Being Different and the Impact of Choice

They say “variety is the spice of life” (William Cowper, 1785).  It makes life interesting where doing, seeing and experiencing different things makes life more enjoyable.  As we experience diversity we need to value those differences where all people see the world not as it is, but as they are. I thought of this as I sat and watched a movie about a couple going through surrogacy to have a child, so desperately seeking for the right surrogate woman to have the child they so desired for.  When they found the right surrogate woman, they went through several procedures to finally having success.  The woman was pregnant with their child.  The moments of joy they shared together ensuring that the surrogate woman had all the support and treatment throughout the surrogacy.  But few months into the pregnancy, the couple found out that the child had down syndrome, they refused to go through the surrogacy, leaving the woman, asking her to abort the child as they no longer wanted the child.  This left the women carrying the child in a dilemma on what to do as she did this only for the purpose to fulfil her dreams with the money she would get.  A single woman, hiding from her family and friends, left to abort the child as the couple did not want it any more due to a standard testing procedure that identified some abnormality to the child.  This left me thinking about the impact of ‘difference’ and ‘acceptance’ but also the results of testing that could change decisions and making some vital choices.  

Abortion is experienced and occurs irrespective of country, income level, region or legal status of abortion.  According to recent research by Bearak et al (2020), almost 121 million unintended pregnancies occurred each year between 2015 and 2019 in the world with women aged 15-49.  This equates to 61% or 73 million, where the actual pregnancy rate had declined since 1990-1994 but the proportion of unintended pregnancy ending in abortion had increased.  However, these figures do not clarify on the unintended or intended pregnancies that may have been aborted due to a disability.  Therefore, to narrow my argument, a report by National Statistic (DHSC, 2020) in Britain identified that around 3183 abortions (2%) were carried out on the grounds that the child would suffer from physical or mental abnormalities.  Within this figure, 693 abortions were due to the identification of having a child with Down Syndrome where up to 90% of women chose to have an abortion.  The abortions are based on the testing that occurs on the basis of being offered a screening test between 10 and 14 weeks of pregnancy after which a further diagnostic test is offered with showing high chances such as the amniocentesis, a test that carries a small chance of a miscarriage.   

Many people born with Down syndrome can live full, healthy lives, with an average lifespan of around 60 years.  But with the rise of prenatal screening tests across Europe and the United States, the number of babies born with Down syndrome has significantly decreased, with few countries having come as close to eradicating Down syndrome births such as Iceland. Iceland is the only country to have reached a consensus: from 2007 to 2015 every single pregnant woman in Iceland terminated a foetus with Down syndrome following a positive diagnosis and currently at 100% termination rate so basically eradicated Down Syndrome from the society.  Other countries aren't lagging too far behind in Down syndrome termination rates. According to data available by Natoli (2012) the United States has an estimated termination rate for Down syndrome of 67 percent (1995-2011); in France it's 77 percent (2015); and Denmark, 98 percent (2015).

So what is wrong and what is right?  What decision and choice to make? 

For the single woman, not being offered any other tests or further investigations before the couple made their blunt decision about aborting the surrogacy, the woman made the brave decision to have the child, alone, within a society that viewed pregnancy without marriage, a taboo.  She had wonderful years full of happiness and joy being a mother to a gorgeous boy. The boy was her future, her dream regardless of any stigma to her own self.  But this is too good to be true.  Four years later, the couple came back to the woman asking for their child and to take him away with them to give him a better future than she could give the boy.  The couple found out that the boy did not have Down Syndrome but he was a normal typically developing boy.  This was the couple who desired for a child and went through several treatments to have a successful surrogacy but they made the decision to terminate the child as soon as they knew it was ‘not perfect’ or ‘not normal’.  So now I ask ‘what is perfect?’, ‘what is normal?’ and who decides on this to enable children, all children to be part of this world. 

There are many critical stances and arguments that arise with abortions where everyone makes the personal choice based on the several boundaries based on the person, child, society, policy, religion, culture and many more.  But when it comes back to the surrogacy where the couple made their decision and then after four years wanting the child as he does not have Down Syndrome, it brought a lot of fear and hate to the surrogate woman. 

Why now? 

What difference in attitude has this made to you? 

You left me to abort the child and what if I did? 

What position do you hold in the boy’s life after four years?

The surrogate mother denied all the couples request to take the child but spent every day with this constant fear of losing the boy at some point of life as the couple threatened to file a court case against the surrogate woman.  This questions the ethical boundaries for all concerned but also the impact of change and possible trauma to the boy of leaving the only attachment figure he knows to create a new one, through a decision made by others 

A choice that the couple made of aborting a child knowing to have possibly have Down Syndrome are now wanting the same child because he does not have Down Syndrome.  They are willing to fight for the child who they wished not to have at one point.  So, who has the rights now?  Who makes the decision and what is the right decision? What are your thoughts? 

As time passed from minutes to days to weeks, the surrogate mother gave up.  She realised she was fighting battle that she was not going to win.  With a heavy heart and holding back her tears from the boy, she took him to the couple.  As the couple walked towards the woman to take the boy, they turned to the surrogate mother.  ‘He is your son more than he will be ours’.  The surrogate woman flooded in tears holding her hands together and giving the boys all the hugs and kisses.  The couple had made a choice initially and they realised the impact of the choice on all concerned.  The boy continued his life with the surrogate mother.      

To conclude, we all make choices whether good or bad and they become our past that cannot be changed.  But we are the ones to live with those choices and they cannot be reverted back but reflect and learn from them.  The choice to abort or keep because the child had a disability, the choice to fight for the same child because he does not have a disability and the choice of what to do right, for the child and yourself.   

References

Bearak, J., Popinchalk, A., Ganatra, B., Moller, A.B., Tunçalp, Ö., Beavin, C., Kwok, L. and Alkema, L. (2020) Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. The Lancet Global Health, 8(9), pp.e1152-e1161.

Natoli, J.L., Ackerman, D.L., McDermott, S. and Edwards, J.G. (2012) Prenatal diagnosis of Down syndrome: a systematic review of termination rates (1995–2011). Prenatal diagnosis, 32(2), pp.142-153.