sex selective abortion essay

The ethical case against sex-selective abortion isn’t simple

sex selective abortion essay

Lecturer in Global Ethics, Department of Philosophy, University of Birmingham

Disclosure statement

Jeremy Williams does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Birmingham provides funding as a founding partner of The Conversation UK.

View all partners

A key theme in public debate over abortion in many countries over the last few years has been the morality and legality of sex-selective terminations. Now the use of an early prenatal testing technique in the UK has led to further concerns.

The Non-Invasive Prenatal Test (NIPT) is being fully introduced on the NHS this year, as a safe method of detecting Down’s Syndrome and other genetic conditions. But it has been internationally available from private providers for a number of years, and, as a 2017 report noted , is often offered as a sex-determination test. This has raised concerns that the test may be used to facilitate sex-selective abortion – particularly within communities where women can be subject to strong cultural and familial pressure not to have girls. The current legal status of this practice in the UK is a matter of some controversy .

The BBC’s Victoria Derbyshire recently reported online discussion among British women about using NIPT to abort female foetuses. In response, the Labour Party announced a policy of banning the use of NIPT for sex determination. Labour’s equality and women’s spokesperson, Naz Shah, described sex-selective abortion as “incredibly unethical”.

Shah’s view – that sex-selective abortion is morally wrong, and that the law ought therefore to prevent it – is widely shared, including among those who otherwise identify as pro-choice. Similar sentiments were expressed by politicians in 2012, when an undercover investigation by the Telegraph found a number of doctors that appeared willing to perform sex-selective terminations.

But if you propose to deprive women of facts about their pregnancies, or interfere with choices they might make about their own bodies and futures, you must do more than allege wrongdoing. Articulation of a clear and compelling moral objection is required.

So: what kind of objections can be made in this case?

Sex discrimination

Sex-selective abortion is often dismissed as an abortion chosen due to a trivial preference, like a preference for one consumer product over another. And it would be natural to infer that it is therefore a classic case of unjust discrimination. What could be more obvious than that it is wrong to treat someone – in this case a foetus - less favourably simply on the arbitrary grounds of sex?

This characterisation of the practice is, however, dubious. Take first the thought that sex-selective abortion cannot be motivated by serious reasons. In fact, women who seek such abortions can have purposes that are just as weighty as those of women seeking non-selective terminations. They may be justifiably afraid, in particular, that the gender of their child may lead to the failure of their marriage, or their being left destitute. Cases described by the organisation Jeena International , for instance, show that it would be a mistake to assume that women in countries like the UK are necessarily immune to these risks. Yet, while Jeena International advocates the prohibition of sex selection, it is precisely when women face precarious circumstances like these that the option of abortion seems most crucial.

Consider next the suggestion that sex-selective abortion constitutes unjust discrimination against the foetus. This casts the foetus as having a right to be treated as our equal. But that idea undermines the case for abortion rights in general, not just sex-selective abortion.

sex selective abortion essay

Social impact

In order to avoid providing tacit support for a pro-life position, ethical critics of sex selection often argue that the practice’s victims are not foetuses, but existing persons in society. There are number of versions of this position, pointing to a variety of anticipated bad social consequences. The question is whether any are strong enough to justify abridging choice in an area of such deep personal importance as procreation.

One immediate fear is that, if sex-selective abortion is available, it could lead to harmful unbalancing of the sex ratio. This seems a fairly remote possibility in a country like the UK, at least, where strong son-preference is not widespread.

But another common rationale for prohibiting sex-selective abortion may be more applicable. It appears , for instance, to have been part of the motivation behind an (unsuccessful) attempt to change the law on sex selection by Fiona Bruce MP in 2015. On this view, a ban is needed to protect women from being coerced by their families or spouses into having the procedure.

Domestic coercion is undoubtedly a matter of grave concern. But it is unclear that prohibiting sex-selective abortion is the right remedy. This is because vulnerable women are at risk of being coerced into unwanted abortions generally. In all such cases, the appropriate policy is arguably instead to tackle domestic oppression directly, giving women meaningful exit options, while leaving abortion open to those who need it.

Tackling inequality

Yet another argument focuses on the message that allowing sex-selective abortion allegedly transmits. As one columnist evocatively puts the point : “I don’t want my daughter to learn that a girl’s life is worthless.” The suggestion here is that the existence of the practice vividly expresses the inferior status of women, making the struggle for gender equality still more difficult. But this case for prohibition can also be questioned on an ethical level.

One reason is that it is analogous to an argument that some disability rights advocates have made, to the effect that prenatal testing likewise broadcasts a hurtful, disrespectful message about the value of disabled lives. If someone were to argue, on these grounds, that selective abortion for disability is not only ethically problematic but ought to be banned, pro-choice people would no doubt reply (a) that there is no intention to express any such message, and (b) that in any case preventing women from obtaining needed abortions is not an equitable way of pursuing justice and equality for the disabled. These replies seem applicable in the case of sex selection too.

All this indicates that the ethical case for prohibition is less straightforward than one might expect. We can agree, of course, that much more progress needs to be made towards a world without the pervasive sex inequalities that lead some women to choose sex-selective abortion in the first place. But our problem is what to do here and now, while those inequalities persist. The dilemma is that, while such abortion can plausibly be seen as reinforcing relevant inequalities, prohibiting it arguably involves a perverse shift of the burdens of achieving gender justice onto vulnerable women themselves.

  • Sexual selection
  • Interdisciplinarity

sex selective abortion essay

Research Governance Officer

sex selective abortion essay

General Manager | La Trobe University, Sydney Campus

sex selective abortion essay

Lecturer / Senior Lecturer - Business Law & Taxation

sex selective abortion essay

Newsletters and Social Media Manager

sex selective abortion essay

Industrial Officer (Senior)

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings
  • Advanced Search
  • Journal List
  • SAGE Choice

Constructing abortion as a social problem: “Sex selection” and the British abortion debate

Associated data.

Between February 2012 and March 2015, the claim that sex selection abortion was taking place in Britain and that action needed to be taken to stop it dominated debate in Britain about abortion. Situating an analysis in sociological and social psychological approaches to the construction of social problems, particularly those considering “feminised” re-framings of anti-abortion arguments, this paper presents an account of this debate. Based on analysis of media coverage, Parliamentary debate and official documents, we focus on claims about grounds (evidence) made to sustain the case that sex selection abortion is a British social problem and highlight how abortion was problematised in new ways. Perhaps most notable, we argue, was the level of largely unchallenged vilification of abortion doctors and providers, on the grounds that they are both law violators and participants in acts of discrimination and violence against women, especially those of Asian heritage. We draw attention to the role of claims made by feminists in the media and in Parliament about “gendercide” as part of this process and argue that those supportive of access to abortion need to critically assess both this aspect of the events and also consider arguments about the problems of “medical power” in the light of what took place.

Introduction

This House must make the matter clear. If we cannot get a consistent line from abortion providers on whether or not it is illegal to abort a girl – it is usually girls but not always so – for the sole reason that she is a girl, then the law is not fit for purpose. To do so constitutes a gross form of sex discrimination. Indeed it is the first and most fundamental form of violence against women and girls. (Fiona Bruce MP, House of Commons debate on the Serious Crime Bill [ Hansard, 2015 ])

On 23 February 2015 the UK Parliament debated and voted on an amendment to the Serious Crime Bill (an extensive set of proposed changes to criminal law) that sought to include these words in a new Serious Crime Act: “Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the unborn child”. The extract above is taken from the speech made by the Member of Parliament (MP) Fiona Bruce, arguing for other MPs to support this amendment. She contended that legal change is needed because it is necessary to clarify to abortion providers that, always, “it is illegal to abort a girl” and that it should be so because sex selection abortion “is the first and most fundamental form of violence against women and girls”. This attempt to change the law followed a three-year period, beginning in February 2012, during which claims along the same lines were repeatedly made in the media, and also in the UK Parliament.

Prior to this attempt to change British law, laws banning sex selection abortion had already been passed in several states in the USA. Bruce’s proposal was similarly for sex selection abortion to be specifically prohibited, but the amendment she proposed was defeated following over two hours of debate (with 201 MPs voting for it, and 292 against). An alternative amendment was passed by 491 votes in favour, two against, committing the UK Government to assess evidence of “termination of pregnancy on the grounds of the sex of the foetus”, and where considered necessary, act to change “prejudices, customs, traditions” which “amount to pressure to seek a termination on the grounds of the sex of the foetus” ( Serious Crime Act, 2015 ). This meant that sex selection abortion was institutionalised as a social problem in Britain, but in the end in a way that left the 1967 Abortion Act formally unaffected.

Drawing on constructionist theories of social problems developed in sociology and social psychology, this paper highlights how abortion was problematized in new ways through this debate, as it came to be associated with perceived problems of religion and ethnicity (described in the Serious Crime Act, 2015 as “prejudices, customs and traditions”) and presented as a form of violence against women. Perhaps most notable, we argue, was the level of largely unchallenged vilification of abortion doctors, on the grounds that they are law violators and participants in acts of discrimination against women. Although other terms were used by participants in the debates, throughout this paper we use “sex selection abortion” to refer to the social problem it was alleged needed to be addressed.

We suggest that two main areas of interest emerge. The first concerns claimsmakers. This is the term used by scholars who explore processes by which conditions that may exist in society come to be defined as social problems; claimsmakers are people who “seek to convince others that something is wrong, and that something should be done about it” ( Best, 2008 , p. 15). In line with efforts to “feminise” opposition to abortion discussed further below, sex selection abortion was initially made a topic of debate by journalists working for The Telegraph newspaper, a publication well known for its “pro-life” position, but less predictable claimsmakers also became involved. Overt threats about prosecuting doctors were made by senior Government ministers, and equally notable was the role of some who describe themselves as feminists. For most of the period of debate, some feminists who commented publicly made claims that advocated strongly in favour of the need to do something about sex selection abortion, an approach which was only called into question in the final phase of debate in 2015.

Secondly, we suggest these events raise related questions about the “medicalisation” of abortion in Britain. Sheldon (1997) details how doctors’ authority, or “medical power”, has been central to the operation of abortion law and practice in Britain. Claims about sex selection abortion, however, called this authority into question on the basis that its exercise harms women. We return to the question of medical authority in the conclusion to this article, but note here that the form through which “medical power” was questioned is one that those concerned to defend access to abortion may be disturbed by. Before detailing how these issues emerge from our research, we first discuss insights from studies that contextualise this episode.

The “feminisation” of the abortion problem

Research based in a variety of disciplines has shown how arguments against abortion are continually modified. Considerable efforts have been made, for example, to secularise the anti-abortion argument by borrowing the authority of science to construct the foetus as an “unborn child”, rather than refer to religious authority ( Savell, 2008 ). Abortion opponents have focussed increasingly on “late term” abortion, including medical techniques used in these procedures, to provoke disgust and disquiet ( Greasley, 2014 ). Some research in sociology and social psychology considers the work of social movements in gaining support for their cause through a consideration of claimsmaking activity and the modification of social problem framing ( Gavey & Gow, 2001 ). Best (2008) explains, for example, that a claim is an effort to persuade others to support and identify with the proposition that something must be done about a putative social problem, and claimsmaking responds to changing contexts and experience. In relation to abortion, research of this social constructionist sort has shown that “feminised” or “pro woman” claims about harms to women emerge as a consistent and prominent feature of the re-framing of abortion as a problem over the past 25 years.

