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Laura Keynes: Why I declined Down’s syndrome screening tests


In the second of our blogs on why some women refuse the Down’s syndrome screening test, Laura Keynes explains her reasons

“Discussed and declined” is how the midwife signed off the screening test section in my notes. A pregnant woman can accept or decline, but there’s no getting out of the discussion.

It was a tiresome and stressful formality: I knew my own mind but still had to justify it to medical professionals; still had to explain my reasons to the State. A simple ‘no’ won’t suffice. You have to give an explanation.

Fortunately, the midwife didn’t remind me that as an ‘elderly primagravida’ (35 and over), I have a 1 in 270 risk of having a baby with Down’s syndrome, compared with a 1 in 800 risk for a thirty-year-old woman. She could have done so, in the hope statistics would cause me to waver. Perhaps she heard the tone of decision in my voice when I said, “I wouldn’t have an abortion if the tests were positive, so there’s no point taking the tests.”

The midwife’s acceptance of my answer only affirmed what I already knew from conversations with friends, who had felt pressured into taking the tests: the assumption from all concerned is that if you want to know, and if the result is positive, you’ll abort. Tellingly, the midwife didn’t say, “Some couples just want to know, so they’re mentally prepared when the baby comes.” She didn’t say it because in reality only 10 per cent of couples choose to carry on with the pregnancy after a positive test result.

I gave the midwife the bare minimum of explanation, but in truth my reasons for declining were complex. I wouldn’t have an abortion because, having already experienced abortion, I know it’s not the bloodlessly clinical procedure medical professionals make it out to be.

It’s traumatic, messy, dehumanizing and undignified, for all concerned. And at 14 weeks, which is the earliest point of screening, the foetus is recognizably human with arms and legs and jerky little movements. An abortion at that stage is not dealing with a ‘bunch of cells’. You’re talking dismemberment.

A former abortion provider describes witnessing an abortion at 13 weeks via ultrasound: “As the cannula pressed its side, the baby began struggling to turn and twist away. It seemed clear to me that it could feel the cannula, and it did not like what it was feeling.”

Knowing the reality, I could never go through that again. I couldn’t inflict that kind of violence on a defenceless human being, or on myself.

Furthermore, there’s a risk of miscarriage with the amniocentesis test, which I’d be pressurised to take if the first test (nuchal fold) showed a risk of my baby having Down’s syndrome. I’m not so desperate to know for certain whether my baby has an extra chromosome that I’d risk miscarrying a perfectly healthy baby. Either my baby has Down’s syndrome or it doesn’t, and whether I find out now or when it’s born, it makes no odds to me.

It all comes down to the kind of woman I want to be, and the kind of society I want to live in. Do I want to be the kind of woman who welcomes life however it comes; who has open arms for the vulnerable; who is willing to share in the joys and sorrows of nurturing a differently-abled child? Yes I do, and I won’t let anyone tell me I’m not capable of rising to that.

Do I want to live in a society where everyone is valued for who they are, no matter what they can do; where provision is made for the weak and vulnerable; where no one is left behind or discarded just because they don’t fit a certain set of norms?

Yes, I want to live in that society. I believe we can build that kind of society, and that giving up on disabled children by aborting them in utero is giving up on that vision of an inclusive society.

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Laura Keynes
Laura Keynes
Dr Keynes is a Cambridge-based academic, writer and critic with two very young children. She writes for Standpoint magazine, the Catholic Herald and The Tablet. Find her on twitter @LMKeynes.

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