Many a pregnant woman has walked into gynaecologist Hajo Wildschut practice, shattered from the result of the ultrasound she had 20 weeks into her pregnancy. Women in the Netherlands are all offered an ultrasound at that stage, when the sex of the baby becomes apparent, but also when defects like hydrocephalus, spina bifida (split spine) or cleft lip can first be detected.

"Most of these children are wanted," said Wildschut. "But then the pregnancy takes such a tragic turn. The parents are struggling terribly with the questions: can we raise a child who has spina bifida or Down syndrome? Can we live with the decision of ending this pregnancy?" The gynaecologist says he has great respect for people who give an affirmative answer to the first question. But he feels the same way about people who choose the second option.

The Dutch orthodox Christian party ChristenUnie however, is now saying it wants postponement of the official ultrasound to week 24, the legal limit for abortion in the Netherlands. The government introduced the 20-week ultrasound for all women in 2007. If a major defect is found at that stage, parents have four weeks to decide whether they want their baby to be born.

Cap at 18 weeks?

The number of abortions between week 20 and 24 has since doubled, data published Thursday by the Netherlands Health Care Inspectorate revealed. In 2006, 140 women had an abortion in that period, 276 in 2008. Before 2007, women had to pay if they wanted an ultrasound at 20 weeks.

Esmé Wiegman, a member of parliament for the ChristenUnie, said Tuesday: "The life of a person with disabilities is a valuable life. We should be able to count on a careful approach when the life of an unborn child with a disability is involved." She announced that she wants the regular echo moved to week 24 when abortion is illegal, to turn the tide. If that proposal fails to get support, she wants legal abortion capped at 18 weeks, before the defects become visible.

The orthodox Christian party has always opposed abortion, claiming only God should decide whether a baby is born or not. When it entered into a coalition with the Christian democrats, CDA, and Labour in 2006, however, it signed a government agreement that said the laws on abortion would not be changed.

Both of the other coalition partners have responded negatively to Wiegman's proposal. They say it is a woman's right to decide whether she wants to continue her pregnancy or not, as long as it happens within the legal limit of 24 weeks.

Not a single euthanasia

The ChristenUnie plan comes at a time of wider debate already going on in society about where to draw the line on abortion. Medical professionals and ethics ethicists have asked whether, when doctors could see if a child will develop autism, that could also be a reason for parents to terminate the pregnancy.

The data released on Thursday don't specify why more women chose to have a late abortion. Doctors are not allowed to document their motivation. But the inspectorate wrote in its report it is "plausible the increase is related to the introduction of structural ultrasound examination, : the screening examination around the 20th week of the pregnancy."

Another possible consequence is that doctors reported not a single euthanasia of a newborn in 2008. They are obligated to disclose if babies with a condition deemed "incompatible with life", such as certain very serious cases of spina bifida, are euthanised. Experts say fewer such babies are born now because their condition can be determined at the 20 week ultrasound.

Gynaecologist Wildschut finds it odd that politicians act surprised about the higher number of abortions. "The whole idea of the 20 week ultrasound was to detect these defects," he said.

Improved care for babies with defects

The deputy minister of health has announced she is considering documentation of the reasons women decide to have abortions. But Wildschut believes it is more important to inform women before they have the ultrasound. "They can opt out if they know they want to keep the baby no matter what."

Nurse Marjan Nijhuis-Kloen, who works as a cleft lip expert at a hospital in Nijmegen, said she has difficulties with parents who choose not to have a child when a cleft is found on the ultrasound. "We explain that the child can be helped by undergoing three or four operations. And we will supervise the child for years, watch it grow up. We will never tell the mother, ‘this life is not worth it.’"

Nijhuis-Kloen said about two out of the 64 women she helps each year decide to terminate the pregnancy.