“Feminised” claims against abortion focused on harms to women’s health have attracted the most scholarly attention ( Kelly, 2014 ; Rose, 2011 ; Saurette & Gordon, 2013 ; Siegal, 2007 ; Trumpy, 2014 ). Cannold has outlined, for example, “the rise and use of a ‘woman-centred’ anti-choice strategy to oppose abortion in Australia and the USA”, based on claims that, “women do not really choose abortion but are pressured into it by others and then experience a range of negative effects afterwards, including an increased risk of breast cancer, infertility and post-abortion grief” ( Cannold, 2002 , p. 171). Rose provides a detailed analysis of what she terms “frame extension in the American anti-abortion movement”, focussing on claims about women’s health ( 2011 ). One point made about these “feminised” claims is that they respond to difficulties this movement has faced in persuading others, or enough others, to support its cause. “Faced with what they believe to be the limited political and cultural effectiveness of movement rhetoric primarily focussing on fetal life”, those who call themselves “Pro-Woman Pro-Life” seek “to refine the terms of the American abortion debate by recasting it as dispute regarding which position best represents the rights, health and interests of woman – pro-life or pro-choice”, suggests Trumpy ( 2014 , p. 164).

A small number of research articles explore efforts to ban sex selection abortion in the USA. A general similarity with “pro woman, pro-life” claims is the perceived need for a new way to frame abortion as a social problem ( Kalantry, 2013 ). However, distinct and specific features of this version of feminised opposition to abortion have been identified. First, claims for bans on sex selection abortion directly draw on feminist language, especially the term “gendercide”. The origin of this term is attributed to the feminist philosopher Mary Ann Warren (1985) who used it to describe the deliberate mass killing of either males or females, and it was subsequently popularised by economist Amartya Sen to describe abortion of female foetuses and infanticide involving female babies in Asia ( 1990 ; see also Purewal & Eklund, 2017 ). Second, they focus not only on the pregnant woman but also the foetus as harmed by abortion (with the latter often described as a “girl child”). Third, they link the abortion problem to ethnicity.

Kalantry (2013) explains that Illinois was the first state in the USA to ban sex selection abortion as far back as 1985 and Pennsylvania introduced a ban in 1989. Kalantry’s argument about these bans, however, is that the claims made for them differ from those made to support later bans, passed in seven further states in the USA by 2013. In the 1980s, there was no linkage made to practices in other countries, but claims supporting more recent bans make such links explicit. In 2011 the state of Arizona, for example, passed the “Susan B. Anthony and Frederick Douglass Prenatal Non-discrimination Act”, which makes it a felony for doctors to knowingly perform abortion for race or sex selective reasons. As Musial explains:

The first of its kind in the United States, HB 2443 (2011) turns abortion into a non-discrimination issue; it is now a class 3 felony to knowingly provide abortion services on the basis of the race or sex of the ‘child’ or the race or sex of the ‘child’s’ parent; it is also a crime to coerce, threaten or intimidate a woman into accepting an abortion on the basis of fetal race or sex; and anyone who ‘solicits or accepts monies to finance a sex-selection or race-selection abortion’ is committing a crime. If convicted an abortion provider who knowingly conducts race or sex-selection abortions may face three and a half years in prison …. Women seeking an abortion cannot be charged with a crime under HB 2443. ( Musial, 2014 , p. 263)

This assessment draws attention to the framing of an abortion ban as an act of “non-discrimination”, to the construction of both “the child” and the pregnant woman as victims of crime, and to the potential for imprisonment of doctors. Musial also notes the explicit linking to “gendercide” as an “imported problem”:

During the discussion about sex-selection, gendercide in China and India was depicted as a real problem ‘over there’ in the East that the American Government … should aim to prevent ‘over here’ in the West. ( Musial, 2014 , p. 269)

Reference, explains Musial, was made to Amartya Sen’s claim about “gendercide” and 100 million “missing girls” in Asia, and sex selection abortion was also compared to “honour killings”. There was deployment of “feminist language”, she argues, when the Bill’s proponents said that “sex-selection and ‘honour killings’ are global manifestations of violence against women”, and that this language created, “an us v. them paradigm where anyone who prefers sons or contemplates sex selection abortion is constructed as foreign or violent” ( Musial, 2014 , p. 270). Work on woman-centred anti-abortion claims has detailed their “diffusion” from the US to Britain ( Lee, 2004 ) and it is arguable, as we go on to detail, that the framing of the problem of sex selection abortion, as outlined by Kalantry (2013) and Musial (2014) , has spread in a similar way.

Our assessment of what happened in Britain is based on a qualitative analysis of the British print media, specifically national newspapers, between 23 February 2012 and 31 March 2015. Articles were retrieved through a LexisNexis search using the terms “sex selection”, “abortion”, “Gendercide” and “Fiona Bruce”. A total of 66 articles comprised the final dataset, but with uneven occurrence in different newspapers. While most national newspapers covered the story at some point, there was most coverage in The Telegraph; journalists working for this newspaper were key claimsmakers. However, The Independent , a newspaper considered, in contrast to The Telegraph , to be pro-choice editorially, also published more articles than other papers and made claims that shaped events through 2014 and 2015.

A second set of documents published in response to claims made by journalists was also analysed. The then Secretary of State for Health Andrew Lansley responded immediately to claims made by The Telegraph in 2012 by initiating investigations into the practices of abortion providers. These were carried out by the Care Quality Commission (CQC) (the body responsible for regulating facilities providing health and social care services in England). Following a police investigation, the Crown Prosecution Service (CPS) (the body responsible for bringing prosecutions of criminal cases investigated by the police in England and Wales) also conducted an inquiry, and both the CQC and CPS published reports. The Department of Health (DoH) published two statistical analyses of birth data and a policy statement. Parliamentary debates were held in November 2014 and February 2015. (Full details of the media coverage discussed below, and of all other documents analysed, can be found in Appendix 1, available online at journals.sagepub.com/home/fap ).

The analysis followed Best’s (2008) argument that efforts to persuade normally include three component parts: grounds (evidence, statistics and information which typify the social problem); warrants (appeals to value sets to indicate why something should be done); and conclusions (recommendations for changes, for example, new laws or policies). We made grounds, “statements describing the condition [which] argue that the condition exists, and offer supporting evidence” ( Best, 2008 , p. 31), the central focus, to consider how those seeking to construct sex selection abortion as a problem typified it. Our discussion broadly follows the way claimsmaking developed chronologically, and our analysis indicates that there were three sorts of grounds for claims, as we now detail.

Sex selection abortion as a British social problem

Abortion doctors as villains.

The “sex selection abortion story” broke in February 2012 when The Telegraph published six articles, accompanied by on-line AV footage, based on undercover filming at three abortion clinics in Manchester, Birmingham and London. Nine clinics in all had been visited, and according to the journalists involved, they had filmed undercover at the clinics because:

The prevalence of sex selection abortions is hard to prove – as discussion between patients and doctors within a consulting room is necessarily sacrosanct. Therefore, this newspaper decided to take the step of accompanying happily pregnant women posing as people seeking abortions, to a limited number of private clinics. (Watt, Newall, & Zhimji, 2012)

Best (2008) notes there are three components to grounds that might be apparent when a claim about a social problem is first made. There may be: typifying examples (examples which are in fact rarely typical, but which dramatise and disturb, to illustrate the seriousness of a problem); the naming of a problem (often as an example of an already accepted problem); and statistics (which show that the problem is very widespread and also measured to be so). As we will go on to discuss, all these were features of claimsmaking as events unfolded. Claimsmaking at the outset, however, as the extract from The Telegraph above suggests, was focussed away from claims about numbers; indeed the case made was that “the prevalence of sex selection abortion is hard to prove”. The naming of the problem at this point was ambiguous; the terms “sex selection abortion”, “gender abortion” but also “abortion on demand” were used, and there was no use of the term “gendercide” in the original reporting.

The ground identified was, rather, a typifying example which sought to disturb, but more specifically this initial ground is perhaps best thought of as a type Best describes as “additional”, which “identifies categories of people involved in the troubling condition” (2008, p. 35). Following Loeseke (2003) , Best suggests these categories often represent people as “victims” and “villains”, and for the problem of sex selection abortion in Britain, it was the latter that most clearly formed the original ground for the claim, with doctors as the villains.

The opening lines of the first Telegraph report read as follows:

With its pale leather sofas and brightly-lit reception, the sleek office could have been just another call centre or accountancy firm in central Manchester. But for one visitor earlier this month, the nature of its business could not have been more serious. Despite its appearance this was an abortion clinic at Pall Mall Medical and it was a matter of life and death. (Watt, Newall, & Zhimji, 2012)

This description of the ambience of one clinic and of abortion provision as a “business”, like “call centres” and “accountancy”, represents the motivation of doctors as at odds with the to-be-expected ethical orientation of medicine. Extracts used from transcripts in the reporting are designed, in part, to highlight this point. The doctor at this clinic, a Dr Sivaraman, is reported to have said, “I don’t ask questions. If you want a termination, you want a termination” (Newell & Watt, 2012). This comment could be interpreted as a commitment to respect women’s autonomy, but here is presented to reinforce a lack of care for patients borne out of a desire to make money.

Another way doctors were villainised was through their representation as supporters of discrimination. Much was made in reporting of a comment attributed to a Dr Rajmohan (named throughout by Telegraph journalists as Dr Raj Mohan) that sex selection abortion is “like female infanticide”, and that, “It’s common in the Third World to have female infanticide” (Watt, Newell, & Winnett, 2012). The implication (especially given the emphasis on the Indian-sounding name of the doctor) is that what is taking place is a version of “gendercide”. However, this claim was not developed in reporting at this point.

Rather, emphasis was placed strongly on the claim that evidence had been found of law violation: “Sex selection terminations are illegal, but clinics show willingness to carry them out” was the subtitle of one of the articles breaking the story (Watt, Newall, & Zhimji, 2012) and it was this ground that was responded to by others, and notably rapidly. The day after they broke the story, The Telegraph carried a piece by the then Secretary of State for Health, Andrew Lansley, titled: “Health professionals must not think they know better than the law”. In it, Lansley argued:

Anyone indulging in illegal activity must understand they are running a great risk. The potential penalty for breaking abortion legislation is imprisonment. Doctors could be struck off. And we will not hesitate to pursue any evidence that comes into our hands. Anyone who flouts the law can be assured that they will end up feeling its full force. (Lansley, 2012)

The rapid linking of the ground of the doctor as villain to the conclusion that doctors will end up feeling the “full force” of law is striking, and the measures through which investigations of law breaking were to be pursued – investigations of abortion clinics by the CQC, and investigations of the doctors filmed by The Telegraph by the General Medical Council, and by the police, were announced by Lansley at this very early stage (2012).

It was reporting about the findings of the CQC investigation that formed the next focus for claims from March 2012, in fact four months before the CQC’s report was made publicly available, and this claimsmaking continued when the report was published in July 2012. At this point the commission published “249 individual inspection reports into providers offering termination of pregnancy services”, with its summary of these inspections noting that inspections took place over less than two weeks in March 2012, and stating the following: “As a result of these unannounced inspections, CQC identified clear evidence of pre-signing at 14 locations, all of which were NHS Trusts” (CQC, 2012).

Under British law, an abortion can only be legally provided where two registered medical practitioners (doctors) agree “in good faith” that the terms of the 1967 Abortion Act have been met. Their agreement must be notified to the DoH, and this takes place through submission of a form designated for this purpose, which they have signed. There have been debates in recent years about procedures sometimes used for signing these forms, termed “signing unseen” and “pre-signing”, and as the extract above indicates, the latter was discussed in the CQC report. In the former case, forms are signed where a doctor has not seen the woman concerned personally, but has discussed her case with other members of clinic staff such as nurses or counsellors. In “pre-signing”, a discussion between a doctor and other staff members may take place, for example, by telephone, and a form that is already signed is then used.

