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Abortion as a feminist issue – who decides, and what?

May 11, 2012

The recent post by Shohini Ghosh on the first episode of Satyameva Jayate has raised key questions around the complicated relationship between abortion as such and the selective abortion of female foetuses. This dilemma is one with which the women’s movement in India has been grappling since the late 1980’s. In this post, I would like to move away completely from the television programme, especially because there the focus was on women who were forced to have abortions after sex determination, on which there is little to debate. I am concerned here with the more troubling question that Shohini also raises, of how to understand a situation in which women themselves decide to have sex selective abortions. I outline here the main contours of feminist debate and activism over close to three decades, that have circled around complex understandings of ethics and agency in the context of women’s control over their bodies. I conclude by stating my own position on the issue, which is not necessarily the position taken by the movement as such.

Although the practice of selective abortion of female foetuses is restricted to India and to some South Asian communities in other parts of the world, its very possibility creates a more fundamental crisis for feminism. This is because feminists generally support the unconditional rights of women to safe and legal abortions. We see this as necessary because pregnancy and child-rearing are for all practical purposes, the sole responsibility of women. We should therefore, have the right to choose when and under what circumstances we will bring a child into the world, for we should be able to control what happens to  our bodies and to our lives. The right to safe and legal abortion is an essential right of self-determination.

In the West, this right has always been challenged and circumscribed by the Christian right-wing, and feminists there even today, have to struggle to retain it. Anti-abortion campaigns emphasize that the foetus is a person and that it has an independent right to life, and so their campaigns position themselves as ‘pro-life’, while feminists call themselves ‘pro-choice’.

The landmark judgement in the USA was Roe v Wade (1973), which defended the right to abortion as a right of privacy. However, this right is precarious, because many states did not repeal pre-1973 statutes that criminalized abortion, which could again be in force if Roe v Wade is reversed. Since there is a powerful anti-abortion lobby in the USA, this possibility cannot be ruled out. Many American feminists have been uncomfortable about seeing abortion in terms of the rights of individual women and locating it in the realm of privacy, for it suggests that pregnancy is an individual and private matter. They stress rather, that under conditions of pervasive sexism and patriarchy, decisions about pregnancy are sometimes out of the control of women. Moreover, they would like to see decisions about pregnancy and abortion as set within networks of responsibility rather than within the realm of ‘individual’ rights. We will return to these questions later.

In the United Kingdom, abortion has been legal since 1967, but continuously challenged, most recently in 1987 by a Private Member’s Bill, which resulted in substantial debate, but was defeated. In many other countries, abortion is illegal, or is permissible only to save the life of the woman, or only permissible up to the first trimester.

In India abortion has been legal since the Medical Termination of Pregnancy (MTP) Act of 1971, which came about not because of feminist concerns, or concern for women, but purely as a method of population control. Abortion is legal up to the second trimester, but it is at the absolute discretion of medical opinion. A study of the MTP Act points out that the pregnant woman cannot simply state that it is an unwanted pregnancy. She must provide explanations that fit into the conditions listed in the MTP Act, and it is medical opinion that has the power to decide whether the woman meets the requirements of the Act. That is, expert medical opinion must certify either that the pregnancy involves a risk to the life of the woman or would cause grave injury to her physical or mental health, or alternatively, that there is a substantial risk that a seriously handicapped child would be born. The Act does not define ‘health’, ‘substantial risk’, ‘seriously handicapped’ and so on. It is left to the medical practitioner to decide how these terms are to be interpreted, although two explanatory notes indicate that pregnancy in the case of rape (excluding marital rape) and contraceptive failure (in the case of married woman) may be treated as causing injury to mental health. In fact, even the words ‘abortion’, ‘miscarriage’ and ‘termination of pregnancy’ have not been defined, which leaves the medical opinion on these matters sacrosanct.

Thus, the currently liberal-seeming provisions of the MTP Act could become restrictive without, a single word of the text being altered (Jesani and Iyer 1993).

