Wednesday, September 03, 2008

Sarah Palin and Abortion

When I read about Republican Vice Presidential Candidate Sarah Palin's decision to go through with her last pregnancy, despite a diagnosis of Down Syndrome at four months' gestation, I had several thoughts. My first was admiration. As people who work in abortion clinics will attest, some of their patients are people who previously (or concurrently) oppose a right to reproductive choice. One can oppose a moral choice in theory but find oneself nonetheless making that choice when it becomes personal rather than theoretical. Sarah Palin is known to be opposed to a right of abortion, even when the pregnancy has resulted from rape. But Sarah Palin, though shocked when she learned that her baby would have Down Syndrome, decided to carry her pregnancy to term and to welcome her child into the world. This is a woman of principle, I thought.
But then I had another thought: if Sarah Palin knew at four months that her baby would have Down Syndrome, then she must have had an amniocentesis, a procedure by which a doctor withdraws fluid from the mother's amniotic sac and then tests the chromosomes in that fluid for the presence of anomalies. The amniocentesis procedure provides what can be devastating information to expectant parents, and there is nothing one can do to "fix" a chromosomal anomaly. After the test, a parent can decide either to terminate the pregnancy or take it to term. At Palin's age (44), the odds of her giving birth to a baby with Down Syndrome were relatively high (1/35, I believe), and this is undoubtedly why her doctor offered her the test. The question, however, is why she agreed to take it. Perhaps she wanted to know. If her test came back negative, she could have experienced relief. And with a positive test, she could prepare herself emotionally for what would be a challenging and painful but also potentially rewarding experience. This all makes sense, except for the fact that an amniocentesis is hardly a risk-free procedure. In some number of cases (1/200, according to some, a smaller fraction, according to others), an amniocentesis induces a miscarriage (also known as a spontaneous abortion). Stated differently, one acquires the information available through an amniocentesis only at the small but real risk of terminating the pregnancy. This is why younger women are generally not offered an amniocentesis at all -- the risk of miscarriage is too great to justify the procedure. For a person in a higher-risk category (an older woman, for example) who either will or might terminate a pregnancy on the basis of a positive result, this risk might be worth taking. But for a person who will not abort no matter what the result is, it would not appear to be. This makes me think that, at least for the moment that she decided to have an amniocentesis, Sarah Palin considered having an abortion.
I do not say this to be unkind. I think that Sarah Palin and her husband made a noble choice by taking the pregnancy to term. In addition to the love they showed to their new baby by deciding to keep him, they also demonstrated forcefully to their other four children that their love for them is unconditional. I also do not fault her for having the amniocentesis. When a woman is pregnant, she is so intimately connected with her baby and yet so ignorant about the baby's progress without a doctor or midwife to give her information. An amniocentesis provides information in an otherwise frustratingly opaque setting. I do, however, fault Sarah Palin for wanting to deprive American women of a choice that she herself had and that she apparently thought about making. Though McCain supporters present her choice to take her pregnancy to term as a principled pro-life choice, it behooves everyone to remember that it was in fact a choice and that in the ideal world envisioned by Sarah Palin and John McCain, no other woman could ever choose again, except by visiting the back alley.

Posted by Sherry F. Colb