In these debates about the signing of forms, some, including some opposed to abortion, have accused abortion providers of acting illegally, and offering inadequate levels of medical attention, where these practices are adopted. Providers have pointed to the need to manage high case-loads of mainly early abortion procedures that rely on care primarily from nursing and counselling staff, not doctors, and hold that it is not necessary for every woman to have a full consultation with a doctor.

In 2012, a controversy of this sort about “pre-signing” spun off following the publication of a CQC report separate to that about sex selection. Claims were made about the need to newly regulate abortion providers in relation to procedures used to sign forms because of what the CQC had reported. The detail of this debate is beyond the scope of this paper; however, what matters here is that the CQC report made no mention of sex selection abortion at all , despite the fact that this was the original focus for its investigation. Yet, despite the fact that the CQC had found no evidence of sex selection abortion at any of the 249 clinics it inspected, links were, nonetheless, made in media reporting back to The Telegraph 's allegations from February (Watt & Newell, 2012). Comments attributed to Lansley indicated, again, a focus on doctors as law violators: “[I]t is pretty much people engaging in a culture of… ignoring the law… If there is evidence of an offence we will give it directly to the police”, he was reported to have stated (Winnett, Newell, & Watt, 2012).

The claims about doctors made between February and July 2012 attracted almost no counterclaims. An editorial in The Independent claimed: “the evidence that some British clinics are unashamedly agreeing to perform abortions on that basis [sex selection] is deplorable” ( Independent, 2012). Commentary from those who describe themselves as feminist was especially noteworthy. Two articles authored by feminists contained a riposte. The legal scholar Sally Sheldon (2012) called into question a range of claims made about both the law and the practices of abortion doctors, and journalist Sarah Ditum (2012) similarly made counterclaims, disputing grounds. She also uniquely argued that the case for the right to choose abortion has to include abortion for fetal sex. However, other feminist commentators endorsed the villainisation of doctors and, although the problem was not named this way by The Telegraph , their commentary also suggested “gendercide” was happening in Britain.

Feminist journalist and writer Yasmin Alibhai-Brown (2012), for example, explicitly constructed doctors as money-grabbing, sexist and prepared to act illegally. An article she wrote was titled: “Greedy doctors and why I despair for British Asian women who abort female foetuses”. In February 2012 The Telegraph published a long feature article by another high profile feminist writer and newspaper columnist, Allison Pearson. The opening lines read:

In the third world, unwanted baby girls ‘disappear’. It’s called gendercide. And it’s happening in this country, too; those who act illegally to abort unwanted babies because of their gender should feel the full force of the law. (Pearson, 2012)

The next point at which sex selection abortion was debated in the press was in autumn 2013, and coverage responded to announcements by the CPS about whether to prosecute the doctors filmed by The Telegraph . The CPS announced its decision this way, in its report on the outcomes of its investigation:

The Crown Prosecution Service has decided that it would not be in the public interest to prosecute two doctors in relation to alleged attempts to commit abortions on the grounds of foetal gender. These decisions result from an investigation (Operation Monto) carried out by several police forces and coordinated by the Metropolitan Police Service, following an undercover operation by a newspaper. We have previously advised police that there is insufficient evidence to prosecute four medical professionals in relation to this matter. (CPS, 2013)

The news that there were to be no prosecutions of doctors formed the focus for subsequent claimsmaking in 2013. Again, the villainy of abortion doctors was central to the claims made by The Telegraph , with the CPS presented as a collaborator in this villainy (Bingham & Newell, 2013), and again feminist commentary endorsed the ground of law-violating doctors. Cathy Newman, the presenter of Channel 4 News, in an article titled “The selective abortion of girls is a crime. Simple as. So why no criminal charges?”, claimed: “Although it’s primarily a problem in parts of India and China, there’s growing evidence it’s also carried out illegally in communities in this country” (Newman, 2013).

Coverage also highlighted comments attacking the CPS, including those from Emily Thornberry, a senior Labour Party MP, known to be a feminist, but who condemned the decision as a “disgraceful” expression of sexism (Cohen, 2013; Watt & Wyatt, 2013). The Guardian carried a comment arguing: “We must be prepared to circumscribe our pro-choice position… A girl’s right to life has to be a basic tenet of any feminist position” (Gupta, 2013). Only The Times reported in a different way, carrying a lengthy interview with Ann Furedi, the Chief Executive of the abortion provider British Pregnancy Advisory Service, in which she commented: “Sex selection is not a problem in Britain today. It simply isn’t happening. If people are going to claim that sex selection abortion is a big issue within certain Asian communities, it is at least imperative for them to demonstrate it is actually happening” (Bannerman, 2013).

Statistics as grounds

As noted previously, the first articles in The Telegraph justified undercover filming on the basis that evidence is hard to come by. Insofar as numbers were mentioned, it was through reference to a research paper by two Oxford academics, Sylvie Dubuc and David Coleman (Watt, Newall, & Zhimji, 2012). Dubuc and Coleman’s study ( 2007 ) had been a reference point for claims about sex selection prior to 2012 ( BBC News Online, 2007 ; Council of Europe Parliamentary Assembly, 2011 ; UNICEF, 2014 ). Those leading efforts from 2012 to bring the problem of sex selection to others’ attention, however, suggested that on its own, this evidence was not enough; as The Telegraph put it, the research found only “indirect” evidence, among “a small minority of Indian born women in England and Wales” (Watt, Newall, & Zhimji, 2012). Numbers did become the focus for grounds, however, with claimsmakers taking issue with official statistics produced by the DoH. This time, it was not The Telegraph that pressed claims, but rather The Independent .

The DoH for England and Wales published two reports about “gender ratios at birth”, in May 2013 and May 2104. These were compiled in response to a mandate from the Council of Europe Parliamentary Assembly (2011) that all member states of the European Union must “collect the ratio at birth [proportion of males to females in the population usually expressed as the number of males per 100 females with a skewed norm of 105 male births to 100 females], monitor its development and take prompt action to tackle imbalances” and “encourage research on sex ratios at birth among specific communities”. The 2013 report’s “Key Results”, based on analysis of births 2007–11, were that:

The UK gender ratio is 105.1 male births to 100 female and is well within the normal boundaries for populations. When broken down by mothers’ country of birth, no group is statistically different from the range that we would expect to see naturally occurring.

Upon its publication, this report did not become a source of any claimsmaking in the media at all. However, in January 2014, The Independent published a series of articles. One was titled “The lost girls” and its opening lines read, “Prenatal sex selection has reduced female population by between 1,400 and 4,700, say academics” (Connor, 2014a) and claimed that “official assurances” about the absence of evidence for sex selection abortion in Britain should not be accepted. This reporting linked claims about the untrustworthiness of “official assurances” based on DoH statistics to “gendercide”. “It seems that global war on girls has arrived in Britain” began one article (Connor, 2014b), with reporting including comment from Amartya Sen: “Selective abortion of female foetuses – what can be called ‘natality discrimination’ – is a kind of hi-tech manifestation of a preference of boys”.

The other feature of grounds introduced by The Independent was the use of typifying examples of abortion’s alleged victims, prefiguring themes in subsequent parliamentary debate. One article began:

Rupi remembers her second pregnancy with terrible despair. Having given birth to a girl two years before, she had expected the further love and support of her husband and his family. Instead, she came under extraordinary pressure to have an abortion.

This article carried comment from Jasvinder Sangera, “a campaigner on forced marriages and ‘honour violence’ against women”, who stated: “There is absolutely no doubt that these terminations, where a mother has an abortion because the child is a girl, are taking place within the South Asian population in Britain” (Milmo, 2014). A further article, published in January 2014, carried a comment from “Rani Bikhu, of the Slough-based woman’s charity Jenna International”, who named the problem “womb terrorism”, claimed the Government sought to “appease communities” and that this was “an issue of violence against women before they are born” (Connor & Milmo, 2014).

May 2014 saw the publication of a second report about birth ratios by the DoH. This report noted that claims had been made in the media, and this time, the “Key Results” set out were as follows:

The analysis by country of birth and ethnicity do not offer evidence of sex selection taking place within England and Wales. Without exception, the wide variation in birth ratios was within the bounds expected as a result of genetics, socio-economic differences and random variation. In both the analysis by country of birth and the analysis by ethnicity, no group was associated with a boy to girl ratio higher than the expected upper limit of 107. That was the case for both the overall birth ratio and by birth order.

This firm refutation of numbers as a ground meant that numbers were rendered insufficient for claims about the prevalence of sex selection abortion to develop further. However, typification of the problem through use of personal stories, explicitly linking abortion to the ethnicity and to violence against women, emerged as central to the last phase of the public debate.

Personal testimony as typification

By mid-way through 2014, strong claims had been pressed about law-violating doctors, but the CQC found no evidence of such, the CPS had rejected the claim that there was evidence sufficient to suggest doctors had broken the law, and statisticians had reiterated birth ratios for all ethnic groups were as expected. There was no further media coverage until November 2014, when the location for claimsmaking shifted to Parliament.

“MPs poised to declare gender abortion illegal” stated a headline in The Telegraph on 2 November (Bingham, 2014), and two days later the paper claimed: “MPs have voted overwhelmingly in favour of a motion declaring that sex selection abortion is illegal” (Graham, 2014). This reporting concerned a debate and vote in Parliament on a 10 Minute Rule Bill in November proposed by Fiona Bruce MP, that asked: “That leave be given to bring in a Bill to clarify the law relating to abortion on the basis of sex-selection; and for connected purposes”. Votes on such bills do not change law, but are taken as an indication about whether further debate should take place, and MPs did vote “overwhelmingly” for this to happen; the vote was 181 in favour, one against ( Hansard, 2015 ).

In introducing her 10 Minute Rule Bill, Bruce began: “[W]e know that sex selective abortions are happening in the UK and little is being done to stop them. We know that because a growing number of courageous women are speaking out about their experiences”. Argued Bruce:

Despite the existence of such stories, there are still those who claim that there is no evidence for the practice. In response to these critics, Rani Bilku, the director of Jeena International, said: ‘Saying there is no evidence is tantamount to saying these women are lying and that our organisation is making things up’.

Personal testimony typifying the problem, of the sort previously highlighted in reporting in The Independent , thus now became the central ground, and opposition was constructed between this ground and statistics. The almost unanimous support for Bruce’s 10 Minute Rule Bill suggests MPs were, at this point, persuaded by this claim.

In the end, Bruce pursued her effort to change the law in a different way, through her proposed amendment to the Serious Crime Bill, and at the outset support for her continued. Reporting in January 2015 stated: “More than 70 members, spanning the main parties” had put their names on Bruce’s amendment to the Serious Crimes Bill, and quoted Bruce, as Chair of the All Party Pro Life Group, and also Mary Ann Glindon, a Labour Party MP: “If opposing the abortion of baby girls – often under coercion – makes me anti-choice then I will wear the label with pride”, she said. The first reference in the media also appeared at this point to a new campaign, called “stopgendercide.org” (Bingham, 2015). A few days later, an article by Bruce herself discussed “the new campaigning website, ‘Stop Gendercide’”, compared sex selection abortion to Female Genital Mutilation (FGM) and forced marriage, and claimed an official statement about numbers “is not the last word on the issue … because Government statistics do not reflect the reality” (Bruce, 2015).

It was grounds of this type that continued to characterize her case. In her speeches in the debate on the Serious Crime Bill, Bruce thus stated the suggestion that “there is no evidence for sex selective abortion” was “quite offensive”, and argued: “Yes, the numbers are small compared with those in China or India but they are real. Should we have to wait for those numbers to grow before we take action?” However, as we noted at the start of this article, the Bruce amendment was defeated in the vote in Parliament. We now turn, in our final account of grounds, to discuss the terms on which her claims were refuted.