But in general in India there has been no consistent and organized opinion against abortion.Far from having to struggle for the right to abortion, feminists have found themselves raising questions about the widespread sanction for abortion rather than contraceptives, especially condoms, as a method of controlling population. This means that the physical cost of population control is borne almost entirely by women. Further, feminists have been critical of governments using incentives and disincentives to influence the decisions of government employees regarding family size, and the imposition of the small family norm even where factors like high infant mortality rates and insecurity of incomes make it rational to have large families. In the wake of the National Population Policy 2000, several states have announced population policies that have a strongly punitive and anti-democratic thrust.  Clearly then, the legal sanction for abortion does not arise from feminist principles at all, but it exists, nevertheless.

(Although I must add that of late there have been some very disturbing advertisements on television that promote contraception such as the pill and the morning-after pill, by contrasting these with abortion presented as the most shameful and terrifying option that a woman could decide upon.)

It is another matter that despite the MTP Act the number of unsafe abortions continues to be high and around 20,000 women die every year due to abortion-related complications, most of which are due to their being performed illegally, that is, by unqualified personnel. Medical facilities and trained personnel are inadequate, especially in rural areas, and in addition, there is the widely held belief that abortion is illegal. Legalisation has not, in short, been buttressed by safe and humane abortion services.

But since the 1980s, these issues have taken a back seat in the face of rising instances of selective abortion of female foetuses. Indian feminists have successfully campaigned for legislation restricting sex testing during pregnancy. The Preconception and Pre Natal Diagnostic Techniques (Prohibition of Sex selection) Act (PCPNDT) came into effect in 1994, but the sex-ratio at birth has continued to fall, showing that sex-selective abortion continues unchecked.

The problem is that the tests routinely used to monitor a pregnancy, for instance, ultra- sound, also reveal the sex of the foetus. It has become a crime to give parents this information, but if a doctor does so, and the woman has an abortion in another clinic, the link between the two is impossible to trace. Government initiatives to address what has come to be called the ‘skewed sex ratio’ have thus increasingly taken forms that threaten to restrict access to abortion itself. Recently for instance (2011), Indian feminists protested strongly at a statement made in the Maharashtra Legislative Assembly that ‘female foeticide’ should be treated as murder. There were a hundred signatories (including myself) to a letter to the Speaker of the Assembly that said in part:

‘First of all, abortion should not be referred to as ‘foeticide’, which has anti-abortion implications that we reject, for we believe that all women have the right to decide when and whether to bear and give birth to children. Making sex selective abortions (wrongly referred to as ‘female foeticide’), a murder charge will only increase illegal abortions and also make access to safe abortion difficult for women, who already do not have many choices  regarding their own reproductive rights. Safe and legal abortion is a woman’s right. Abortion is legal in India. The MTP Act, 1971 spells out the conditions under which it can be carried out.

Sex selective abortion however, amounts to discrimination against a particular sex, in most cases, the female sex. Sex selection in favour of the boy child is a symptom of devaluation of female lives.

It is important to remember that those who want to use abortion for elimination of the female foetus have to first determine the sex of the child.  Rightly, it is this process of pre-natal selection which is a crime, and it is being regulated and monitored through the PCPNDT Act.

Unless we are able to deal with all those social and economic factors that are going into the culture of son-preference and daughter-aversion, the child sex ratio will go on plummeting. But the solution is not to curb the legal right to abortion. Rather the PCPNDT Act should be enforced, and clinics that offer prenatal sex testing weeded out…

Checking pre-natal sex selection requires the proper implementation of the PCPNDT act and monitoring of sex-selective procedures by the government, and cannot be achieved by introducing such draconian measures that curb women’s right to safe and legal abortion.’

This letter reflects the feminist position on sex-selective abortion in India today, and marks key shifts that have taken place over the last two decades or so. ‘Female foeticide’, for instance, was a term that many of us used earlier. But gradually, through internal debate, we came to the understanding that ‘foeticide’ is an emotive word, suggesting the ‘murder’ of the foetus who is already a separate person, and is widely used by the anti-abortion Christian right-wing in the USA. The alternative term ‘abortion of a pregnancy’ prioritizes the pregnant woman as the implicit subject. However in media reports as well as in government statements, ‘foeticide’ (often without even the qualifying term ‘female’) has come to replace ‘abortion’ in the context of sex-selective abortion in India.

