How Many Babies Were Aborted in the Us

How many babies prenatally diagnosed with Downwardly syndrome (DS) are aborted in the United States each year? Well, we don't know. While new data suggesting lower numbers has recently been published,[one] nosotros continue to see nearly oftentimes in print a statistics of 90% – 92%. While that certainly draws attention to the horrifying reality that the bulk of children prenatally diagnosed with DS are aborted, information technology is not accurate. That number relies on a 1999 European report with little data drawn from the U.S.[ii] In that location are good reasons for advocates to use the best data available to raise sensation of the trouble that exists in the link betwixt prenatal diagnosis and ballgame.

A new study conducted by Gert de Graaf, Frank Buckley, and Brian Skotko and recently published in the American Journal of Medical Genetics[3] applies rigorous statistical modeling to diverse data sets in an attempt to provide the most accurate number possible. It is important to know over fourth dimension what impact relatively new noninvasive prenatal screening (NIPS) technologies, simply available since October 2011, will have on the already high termination rate afterward a prenatal diagnosis of DS.

These new NIPS tests are able to identify cell-gratis DNA from the placenta in the female parent'south blood as early equally 10 weeks into her pregnancy, and claim to inform women – with about 99% sensitivity and specificity – if the baby she is carrying might accept DS.  Recent reports accept indicated that some women are using these tests to make the decision to cease their pregnancy without having the effect confirmed with an invasive diagnostic test.[4] To understand the touch this new technology will accept over time on nascency rates of children with DS, it is essential to constitute a benchmark that tin be used for hereafter comparison.

Unlike the U.South., some countries track birth defects in national registries forth with prenatal diagnosis and termination rates, so there are little or no vagaries around this question. For example, the National Down syndrome Cytogenetic Annals (NDSCR) is a part of the larger British Isles Network of Congenital Anomaly Registers.[v] Both of these are part of EUROCAT, the broader European network of population-based registries that compiles epidemiological data on built anomalies across Europe. The NDSCR collects information on all diagnoses of trisomies 13, eighteen, and 21 in England and Wales. With a few clicks of a mouse, anyone can access the database and learn the prevalence, prenatal detection rates, and other fundamental public wellness indicators related to genetic anomalies.

For example, using information gathered from all member registries, from 2008 to 2012, there were 4,288 live births of children with DS, 231 natural fetal deaths, and 5,215 terminations. DS live births as a percent of full diagnosed pregnancies was 44%. Fifty-three percent of all pregnancies were aborted following prenatal diagnosis and a small-scale percentage were lost to natural causes. We can also learn that during the same four-year flow, 65.ane% of the total DS cases were prenatally diagnosed.[half dozen]

In the Usa, we take no such information drove. And given how polarized nosotros are as a nation around the topic of abortion and the potent value placed on the right to privacy, at that place is lilliputian chance that this level of data drove will ever be possible.

The authors of this report gathered information that is available and devised a sophisticated statistical model to estimate as closely as possible the bear on of prenatal diagnosis on abortion rates. They then asked this question: How many children with DS have been born, and what has been the net effect of pregnancy terminations following prenatal testing on live nativity prevalence during the menstruum from 1900–2010? Given that prenatal diagnosis and legal abortion weren't bachelor earlier about 1974, the authors focused on the years from 1974 to 2010 to develop their estimates.

In cursory, the answer to their question is that for the well-nigh recent years, 2006–2010:

• The estimated alive nascency prevalence for DS was approximately 12.vi per x,000, or a total of around v,300 births each year;
• The number of pregnancy terminations following prenatal diagnosis is estimated at 3,100;
• Taking natural losses into business relationship, the authors judge that there would have been 7,600 live births each year in the absenteeism of prenatal diagnosis that resulted in abortion;
• Their estimate of live-birth prevalence for 2010 is around 1 in 792, or slightly fewer births than the fourteen.47 per ten,000, or 1 in 691, live-birth prevalence published by the Centers for Disease Control (2004–2006 estimates).[seven]

The net result of their inquiry is that abortion afterwards prenatal diagnosis has reduced the population of individuals living with DS in the U.S. by approximately 30%. This should not exist dislocated with the percentage of women who abort following a prenatal diagnosis. That number would certainly be higher. This reflects the overall reduction in the DS population, and takes into consideration total DS pregnancies, whether prenatally diagnosed or not. The authors state that prior to October 2011 and the availability of NIPS, near 72% of women elected to have traditional prenatal screens and but an estimated maximum of ii% went on to have invasive diagnostic procedures, i.e., amniocentesis or chorionic villus sampling. If prenatal screening becomes more widely available, as seems to be happening, and so 1 would await the number of terminations to increase.