As we noted already, through 2012 and 2013 very few spoke out against those claiming that sex selection abortion was a social problem in Britain, and our searches identified only one newspaper article written in response to Bruce’s 10 Minute Rule Bill critical of it (Eddo-Lodge, 2014). However, in the immediate run-up to the debate on the Serious Crime Bill in 2015, matters began to shift. For example, in response to the publication of Bruce’s proposed amendment to the bill, “medical professionals and academics” ( The Telegraph , Letters, 2015) and “academics and groups representing black and Asian women” ( The Independent , Letters, 2015) wrote to the press arguing against what Bruce sought to do. An editorial in The Observer published the day before the debate argued the amendment should not be supported ( The Observer , 2015).

The day before the debate in Parliament, reporting seemed to indicate that, without doubt, Bruce’s proposal to include a new clause in the bill to specifically prohibit sex selection abortion was to face a rocky ride. Influenced by campaigning from pro-choice groups and other organisations (e.g. Voice for Choice, 2015 ), some MPs had by this point organised to oppose Bruce’s efforts. “Labour torpedoes attempt to outlaw same sex [sic] abortions”, reported The Telegraph , highlighting that a letter from a senior Labour Party MP, Yvette Cooper, which had been circulated to MPs in her party, objecting that the Bruce amendment could have “troubling consequences” (Swinford, 2015). On the day of the debate itself, commentary was published against Bruce’s proposal in newspapers including The Telegraph (Kent, 2015; Gordon, 2015; Sanghani, 2015a). This media coverage indicated that pro-choice organisations and some medical organisations had, by now, worked to raise convincing objections to the Bruce amendment.

These counterclaims were reflected in debate in Parliament, with a group of MPs speaking to oppose the Bruce amendment. The shift, however, was not in relation to the warrant; no one made a case in Parliament that sex selection abortion, where chosen, could ever be tolerated morally. When it came to grounds, no overt counterclaims were made either, disputing the veracity of The Telegraph 's undercover films. (Rather, assurances were given that all doctors and abortion providers had been given new guidance emphasising their legal obligations.) Neither was it argued generally that statistical evidence meant claims about sex selection abortion being a problem should be rejected. Rather, as the then Minister for Health Jane Ellison put it, “the Government will remain vigilant, will continue to monitor data and will be fully open to any other evidence that comes to light”. Only one MP, Fiona Mactaggart, took issue with the veracity of “other evidence” as it pertained so far, namely personal testimony:

[S]he [Fiona Bruce] quoted extensively from an organisation based in my constituency, but personal experience of how that organisation has failed to help individual constituents has led me to the conclusion that it is not possible to depend on the accuracy of what it says. I am therefore concerned that we are using anecdotes from an unreliable source to make legislation on the hoof.

Counterclaims rested, rather, on problematic consequences of the amendment and its wording. Three main consequences were raised. These were, first, that justifiable sex selection abortion – that associated with genetic disorder – would be inadvertently outlawed (Kate Green MP and Glenda Jackson MP). Second, it was argued that women whom Stop Gendercide purported to help would in fact end up being harmed. Ann Coffey MP, for example, argued, that “[W]omen subject to intolerable pressure to abort will continue to be subject to coercion” and “that might lead them to pursue alternative routes… We do not want to go back to the days of botched backstreet abortions”. Third the claim was pressed that, if passed, the Bruce amendment would potentially undermine the basis for all abortion by including the term “unborn child” in the law (Lucian Berger MP, Dr Sarah Wollaston MP).

Almost 300 MPs were, in the end, persuaded to vote against Bruce’s proposal, and reporting following the vote made it clear she and her supporters perceived this as a very heavy defeat for their efforts (Sanghani, 2015b). However, the Bruce amendment was not simply voted down. It was defeated because MPs were able to vote for an alternative amendment, committing the Government to address “prejudices, customs, traditions” which “amount to pressure to seek a termination on the grounds of the sex of the foetus.” This amendment was passed almost unanimously and ensured that Bruce’s efforts failed. MPs did not, therefore, opt to reject the claim that sex selection abortion is a British social problem outright, but rather voted to address it as a serious crime in a different way to that proposed by Bruce.

Conclusions: A social problem in search of grounds

From a social constructionist perspective, sex selection abortion in Britain can be considered a social problem in search of grounds. No ground about which claims were made ultimately persuaded enough others to agree with conclusions proposed to prosecute doctors for law violation, or to amend the law to specifically prohibit sex selection abortion. However, counterclaims were made only at “the 11th hour”, in the days before the debate on the Serious Crime Bill. This meant that it was possible for new grounds to emerge and reignite the debate over the three years 2012–15. It also meant that the end result was not a clear rejection of the claim that sex selection abortion is a social problem in Britain, but rather the institutionalisation of the claim in what became Section 84 of the Serious Crime Act. The amendment that was passed and that became Section 84 allowed MPs to make it clear that they abhor the idea of sex selection abortion without changing the terms of the abortion law itself. The subsequent outcome of Section 84 is interesting in this regard. As noted above, this committed the Government to assess evidence of “termination of pregnancy on the grounds of the sex of the foetus”, and in August 2015 the DoH published its findings. This, on the one hand, very strongly reiterated the outcomes of assessments of birth ratio data discussed in this paper, specifically that there is no evidence that sex selection abortion was taking place. On the other, however, it offered support for research and other activities that might be pursued by those claiming sex selection abortion occurs in Britain, thus making clear official abhorrence of the practice (DoH, 2015).

We have suggested the contribution of some feminist commentators to this outcome was significant. Public feminism, in the form of commentary in the media and in the political sphere, allied itself most strongly with claims that “something must be done” about sex selection abortion. This meant, first, that for the first time in Britain, those who oppose abortion gained a significant degree of endorsement of their feminised claims. Second, it highlighted that some feminists were also prepared to racialize the abortion problem. As we noted previously, one aspect to claims made about sex selection abortion in the USA has been about “Asian problems” taking root “over here” ( Musial, 2014 ), and part of the feminist contribution to the British debate was to make claims along these lines. Some high-profile feminists saw the furore surrounding The Telegraph 's undercover operation as an opportunity to link abortion in Britain to “gendercide”. They opted to make claims that what happens in Britain is a version of this well-established social problem, and to condemn it in the strongest possible terms.

While the abortion law on paper remained unchanged at the end of this abortion debate, this does not mean that what happened can be considered without consequence. We end with comment on two aspects of law in practice – how abortion is actually provided to women – which we suggest should be matters for research and attention by those concerned with women’s ability to access abortion services. The first is the provision of abortion to women of Asian heritage. The claim that such women presenting for abortion may be doing so because they are victims of male pressure or violence emanating from “their culture” attained a new degree of attention during the debate discussed here. Opponents of the Bruce Amendment raised concerns about possible consequences of this claim. They pointed to the prospect of abortion providers feeling pressure to enact “racial profiling” and, for example, question women of Asian heritage in a different or more detailed way about their request to terminate a pregnancy ( Voice for Choice, 2015 ). This draws attention to the way campaigns against sex selection abortion can potentially lead to differential treatment of women that undermines the autonomy of some, in the name of “rights for women and girls”.

The second aspect of the law in practice is the destabilisation of longstanding presumptions about medical authority and judgement as part of the provision of abortion in Britain. The underlying context for the episode of debate discussed here is the abortion law. Under British law, abortion is criminalised by the 1861 Offences Against the Person Act (OAPA). Section 58 of this act makes it an offence punishable by imprisonment for a woman to attempt to “procure her own miscarriage” and “administer to herself any poison or other noxious thing, or… unlawfully use any instrument or other means whatsoever with the like intent”. It also makes it an offence for anyone else to “unlawfully administer to her or cause to be taken by her any poison or other noxious thing, or shall unlawfully use any instrument or other means whatsoever with the like intent”. This archaic criminalisation of both women and doctors is, however, modified by the 1967 Abortion Act. Under this act, abortion can be legally provided to women as long as two doctors agree “in good faith” that the terms of the act have been met. It was these terms, under which a woman can be legally provided abortion, which the Bruce amendment sought to modify, by specifically stating that the sex of the foetus is not one of them.

This abortion law, as feminist scholars have emphasised, gives British women no right to abortion at any stage in pregnancy ( Boyle, 1997 ; Sheldon, 1997 ). Rather, through its Section 1, it allows “registered medical practitioners” to legally provide abortion on the basis of their “good faith” assessments of the woman’s health and circumstances. The terms on which doctors can make these assessments are very broad; they do not rule in or out any reason a woman might herself have for an abortion but, rather, they “medicalise” the basis for legal abortion as a matter requiring doctors’ insight about the effect of a pregnancy for a woman and her existing family (see also McCulloch and Weatherall, 2017 , for discussion of a legal arrangement in New Zealand with some similar features).

Literature on the subject has generally characterised the doctor as being made powerful by this law. The main focus of commentary from a feminist perspective has been that women are, as a result, detrimentally affected because women are denied the right to make a choice about their pregnancies (decision-making instead rests ultimately with doctors) and may be denied access to abortion. One overriding feature of the debate discussed here, in stark contrast, was that some abortion doctors specifically, and abortion providers in general, were claimed on “feminised” grounds to have acted to the detriment of women not by denying women abortion, but by providing it too easily . It was on this basis that doctors’ “interpretation” of the law became the subject of forceful criticism and politicians and doctors were, on this basis, investigated under threat of criminal prosecution and potential prison sentence.

This representation of women and doctors as in opposition, with the former as victims of cultural norms with which doctors may collaborate unless prevented from doing so by the criminal law, emerges overall as the most distinctive feature of the construction of sex selection abortion as a social problem in Britain. The “villainisation” of doctors and abortion providers is a familiar aspect of claimsmaking about abortion in the USA ( Lee, 2004 ) and has some precedents in debates in Britain through claims that uncaring abortion providers fail to counsel women sufficiently ( Hoggart, 2015 ). However, during the events discussed in this paper doctors were threatened with prosecution and investigated by the most powerful criminal law agency in Britain with almost no counterclaims made in their defence, including by those who call themselves feminists. Those who research and comment about abortion now need to find ways to highlight and explore this development in the social construction of abortion.

Supplementary Material

Acknowledgements.

I would like to thank the following for their insights and also comments on drafts of this article: Jennie Bristow, Sally Sheldon, Kate Greasley, Carole Sanger, Lesley Hoggart, Navtej Purewal, Pam Lowe and Ann Furedi. Thanks especially to Kate Greasley and Carole Sanger for giving me the opportunity to discuss the issues at a Law School Seminar at the University of Oxford in 2015.

Author Biography

Ellie Lee is Reader in Social Policy at the University of Kent. Her work explores why everyday issues – for example how women feel after abortion, what they eat, drink and feel when pregnant, or how mothers feed their babies – turn into major preoccupations for policy makers and become heated topics of wider public debate. She is the author of Abortion, Motherhood and Mental Health: Medicalizing Reproduction in the United States and Great Britain (Transaction, 2004) and co-author of Parenting Culture Studies (Palgrave, 2015). She is the Director of the Centre for Parenting Culture Studies ( https://blogs.kent.ac.uk/parentingculturestudies/ ) and regularly discusses her research in the media and other public forums.

Author’s note

This article reflects ongoing discussion with colleagues and was written alongside the scholarly work of others also writing about the events discussed here; although I am the sole author and the work is mine, it is for this reason that I use the word “we” throughout the text.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The author(s) received no financial support for the research, authorship, and/or publication of this article.

