Candidate for the Lee B. Lusted Student Prize Competition
Purpose: In this paper, we analyze pregnant women’s decision towards the prenatal diagnosis of Down’s syndrome (amniocentesis); the trade-off is between doing the test which increases risk of miscarriage and not doing it with a risk of giving birth to a child suffering from Down’s syndrome.
Method: We use a unique database with exact information on the risk of Down syndrome (as estimated from the blood sample after 14 and 18 weeks pregnancy), the mother’s age and amniocentesis decisions for a large sample of pregnant mothers, who took the free screening test between 2003 and 2007 in a French maternity hospital (Robert Debré). We have built a basic model in a standard expected utility (EU) framework and we have estimated it empirically by using the previous database. Thus, we have implemented an econometric approach, in which observed behaviours are supposed to reveal women’s valuations of Down’s syndrome.
Result: We obtain an estimation of the distribution of the implicit value of a foetus death for women in the database. Using a scale on which the value of a child affected by the Down syndrome is 0 and the value of a healthy child is 1, the mean value for a death foetus is roughly 1/3 (meaning that, on average, women are indifferent between abortion on one hand, and a lottery where their new born child is affected with the Down syndrome with probability 2/3). Interestingly, the theoretical implicit value of a foetus death that can be deduced from the legislation (using the risk threshold at which amniocentesis is reimbursed by the Health System) is 2/3.
Conclusion: One can interpret this difference as an indication that women actually give a substantially higher value to child affected by the Down syndrome than the society does.
See more of: The 33rd Annual Meeting of the Society for Medical Decision Making