Fact Check: No, Iceland is NOT systematically eradicating Down syndrome
Recently the US news network CBS News ran a story which took viewers "Inside the country where Down syndrome is disappearing". This story prompted a swift backlash in the US, with political and religious leaders denouncing Iceland for practicing eugenics. Some commentators went so far as to suggest Iceland was pursuing Nazi policies.
CBS News claimed in its story that the government pushes pre-natal screening on women, and that "close to 100 percent" of women who received a positive test for Down syndrome opted for abortion:
"Since prenatal screening tests were introduced in Iceland in the early 2000s, the vast majority of women -- close to 100 percent -- who received a positive test for Down syndrome terminated their pregnancy."
One of those who reacted to this story was the conservative firebrand Sarah Palin, who has a child with Down syndrome. On Fox News Palin blasted what she saw as as wrong and evil practice , arguing.
"To try to snuff out a life, in the name of building a perfect race or a perfect country back to Nazi Germany"
Others, including Texas Senator Ted Cruz, who reacted to the story on Twitter, described the alleged policy as "sad".
The story, and the intense criticism it sparked in the US, has generated a debate in Iceland about the screening for Down syndrome and the termination of pregnancies following positive results. Not least because the story, and the follow-up in the US seems to have gotten a number of things about this wrong.
So, what are the facts?
Abortion in Iceland
The first point, we must keep in mind, is that Icelanders have a different view of abortions than many on the political right in the US.
In Iceland women's right over their own bodies is generally recognized by politicians, health care workers and the public alike. While Iceland does not have "abortion on demand", women who wish to terminate their pregnancy must have a conversation with a social worker at the hospital before having an abortion within the first trimester, there is no effort to pressure women to change their minds.
The decision to carry a pregnancy to completion is viewed by the overwhelming majority of Icelanders as a decision that women must make on their own, or with their partners. In Iceland strangers, whether they are religious, political or community leaders, are not viewed as having any say in people's intensely personal and moral decisions like family planning.
This also applies to questions of Down syndrome.
Nowhere near 100% choose abortion
Sometime between the 11th and 14th week of the pregnancy women are offered a pre-natal screening where the fetus is checked for abnormalities, and the findings are shared with the woman. This screening can, among other things, detect whether there is an increased likelihood of the fetus having Down syndrome. Women are not pressured to have this screening, but strongly urged to do so.
Hulda Hjartardóttir, chief physician at the maternity ward of the National University Hospital told the local newspaper Morgunblaðið that it is plain wrong to claim, as CBS News does, that "close to 100%" of women who are told that the fetus has an increased likelihood of having Down syndrome.
Women receive information and advice, are nut subjected to pressure
Hulda explained to the Icelandic National Broadcasting Service that roughly 85% of women choose to have the optional pre-natal screening, while 15-20% choose not to have the screening. The screening reveals whether there is an increased likelihood of the fetus having Down syndrome. If the screening finds that there is an increased likelihood of the fetus having Down syndrome 15-20% of women or prospective parents choose not to undergo any further tests, and simply choose to carry the pregnancy to term.
The other two thirds undergo further tests and follow up discussions with doctors and nurses where the findings of the tests are explained. If the tests conclude that the child will be born with down syndrome women are told they have two options: to end the pregnancy or carry it to term.
Hulda told the Icelandic National Broadcasting Service that the presentation of CBS News was "misleading":
"Yes they are a bit misleading. It is possible to use statistics to say different things, and I think this news program did that. It distorted the reality."
Hulda told Morgunblaðið that women and parents are then offered the opportunity to meet with doctors and nurses who work with people with Down syndrome. They are also offered the opportunity to meet parents who have children with Down syndrome. No effort is made to pressure the women to make a certain decision, she explains.
Woman make the decision themselves
In fact, Hulda stresses that every effort is made to ensure that the decision comes from the woman herself. She told Morgunblaðið that her experience is that no woman takes this decision lightly:
"It is very difficult to force a woman to carry a pregnancy to term, whether or not it is for social or some other reasons. If we really support women's right to choose it is extremely difficult to say that one thing is ok, but not another. But this is an extremely difficult decision which no woman makes lightly."
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