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,
Science
Send your science questions to
dearscience@thestranger.com
“pose virtually no risk to the fetus” isn’t exactly true, is it Jonathan? Amnio is pretty safe, but you can’t do it till second trimester. chorionic villus sampling, on the other hand, can be done trimester uno, but has a higher risk of miscarriage. more info with your hyperbole, por favor?
You can also do a blood test on the mother’s blood for a molecule called alpha-fetoprotein. A low value with correct dates (15 weeks, usually) is a good predictor. See this free article for more info.
Nope, CVS carries no higher a risk for miscarriage than amnio:
http://www.acog.org/from_home/publications/press_releases/nr08-31-06-1.cfm
Plus, kudos to Dear Science for being clear that it’s only the risk for chromosomal abnormalities that goes up with a woman’s age. Other genetic defects do not. Too many people don’t understand that.
Last, but not least, Dear Lord, how on Earth would you ban older mothers from having babies? Sterilize them all?! Force abortions? Completely incompatible with freedom.
There are no easily reversible vasectomy procedures. I assume you are referring to the Vasclip. Although using a clip to close off the vas deferens is more easily reversible than a traditional vasectomy, there would almost certainly be some impairment in fertility to due damage to the vas and development of anti-sperm antibodies. Like a vasectomy, the vasclip procedure should not be performed on someone who isn’t sure he doesn’t want children.
Science does create more options, but not infinite ones. At some point, you have to close off some options in order to pursue others.
Vasectomies are more reversible than they used to be, due to both less destructive vasectomies and better reversal surgeries, but they are far from being ‘easily’ reversible. If a person gets a vasectomy, they should assume they are going to be infertile forever. The possibility of a successful reversal is a bonus.
So,”Not Born Right” (and I’m assuming you weren’t), would you tell a person with Down Syndrome, (or their mother) that they don’t have a right to be on earth and should never have been born because of their “mental weakness?”
Would you mandate that older women, disabled women, and maybe poor women or women of color shouldn’t have babies because you’re uncomfortable with looking at difference?
Who the hell are you to determine whether someone else’s quality of life makes it not worth living? Please don’t tell me you’re “pro-choice” or I’m going to vomit.
My mom was 40 when my parents decided to try for one more, 23 years ago– and here I am. My only health problem is asthma. Every pregnancy has risks, and women who have been properly educated are quite capable of making an informed decision. Should we limit any group who may carry a higher risk from conceiving (which would, in the end, include every woman)?
Having older parents has been a bit of a boon. They’re more stable, more experienced, and a heck of a lot calmer. Our household was never frantic. My dad retired when I was in kindergarten, meaning I had two full-time parents.
The reproductive crisis we face, truly, is that 17-year-old girls like Palin’s daughter feel pressured to marry somebody who doesn’t love them and keep a baby they have no business having. Adoption, maybe, would be the answer, but the better answer would have been birth control and real sex ed in the first place.