Screen all pregnancies

An article in The New York Times reports that the American College of Obstetricians and Gynecologists now recommends that all pregnant women, regardless of age, be offered screening for Down Syndrome. This is a change from offering screening primarily to pregnant women age 35 and older, and while the new guidelines are prompted partly by technology that makes early screening less dangerous to the fetus, the change also reflects what can only be described as a more comfortable relationship with the eugenic tendencies of prenatal screening to "screen out" flawed fetuses.

From the article:

In explaining the new recommendation, several physicians said the cutoff age of 35 had always been somewhat arbitrary. “Many women are unhappy with it, because it doesn’t mean anything to them; it’s kind of being put upon them,” said Dr. James Goldberg, a former chairman of the obstetrics college’s committee on genetics, who helped develop the new guidelines.

For example, Dr. Goldberg said, a 29-year-old woman and her partner might now choose amniocentesis instead of a blood test. In the past, the more invasive procedure was seldom recommended for younger women because it could sometimes result in miscarriage. Now the risk is considered to be quite low, and in any event, Dr. Goldberg said, for some couples “losing a normal pregnancy secondary to the procedure is not as problematic as the birth of a Down syndrome child, so they’re willing to take that risk.”

As I understand it, the old age-35 policy was based on balancing the concern of miscarriage of any fetus to the statistical probability of a woman giving birth to a child with Down Syndrome. As stated explicitly above by Dr. Goldberg, that balance is perceived to be shifting significantly enough to encourage wider screening practices. Implicit in his statement is the notion that a positive test result for Down Syndrome is alleviated with abortion, otherwise the risk would not be worth it.

Significantly, the NYT article does not associate this medical policy with societal perceptions of or supports (or lack of) for people with Down Syndrome. It does not recognize through further interview or research that women receiving a positive screening get significant pressure by both the medical community and society at large to abort fetuses with this largely nonfatal and highly variable condition. While the changing policy may provide more women with more information about their pregnancies, it will not provide that information in full cultural context and will not, apparently, include guidelines for how to best decide what to do with that information.

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On a separate note: The website for the medical organization issuing these guidelines reveals that uterine transplants are just around the corner.