Over the past 25 years, parents have largely stopped aborting girls just because they are girls. In 2000, 1.6M pregnancies were ended worldwide because parents would rather have boys than girls. “This year that number is likely to be 200,000—and it is still falling.”

This is terrific progress and should be celebrated. Because terminating a pregnancy on the basis of sex is wrong.

In the US and Europe we have another related problem - which is that people routinely terminate pregnancies where the unborn baby has Down syndrome.

The numbers here are pretty sobering. In the US, ~75% of pregnancies tested for Down syndrome get terminated. In Europe it is ~90% (1).

If you don’t think this is a problem, I want to convince you it is.

In the US and Europe, most of us believe people have equal worth, with equal rights to “life, liberty, and the pursuit of happiness”. If you agree, you should be skeptical about denying life – even to an as of yet unborn person - based on genetics.

We also generally value diversity - it’s good to have people with different worldviews and values, different appearances and different levels of ability because encountering human variety helps us become better. People with Down syndrome (DS) intimately force the people around them to see the world differently – and generally more positively. Do we want to get rid of those people?

But still, you might think the arguments from liberty and diversity perspective are outweighed by the costs to the person with DS and to their parents.

But on the whole, people with DS lead long and happy lives. Life expectancy is 50-60 years in the developed world (2). And 99% of people with DS report being happy with their lives.

Parents do face a burden in raising children with DS – a meta-study shows higher levels of stress and depressive symptoms. But they show similar levels of parenting reward to other parents. And many parents report being thrilled to have their child with DS. There is some evidence that at the time of making an abortion decision, parents are given a more-negative-than-accurate picture about what life is like for someone with DS.

So it is possible for parents of children with DS to thrive given the right circumstances. To the extent that DS creates extra burden for parents, we should take this as a problem to be solved, rather than looking to eliminate DS. Schools, healthcare, and societal expectations about what a good life look like all play a role here.

So on net - the costs of DS seem nonexistent from the perspective of people with Down syndrome, and the extra burden to parents seems manageable. But systematically we are ending pregnancies of people with Down syndrome.

A wealthy society that fundamentally values liberty and champions diversity cannot be satisfied when 70%+ of pregnancies with Down syndrome end up terminated.

I don’t think this is an easy one to solve – because it comes down to our fundamental values as society. But I may take a stab at it in another post – because why else would I be writing on the internet?

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1. To translate that into a “missing people” number: Between Europe and the US there are about 12,000 “missing” people with Down Syndrome. 9,000 from Europe and 3,000 in the US.

2. Lower than average in rich countries. But still high by world historical standards – world life expectancy was <60 until 1979.