As an interesting aside, the authors estimate the total example prevalence of DS in the U.Southward., excluding elective termination and natural loss, to be one in 365. This number correlates closely with the reported alive birth incidence of DS in the Arab world where abortion for DS is not permitted. The nascence prevalence in Dubai is estimated at ane in 449 overall, but much greater among the Emiratis: 1 in 319.[8]

In this publication, the authors have identified regional and racial/ethnic differences in the prevalence of abortion following prenatal diagnosis past drawing data from 12 states that maintain live birth data of DS births by racial/ethnic group. The group with the highest number of terminations was Asians/Pacific Islanders (61%) followed by non-Hispanic whites (39%), non-Hispanic blacks/Africans (27%), Hispanics (18%), and American Indians (16%). Regionally, Hawaii and the Northeast states take the highest termination rates compared to other regions of the US at 62% and 46%, respectively. The Southward is the lowest with an overall reduction rate of approximately 23%.

The authors of this study accept provided valuable baseline data that should help frame the discussion of the bear on of prenatal diagnosis on future termination rates.

The fact that there have been no clear-cut statistics in the U.S. regarding how many women receive a prenatal diagnosis for DS, their subsequent decision regarding nascence, termination, or adoption is frustrating. It is equally frustrating that there is no accurate census of the population living with DS in the U.S. Some other statistically based study published in 2013 revised the estimated population of those living with DS in the U.S. in 2008 from a previously estimated number of 400,000 to around 250,000 – that represents a 25%–twoscore% reduction in population that could substantially impact services and supports, and too potential funding made available for inquiry.

Using the statistic of 90% or 92% when citing abortions of babies with DS indeed presents a horrifying scenario, merely in truth so practise the numbers derived from more recent and presumably accurate surveys. DS advocates should consider the impact using old and inaccurate information might have on those considering their options following a prenatal diagnosis of DS. Hearing that 90% to 92% of parents opt for termination might have the reverse effect from what advocates want and fifty-fifty encourage those who would consider abortion after a prenatal diagnosis.

Advocates would be far better served by using the statistics provided in this new study, i.e., that information technology is estimated that ballgame following a prenatal diagnosis of DS results in a thirty% reduction in overall DS births. Jamie Natoli, et al., proposed some other statistic that correlates well with this study. In a 2012 publication in Prenatal Diagnosis, their research calculated a weighted mean beyond the U.S. of a 67% termination rate following prenatal diagnosis.[nine]

Whatever the statistical realities may be, the number of those who choose abortion after a prenatal diagnosis  is far too high. It should exist none. To paraphrase the recently deceased disabilities rights activist, Dr. Adrienne Asch, the only thing prenatal diagnosis can provide is a kickoff impression of who a child will be. Making such a radical decision as to end the life of a child based upon a start impression is a most horrible and violent course of discrimination. It has no place in an American society that is committed to catastrophe discrimination in whatsoever course and that has intensified that effort for persons with disabilities over the final 25 years since the signing of the Americans with Disabilities Act in July 1990.

Mark Bradford is president of the Jérôme Lejeune Foundation U.s.a..

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[i] Jaime 50 Natoli, et al. (2012), Prenatal Diagnosis of Down Syndrome: A Systematic Review of Termination Rates (1995–2011). Prenat. Diagn., 32: 142–153. doi: 10.1002/pd.2910

[two] Caroline Mansfield, Suellen Hopfer and Theresa Grand. Marteau on behalf of European Concerted Activeness. (1999), Termination Rates later Prenatal Diagnosis of Down syndrome, Spina Bifida, Anencephaly, and Turner and Klinefelter Syndromes: A Systematic Literature Review. Prenat. Diagn., 19: 808–812. doi: 10.1002/(SICI)1097-0223(199909)nineteen:ix<808::AID-PD637>3.0.CO;two-B

[3]  Gert de Graaf, Frank F. Buckley, Brian G. Skotko. (2015), Estimates of the alive births, natural losses, and constituent terminations with down syndrome in the United States.

Am J Med Genet Part A 167A:756–767.

[iv] Beth Daley, "Oversold and misunderstood: Prenatal screening tests prompt abortions." New England Center for Investigative Reporting. Accessed online at http://features.necir.org/prenatal-testing

[v] See http://www.binocar.org/data

[half dozen] Encounter http://www.eurocat-network.eu/prenatalscreeninganddiagnosis/prenataldetection(pd)rates

[7] See http://world wide web.cdc.gov/ncbddd/birthdefects/features/birthdefects-keyfindings.html

[8] Meet http://world wide web.researchgate.internet/publication/6641058_Incidence_of_Down_syndrome_in_ Dubai_UAE

[ix] Op cit.

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Source: https://lozierinstitute.org/new-study-abortion-after-prenatal-diagnosis-of-down-syndrome-reduces-down-syndrome-community-by-thirty-percent/

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