At one point in her documentary, A World Without Down’s Syndrome?, Sally Phillips finds herself earnestly agreeing that the most important thing about a woman’s decision to abort or continue with any pregnancy is that it’s exactly that – her decision.
But a decision can only be as good as the information you base it on, which makes this a strange moment when the film itself is essentially a plea to deny women access to a safe and accurate test for Down’s syndrome. It’s your choice, was the message, but you shouldn’t know too much about what you’re actually choosing.
At the moment, detecting Down’s syndrome involves a scan or a blood test in early pregnancy. A woman who is told she has a high risk of carrying a baby with Down’s syndrome at that point can then opt for a follow-up test that involves a sample of either the placenta or amniotic fluid: both are invasive, and have a 1 per cent chance of causing miscarriage.
So the new test, called NIPT (non-invasive pre-natal testing), should be welcome. Not only will it tell women more about the foetus inside them, but it will spare one in 100 of them the trauma of miscarriage and the loss of a wanted child – because it should not be forgotten that every woman who goes through these tests is a woman who plans to have a baby.
Motherhood is an act of love, not just a fact of nature, and a woman who is concerned about what her child might be like is already, tentatively, in love with that child. If you intend to have an abortion regardless, testing is irrelevant: you don’t need to know any more about an unwanted pregnancy than the fact that you don’t want it.
Phillips’ objection to NIPT is that, once women know that they have a high risk of having a baby with Down’s, 90 per cent go on to terminate. A more accurate test will mean both that women are more confident in deciding to abort, and that fewer foetuses with Down’s will go undetected. It’s disingenuous to argue, as some NIPT proponents do, that this won’t drastically reduce the birth rate for Down’s.
For Phillips, that’s a source of grief. At one point, she leaves a meeting with a woman who chose to abort her high-risk pregnancy, and is obviously distressed: “Kate didn’t want a child like mine. That was difficult to hear,” she tells the audience.
How Kate feels, having been forced to justify her abortion and questioned on whether a gymnast with Down’s syndrome would have been “better off not happening”, is left unrecorded.
But why should Phillips take one woman’s choice as a judgement on her own? Every year, women have abortions for every imaginable reason. Every one of them has weighed the pressures and possibilities of her own life and known that, for whatever reason, they do not want a child.
And Down’s syndrome is a peculiar pressure. Phillips clearly has a happy and loving relationship with her son, but she also has a lot of things that help to make that possible. She’s well-off, which means she doesn’t have to scrap for funding for every bit of support that Olly needs. Olly’s learning disability seems relatively mild, and he doesn’t appear to suffer from the life-limiting problems that often go along with Down’s.
There’s no mention of the heart disease, cancers and early-onset dementia that are common in people with Down’s syndrome, nor of the strains on parents – especially mothers (fathers are a notable minority among the carers we meet) – who must support a dependent adult child into their old age while services are slashed around them.
In Phillips’ version, Down’s is all upsides for everyone involved. Perhaps that’s because she has one other thing, which isn’t mentioned in the documentary: faith. In an interview with the magazine Premier Christianity, she says: “I feel I’ve been given a present. I’ve been given a Narnia cupboard which I can look through and see things God’s way.”
In a programme that insists admirably on seeing people with Down’s as individuals, it’s a strangely utilitarian position, because what it implies is that people with Down’s syndrome are valuable as a kind of sacrament. For the non-religious, this seems a very poor argument for being kept in the dark about your own pregnancy.
Later on the same evening that A World Without Down’s Syndrome? was broadcasted, an episode of Dispatches presented by Cathy Newman showed the blunt end of religious coercion in pregnancy as she investigated anti-choice organisations that harass and lie to women. A consultant gynaecologist watches secret footage of a “counsellor” telling a woman that abortion causes cancer with obvious horror at the falsehood: “If you’re given incorrect information, you’re making a choice based on error. There is no excuse whatsoever not to give people true information,” she says.
If you believe in choice, then you also have to believe in giving women the information to make those choices. At the bottom of it all, being pro-choice means believing that women owe our bodies and our lives to no one but ourselves: not to men, not to God, not to unborn children, not to other parents who wish you would have a child like theirs.
Uninformed choice is no choice, which is why, however much Phillips might think otherwise, the documentary she made was profoundly anti-choice.