In the West we decry these practices as gendercide, but the United States practices its own form of selective abortion when it comes to fetuses diagnosed in utero with Down syndrome and other chromosomal conditions. Definitive numbers related to pregnancies terminated as a result of a prenatal diagnosis of Down syndrome are hard to come by. Older studies suggest that up to 90 percent of all pregnant women with a definitive prenatal diagnosis chose abortion. As Jamie Natali, et. al. demonstrated in the Journal of Prenatal Diagnosis, more recent studies put the number closer to 70 percent. Either way, women who learn through prenatal testing that their fetuses have Down syndrome often decide to abort, and their reasons aren't that different from the reasons women across the globe choose (or are forced) to abort girls. In India, daughters grow up with social stigma, a lack of educational opportunities and the prospect of becoming a burden to their parents. Substitute the words "America" and "children with Down syndrome" for "India" and "daughters," and you get the picture.
Down syndrome occurs upon conception when an embryo receives three copies of chromosome 21 instead of the typical pair. This additional chromosome can lead to physical differences such as shortened stature, an extra fold of skin around the eyes, small facial features, and pronated feet. It can also lead to medical concerns that vary from person to person but include heart defects, hearing deficits, and a heightened risk of childhood leukemia, hyperthyroidism, and celiac disease. Down syndrome also usually involves some unpredictable degree of intellectual disability, so many individuals with Down syndrome have greater challenges to overcome when learning or when trying to live independently as adults.
It is precisely because of information like this that many people choose to abort a fetus diagnosed with Down syndrome. These medical and social challenges seem fixed and unchanging. But as the past 40 years demonstrates, these challenges reflect social mores and choices as much as biologically-based reality or necessity. In 1975, Congress ensured all children's rights to a free public education, including those with intellectual disabilities. Around that same time, parents on the whole stopped sending their kids with Down syndrome to institutions and availed themselves of "early intervention," therapy services that target physical and brain development from very early on in a baby's life. In 1980 the life expectancy for an infant with Down syndrome was 25. As a result of social change and medical advances, people with Down syndrome are now expected to live until at least 60. And people with Down syndrome overcome expectations every day. They read, they write, they go to work, they make friends. When given the opportunity, they lead lives of hope and promise.