What Is Trisomy 18?

As you might have read in my Wednesday post, Ann Coulter declared on Twitter that when the Texas Supreme Court reversed a lower court decision and refused to allow Kate Cox to have an abortion-- was cruel. 

Some have suggested that Coulter had no business commenting on the matter, because she has never been pregnant. I will add that if pregnancy is a qualification for commenting on an abortion decision, I too am unqualified. I know precious little about the conquences of being pregnant with a fetus that suffers from the genetic condition called Trisomy 18. Heck, I am not even an obstetrician.

As it happened, a Washington Post reporter, by name of Kelsey Ables, has collected some of the evidence. She helps us al to understand the issues. For the record, the issue is now moot, because Cox traveled to another state to have the procedure done.

After Kate Cox learned her fetus had Trisomy 18, a genetic disorder that almost always results in miscarriage or stillbirth, the Dallas-area mother of two realized: “It isn’t a matter of if I will have to say goodbye to her, but when,” the 31-year-old wrote in a Dallas Morning News essay.

Now, almost always is not the same as always. And yet, the likelihood of a healthy baby is miniscule, though not impossible. Imagine if a surgeon told you that, if you do not have a certain surgery, your chances of survival are around 10%, but if you do have the surgery, your chances are closer to 100%. What would you choose?

Meanwhile, back in Texas, the state Supreme Court decided that there was not a high enough risk to the mother’s health. Which leads you to ask why a panel of judges should have the last word on this issue:

She petitioned a judge to get an abortion in Texas — where the procedure is banned in most cases — under a narrow exception that allows abortions when the mother’s health is put seriously at risk. While a lower court ruled last week to allow the exception, the Texas Supreme Court reversed the decision on Monday, arguing that the condition does not “pose the heightened risks to the mother the exception encompasses.”

As for Trisomy 18, you are doubtless curious to know what it is. The Post addresses the issue:

Trisomy 18, also known as Edwards syndrome, is a disorder in which a fetus has three copies of chromosome 18 rather than two. Because genes direct development, “almost all the organs have abnormalities,” said Mary Norton, a professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco. There is some variation, but brain, kidney, limb and especially heart abnormalities are common, she said.

As for survival rates, for babies with Trisomy 18, the statistics are grim. The great majority do not survive their first year. Most die within two weeks of birth:

About 50 percent of babies carried to term with Trisomy 18 are born alive, according to studies cited by the Minnesota Department of Health; among them, an estimated 90 to 95 percent do not survive beyond their first year. Most die within 10 to 15 days, often from cardiac arrest or respiratory failure, according to the amicus brief filed by the American College of Obstetricians and Gynecologists.

As for specifics of Kate Cox’s case, especially involving her health, the news is certainly not very encouraging. In general, Trisomy 18 pregnancies are far more likely to be delivered before 32 weeks, and to involve Caesarean section:

A California study of deliveries between 2005 and 2008 found Trisomy 18 pregnancies were 2.5 times more likely to be delivered by Caesarean section and 10 times more likely to be delivered at less than 32 weeks.

Presumably, an important issue was the health of the mother. As you might know already, Cox had had a very difficult pregnancy:

Cox had been to the emergency room at least three times during her pregnancy, The Washington Post reported, with “severe cramping, diarrhea, and leaking unidentifiable fluid.” Cox has had two prior C-sections and would have probably needed a third if she carried the pregnancy to term, according to the complaint — which doctors said could have affected her ability to have more children.

Apparently, none of this counts for the pro-life forces in Texas. As Ann Coulter recognized, their fanaticism has undermined their cause. Perhaps physicians have different opinions. And yet, do we really want judges and other assorted attorneys to make the decisions?

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