Dear Science,

I'm wondering about Sarah Palin. She had a baby at the age of 44. That baby has Down syndrome. This turnout, however, was not a surprise to Palin. Long before the baby was born, the doctors told her it would be mentally weak. But she went ahead and had the baby because she believes that God is pro-life and Satan is pro-choice. My question is this: Should older women who are more likely to produce defective babies be banned from having them?

Not Born Right

Should women at an age more likely to have genetically abnormal babies be prohibited from having children? No. Thanks to science and medicine, we are no longer beasts left beset by the waves of fertility. We can control our reproductive fates to an astonishing degree.

If you're over 35—more or less the point at which the risk of having a child with trisomy 21 (Down syndrome), or another chromosomal abnormality, dramatically increases—prenatal genetic tests are remarkably accurate at detecting such abnormalities. They can be done in the first trimester of pregnancy and pose virtually no risk to the fetus. If the screen comes up positive, you can elect to terminate the pregnancy while still in the first trimester. That's great! Combining such a screen with the choice of termination, even a woman well into her 40s can make her risk of having a child with trisomy 21 lower than a young woman.

If you want to carry the child to term regardless of the test results—as Governor Palin decided—the screen is still of immense value. Knowing that a child with trisomy 21 is coming allows you to start assembling the immense emotional, social, familial, medical, and financial resources needed to care for such a child months before it arrives. Raising a child with Down syndrome is a profound undertaking and having six months to prepare makes all the difference.

If you are comfortable with neither the chance of having a child with a chromosomal abnormality nor termination of a pregnancy, superb forms of contraception are available to you. IUDs have fantastically low failure rates, as do the many forms of hormonal birth control. If you believe that life begins at the moment when a sperm fertilizes an egg, you can instead opt for a tubal ligation, or your partner can get a vasectomy—preventing the egg and sperm from ever meeting. Vasectomies can even be performed in a manner that is easily reversible later, if your decision changes.

This is the essence of the pro-choice philosophy—science and medicine giving the person most at the center of this ethical decision accurate information and assistance regardless of the path chosen.

It's too bad Governor Palin's politics want to deprive women of all these excellent choices science has to offer.

Assistingly Yours,


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