EngagedScholarship@CSU

  • < Previous

Home > Law > Faculty Scholarship > FAC_ARTICLES > 995

Law Faculty Articles and Essays

A feminist understanding of sex-selective abortion: solely a matter of choice.

April L. Cherry , Cleveland-Marshall College of Law, Cleveland State University Follow

Document Type

Publication date, publication title.

Wisconsin Women's Law Journal

abortion, reproductive rights

This essay consists of five sections. The first section describes the problem of sex-selective abortion, including an analysis of sociological data regarding adult preference for male children and its current effects. Section Two discusses various philosophical paradigms and analyses of sex-selective abortion with the goal of developing a coherent philosophical base from which to argue for a policy regarding sex-selective abortion which furthers the goals of gender equality. Section Three addresses the constitutionality of sex-selective abortion prohibitions in light of the Supreme Court's pronouncement in Planned Parenthood of Southeastern Pennsylvania v. Casey. Section Four outlines the liberal feminist response to sex-selective abortion and addresses the inadequacy of traditional legal doctrines to deal with the issue. In Section Five, Cherry proposes a feminist treatment of sex-selective abortion.

Repository Citation

Cherry, April L., "A Feminist Understanding of Sex-Selective Abortion: Solely a Matter of Choice" (1995). Law Faculty Articles and Essays . 995. https://engagedscholarship.csuohio.edu/fac_articles/995

Since October 21, 2019

Included in

Bioethics and Medical Ethics Commons , Law and Gender Commons

Advanced Search

  • Notify me via email or RSS
  • Collections
  • Disciplines

Author Corner

  • Submission Guidelines
  • Submit Research
  • Scholar Profiles
  • Expert Profiles
  • Learn More About Profiles
  • The Michael Schwartz Library
  • CSU|LAW Library

Additional Links

  • CSU|LAW Home
  • CSU|LAW Faculty Blog
  • ES@CSU Administrator
  • Personal Librarians

ES@CSU ISSN: 2572-3480

sex selective abortion essay

  • View Larger

Home | About | FAQ | My Account | Accessibility Statement

Privacy Copyright

Scholarship@Cornell Law: A Digital Repository

  • < Previous

Home > FACSCH > FACPUB > 1399

Cornell Law Faculty Publications

Replacing myths with facts: sex-selective abortion laws in the united states.

Brian Citro , University of Chicago Law School Jeff Gilson , University of Chicago Law School Sital Kalantry , Cornell Law School Follow Kelsey Stricker , University of Chicago Law School University of Chicago Law School. International Human Rights Clinic National Asian Pacific American Women's Forum (U.S.) Advancing New Standards in Reproductive Health (Organization)

Document Type

Published Papers

Publication Date

Abortion, Sex selection, Sex-selective abortion bans

  • Disciplines

Law and Gender

Several countries in the world have sex ratios at birth that are as high or higher than China and India, including countries with predominantly white populations. Nonetheless, immigrant communities in the United States from China and India are consistently accused of harboring a preference for sons. It is supposedly this preference for sons that leads Asian Americans to abort female fetuses. In response, eight states have enacted bans on sex-selective abortion and 21 states and the United States Congress have considered such bans.

Proponents of sex-selective abortion bans claim that the United States is one of the few countries in the world where sex-selective abortion is not prohibited. However, our research reveals that only four countries explicitly prohibit sex-selective abortion and that, instead, many countries that are concerned with sex selection prohibit the practice even before the embryo is implanted in the uterus. Our research also reveals that sex-selective abortion bans are not likely to change sex ratios at birth. In a study we conducted on sex ratios in two states that adopted sex-selective abortion bans over 15 years ago—Illinois and Pennsylvania—we found that the laws were not associated with changes in sex ratios.

Laws banning sex-selective abortion purport to combat gender discrimination. However, the text of the laws and the statements made in support of the bans during legislative hearings make it clear that they are intended to place restrictions on abortion services generally. Moreover, the laws purport to solve a problem that may not exist at all in the United States. Rather than changing behavior or addressing a purported problem, sex-selective abortion bans are likely to lead to the denial of health care services to Asian American women. Many of the laws require medical professionals to scrutinize a woman’s reproductive choices. Since it is difficult to determine the true reason a woman has chosen to terminate her pregnancy, medical professionals may err on the side of caution and deny care to women in order to avoid liability under the law, even when a woman is not seeking a sex-selective abortion. Laws banning sex-selective abortion have been enacted on the basis of misinformation and harmful stereotypes about Asian Americans. We do not support the practice of sex selection by any means, but rather than combating discrimination, sex-selective abortion bans perpetuate it.

Recommended Citation

Citro, Brian; Gilson, Jeff; Kalantry, Sital; Stricker, Kelsey; University of Chicago Law School. International Human Rights Clinic; National Asian Pacific American Women's Forum (U.S.); and Advancing New Standards in Reproductive Health (Organization), "Replacing Myths with Facts: Sex-Selective Abortion Laws in the United States" (2014). Cornell Law Faculty Publications . 1399. https://scholarship.law.cornell.edu/facpub/1399

Since April 15, 2015

Included in

Law and Gender Commons

Advanced Search

  • Notify me via email or RSS
  • Collections

Author Corner

Home | About | FAQ | My Account | Accessibility Statement

Privacy Copyright

Repository logo

Please log in to DSpace

Recommended pages

  • Undergraduate open days
  • Postgraduate open days
  • Accommodation
  • Information for teachers
  • Maps and directions
  • Sport and fitness

Is sex- selective abortion morally acceptable?

Is sex-selective abortion morally acceptable, dr jeremy williams, leverhulme early career fellow in philosophy, university of birmingham .

Last week, The Daily Telegraph published details of an undercover investigation which found that some private clinics were willing to offer women a sex-selective abortion – an abortion, that is, on grounds that the fetus is of the ‘wrong’ sex. The response to this story suggests that many people share a strong intuitive belief that it is morally objectionable for a woman to terminate her pregnancy for this reason, or for the state to allow it. But can that intuition be supported with compelling arguments? For those of us with Pro-choice sympathies, at least, it is dubious that it can. Many people assume that nobody could have a valid reason for wanting a child of a particular sex, and that any preference a parent might have must be simply self-indulgent. Not true, however: in at least some cases, a woman could have very compelling grounds for wanting, specifically, a boy or a girl. Take the woman who was sexually abused by her mother as a child, and cannot form close relationships with other females. Or the woman whose husband will leave her and her children in poverty if she has yet another girl. To these individuals, the sex of their child matters crucially. Now to be sure, other women may prefer a son or daughter for rather more frivolous reasons. It seems unlikely that many would go as far as an abortion to gratify such a preference. But even if some would, that is not to say that the state would be morally justified in interfering with them. For on a liberal view, we should adopt a presumption in favour of individual choice, unless there are compelling grounds for restricting it. Do any such grounds exist in the case of sex-selective abortion? At this point, of course, the Pro-life advocate will say that sex-selective abortion represents a particularly egregious injustice against the fetus – a violation of its right to life, merely on account of its sex. But people with Pro-choice beliefs typically deny that fetuses have rights – at least in the earlier stages of pregnancy. For them, any objections to sex-selective abortion must lie elsewhere. Opponents of sex selection who do not object to abortion in general often argue, then, that the practice has negative effects on others in society. In particular, they say that it communicates a pernicious view about females, as being inferior to males. However, some disability advocates make parallel claims: they say selecting against disabled fetuses implies that disabled people are not valued by society. In both cases, the right response seems to be to say that, first, any perceived disrespect is unintended, and to emphasise, second, that allowing selective abortion is compatible with our being committed to promoting justice for women and the disabled in other respects. Some people also worry that allowing sex-selective abortion would unbalance the sex ratio. In a country like the UK, where strong son-preference is not widespread, this fear seems overstated. But, in any case, ethicists have suggested regulatory mechanisms for addressing the problem. For instance, we might say that, if the woman’s need for a selective termination is less urgent, she can go ahead only as part of a pair with another woman, who wants to select for the opposite sex. It is true that, in a gender equal world, demand for sex-selective abortion would be much reduced. So, if we are concerned to minimise the practice, we should accelerate progress toward such a world. However, in the meantime, banning sex-selective abortion should give us significant moral qualms. For to do so appears to be to force some people – pregnant women who need these abortions – to pay the price for our failure to create a more just society. For a longer argument, see J. Williams, ‘Sex-Selective Abortion: A Matter of Choice’, Law and Philosophy 31.2 (2012): pp. 125-59  Dr Jeremy Williams at The University of Birmingham  

Culture and collections

sex selective abortion essay

Schools, institutes and departments

College of arts and law.

  • Birmingham Law School
  • English, Drama and Creative Studies
  • History and Cultures
  • Language, Cultures, Art History and Music
  • Philosophy, Theology and Religion

College of Medical and Dental Sciences

  • Applied Health Research
  • Biomedical Science
  • Birmingham Medical School
  • Cancer and Genomic Sciences
  • Cardiovascular Sciences
  • Clinical Sciences
  • Graduate School
  • Immunology and Immunotherapy
  • Inflammation and Ageing
  • Metabolism and Systems Research
  • Microbiology and Infection
  • Nursing and Midwifery

College of Life and Environmental Sciences

  • Biosciences
  • Geography, Earth and Environmental Sciences
  • Sport, Exercise and Rehabilitation Sciences

College of Engineering and Physical Sciences

  • Chemical Engineering
  • Computer Science
  • Engineering
  • Mathematics
  • Metallurgy and Materials
  • Physics and Astronomy

College of Social Sciences

  • Birmingham Business School
  • Social Policy

See all schools, departments, research and professional services

  • Liberal Arts and Natural Sciences

Services and facilities

  • Conferences and Events
  • The Exchange
  • Birmingham Day Nurseries
  • Guild of students
  • Facilities search
  • University of Birmingham School
  • UoB Sport and Fitness
  • Online Shop
  • Freedom of Speech
  • Accessibility
  • Canvas Learning Environment
  • Publication Scheme
  • Information for Applicants
  • Freedom of information
  • Charitable information
  • Cookies and cookie policy
  • Website feedback

Morning Rundown: Trump may struggle to get appeal bond, Petito and Laundrie families settle, Travis Kelce in Australia for Eras Tour

Sex-selective abortions: Reproductive rights are being pitted against gender equality

Image: US-politics-RIGHTS-abortion

When Dr. Colleen McNicholas treats a woman seeking an abortion in Missouri, she must, under penalty of law, ask a series of uncomfortable questions probing why the woman wants the procedure, including if it’s because of the fetus's gender.

That question, which she said patients find “absurd” and “completely inappropriate,” is a requirement that was left intact by a Missouri federal judge who halted several other restrictive measures , such as a ban on abortions after eight weeks of pregnancy, signed into law by Gov. Mike Parson, a Republican, in May in an effort to block abortion access.

Under the law, a doctor is banned from performing abortions when they are based solely on sex selection.

While the measure is billed by anti-abortion advocates as ensuring gender equality since females have been the target of feticide and infanticide in other countries, reproductive rights advocates say that there is no evidence of the practice happening in the United States and that the ban plays on racial stereotypes and has discriminatory medical effects that could result in restricting access to abortion.

Netflix's "Reversing Roe" New York Screening

McNicholas, the chief medical officer at Planned Parenthood of St. Louis, which is the last abortion clinic in the state, said requiring doctors to be “agents of the law” and eliciting reasons behind a woman’s choice is “medically inappropriate.”