The monitoring of sex-determination tests is one thing, but it is quite another to monitor abortions themselves. Whatever the limitations of the former, the dangers of the latter are far greater. But one of the measures undertaken under Renuka Chowdhury as Minster for Women and Child Development, made it mandatory to register all pregnancies, and to monitor abortions. A pilot project has been implemented in ten blocks with a high malnutrition rate and a skewed sex ratio. (See my earlier post on this particular development on kafila). Under the conditions of this project, abortions will be permitted only for ‘valid and acceptable reasons’ (Chauhan 2007).

But what constitutes a valid reason for abortion and who decides? Most women in India have no control over the conditions in which they have sex, and often abortion becomes the only form of birth-control. Women also have abortions because of the stigma of illegitimacy, or because they cannot afford another child, or because they are at a stage in their careers or their lives where they cannot take on the responsibility for yet another human life. Will the government officials monitoring abortions have the right to determine which is a valid reason for abortion and which not?

This is where we come to some very difficult issues that must be addressed.

First, it seems to me we cannot hold simultaneously that abortion involves the right of women to control their bodies, but that women must be restricted by law from choosing specifically to abort female foetuses. We seem to be counterposing the rights of (future) women to be born against the rights of (present) women to control over their bodies. It is true that many women in India go in for sex-selective abortion under pressure from their husbands’ families – it is not a ‘choice’ they willingly make. But is abortion ever a positive choice? Decisions to abort are almost always shaped by factors like those outlined above – illegitimacy, lack of social facilities for childcare that place a disproportionate burden on women, economic constraints and so on. Decisions to abort on these grounds are no more reflective of a woman’s autonomy than her decision to abort a foetus because it is female. Nor are such decisions less determined by the constraints of a patriarchal society and a family structure based on the sexual division of labour. So why is abortion in all these other circumstances legitimate but not the abortion of female foetuses?

Second, what is our position on using pre-natal tests to detect ‘foetal abnormality’, a currently legal option? If we consider this valid, we are accepting a hierarchy of human beings based on physical characteristics, the lower levels of which do not have the right to be born. But then this reasoning can be extended to other categories, such as females. One feminist response to this dilemma is to argue that since women would have the sole responsibility of looking after such children, they should have option of whether to bear them or not. But then the identical argument can be made about female children – that because the social pressure to bear male children falls entirely on the woman, she should have the right to abort a female foetus.

The painful question is this: as feminists, can we insist that individual women should have to deal with the consequences of giving birth to every kind of foetus, and that abortion should be permitted only if you know nothing about the foetus you are aborting?

Can we hold the lives of existing women to ransom in order that the rights of abstract categories – ‘women’, ‘the disabled’ – can be protected? Surely one can stand for the rights of existing women and people with disability while recognizing the rights of women to decide when, how and to whom to give birth?

I use the term dilemma for such instances precisely because an easy resolution of the ethical issues involved is impossible. To assume that either the pro-abortion or the anti-abortion position, devoid of context, is feminist or anti-feminist in itself, is clearly ill-founded.

The pregnant body after all, is not two individuals with equal rights, it is a unique entity that cannot be addressed in the language of individualism – a life within a life, one life dependent on the other. Children are seen in the abstract as national resources, but concretely, under the present sexual division of labour, must be taken care of on a day-to-day, minute-to-minute basis by their mothers. There is no social responsibility for child-care at all – for instance surely every employer should have the responsibility to ensure day-care for all ( not only women) employees?

Under such circumstances, I think the host body of the mother acquires the right to decide the fate of this unique entity. This is why the access to safe and legal abortion should not be defended as a right of privacy. Although it is a decision taken by individual women, that decision is shaped and driven by public and social arrangements and limitations – indeed, by a collective failure of social responsibility

There can be no quick fix for the selective abortion of female foetuses. The practice reflects the fundamental devaluing of women, which will have to be tackled in other ways, through consistent feminist politics. Such a politics would have to confront marriage itself and more importantly, question the necessary framing of motherhood within discourses of hetero-patriarchal legitimacy.

