Published on the British Medical Journal Guest Blog, 24th February 2012
Ach, what a furore. The Daily Telegraph is in its element and having a ball printing nasty allegations about doctors doing abortions illegally on grounds of sex selection. Let’s look at the issues a bit more dispassionately. First, is it actually illegal? Yes and no. The 1967 Abortion Act does not permit abortion on grounds of sex selection per se, it is true, and the law is framed so that anything that cannot be defended as coming under one or more of the named legal grounds is technically illegal. However, the question remains whether abortion on grounds of sex selection can be defended under the existing legal ground for abortions. I believe the answer is yes.
Sex selective abortion, like late second trimester abortion, lends itself to easy condemnation and stigma, and many otherwise pro-choice people are opposed to it. In India and China, where the laws on abortion are otherwise very liberal, sex selective abortion is subject to several laws banning it, all of which are totally ignored ̶ both because women are under great pressure to have boys, especially women whose first child was a girl and who have only one or two chances, and because those doing the ultrasound scans are making a lot of money from them.
This isn’t a question of designer babies, though it is always the case that where something is possible technically, and is available for a range of reasons, e.g. determining whether there is a risk of sex-specific genetic anomalies, it will also be used in other ways. In this sense, finding out fetal sex during an ultrasound scan is inevitable and justified. This information belongs to the parents and should not be withheld. The baby is theirs after all. Preferring a baby of one sex over the other is nothing new, but has become more of an issue, according to the literature on sex selection in Asia, precisely because people are having so few children. But this is not just a cultural or ethnic issue. I watched my next-door neighbour treat her second child, a boy, badly throughout his childhood because she had wanted a second girl. She never forgave him for being born, at a time when there was no ultrasound for finding out fetal sex. Is this so uncommon?
I believe doctors faced with a request for abortion from women whose cultures practise discrimination against women and girls can justify it under the existing abortion law on the following grounds: taking the woman’s social situation into account, and because the woman’s physical and mental health and well-being may be at risk, and also her existing children. The potential for abuse of a woman by her husband and family, and poor treatment of and even purposeful neglect of girl children (leading to poor development and even death), are common outcomes in Asian cultures that demand that women produce boys. Women can be rejected and their lives made miserable. No one that I am aware of has ever investigated the existence or extent of such abuse and neglect in the UK among families from these cultures, but perhaps it’s time someone did. Moreover, it is also the case that a woman may not want another baby anyway, for other valid reasons, and fetal sex may be the only acceptable excuse she can give in her family situation for seeking an abortion.
Lastly, if anyone thinks that incrimination, condemnation and prosecution of pro-choice doctors is going to make this situation go away, they need to think again. Women will simply say they have a different reason and doctors will duly record it.
I believe health professionals and everyone who is pro-choice on abortion should support pro-choice doctors and women seeking abortions, whatever their reasons, even when sex selection may be involved.
The Daily Telegraph’s stories and the cowards who remain unidentified who went under false pretences to abortion providers and doctors who authorise abortions with the intention of incriminating them, should be condemned. Their aim is not to stop sex selection, which will not go away until discrimination against women and girls becomes history. Their aim is to stigmatise abortion and women who have abortions, to frighten women and abortion providers that they are breaking the law, and to seek to restrict the law on abortion. Their behaviour is unethical and under-handed, and constitutes harassment, which should be rejected and even subject to prosecution for wasting the Health Department’s and police time.
The UK needs to make abortion available legally on the request of the woman, and to decriminalise abortion altogether. This is an idea whose time would have come long ago if misogyny and harassment of women were illegal ̶ and prosecuted ̶ instead.