Until relatively recently when we talked about sex-selective abortion it was largely something that happened in far away lands and was almost always something carried out by women carrying female fetuses. It’s something that the Indian government and others have been trying to address for many years. The practice is both the result of, and reinforces, social, sexual, economic and political inequality. It also leads to numerical imbalance in the population which you can see in countries where abortion of female fetuses is routine.
Sex-selective abortion in this context presents a huge challenge. In addition to embedded historical valuing of boys over girls, there are compelling material reasons for families to dread the birth of a baby girl. The dowry system can impoverish a family, the loss of a daughter to the in-laws family after marriage can leave parents with no support in old age; this in addition to all the incidental inequality and discrimination that can blight, and prematurely end, the lives of women and girls. Women carrying female fetuses may also be subject to violence if they have been unable to ‘produce’ a boy child. All this contributes to a context in which it’s possible for mobile ultra sound units to travel through rural areas making a fortune out of extremely poor families who want to know the sex of their fetus and will often resort to unsafe illegal abortion to end their pregnancies if they get the ‘wrong’ news.
Criminalising this practice has not ended it, and those who dread the birth of a female child but cannot access ultrasound or abortion sometimes resort to infanticide of female infants. For girls who survive their early years, a life time of poorer access to education, health care, and food means that for many life is harsh, brutal and short. Those working in this field recognise that until girls and women are seen and treated as equals; until families and communities reject traditions that socially and financially disadvantage women; until marriage traditions that impoverish the families of brides are ended and women are no longer seen as a burden, until universal good quality health care and education is a realised right, and the burden of poverty is lifted no amount of legislation will bring sex-selective abortion to an end.
Today the Telegraph runs a story about abortion clinics in the UK providing abortion for women and their partners who want to choose the sex of their child. While some people desiring this may come from communities where boys are traditionally seen as more desirable than girls, there may be other motivations for people in the UK to want to choose the sex of their children. Although I have not seen a research evidence to support this, there is anecdotal evidence (reported on the Radio 4 Today programme this morning) of couples who want to have ‘one of each’ or as the Telegraph article calls it ‘family balancing’. I’ve also heard of couples who, ironically, want to have girls only (as girls in UK mainstream culture are seen as less trouble or less of a burden than boys). If it is true, it is hard to know where to start with it. People in the economically developed world may look down their noses at the global South, and the appalling gender discrimination that leads to specific abortion of girl fetuses, but what notions of gender could be behind such decision-making in the global North? Only yesterday a Daily Mail journalist showed how far we have to go, characterising ‘tom boys’ as an irritation who, thankfully, grow out of it when they start getting interested in boys and start dressing and behaving like proper women - alongside a whole load of other prejudice and ignorance... *despair*. This is such a big discussion, I’m going to leave it for another day...
Meanwhile, I’m sure the anti-abortion lobby are going to have a field day with the Telegraph’s report. It is, of course, no coincidence that the article has come out just before the Department of Health is about to publish a consultation document on pre-abortion counselling which is premised on the un-evidenced claim that there is a current problem with the abortion counselling provided by the two big independent abortion providers MSI and bpas. It is part of whipping up anxiety about the current state of practice in order to support changing the system, despite the House of Commons wholeheartedly rejecting an attempt to do so through Nadine Dorries MP’s amendment to the Health and Social Care bill in September last year.
The current system means that all women seeking abortion from MSI and bpas which provide 62% of NHS funded abortions and a large proportion of privately funded abortions to women from N.Ireland and the Republic of Ireland, go through a process heavily regulated by the Department of Health. Education For Choice has worked tirelessly to promote good practice in supporting pregnancy decision-making for years and to root out poor practice, and have found no evidence of poor practice, and no record of formal complaints to regulators about the practice of organisations currently registered as Pregnancy Advice Bureaux.
If clinics are providing abortion without offering good standards of care then of course this should be addressed as a matter of urgency. As well as meeting legal requirements, women attending properly regulated Bureaux are always checked for signs of coercion or pressure from partners and family members, and a check on how confident she is in her decision. Every piece of research I have read about the outcomes of abortion suggest that feeling ambivalent about the abortion or being coerced into having one are significant risk factors in negative psychological outcomes. So clinics should ensure that this check on the decision-making process is part of the referral procedure.
If there is any evidence of poor practice, it should be addressed. However, we should be wary about using this as the basis for a wide ranging change in law and regulation of all clinics which would disadvantage all women seeking abortion in the long term. Suggestions of new commissioning regulations for abortion counselling are likely to divert women away from professional, well-regulated and well-evaluated abortion services towards a hotch potch of unskilled, unregulated independent counsellors some of whose agenda might be to prevent women accessing abortion and who will, in any case add delays into the process of accessing abortion, adding to the waiting times, risks and costs for women and the NHS.
Most importantly, these ‘revelations’ should not be seen as grounds for rexamining the basis of our abortion law in this country as is clearly the intention behind this article. A minority of people in the UK would like to see abortion completely criminalised here and aim to get there by stealth, chipping away at, and reducing women’s access to abortion incrementally through changes to regulation, law and practice. This strategy has been extremely successful in the United States, making abortion extremely hard to access in many parts of the country, though failing to bring down the abortion rate overall.
The anti-abortion movement in the UK is learning its lessons from the US well. The rest of us – who all want abortion to remain a safe, legal and well-regulated option for women – need to be alert and learn them too. Be prepared for more ‘revelations’ more ‘shocking truth’ about abortion, more undermining of current law and provision. Coming to a newspaper near you soon. Watch this space...
Post Script - Some couples sex-select because they want to prevent the risk of passing on genetic disesases. I have not addressed this in this blog, but it is addressed in this report on the issue from the Human Fertilisation and Embryology Authority