“The ban is clearly an oversimplification and distortion of reality, and it violates several principles like trust, autonomy and privacy between a doctor and patient,” she said. “When we say we trust women that means we trust all women to make decisions about their pregnancy.”

Over the last decade, a wave of legislation targeting sex-selective abortions have passed into law.

Image: Planned Parenthood Clinic Missouri

Along with Missouri, eight other states currently have similar laws restricting women from sex-selective abortions and at least 21 other state legislatures have considered some sort of sex-selective ban since 2009, according to a study on sex-selective abortions in the U.S. by the University of Chicago.

The most recent of these bills includes HB 1396 in Oklahoma, a state that already bans sex-selective abortions, but this bill, which is pending, would extend the prohibition to women who know the gender of the fetus.

The narrative surrounding these kinds of bans plays on racial stereotypes and inaccurate assumptions that sex-selective abortions may be more prevalent in Asian communities and that those ideals are being brought here, said Sital Kalantry, a professor at Cornell University Law School and a co-author of the University of Chicago study. “It completely ignores that the structural factors at play which lead to sex selection in those countries don’t exist here.”

This becomes problematic because the bans could lead to racial profiling of certain women even though there is no conclusive evidence showing that sex-selective abortions are occurring in the United States, Kalantry said.

The University of Chicago study found that Asian Americans in the United States are actually having more girls than white Americans and that there were no changes in sex ratios in two states — Illinois and Pennsylvania — that adopted sex-selective abortion bans 15 years ago.

“The bans are not factually supported,” said Jennifer Wang, the deputy director of programs at the National Asian Pacific American Women's Forum. “They are being enacted to solve a problem that doesn’t exist in the United States. There is no false choice between gender equity and abortion.”

The concept of sex-selection bans are “anti-abortion ruses” rooted in an effort to racially profile Asian American and Pacific Islander pregnant women, she added.

But anti-abortion organizations say the practice is necessary to prevent discrimination. “Gender discrimination is already illegal in the United States. We want to also extend to protect unborn children who could possibly face that discrimination as well,” said Ingrid Duran, director of state legislation for the National Right to Life Committee.

"Sex selection is not compatible with Roe v. Wade," Duran said. "Here a woman is not saying she no longer wants to be pregnant. She's saying she no longer wants to be pregnant with a particular gender."

Duran adds that sex-selective abortions can happen anywhere in the world, including the United States, which is why states need laws that protect unborn children from that type of discrimination.

“We’re not asking women to be judgmental. Knowing the reasons why a woman aborts is crucial in order to assess what kind of support she needs so she doesn’t have to make that choice.”

Since the laws are being framed as an equal rights issue, as opposed to a reproductive rights issue, it has become a divisive quandary not only for those who are undecided on abortion rights, but even those within pro-choice factions.

The lawmakers behind these laws are using language in a way that evokes emotions and elevates nonexistent problems, forcing people who support abortion rights to respond to things that aren’t issues, said Megan Donovan, a senior policy manager at the Guttmacher Institute, a research organization that supports abortion rights.

This can also deter doctors who face hefty penalties, including losing a medical license or possible criminal charges, for not complying, she added.

The laws require a provider to scrutinize intent behind an abortion, and because it is nearly impossible to determine a woman’s intent, physicians may deny care to women to avoid liability.

“Any law where providers are at risk of going to jail could have a chilling effect and make providers extremely fearful,” said Dr. Lin-Fan Wang, a member of Physicians for Reproductive Healthwho practices medicine in Pennsylvania where there is a sex-selection abortion ban. “You’re making physicians act on behalf of law enforcement, and that’s really not our job.”

The bans also don’t address other forms of sex selection, such as sperm sorting, that have become more common over the last few years, Kalantry said. These technologies also put people in a position to select gender, yet there are no laws addressing them, she added.

“This is a wolf in sheep’s clothing,” Wang said. “If supporters of these bans are truly concerned about gender equity, they would work on pay equity, maternity leave policies, stop sexual harassment in the workplace, and would fund programs that support girls. Clearly that’s not happening here.”

While states continue to consider the issue, the harm it causes grows, Donovan said.

“The bans are intended to reduce opportunities for people to get abortion care," she said, "while at the same time teeing up constitutional challenges that could strip away the right to abortion overall.”

Safia Samee Ali is a reporter for NBC News Digital, based in Chicago.

The Social Construction of Selective Abortion

Many American women terminate their pregnancies when they discover their child will have Down syndrome. Is that so different from mothers in other parts of the world who abort unwanted girls?

becker_abortion_post.jpg

In her Pulitzer-Prize nominated book Unnatural Selection: Choosing Boys Over Girls and the Consequences of a World Full of Men , journalist Mara Hvistendahl takes a close look at the distorted sex ratios among the populations of China and India. Hvistendahl writes, "sex selection has resulted in an imbalance of over 100 million more men than women worldwide." Inexpensive ultrasound technology has enabled this imbalance as couples can now learn whether they are having boys or girls and respond with "selective abortions" if having a girl seems undesirable.

Social conditions and systemic bias against women contribute to the millions of couples worldwide who choose against giving birth to a girl. As the Economist explained a few years back, "Perhaps hard physical labour is still needed for the family to make its living. Perhaps only sons may inherit land. Perhaps a daughter is deemed to join another family on marriage and you want someone to care for you when you are old. Perhaps she needs a dowry." Social conditions, economic reality, even the prospect of being able to provide adequate long-term care—all of these factors contribute to the decision to abort girls.

In the West we decry these practices as gendercide, but the United States practices its own form of selective abortion when it comes to fetuses diagnosed in utero with Down syndrome and other chromosomal conditions. Definitive numbers related to pregnancies terminated as a result of a prenatal diagnosis of Down syndrome are hard to come by. Older studies suggest that up to 90 percent of all pregnant women with a definitive prenatal diagnosis chose abortion. As Jamie Natali, et. al. demonstrated in the Journal of Prenatal Diagnosis , more recent studies put the number closer to 70 percent. Either way, women who learn through prenatal testing that their fetuses have Down syndrome often decide to abort, and their reasons aren't that different from the reasons women across the globe choose (or are forced) to abort girls. In India, daughters grow up with social stigma, a lack of educational opportunities and the prospect of becoming a burden to their parents. Substitute the words "America" and "children with Down syndrome" for "India" and "daughters," and you get the picture.

Related Story

sex selective abortion essay

Down syndrome occurs upon conception when an embryo receives three copies of chromosome 21 instead of the typical pair. This additional chromosome can lead to physical differences such as shortened stature, an extra fold of skin around the eyes, small facial features, and pronated feet. It can also lead to medical concerns that vary from person to person but include heart defects, hearing deficits, and a heightened risk of childhood leukemia, hyperthyroidism, and celiac disease. Down syndrome also usually involves some unpredictable degree of intellectual disability, so many individuals with Down syndrome have greater challenges to overcome when learning or when trying to live independently as adults.

It is precisely because of information like this that many people choose to abort a fetus diagnosed with Down syndrome. These medical and social challenges seem fixed and unchanging. But as the past 40 years demonstrates, these challenges reflect social mores and choices as much as biologically-based reality or necessity. In 1975, Congress ensured all children's rights to a free public education, including those with intellectual disabilities. Around that same time, parents on the whole stopped sending their kids with Down syndrome to institutions and availed themselves of "early intervention," therapy services that target physical and brain development from very early on in a baby's life. In 1980 the life expectancy for an infant with Down syndrome was 25. As a result of social change and medical advances, people with Down syndrome are now expected to live until at least 60. And people with Down syndrome overcome expectations every day. They read, they write, they go to work, they make friends. When given the opportunity, they lead lives of hope and promise.

Although most women with a prenatal diagnosis of Down syndrome choose to terminate, even within the United States demographic differences demonstrate the socially-construed nature of these personal choices. A broad study by James Egan, et. al. in the Journal of Prenatal Testing analyzed demographic differences in Down syndrome livebirths in the United States from 1989 to 2006. As the study records, "a Down syndrome fetus is more likely to be prenatally diagnosed and terminated in the West and least likely to be diagnosed and terminated in the Midwest" and, "women with 12 or fewer years of education were less likely to either receive a prenatal diagnosis of Down syndrome or terminate an affected fetus compared to women with 13 or more years of education." In other words, social context affects the decision to abort.

Americans recognize the discriminatory nature of allowing sex to determine the value of a human life. We should also recognize the discriminatory attitudes that can lead to selective abortion in our own country. There has never been a better time to be born with Down syndrome, medically, educationally, and socially. We can overcome the residual cultural bias towards individuals with intellectual and physical disabilities not through pregnancy termination but through social supports, inclusive classrooms, and a culture that recognizes the distinct contributions offered by each individual.

  • Share full article

Advertisement

Supported by

160 Million and Counting

Ross Douthat

By Ross Douthat

  • June 26, 2011

In 1990, the economist Amartya Sen published an essay in The New York Review of Books with a bombshell title: “ More Than 100 Million Women Are Missing .” His subject was the wildly off-kilter sex ratios in India, China and elsewhere in the developing world. To explain the numbers, Sen invoked the “neglect” of third-world women, citing disparities in health care, nutrition and education. He also noted that under China’s one-child policy, “some evidence exists of female infanticide.”

The essay did not mention abortion.

Twenty years later, the number of “missing” women has risen to more than 160 million, and a journalist named Mara Hvistendahl has given us a much more complete picture of what’s happened. Her book is called “ Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men .” As the title suggests, Hvistendahl argues that most of the missing females weren’t victims of neglect. They were selected out of existence, by ultrasound technology and second-trimester abortion.

The spread of sex-selective abortion is often framed as a simple case of modern science being abused by patriarchal, misogynistic cultures. Patriarchy is certainly part of the story, but as Hvistendahl points out, the reality is more complicated — and more depressing.

Thus far, female empowerment often seems to have led to more sex selection, not less. In many communities, she writes, “women use their increased autonomy to select for sons,” because male offspring bring higher social status. In countries like India, sex selection began in “the urban, well-educated stratum of society,” before spreading down the income ladder.

Moreover, Western governments and philanthropic institutions have their fingerprints all over the story of the world’s missing women.

From the 1950s onward, Asian countries that legalized and then promoted abortion did so with vocal, deep-pocketed American support. Digging into the archives of groups like the Rockefeller Foundation and the International Planned Parenthood Federation, Hvistendahl depicts an unlikely alliance between Republican cold warriors worried that population growth would fuel the spread of Communism and left-wing scientists and activists who believed that abortion was necessary for both “the needs of women” and “the future prosperity — or maybe survival — of mankind,” as the Planned Parenthood federation’s medical director put it in 1976.

For many of these antipopulation campaigners, sex selection was a feature rather than a bug, since a society with fewer girls was guaranteed to reproduce itself at lower rates.

sex selective abortion essay

Hvistendahl’s book is filled with unsettling scenes, from abandoned female fetuses littering an Indian hospital to the signs in Chinese villages at the height of the one-child policy’s enforcement. (“You can beat it out! You can make it fall out! You can abort it! But you cannot give birth to it!”) The most disturbing passages, though, are the ones that depict self-consciously progressive Westerners persuading themselves that fewer girls might be exactly what the teeming societies of the third world needed.

Over all, “Unnatural Selection” reads like a great historical detective story, and it’s written with the sense of moral urgency that usually accompanies the revelation of some enormous crime.

But what kind of crime? This is the question that haunts Hvistendahl’s book, and the broader debate over the vanished 160 million.

The scale of that number evokes the genocidal horrors of the 20th century. But notwithstanding the depredations of the Chinese politburo, most of the abortions were (and continue to be) uncoerced. The American establishment helped create the problem, but now it’s metastasizing on its own: the population-control movement is a shadow of its former self, yet sex selection has spread inexorably with access to abortion, and sex ratios are out of balance from Central Asia to the Balkans to Asian-American communities in the United States.

