Regulating Abortion May Be OK But Not To Avoid Sex-Selection

(Originally posted on the Huffington Post)

Sex-selective abortion raises a multitude of overlapping ethical concerns regarding eugenics, population control, and provider privilege or knowledge. It was also, until recently, an issue we linked mostly to China, Korea, and India. Not anymore. Recent news coverage indicates that the son-preference that has led to sex-selective abortions abroad is alive and well in some ethnic communities within the United States.

This has generated a new discussion about what to do -- indeed, what to think -- about the practice here.

This week, one commentator -- William Saletan -- raised an essential issue in that regard: "Absolutists on both sides need to think carefully. If you're pro-life, how far are you willing to go in regulating abortion? If you're pro-choice, how far are you willing to go in leaving it unregulated?"

Full disclosure: I am a pro-choice European transplant to the United States. I am also a human rights advocate and researcher, and have spoken to dozens of resource-poor women about their reproductive choices. My answer to Mr. Saletan's question is invariably colored by this background and experience. And it falls in two parts.

1. The effect of abortion regulations depends on the context and motivation.

Regulation on abortion, or any other medical procedure for that matter, isn't bad per se. From a human rights perspective, the regulation of medical procedures and interventions is legitimate and indeed often necessary so long as they are based on full respect for the full range of human rights.

In the context of abortion, this, in some cases, has more to do with the context of the regulation than with the regulation itself. Many pro-choice commentators in United States have traditionally criticized the trimester-based regulation on abortion that is the norm in most of Western Europe. Generally, the criticisms are based on the fact that restrictions imposed on access to abortion after the first trimester in those European countries subject female decision-making to medical authority.

I have never had a problem with the European model as such. For one thing, it is, most often, implemented in the context of universal health care, comprehensive sex education, and parental benefits such as leave and childcare support. As a result, women seem to have more control over their parental choices to start with. For another, the social workers and doctors who make up the panels to whom women must apply if they want an abortion in the second or third trimester are generally directed to base their decision on the best interest -- health, life, broadly speaking -- of the woman involved. While there surely is much to criticize about the European model, it is not the fact that regulation exists.

By the same token, the relative lack of blanket bans or federal regulation on abortion in the United States does not mean that abortion access is easy, or, indeed, that woman can decide on their fertility without interference. In fact, studies indicate that the United States rate of unintended pregnancies is higher than the world average, and much higher than that in other industrialized nations.

Moreover, despite the apparent illusion that abortion is unregulated in the United States, it is actually already pretty heavily regulated. Many women and girls face serious legal or financial obstacles to accessing safe abortion services because of burdensome regulations, lack of providers, insufficient funding, or political opposition. Also, US restrictions on abortion, whether at the state or federal level, are not motivated by concern for women, and are often implemented in a context in which lack of access to health care generally and to contraceptives specifically make it even harder for women to control their fertility prior to a crisis pregnancy.

2. Regulating sex-selective abortion by banning it would not eliminate the practice.

In the face of news that the gender balance of certain ethnic groups in the United States is starting to tilt, it is perhaps tempting to hope that banning sex-selective abortions would safeguard the gender balance of future generations. However, the criminalization of abortion for whatever reason has in the past led only to underground and unsafe practices. In fact, the criminalization of sex-selective abortion would put the full burden of righting a fundamental wrong--the devaluing of women's lives--on women.

The fact is that many women who choose to abort a fetus because it is female believe they will face violence, exclusion, or stigma if they don't produce a boy. Some--rightly or wrongly--see the financial burden of raising a girl as detrimental to the survival of the rest of the family, a sentiment that can outlast generations even after an ethnic community has been transplanted to the United States.

The solution to the prevalence of sex-selective abortion is to remove the motivation (emotional or real) behind the procedure by advancing women's human rights and their economic and social equality. Choosing the blunt instrument of criminal law over promoting the value of women's lives and rights will only place further burdens on individual women for something that essentially is a social wrong.

So, in short, I support regulation that serves the purpose of furthering the human rights of women to health, physical integrity, equality, as well as the right to decide when and if to become a mother. I also support regulation that brings down the need for (and number of) abortions.

My experience tells me a blanket prohibition of abortion of any kind -- even if to limit a practice as ethically questionable as sex-selective abortion -- would accomplish neither.