Down Syndrome and Social Capital: Assessing the Costs of Selective Abortion
All people with Down syndrome are intrinsically and immeasurably valuable. In addition, people with Down syndrome are happy with their lives and make their families and communities better off.
Medical advancements have helped increase life expectancy of people with Down syndrome from about 10 years in the 1960s to over 50 years in 2020 according to JEC Republican estimates, but at the same time have led to expanded screening during pregnancy that opens the door to a rise in selective abortions.
JEC Republicans estimate that absent selective abortion, 80 percent more babies with Down syndrome would be born each year and that the Down syndrome population would be 217,000 people greater in 50 years, an increase which is greater than the current Down syndrome population.
World Down Syndrome Day is an important opportunity to reflect on the lives and contributions of an often overlooked group of Americans. Misconceptions about people with Down syndrome lead to a disproportionate number of diagnosed children being aborted. It is estimated that 60 percent to 90 percent of children diagnosed with Down syndrome are aborted in the U.S., compared to 18 percent of all pregnancies ending in abortion.
These issues are even more important this year, as Americans wait for the Supreme Court to rule on Dobbs v. Jackson Women's Health Organization. Dobbs is expected to challenge the precedent set in Roe v. Wade and later cases, and if overturned could change the legal status of abortion within the United States. While abortion impacts all kinds of Americans, few populations are affected as much as those with Down syndrome.
A likely driver of the difference in abortion rates of people with Down syndrome and the general population is noninvasive prenatal screenings, which were introduced in 2011 and have become increasingly widespread in the years since. Noninvasive prenatal tests are non-diagnostic but screen for chromosomal disorders such as Down syndrome and Turner’s syndrome. Compared to other prenatal screening tests, the accuracy of screening for Down syndrome is relatively high with a low false negative rate. However, these prenatal tests do not address the extent of the disability or the symptoms that the baby might have. Misconceptions about Down syndrome and a lack of counseling following a positive screening likely leads to more children being aborted than otherwise would have been had the parents had better information. As testing becomes more prevalent, even more abortions of children with Down syndrome will likely occur.
This report evaluates the impact of selective abortion by estimating the additional number of babies with Down syndrome who would be born each year absent selective abortion, and how this would affect the population of Americans with Down syndrome over time. Weighing the impact of selective abortion is especially important given the incalculable intrinsic value of all human life. For individuals with Down syndrome, it is particularly important to understand that they have high life satisfaction, improve the lives of their family members, and contribute to their communities through work and other activities. Recognizing the value of people with Down syndrome is more important than ever given medical advancements that on the one hand have led to a surge in life expectancy for Americans with Down syndrome, and on the other hand have led to expanded screening during pregnancy that opens the door to a rise in selective abortions.
The report proceeds by describing the population of people with Down syndrome and their rise in life expectancy over the past several decades, documenting their contributions to society, and providing novel estimates of the additional births and higher population of Americans with Down syndrome if selective abortion were ended.
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