This places many Western liberals, Hvistendahl included, in a distinctly uncomfortable position. Their own premises insist that the unborn aren’t human beings yet, and that the right to an abortion is nearly absolute. A self-proclaimed agnostic about when life begins, Hvistendahl insists that she hasn’t written “a book about death and killing.” But this leaves her struggling to define a victim for the crime that she’s uncovered.

It’s society at large, she argues, citing evidence that gender-imbalanced countries tend to be violent and unstable. It’s the women in those countries, she adds, pointing out that skewed sex ratios are associated with increased prostitution and sex trafficking.

These are important points. But the sense of outrage that pervades her story seems to have been inspired by the missing girls themselves, not the consequences of their absence.

Here the anti-abortion side has it easier. We can say outright what’s implied on every page of “Unnatural Selection,” even if the author can’t quite bring herself around.

The tragedy of the world’s 160 million missing girls isn’t that they’re “missing.” The tragedy is that they’re dead.

Paul Krugman is off today.

The Public Health Advocate

Un-Natural Selection: Female Feticide in India

This article was originally published in our Spring 2021 print issue .

I ndia’s skewed sex-ratio due to mass sex-selective abortions is based on the perception that women should be valued less than men in society. 

The Issue of Sex-Selective Abortions

A pregnant woman sits alone with her thoughts inside the cold, empty hospital consultation room in India. She simply wants to make sure her baby is okay, but in the back of her mind, she knows there is a lot riding on whether the baby is a boy or girl. She knows it is illegal to ask the doctor to disclose information about the sex of her baby, but is desperate to please her husband and in-laws with the news of a son. In the United States, finding out the sex of a baby is simply another regular milestone that parents undergo during pregnancy. Normally, the moment is filled with excitement and love, but that is not the case for women in India.

A poll by the Thomson Reuters Foundation found that India is ranked the most unsafe country for women. Their culture of perpetuating female inferiority and subordination contributes to a vicious cycle of mass sex-selective abortions and female feticide, which has exacerbated crimes against women. Sex-selective abortions , also known as female feticides, occur when female fetuses are aborted due to a cultural preference for sons. In India, the cause for female feticide is the overwhelming belief that women have less societal value than men. A lack of education among women, insufficient female leadership, and negative perceptions of women as “economic burdens” contribute to this view.

History of Female Feticide

Professor Anibel Ferus-Comelo, a professor at the UC Berkeley Goldman School of Public Policy specializing in labor and gender studies in India, explained that “before technology, it used to be that births were just ‘hidden’ because of female infanticides. Baby girls were killed, and it continues among the population that cannot afford or do not have access to technology or medical clinics.”

In the 1970s, medical diagnostic testing using ultrasounds became available to determine the sex of a fetus during pregnancy. Using high-frequency sound waves, ultrasounds can display accurate images of a fetus within the mother’s uterus to understand fetal health, positioning, and visualize potential problems during pregnancy. However, a tool meant to help families prepare for a new life exacerbated India’s existing infanticide issue. Since sex determination technology became available in the 1970s, India is estimated to have about 63 million fewer women.

Female feticide based on sex-determination testing is a relatively new practice. It skyrocketed in India around the 1990s when ultrasound technology became widespread among upper-class and upper-caste society members. When the Indian government became aware of this technology, they passed the Pre-Conception and Pre-Natal Diagnostic Techniques Act (1994) , which made it illegal to determine the sex of a fetus unless it was necessary for urgent medical reasons. Despite the illegality of sex determination testing in India, this policy’s efficacy varied upon jurisdictional enforcement, which resulted in the continuation of mass sex-selective testing and abortions. As a result, it is estimated that there will be 6.8 million fewer female births by 2030, precisely due to the consistent practice of sex-selective abortions.

Root Causes Behind Female Feticide

Sex-selective abortions and female feticide are rooted in Indian patriarchal perceptions. From a cultural standpoint, Indian boys maintain the family legacy as they carry the family name and typically perform funeral rites for their parents, allowing their souls to have safe passage. These perceptions have bolstered the mentality that parents should value their sons and treat them with more pride and respect than Indian girls who are less valued in society. Although this view has become outdated among more globalized nations, India’s urban and rural areas continue to believe that women should be confined to their roles as caretakers and mothers.

Economically, boys have always been viewed as the “breadwinners” of the family. They have held the burden of getting a job and providing for their family. However, girls have continually been viewed as an economic burden, especially during marriage. In India’s rural areas, it is still common for girls to get married at a very young age. According to Girls Not Brides, a global partnership that aims to end child marriage, about 27% of girls in India are married before turning 18. When girls are married, their parents are expected to pay a “dowry” to the groom’s family, which is essentially a payment in cash, food, household items, and clothes. Professor Ferus-Comelo mentioned that dowries are “a very degrading practice. It almost symbolizes that you have to pay someone to take your daughter.” She further elaborated that the practice continues to be maintained, except that “Dowries are not necessarily called ‘dowries,’ but sometimes they are called ‘gifts,’ and that there are many other nomenclatures and euphemisms for them.” Once married, daughters are expected to take their husbands’ last name and move in with their family to begin their role within the home. As a result, young girls are often not well-informed, confident, or financially independent enough to make educated decisions about pregnancy and children.

The political culture in India further exacerbates the perception that women should be treated inferiorly. In the 1980s, political propaganda in India and the United States portrayed slogans such as “ Pay 5,000 now, save 50,000 later ” directed towards South-Asian communities to encourage them to pay the cost of sex-determination technology than having a daughter and bearing an economic cost in the future. Professor Ferus-Comelo remarked that, “The same ads, now decades later, have come back with the clinics offering the same possibilities, and it shows that there is still a market for sex-selective abortions even in the United States.” She also explained that the rise of the Hindu political right has furthered, “notions of womanhood tied exclusively to the heteronormative wife and mother roles. This then restricts women’s abilities to break out of these molds.”

Objectively, the preference for sons over daughters is further supported by data. Boys are more likely to receive higher quality medical treatment and food. On the contrary, girls have less access to quality healthcare, education, and work. The problem of female feticide in India is multifaceted with cultural, economic, and political factors, and each aspect reinforces the attitude that women’s lives should be valued less than men’s.

The Legality of Abortion in India

Both government and private entities provide healthcare services in India. However, government services are rare and lack the high quality of treatment, while private services provide a high standard of care but are not affordable to most of the population. Furthermore, Indian health insurance is not mandatory, and employers do not have a legal obligation to provide insurance to their employees. As a result, 70% of the population does not have health insurance, meaning that they have to pay for most services and procedures out-of-pocket.

Abortion is one of these procedures. Abortion is legal in India, but sex-selective abortions, abortions solely based on the sex of the fetus, are illegal. Legal abortions are performed strictly at the discretion of the physician. The woman does not have the right to choose whether she would like to have an abortion. A physician can perform a legal abortion if the fetus has any abnormalities, if the pregnancy is life-threatening to the mother or the fetus, if pregnancy occurred due to the failure of contraception in married women, and if the pregnancy resulted from instances of sexual assault or rape. In India, legal abortions can be performed within the first seven weeks of pregnancy using an abortion pill in the presence of a medical professional. However, after the first seven weeks have passed, surgery is required to abort a fetus to maintain the safety of the woman’s life. Insurance companies would cover some medical costs only if the pregnancy were terminated due to a medical threat to the woman’s life. Otherwise, the woman has to bear the total economic cost.

This raises an important question: why do women not have the autonomy to make decisions about having an abortion? Autonomy is not simply about making individual choices, but it also involves economic autonomy or independence. Even if a woman wants to have an abortion for medical reasons but cannot afford to, she may have to turn to unsafe or illegal options. Obviously, due to the illegal nature of sex-selective abortions, a woman’s only option is to use illegal or unsafe methods.

Exacerbation of Life-threatening, Sex-Selective Abortions by the Pandemic

Although abortion in India is legal, illegal abortions currently outnumber them because most abortions in India are solely based on the fetal sex preference for boys. Almost ten women die every day of unsafe, illegal abortions in India. According to India’s health ministry, nearly half of abortions are conducted in hazardous and unhygienic conditions and are often performed by untrained physicians or healthcare professionals.

Since sex determination tests are illegal within India, many women opt-in for diagnostic testing (conducted illegally by gangs), take sex selection drugs (SSDs), or try “old-wives tale” remedies to change the sex of the fetus after conception. Still, many women are unaware that the fetus’s sex is determined during the fertilization of the egg by sperm and cannot be changed after that. The mother donates an egg, which always contributes an X chromosome to the fetus’s genome, while the father’s sperm can contribute either an X or a Y chromosome. If the sperm contributes an X chromosome, the fetus will be a girl, while a Y chromosome indicates that it will be a boy. Not only are many women uninformed about this concept, but they take harmful drugs containing synthetic chemicals and heavy metals that often result in congenital disabilities and stillbirths.

Social Impact of a Skewed Sex Ratio

Studies show that countries with imbalanced sex-ratios tend to have a more violent culture . According to Professor Ferus-Comelo, “crimes against women, particularly by upper-caste on the lower-caste, continues when the signal goes out from the top-down that violence is okay and that they deserve it because they are beneath our level.” This can be observed in India’s north and northwestern states where the highest gender disparities exist and power is centralized among criminal gangs called goondas. Studies have shown that when there is an enormous surplus of men within countries with a skewed sex ratio (30+ million within India), they are unlikely to obtain stability economically through labor or socially through marriage. To gain economic stability, men are more likely to join criminal gangs . In order to gain social stability, men seek out marriage. However, in some areas where the ratio of women to men is alarmingly low, men cannot find girls to marry. As a result, brides are “purchased” from other areas leading to forced marriages and human trafficking . Professor Ferus-Comelo remarked that, “one would think, logically, that if there are fewer women, their value actually rises. Their value in the marriage market should increase. But, that is not the case.”

COVID-19 has exacerbated this issue as women are more likely to seek unsafe or illegal abortion options since medical professionals and resources have been redirected to help combat the pandemic. Even before the pandemic, domestic violence has been an immense problem in India. In 2018, “Cruelty by Husband or His Relatives” accounted for 32% of all crimes against women registered by the police amounting to over 100,000 cases. Due to quarantine orders, women are more likely to be trapped with abusive partners or lack access to contraception. Many Indian women who are victims of domestic violence have limited education and are usually unable to be financially independent. They have inadequate options and resources because they cannot turn to their parents due to social stigmas, or their parents cannot take them in due to financial burdens. However, the future looks optimistic as more organizations such as Shakti Shalini, Rise Up , and SNEHA Crisis Helpline are working to provide health and sexual education to girls and women in India to inform them about safe sex practices, contraception, and resources for domestic violence survivors.

Professor Ferus-Comelo explained that as more young people become exposed to other cultures and lifestyles, “people have higher expectations of one’s own culture.” She continued to explain that, “there has been a very positive, inspiring awakening of women when their worlds have been constrained, and they know there is greater potential.” The only way to combat the issue of such a complex problem of female-feticide is to solve the root causes: skewed political propaganda, and a lack of economic opportunities, and unenforced legislation.

South Korea , which also faced a severely skewed sex-ratio, implemented solutions that have shown promising results, and many Indian government officials are looking to emulate their approach. They improved, enacted, and strictly enforced laws that prohibited female feticide, encouraged and provided opportunities for more women to enter the labor force, and used the media to mobilize support for their initiatives.