An ideal feminist world would not be one in which abortions are free and common, but one in which women have greater control over pregnancy, and in which the circumstances that make pregnancies unwanted, have been transformed. Until then, in a hugely imperfect, unfair and sexist world, I believe feminists must defend women’s access to legal and safe abortions whenever they decide to have them – whatever the reason for their decision.

References

Chauhan, Chetan (2007) “Govt to monitor pregnancies, abortions” Hindustan Times, July 13

Jesani, Amar and Iyer, Aditi. 1993. “Women and Abortion” Economic and Political Weekly, November, 27

25 Comments leave one →
  1. Shohini Ghosh permalink
    May 11, 2012 5:44 PM

    Thank you, Nivedita for laying out the contours of this debate lucidly.

  2. Mohan Rao permalink
    May 11, 2012 6:17 PM

    I want to say a word about Ultrasounds in particular and medical technologies in general. When the X Ray was invented, it was held safe even for pregnant women; it was used to diagnose pregnancy. Of course we discovered about mutations soon enough. When ultrasounds came into being, the frequency of the sound waves was 30 times what it is today. Yet it was said to be utterly and completely safe. Late in the 1970s, Paul Ehrlich, author of The Population Bomb, suggested that USGs be imported in India and China to identify the sex of the child so that the birth rate could be brought down: people would stop having girls in order to bear a son. It was with this logic that UNFPA funded the imports of these USGs. They did not obviously stop the imports when they discovered it was leading to SSA.
    In the USA meanwhile, having captured the ObG market, the USG entered the pleasure industry. Also, the right to life – astonishingly ill-named – contributed to this: pregnant couples were encouraged to go to the nearest mall for an USG “to bond with the foetus”. At the same time, questions were increasingly being raised about the safety of the USG.
    It was Tom Cruise who gave a whole new twist to this debate. When his wife Katie Holmes became pregnant with a very precious Suri, he went and bought a USG so they could bond with the foetus in the privacy of their home.
    This sent alarm bells ringing. Should something befall baby Suri, there was bound to be a class action suit.
    The American radiological association immediately issued a statement that this was a medical procedure, to be carried out by trained personnel, and that an ULTRASOUND WAS NOT WARRANTED IN NORMAL PREGNANCY. IT SHOULD ONLY BE DONE ON MEDICAL RECOMMENDATION.
    The very next week the British radiological association issued a similar statement.
    In India meanwhile it is estimated that every pregnant woman going to the private sector, gets three ultrasounds per normal pregnancy.
    Both associations had for 20 years assured us that an USG was completely and utterly safe.
    We have 26 million births a year. If half of them are going to the private sector, that 13 million. Or 39 millions unsafe ultrasounds ever year.
    WHAT A LOVELY MARKET!
    Similar with full body scanners. London has 6; New Delhi has 33 – all doing very well thank you!
    By the way, anecdotal evidence suggests that in India ObGs are increasingly marrying radiologists.

    • Sunalini Kumar permalink*
      May 14, 2012 9:09 AM

      @ Mohan Rao, thanks for the eye-popping factoids! It’s truly an explosion of insanity, if you look at technology, numbers and the third world.

  3. bilbo baggins permalink
    May 11, 2012 8:25 PM

    mostly i agree with you, therefore i can only applaud.

    but 1, i don’t think you can brush over the ethics of abortion vs foeticide by postulating either that the pregnant woman is a unique entity, or by suggesting that women are not in control of the circumstances of pregnancy. in my opinion the ethical issue persists, and isn’t one that, as a doctor, i’m very comfortable with. overall, i think i would be choosing the lesser of two evils, and say that the existing woman has more rights than the potential baby. but i have no doubt that abortion is the voluntary ending of a human life. (don’t get me wrong, even under those circumstances, i’m heartless enough to be in favour of mtps)

    2. if you’re suggesting enforcement of the pndt as something to prevent sex selective abortions, that’s straight from cloud cuckoo land. it’s impossible, for the very reasons you’ve stated. the act needs to be in place to state the state’s position, and to make examples of those violators whom you do pick up. that’s about all. it’s everything else that’s needed to prevent sex selective abortions, and those aren’t quick fixes.

