The story so far…

In Part 1, and Part 2, I’ve been talking about the way imperfect babies – specifically those diagnosed in utero as having Down’s syndrome (abbreviated to DS for the rest of this post) – are routinely aborted.

Most women take the screening tests and, if those tests are positive, go on to have amniocentesis. A huge number of women who then discover that their child does have DS decide to terminate the pregnancy.

DS is, while serious, not the kind of condition that is so serious that from the child’s point of view termination is plausibly a better option. From the child’s point of view, a life with DS is markedly better than no life at all.

There may be exceptions where antenatal tests can show that the child has additional problems, perhaps a serious heart defect, that might seriously shorten life expectancy or worsen the child’s expected quality of life. But I am assuming that this is not normally the case and that we do not know, at least not in time to make a decision about termination, how serious the child’s condition will be. So in the usual case, a termination would not be for the benefit of the (potential) child to save it from a life of suffering, but would be (almost) entirely for the benefit of the family, who may feel that they do not want or cannot cope with a child who has DS.

I don’t say that it is never right or ethical to terminate a pregnancy where the foetus has DS. There are some families who genuinely could not cope with the significant extra demands of parenting a child with special needs. (I really can’t imagine how I would cope, and have the most enormous respect for people who do – I suppose, like them, that somehow I would if I had to!)

I don’t claim that I am a better judge for any given family than they are themselves.

But I cannot deny that I find troubling the very high proportion of people who feel that they “do not want or could not cope” with a baby who has DS. As I said in Part 2, this seems to demonstrate to me a widespread attitude that I find unsettling. It is an attitude that seems to demand perfection, that demands a dream family and a dream baby and refuses to accept a baby who cannot live up to those standards. It seems to flirt dangerously with the idea that “designer babies” are acceptable and even desirable.

I have been posing myself the question how this fits in with my pro-choice views.

If I support the right of every woman to choose whether to continue any pregnancy to term, how can I at the same time make moral assessments of the decision that any woman makes? How can I play Judgement, when the key claim of my pro-choice stance is that no-one other than the woman herself is qualified to make that judgement?

I think there are a few ways to answer this.

The first, and most obvious, is that when we allow a person the right to choose, we allow her the right to make the wrong choice and not just the freedom to make the right one. It would be silly to pretend that every choice is the right choice, just because the right person made the choice. So it is perfectly possible for a woman to make the wrong choice – for any number of reasons – and perfectly allowable for somebody else to express an opinion to that effect. I am free to choose whether to eat a litre of ice-cream, and you can criticise my choice even while you acknowledge that you have no power or legitimate authority to try and impose your own choice.

But I don’t claim to criticise any individual choice. I am merely criticising the trend and asking questions about why we have such a trend. That is not the same as criticising any individual decision, or any individual person who makes that decision.

To use an analogy – it is perfectly proper to criticise and ask questions about a general trend away from breastfeeding and towards formula feeding, without criticising any individual who chooses not to breastfeed or finds herself unable to do so. The reasons underlying the trend are nothing to do with individual decisions, except insofar as the reasons for individual decisions can give us clues about the reasons for the trend. Similarly, it is perfectly proper to criticise and examine a general trend towards elective Caesarean births and away from natural deliveries, without implying any judgement of any individual who elects for a Caesarean.

By golly it’s emotive, but that doesn’t mean we should not think or talk about what the best choices might be, about the causes of other choices becoming prevalent, or about how we might better support women to enable them to make good choices for them, free of the kind of pressure that might steer them inappropriately in a different direction.

I admit up front that I am not best qualified to come to any firm conclusions about this, having precisely zero experience of special needs parenting – I’m not even sure how I got onto this subject, except that I was writing about antenatal screening and it got me thinking!

My views about choice are broadly as follows:

No person has the right to force a woman to undergo pregnancy and bear a child against her will. A foetus does not have this right, and nor does a government.

I am not sure whether a foetus has any rights, but if it does, these rights do not include a right to be nourished and supported as a parasite inside an unwilling mother, putting her health and even her life at risk without giving her anything back.

However, even if a foetus does not have rights, people have responsibilities towards it. Nobody has a greater responsibility than the two people who created it, and nobody has a more immediate responsibility than the one person in whose body it is growing. At the highest, this is a responsibility to take care of the foetus and of its mother, to ensure that the child it will become has the best start in life. At a minimum, it is an obligation to ensure that termination is as painless as possible for the foetus, preferably taking place before it becomes sensitive to pain.

This responsibility is in my view greatest when the pregnancy has been chosen – which is why, when a person has chosen to have a child but then rejects the child for some imperfection or defect, there is something troubling about it. The responsibility is least when it has been forced upon the woman (by rape, or the bad luck of contraceptive failure, for example).

And that is a key point in arguments about choice.

My pregnancy was unplanned and unwanted. But because I chose to continue it, it was not forced upon me. And so I did not feel bitterness and resentment at a thing taking over my body and my life; I felt a growing sense of awe at the responsibility I had undertaken, and a growing love for the unfelt life within me. Because I chose it.

And so much as I might (with not a jot of experience or moral authority, I freely confess) urge families to take more seriously the possibility of special needs parenting, I would never dream of forcing it upon them. If it is wrong to force any child on a woman, then it is doubly wrong to force her to take on the extra demands of a child with special needs.

If it is easy to resent a child that makes ordinary demands, how much easier would it be to resent one that makes inestimably higher demands?

Resentment and frustration at the restrictions and demands of parenthood (especially special needs parenting) will happen anyway. But, for me, when those feelings come boiling up to the surface and threaten to overwhelm me, it helps bring me back to earth to think: I chose this; I chose you. I’m glad to the skies that I had that choice.