India should work to allocate more resources to better enforce the Prohibition of Sex Selection Act. Although the government launched a similar campaign in 2015, it was unsuccessful. To improve their efforts, experts recommend that the government should charge doctors who conduct illegal sex determination testing with hefty fines and strengthen detection for illegal clinics and services provided by gangs.

Most importantly, the government should promote women’s education, provide better opportunities for women to enter the labor force, enable more women to serve political positions, and enact equal inheritance laws. Furthermore, health education on domestic violence awareness and safe sex practices should also be provided for men. Female education is one of the most influential factors in reducing gender discrimination and sexual violence. Studies prove that exposure to female leadership leads to a significant decrease in the gender gap for educational attainment (32%) . Moreover, introducing cable television to India’s rural areas and playing shows that had strong female characters or women in power caused preference for sons to decrease by 12% and school enrollment for children to increase by 5%. If women have better access to quality education, they can have better opportunities to enter the workforce and become financially independent. Professor Ferus-Comelo expressed that, “economic independence leads to less discrimination. If girls and women had equal access to wealth and income and legal inheritance rights, they could have a sense of economic independence, then these kinds of norms are going to change.”

  • Skip to main content
  • Keyboard shortcuts for audio player

Shots - Health News

  • Your Health
  • Treatments & Tests
  • Health Inc.
  • Public Health

Reproductive rights in America

Abortion pills that patients got via telehealth and the mail are safe, study finds.

Selena Simmons-Duffin

Selena Simmons-Duffin

sex selective abortion essay

Access to the abortion drug mifepristone could soon be limited by the Supreme Court for the whole country. Here, a nurse practitioner works at an Illinois clinic that offers telehealth abortion. Jeff Roberson/AP hide caption

Access to the abortion drug mifepristone could soon be limited by the Supreme Court for the whole country. Here, a nurse practitioner works at an Illinois clinic that offers telehealth abortion.

In March, the Supreme Court will hear a case about mifepristone, one of two drugs used in medication abortions. A key question in that case is: Was the Food and Drug Administration correct when it deemed the drug safe to prescribe to patients in a virtual appointment?

A study published Thursday in Nature Medicine looks at abortion pills prescribed via telehealth and provides more support for the FDA's assessment that medication abortion is safe and effective.

Researchers examined the electronic medical records for more than 6,000 patients from three providers of abortion via telehealth. They also conducted an opt-in survey of 1,600 patients.

Some abortion patients talked to a provider over video, others used a secure chat platform, similar to texting. If patients were less than 10 weeks pregnant and otherwise found to be eligible, the providers prescribed two medications: mifepristone, which blocks a pregnancy hormone called progesterone, and misoprostol, which causes uterine contractions. Patients got both medicines via mail-order pharmacy.

Research at the heart of a federal case against the abortion pill has been retracted

Shots - Health News

Research at the heart of a federal case against the abortion pill has been retracted.

"Then 3 to 7 days later, there was a clinical follow up," explains the study's lead author, Ushma Upadhyay of the University of California – San Francisco. "The provider checked in with the patient. 'Did you receive the medications? Did you take the medications?' They asked about symptoms. And then there was a clinical follow-up four weeks after the original intake."

The researchers found that the medication was effective – it ended the pregnancy without any additional follow-up care for 97.7% of patients. It was also found to be safe – 99.7% of abortions were not followed by any serious adverse events. The safety and efficacy was similar whether the patients talked to a provider over video or through secure chat.

"These results shouldn't be surprising," Upadhyay says. "It's consistent with the over 100 studies on mifepristone that have affirmed the safety and effectiveness of this medication."

The results also echo international research on telehealth abortion and studies of medication abortion dispensed in a clinic with an in-person appointment, she notes.

Rishi Desai of Harvard Medical School is a medication safety expert who was not involved in the study. He says it was "well-conducted," especially considering it can be difficult to track patients who only connect with providers remotely.

"I would say that this study provides reassuring data regarding safety of the medications, and this is very much in line with what we have seen in many previous studies," he says. "So it's good to see that safety findings hold up in this setting as well."

Still, whether mifepristone is safe and whether FDA has appropriately regulated how it is prescribed is a live legal question right now.

An anti-abortion rights group sued FDA in 2022, arguing that mifepristone is not safe and was improperly approved in 2000. Judge Matthew Kacsmaryk, a district court judge appointed to the federal bench by President Trump, ruled that mifepristone should be pulled from the market nationwide. Although his decision didn't take effect pending appeals, the appeals court ruled against the FDA in part, specifically rolling back telehealth abortion access. That is also on hold for now.

The Supreme Court hears arguments in the case on March 26. The decision could affect access to medication abortion nationwide and set a new precedent on challenges to the FDA's authority.

Recently, there's been a flurry of mifepristone research news. Last week, a paper that raised safety concerns about mifepristone was retracted . This study, released Thursday, affirms the FDA's position that the medicine can be safely prescribed remotely.

Upadhyay says she's been working on this research for years and that the timing of its publication weeks before the Supreme Court arguments is coincidental.

"I don't know if they can enter new evidence into the case at this point," she says. "But I do hope it impacts the perception of how safe this medication is."

  • abortion pill
  • mifepristone
  • Abortion rights
  • Supreme Court

COMMENTS

  1. Sex-selective abortion

    Sex-selective abortion is the practice of terminating a pregnancy based upon the predicted sex of the infant.

  2. The ethical case against sex-selective abortion isn't simple

    Sex-selective abortion is often dismissed as an abortion chosen due to a trivial preference, like a preference for one consumer product over another. And it would be natural to infer that...

  3. A framework for analyzing sex-selective abortion: the example of

    Sex-selective abortion (SSA), defined as the voluntary termination of pregnancy based on the anticipated sex of the child (most often a girl), has spread rapidly since the 1980s, due to the development of new sex-determination techniques in early pregnancy.

  4. Sex-Selective Abortion: A Relational Approach

    Sex-selective abortion (hereafter referred to as SSA) depends on the ability a physician or technician to determine the sex of the fetus before birth, something that could not be done reliably before the advent of ultrasound amniocentesis.1 Given that SSA is made possible by these two procedures, conflicts and contradictions that surround both t...

  5. Constructing abortion as a social problem: "Sex selection" and the

    Based on analysis of media coverage, Parliamentary debate and official documents, we focus on claims about grounds (evidence) made to sustain the case that sex selection abortion is a British social problem and highlight how abortion was problematised in new ways.

  6. A Feminist Understanding of Sex-Selective Abortion: Solely a Matter of

    This essay consists of five sections. The first section describes the problem of sex-selective abortion, including an analysis of sociological data regarding adult preference for male children and its current effects. Section Two discusses various philosophical paradigms and analyses of sex-selective abortion with the goal of developing a coherent philosophical base from which to argue for a ...

  7. "Replacing Myths with Facts: Sex-Selective Abortion Laws in the United

    Several countries in the world have sex ratios at birth that are as high or higher than China and India, including countries with predominantly white populations. Nonetheless, immigrant communities in the United States from China and India are consistently accused of harboring a preference for sons. It is supposedly this preference for sons that leads Asian Americans to abort female fetuses ...

  8. Sex-selective abortions are discriminatory and should be banned

    Ultrasound equipment is now generally available, and sex-selective abortions have started to rise. At the same time it is hard to prove that an abortion has been done because the foetus was a girl. The International framework gives weak protection. The European Court of Human Rights case law does not yet provide guidance on sex-selective abortion.

  9. Sex-Selective Abortions, Fertility, and Birth Spacing

    This paper presents a novel approach that jointly estimates the determinants of sex-selective abortions, fertil - ity, and birth spacing, using data on Hindu women from India's National Family and Health Surveys.

  10. [PDF] sex selective abortion, neoliberal patriarchy and structural

    abstractThis article explores sex selective abortion (SSA) as a form of structural violence within the broader notion of women's 'protection' in contemporary India.

  11. Sex-selective Abortion: a Matter of Choice

    disparate treatment of selective abortion for disability and for sex cannot be defended. More specifically, my thesis will be that if we are committed to a Pro-choice stance with regard to selective abortion for disability, we will be unable to justify the prohibition of SSA. The philosophical background to my argument is as follows. First,

  12. Sex-Selective Abortion: A Relational Approach

    A critical application of Ruddick's model of maternal thinking is the best way to grapple with the ethical dilemmas posed by sex-selective abortion which I view as a "moral mistake.". Chief among these is the need to be sensitive to local cultural practices in countries where sex-selective abortion is prevalent, while simultaneously ...

  13. Is sex-selective abortion morally acceptable?

    First it is important to clarify that it is 'sex-selective' abortion that is in question not abortion in general. The two issues should not be confused. Abortion is a basic right, a right to bodily integrity that all non-slave men take for granted: a right not to have one's body invaded against one's will.

  14. Is sex-selective abortion morally acceptable?

    Yes Dr Jeremy Williams, Leverhulme Early Career Fellow in Philosophy, University of Birmingham Last week, The Daily Telegraph published details of an undercover investigation which found that some private clinics were willing to offer women a sex-selective abortion - an abortion, that is, on grounds that the fetus is of the 'wrong' sex.

  15. Sex-Selective Abortion: A Matter of Choice

    This paper argues that, if we are committed to a Pro-choice stance with regard to selective abortion for disability, we will be unable to justify the prohibition of sex-selective abortion (SSA), for two reasons. First, familiar Pro-choice arguments in favour of a woman's right to select against fetal impairment also support, by parity of reasoning, a right to choose SSA.

  16. Sex-selective abortions: Reproductive rights are being pitted against

    Sex-selective abortions: Reproductive rights are being pitted against gender equality Critics say the bans are "anti-abortion ruses" rooted in an effort to racially profile Asian American and...

  17. The Social Construction of Selective Abortion

    Social conditions and systemic bias against women contribute to the millions of couples worldwide who choose against giving birth to a girl. As the Economist explained a few years back, "Perhaps ...

  18. Opinion

    160 Million and Counting. By Ross Douthat. June 26, 2011. 288. In 1990, the economist Amartya Sen published an essay in The New York Review of Books with a bombshell title: " More Than 100 ...

  19. BBC

    Introduction What is a selective abortion? Most abortions are caused because the pregnancy is unplanned and having a child causes a crisis for the woman. Therapeutic abortions result from a...

  20. Sex-selective Abortions and Infant Mortality in India: The Role of

    Abstract In India, millions of female foetuses have been aborted since the 1980s alongside an abnormally high infant girl mortality rate; this has generated a vast literature exploring the root causes of son preference. The literature is sparse, however, on how the decisions to abort or neglect girls are made. This paper examines mothers' and fathers' respective roles behind those ...

  21. PDF Preventing gender-biased sex selection

    Sex selection can take place before a pregnancy is established, during pregnancy through prenatal sex detection and selective abortion, or following birth through infanticide or child neglect. Sex selection is sometimes used for family balancing purposes but far more typically occurs because of a systematic preference for boys.

  22. Un-Natural Selection: Female Feticide in India

    Sex-selective abortions, also known as female feticides, occur when female fetuses are aborted due to a cultural preference for sons. In India, the cause for female feticide is the overwhelming belief that women have less societal value than men.

  23. Abortion pills prescribed via telehealth are safe and effective, study

    The study looks at 6,000 patients who got abortion pills after an online appointment. It found that 99.7% of those abortions were not followed by any serious adverse events.

  24. Sex Selective Abortion

    Sex-selective abortion is the practice of terminating a pregnancy based upon the predicted sex of the fetus. The selective abortion of female fetuses is most common in areas where cultural norms value male children over female children, [1] especially in parts of People's Republic of China, India, Pakistan, Korea, Taiwan, and the Caucasus.