Why are Danish Women Aborting Foetuses with Severe Developmental Disabilities?
"I think that Danish women are less sentimental about aborting malformed foetuses partly because that view is supported by professional medical staff"
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This post originally appeared on VICE Denmark.
As a young female – especially living in a country where getting laid is about as big of a deal as having lunch – the topic of abortions hits close to home. It's a nightmarish vision for most young women: the chilling moment of "holy fuck, I'm pregnant" leaving you in emotional tatters as you must decide if you're keeping the child or opting for an abortion. In Western countries, we're lucky to have an array of options: we can get operations, we can gets pills from our local hospitals, or we can even order pills online with about as much difficulty as it takes to order a new pair of shoes. Yet are we a little bit too lucky, perhaps?
The ethical question doesn't rear its head too often in Denmark—but it does when you consider a particular statistic. Apparently, Danish women abort more foetuses that exhibit signs of Down Syndrome than anywhere else in the world. Between 95 and 98 percent of pregnant women terminate their pregnancy if they discover that the baby they're carrying may be born with Down Syndrome. When compared with other countries (Norway, for example, sits at 80 percent), it's hard to ignore this not-so-subtle difference.
"I think that Danish women are less sentimental about aborting malformed foetuses partly because that view is supported by professional medical staff" - Øjvind Lidegaard
You may immediately think this astounding rate is indicative of a country that fiercely values female empowerment and independence—and according to Øjvind Lidegaard, Chairman Professor in Gynaecology and Obstetrics at the University of Copenhagen, that may very well be the case if you consider the stance taken by medical professionals. "I think that Danish women are less sentimental about aborting malformed foetuses partly because that view is supported by professional medical staff," he tells me. "Recommending abortions isn't an obligation but we give very realistic prognoses. 80 percent of children with malformations end up in an institution and the majority of their families go through many problems. We give parents realistic expectations about future problems and generally, women carrying foetuses with severe malformations are recommended to terminate the pregnancy."
As a society, we tend to trust the medical professionals around us, almost because we have no choice. If someone's prescribing you weird little pills to swallow while promising they'll save you from whatever confusing thing is happening to your body, it's only logical you'd bank on trusting their word wholeheartedly. So you can imagine how much weight a recommendation like this would bear—especially for a pregnant woman as equally freaked out as she is thrilled about carrying a human being inside of her.
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Yet the recommendation is just the first step in the medical experience that may account for Denmark's high rate of aborting foetuses with malformations. According to Lillian Bondo, chairwoman of the Danish Midwives' Association, it's not only a matter of medical professionals in Denmark swaying women's opinions. It's more rooted in the two types of thorough testing available for pregnant women: risk assessment and invasive testing. "In Denmark, we have a tradition of offering women over 35 active screening for malformation of chromosomes, but all women can be screened," she says. "The risk assessment consists of blood sampling and a scan of the foetal neckline, where a specific measurement might indicate that the foetus has chromosomal anomalies or other problems, such as malformations of organs. When presented with a high risk according to these exams, most women prefer to have invasive testing performed - amniocentesis or placenta sampling. These tests will either show no chromosomal aberration or in fact point to the foetus carrying for instance Down Syndrome."
"[...] I think a lot of Danish women would think children with Down syndrome are very sweet and will grow up to be sweet adults... but they wouldn't choose to have one." - Lillian Bondo
The thing is, opening up that Pandora's box of risk assessment and invasive testing isn't unique to Denmark. Britain and Sweden offer all of their pregnant women the same kind of combined testing, and Norway does for women over 38 years old.
So, what's going on in Denmark that makes women act on these risk assessments and diagnoses a whole lot more than women elsewhere?
Perhaps it all comes back to Denmark's fierce respect for individual independence—that nationally-cemented value that keeps the country a fantastically progressive, judgment-free environment where women can do what they want simply because they want to. "I cannot speak for all women, but I think a lot of Danish women would think children with Down syndrome are very sweet and will grow up to be sweet adults... but they wouldn't choose to have one," says Bondo. "And they wouldn't lose public empathy or anything for it. There is no stigma on a woman who chooses an abortion."
Individual independence coupled with the right to choose is one thing—and one that I am unquestionably, 100 percent behind. Yet I can't help but wonder if this particular abortion rate would still be as high if the medical path a pregnant woman in Denmark undergoes was just a tiny bit different. Because if anything, it's a noticeable juxtaposition: professionals are telling women general presumptions about the quality of life their child could have, and using systematically-driven statistics as validation—but a pregnancy is hardly general or systematic. A pregnancy is very much an individual experience that's largely emotionally driven. Addressing that individual and the emotional with the general and the systematic may fill some gaps, but perhaps it opens up even more for error—whether through lack of empathy, understanding or both.
Of course, there are some barriers to abortions in Denmark. If a woman wants an abortion after 12 weeks of pregnancy, for example, she has to go through a committee of three people who evaluate her case—a gynaecologist, a psychiatrist and a lawyer. Yet in a way, those barriers are an archaic illusion: 94 percent of women who want an abortion get approved anyways—and even if they don't, there are other options they can take to abort their child, especially online. "You can buy pills for abortions online in every country", says Lidegaard. "For that same reason, the number of induced abortions in countries with more restrictive abortion policies is basically the same as in Denmark. We are within the 21st century now and we're working like we're still in the 20th century. It's outdated."
So in a way, it makes sense that the abortion debate basically doesn't exist in Denmark: if we're at the point where we can buy pills online to get abortions, the debate is kind of moot. Yet abandoning the debate doesn't mean the dilemmas will disappear, too. Despite the medical advancements and social progress taking place in many countries around the world, it's still an important conversation to have – also in Denmark.
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