Background: More knowledge about the particularities of pregnancy and childbirth in women with Down syndrome (DS) might improve medical and psychosocial support for expectant mothers. Method: In a sample of 351 pregnancies, women with DS were compared with women with other forms of intellectual disabilities (ID) and women without ID with regard to pregnancy outcome, characteristics of hospitalisation, and complications. Results: Among women with DS, 62.9% of pregnancies ended abortively compared with 15.1% for women without ID and 22.0% for women with other forms of ID. Significant group differences were found for pre-existing diseases that complicate pregnancy, birth, and puerperium. No group differences were found in pregnancy-specific diseases, in complications associated with the foetus, and in complications of labour and childbirth. Conclusions: The increased abortion rate of women with DS appears to be a central characteristic of pregnancies in this population and merits further investigation.