregnancy due to a fetal anomaly express considerable physical and emotional pain, with psychosocial and reproductive consequences."
Another study, published in 2015 in the journal Prenatal Diagnosis, compared women who aborted because of a fatal condition to women who did not. "Women who terminated reported significantly more despair, avoidance, and depression than women who continued the pregnancy," the Duke University authors conclude. "There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis."
Abortion in life-limiting cases isn't healthy for pregnant women—or for their unborn children.
A better way: Dignity, equality, and love
Human beings in utero are valuable members of the human family. We ought to treat them accordingly.
That means we should respect their dignity, recognize the equal rights of those who have disabilities or diseases, and love them even when their time is short. It means that, at the very least, we should never choose to dismember or poison them to death.
None of this, of course, is to deny the challenges of an adverse prenatal diagnosis. But support and options are available. Numerous organizations and programs help families deal with unexpected diagnoses. Many couples seek to adopt children with special needs.
In the case of a life-limiting diagnosis, perinatal hospice and palliative care is a healthy alternative to abortion. It acknowledges terminally ill unborn children as real patients and real children. It gives parents time to process and to make memories. It provides support and closure to grieving families.
One study found that 75 percent of parents choose this option if it is simply offered to them. Another study determined that 85 percent make that life-affirming decision.
Amy Kuebelbeck, a Minnesota writer, authored a book recounting her own pregnancy with a child who received a terminal diagnosis. It's called Waiting with Gabriel: A Story of Cherishing a Baby's Brief Life.
"I believe that [abortion] would have caused us real emotional harm," she writes, "as well as closed us off from the extraordinary gifts that we and our families and close friends were able to experience as we all waited with Gabriel."
Many parents tell a similar story of meaning, beauty, and life in the midst of hardship. Testimonies can be found through organizations and websites like Prenatal Partners for Life, Be Not Afraid, Carrying To Term, and PerinatalHospice.org.
"Yes, Gabriel was going to die," Kuebelbeck says. "But first he was going to live."
This article appears in the May 2018 issue of NRL News.