    • rajphys permalink
      May 12, 2012 11:19 AM

      In fact cracking down will drive the business underground, and not stop it. Similar arguments have been made (quite rightly) for abortion, that making it illegal drives it underground and makes it unsafe. You are right that strict enforcement as an initial jolt to the system is a part, but unless the demand is removed, it will be ineffective in the long run.

  4. Tanmay Shukla permalink
    May 12, 2012 12:02 AM

    Wow, Nivedita, I am just blown away. This really hits the nail on the head – abortion rights in a society where both men and women are guilty of sex-selective abortion do indeed represent a fundamental crisis for feminism. It’s a delicate issue that I’ve had a lot of trouble communicating to people who have a solely western perspective on this issue.

  5. Tanmay Shukla permalink
    May 12, 2012 12:31 AM

    To clarify my post above, in the end I agree with your conclusions in the abstract – that ex ante it’s impossible to judge if abortion is pro-feminism or against it – but not with your suggestion that in the imperfect world we live in, the rights of the existing women “cannot be held hostage” to an abstract category like women yet unborn. That argument can be attacked quite legitimately in two different ways.

    The first is the sheer scale of the consequences following such a principle can have. Imagine that we lived in a society where everyone voluntarily chose (due to some kind of social and economic pressures) to abort female foetuses. In the long run this would do much more harm to the feminist (or, indeed, humanitarian) cause than taking a less principled but more pragmatic stance.

    The second is that the same argument can be used to justify any action which imposes a large negative externality, but only on future generations. If we could destroy forests in such a way that the harm caused to the environment is negligible in the near future but severe in the long run, would deforestation be justified? Is it okay not to account for the welfare of future generations when deciding at what rate the world should deplete its oil reserves? Would it be okay to set up a welfare system that generously benefits retirees for next 30 years but then leaves nothing for the next generation of retirees? I think the answer in all cases is no. No society can afford to make decisions that ignore the rights of the yet-unborn.

  6. rajphys permalink
    May 12, 2012 1:36 AM

    If the right to privacy is completely abandoned in favor of a failure of social/collective responsibility, does it not make the right to safe and legal abortions more vulnerable to future encroachment by the state? e.g. if the state takes responsibility for rearing unwanted children, can it argue that part of the social failure has been mitigated? In this context, it might be more useful to keep the argument to child bearing (gestational periods) rather than child rearing (which is a longer term project). The state can hypothetically mitigate the first, but not the second. As you must be aware this adoption/foster care argument has already been forwarded by christianist right in the US and the putting the collective front and center in lieu of the individual makes the right to abortion more vulnerable to attacks. The right to privacy is intellectually unsatisfying, but, if accepted, makes the basic right to abortion much less vulnerable to attacks. In fact, the core Roe v Wade decision has been highly resilient to attacks in courts, which is why the religious conservatives have used alternative strategies which cuts the access to abortion at the margins, i.e. de facto rather than de jure nullification. That is a great concern, but losing the core would be even more disastrous.

    The ethical dilemma of SSA vs absolute right to abortion was finessed by the Indian activists by focusing on criminalizing sex selection (or rather knowing the sex of the foetus) rather than abortion. That has come apart at the seams since enforcing this has been a nightmare, both due to advancement of technology and more specifically, the deeply ingrained patriarchal dogmas of the very people who are supposed to enforce this. If the feminist movement in India wants to claim the absolute right to abortion it needs to provide a sketch of a policy response to this problem. Otherwise, it will soon become politically untenable position.

    Part of the problem is that what Sohini refered to as “son preference of the mother” is also a manifestation of a collective/social failure. It has its roots in the same patriarchal oppression and within this context, one can ask whether this is actually a free choice. Coercion does not need to take the form of physical coercion and if we are going to take the whole history of oppression in deriving a right to abortion, why should we neglect this history for SSA?

