The feminist position of supporting the ban on sex selective abortion but permitting abortion of a foetus with genetic abnormalities is a sore point for disability movement activists in India
By Vineeta Bal
In India, women got legal access to abortion from a population policy perspective rather than rights perspective. Until 1971, women were not allowed to get abortion done legally except in the cases of medical emergencies. The Medical Termination of Pregnancy (MTP) Act of 1971, in addition to ‘failure of contraception’ as a reason, also granted the right to abortion on the basis of detecting prenatal genetic abnormalities.
Amniocentesis – taking out a small amount of fluid from a pregnant mother’s uterus, commonly during 14-16 weeks of pregnancy – was the method of choice for detecting genetic abnormalities and it could detect only a few abnormalities.
In reality, in countries like India where male children are the preferred choice, it was widely misused for detecting sex of the developing foetus, resulting in high frequency of abortion of the female foetus. A recent paper published in the Lancet Journal has a detailed analysis on sex-selective abortions in India from 1995-2005 which predicted 3.1 to 6 million sex-selective abortions in the 2000s.
While the women’s movement has been silent on abortion of genetically abnormal foetus, there was an urgent demand to stop female sex selective abortion. Women’s rights activists had anticipated the skewing of gender ratios many years back and argued that there was a need to ban amniocentesis, resulting in the Pre Natal Diagnostic Techniques (PNDT) Act in 1994 for regulation and prevention of misuse of the diagnostic techniques. Subsequently, it was modified as Pre Conception and PNDT (PC-PNDT) Act in 2003.
By mid-90s, the need for an invasive technique to detect the female foetus had been bypassed. The new technology of sensitive ultrasonography machines which could ‘see’ the presence or absence of a penis during the scanning procedure had made female sex selective abortion easier.
Since women form half of the population and are necessary for the survival of the species, large-scale female sex selective abortion was considered a major risk from the ‘greater good’ perspective. However, legally banning female sex selective abortion but permitting abortion of a foetus with genetic abnormalities is a sore point for disability movement activists, who often question feminists about their logic for stopping abortion for one reason but not the other.
The issue of ‘greater good’ takes precedence here if the comparison between sex selective abortions versus genetic defect linked abortion has to be made. Genetic abnormalities or other structural and functional abnormalities present at birth which are detectable during pregnancy with certainty are still very few. There is also a spectrum of defects – some like anencephaly (near absence of brain) are very severe with a possibility of foetus dying in the uterus before delivery whereas some others like polydactyly (having more than five fingers per hand or foot) can be considered relatively minor. Abnormalities of this kind can be detected easily by ultrasonography but not necessarily by amniocentesis.
While the number of detectable abnormalities may increase in future, amongst the disabled people today the proportion contributed by disabilities detectable during early pregnancy is very small. When amniotic fluid samples were tested to rule out genetic abnormalities, in a referral laboratory in Spain, the frequency of detectable abnormalities was found to be 2.9% over a 10-year period. In other reports the frequency was even lesser than this. And one must keep in mind that not every pregnant woman is asked to undergo this test. Thus, the numbers of abortions which might be an outcome of this screening is nowhere comparable with female sex selective abortion. In a developing country, this percentage would be even lower because of limitation in the availability of these tests and the awareness about them!
The debate around the right to life of a foetus with abnormalities detected during early pregnancy does evoke a passionate response even amongst some feminists, who think of the foetus as an independent entity. At present, despite technological advances a 16-18 week old foetus, born as a premature baby, is almost always incapable of surviving outside the mother’s body even with all available outside assistance. Thus providing any ‘rights’ to this foetus which cannot survive while preventing the mother’s right to abortion does not appear justified.
However, in the present circumstances, what should be the best approach to address the dilemma? What steps could/should be taken? Should genetic screening be banned? Should all abortions be banned including female sex selective abortions? Should the right to life of a foetus with abnormalities detected during early pregnancy be invoked over the right of the mother to abort a foetus?
An ideal situation for feminists would be when the PC-PNDT act can be revoked because there is no longer gender-based discrimination in the society. Even on such a dream day a woman’s right to abort the foetus should not be taken away.
What about the right of the mother to abort a foetus with some abnormalities in this dream period? Well, it should still remain intact and abortion should be permissible as mother’s primary right during that stage of pregnancy when a foetus born is incapable of sustaining itself despite adequate technology-based assistance. Today this period is about 20 weeks, and it may decrease with improvements in support systems in the future.
Beyond this critical period, other considerations may come into picture. For example, it is likely that stem cell therapy in the foreseeable future will help in providing cure for some of the genetic defects detected using pre-natal diagnosis. It also needs to be mentioned that some sections of the activists, because of misconceptions and lack of nuanced understanding, link stem cell therapy to eugenics (practices aimed at improving the genetic traits in a population) thereby opposing one potential therapeutic option for curing genetic defects. If such a cure exists and is available, at that point of time, counselling of mothers for continuation of pregnancy will become a real choice.
However, be it in the ‘dream’ period of the future or in the current reality, we need to demand and work towards providing social security for all disabled people, not just to those who are born with a defect.
In conclusion, while the woman’s right to choose is paramount and inalienable, civil society movements and activists should be able to modify their concerns and strategies by better understanding and assessing technological developments on their path to achieve social equality.
Vineeta Bal is a member of Saheli and a scientist at the National Institute of Immunology, Delhi. The views expressed here are personal.
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