COGNOSCENTI | What prenatal testing can’t tell you

November 18, 2025

Having a child with Down syndrome has been an irrational, unprovable good. In a world of increasing mechanization, measurement and merit, we need people like our daughter among us to return us to our humanity.

For anyone who has paid any attention to prenatal screening, abortion and Down syndrome in recent years, it will come as no surprise that increased availability of prenatal screening leads to a reduction in the number of babies born with Down syndrome. A new study published in the American Journal of Medical Genetics offers a comprehensive report about the reduction in live births of babies with Down syndrome in 33 countries over the course of 30 years (1990-2020). They conclude that when women receive a prenatal indication that their fetus has Down syndrome, they are more likely to terminate their pregnancies.

I’m not interested in pressuring women to carry their babies with Down syndrome to term. I am interested in providing a counter-narrative about Down syndrome.

Our daughter Penny is 19 years old. The doctors told us they suspected she had Down syndrome a few hours after she was born. Penny was 2 years old when I heard on NPR that the American College of Obstetricians and Gynecologists (ACOG) decided that offering prenatal screening for Down syndrome should become part of the “evidence-based standard of care” for pregnant women for the first time.

I knew the vulnerable position of women receiving a prenatal diagnosis. I had felt fear and grief and guilt and shock with my own experience of postnatal news. I also knew that prenatal screening results present a sense of urgency — termination is not a decision to be taken lightly, and yet it is a decision that needs to be made quickly.

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