    I was however surprised at your distinction between real women and the abstract categories of “women” or “disabled”. Isn’t feminism in part derived from making an abstract category out of very real women? Any collective “ism” abstracts from the individual, so placing the collective at the center of the construct and then making this distinction between an individual woman and the category seems a little disingenuous.

  7. Shama Zaidi permalink
    May 12, 2012 9:43 AM

    maybe reservations and government jobs and admission to higher learning should only be available to those who have daughters and sisters

  8. Alternative Approach permalink
    May 13, 2012 4:13 AM

    “Although the practice of selective abortion of female foetuses is restricted to India and to some South Asian communities in other parts of the world”

    You’re forgetting China.

  9. May 13, 2012 7:18 AM

    Thanks Nivedita and Shohini for weaving in and bringing out the many aspects of rights vs wrongs…. the on women for women aspects are often ignored, or deliberately left unaddressed in many debates. anita cheria

  10. May 14, 2012 4:11 PM

    You say thus:

    We seem to be counterposing the rights of (future) women to be born against the rights of (present) women to control over their bodies.

    If the future of women itself is under threat then what shall one do? Let them follow a suicidal path or find means to avoid the same?

    The only way to stop this menace is to let women have a better sense of respect for herself. This is the only way she shall love another of her own kind. Give her education and means to stand on her two feet. Let this country learn to love their daughters in the same way a son is loved. Let this country stop thinking that daughters are a liability but an asset. Stop silly advertisements on jewellery etc which encourages the practice of dowry.

    Let the government work towards this.

  11. August 8, 2012 7:22 PM

    I don’t think there is a single family you will find where the woman wants to abort a female fetus and the rest of the family her husband, in-laws etc. (all of who in India for some reason feel entitled to a say on what happens to her uterus,) want the opposite. In the end women in India who apparently voluntarily want to abort female fetuses — do so because there is already this built up pressure on them emotionally and psychologically. it’s the right thing to do — that helps them find acceptance in their marital family and its patriarchal goals. I’ve been running a campaign, The 50 Million Missing against female gendercide, for almost 7 years now. When women, educated, professional, ones even, all they want to do is stay in the marriage. And they just want someone, maybe our campaign and public lobby to make their husbands and in-laws stop abusing them. If that doesn’t happen, as unhappy, miserable, and tormented they are — they go through the abortion. It internally rips them up. You make a point about birth control being a woman’s responsibility. Actually, there are many other ways of birth control which women in middle and upper class families could and do use. In the lower classes, the one thing I hear repeatedly from women is how they have no control over their wombs. They get battered by their husbands if they use birth control in any way. Ultimately, the man and his patriarchal clan decide when and how many children he wants and of what sex. Women in India don’t own their bodies. That is the most fundamental violation of the pro-choice movement.

    • August 9, 2012 12:41 PM

      Maybe it is time women put their foot down. Unless women themselves try, no amount of encouragement from others will help. Inspite of education and financial independance why cannot a woman escape from this emotional trap? Why cannot she love her own kind? The lower class women maybe excused but I think the rest should no longer wait for outside help but help themselves.

  12. August 11, 2012 7:26 PM

    Rita Banerji lets the middle and upper classes off the hook too easily. I would suggest a closer look at the data from more sources. Amir Khan’s program showed clear examples of violence related to abortions of female foetuses in very well-to-do families, even in one family with medical professionals among the in-laws.

    • August 12, 2012 11:53 AM

      When it comes to female feoticide, middle class nor the upper classes behave differently. They are all stuck in the same cultural desire for a male offspring.. for the upper class it has to be only cultural norms that force them to abort while for the middle class, dowry and such other issues may also be the reason. But here one has to remember that these women who are forced to abort are not weaklings. They are ecucated and has the means to nurture and care for their daughters if they themselves try and get out of the cultural norms. If not, there is no one who is going to help them. One could take the example of the lady doctor who fought for her girls. It can be done and has to be done.

      Else one has to believe that is the Indian mothers who crave for a son more than the father.

  13. Wendy permalink
    January 27, 2013 1:50 AM

    Absolutely brilliant piece and well put
    Brings some clarity to the current simplistic pro choice pro life debate

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