Conundrum

Marianne Wigbers, obstetrician

‘It was her first child, and initially there were no signs of any complications. She and her husband had moved to our village a short time before: they both had busy jobs and led full and active lives. Two city slickers, busily pursuing their careers … I thought I had them pegged, I must admit, and I was taken aback by the decision they would eventually make.

At the first ultrasound, everything seemed fine. But during the twenty-week scan at a nearby hospital, the troubled ultrasound operator called in the gynaecologist, who diagnosed the problem straight away. The unborn foetus had a prolapsed abdomen: a hole in its belly near the navel, where the intestines had protruded and were now suspended in an external membrane. The child also had a heart abnormality. The gynaecologist’s immediate suggestion was to terminate the pregnancy. This is serious, he said, and it’s still possible to turn back.

Some parents, I know, would prefer not to risk a life with a disabled child and would choose abortion if the ultrasound showed any abnormalities. Society also seems to have become more critical, and these days, anyone who willingly chooses to have a child with Down’s syndrome practically needs to defend themselves. But these two young parents gave a resolute, almost passionate response to the gynaecologist’s proposal. Termination was out of the question. No discussion, it wasn’t going to happen. End of story.

Their baby was born on Liberation Day in the Netherlands. It was a little girl, whom they named Fiona. I couldn’t be there, as the delivery took place in the academic hospital some distance away, but because I was in the neighbourhood for a meeting with my professional association, I decided to pop by anyway. The young mother was recovering from her labour, and the baby had gone straight into surgery. The procedure was a lot simpler than the doctors had first imagined. They successfully closed the hole in the abdomen and found that her heart abnormality was less serious than initially supposed. The parents and I talked about it often afterwards: they’d taken such a strong position that I drew strength from it myself. In choosing their child’s life, they sent out a powerful message, a response to a conundrum faced by many young parents. Now that pre-natal testing can identify a range of abnormalities in utero and abortion is meeting with less social opposition, the possibility of a “designer world” seems within reach. But if a child is born with a disability, it doesn’t mean that their life will be meaningless. To these parents, deciding against the birth of their child was never even an option.

It takes guts to stand up to a gynaecologist who delivers bad news and suggests an abortion. There’s no way of knowing what’s coming, or even how serious the disability might be. I had assumed that a disabled child would be unwelcome in the lives of these two busy, hardworking people. How wrong I was. It taught me not to judge a book by its cover and that we can never truly predict other people’s choices.

I’ve occasionally considered confronting the gynaecologist about his initial response to the scan. The problems he predicted never even eventuated: Fiona is now a lively, sweet and happy eight-year-old girl. She’s missing her abdominal muscles on one side but manages just fine with physiotherapy. Her heart abnormality eventually disappeared by itself.

Just as long as it’s healthy … how often do expectant parents hear that nowadays? It’s a well-meant platitude that’s trotted out all too easily, and it’s a fairly ludicrous sentiment, when you think about it. These parents showed me just how vast and unconditional the love for a child can be.’