Selective Abortion Research Articles

Pilot study of genetic counseling and prenatal diagnosis in androgen insensitivity syndrome: with 3 families reports

Objective: To explore genetic counseling and prenatal diagnosis strategies for women who have androgen insensitivity syndrome (AIS) family history or pregnancy history of AIS proband. Methods: Three families of complete AIS (CAIS) were retrospectively reported and summarized. The subsequent pregnancies and processes of prenatal diagnosis were followed up. Results: Among three CAIS families, one family had androgen receptors (AR) gene mutation diagnosis; the other two families were diagnosed clinically without gene diagnosis. All three mothers of CAIS probands were in pregnant again when they sought counseling, with gestational weeks between 7－13 weeks. They underwent chorionic villi sampling or amniocentesis in their second trimester (at 12, 16, 17 weeks respectively). Chromosome gender of all three fetuses were 46,XY, which was inconsistent with the ultrasonographic phenotype of external genitalia. All patients chose selective abortion in their second trimester. The external genitalia of all aborted fetuses were female phenotype, which supported the diagnosis of CAIS. Conclusion: Genetic counseling and prenatal diagnosis should be provided to high-risk patients with family history of AIS or proband pregnancy history, so as to achieve the goal of good childbearing and sound childrearing.

Time to end daughter aversion in India

Time to end daughter aversion in India

Trends in missing females at birth in India from 1981 to 2016: analyses of 2·1 million birth histories in nationally representative surveys

Half of the world's missing female births occur in India, due to sex-selective abortion. It is unknown whether selective abortion of female fetuses has changed in recent years across different birth orders. We sought to document the trends in missing female births, particularly among second and third children, at national and state levels. We examined birth histories from five nationally representative household surveys (National Family Health Surveys 1-4 and District Level Household Survey 2) to compute the conditional sex ratio (defined as the number of girls born per 1000 boys depending on previous birth sex) in India during 1981-2016. We estimated decadal variation in conditional sex ratio for 1987-96, 1997-2006, and 2007-16, and quantified trends in the numbers of missing female births for the states constituting >95% of India's population, as well as in 5-year intervals for each survey round. We used multivariate logistic regression to calculate the odds ratio of a second (or third) girl depending on the sex of the earlier child (or children), adjusting for education, wealth, religion, caste, and place of residence. We assessed 2·1 million birth histories across the five surveys. Applying the conditional sex ratios from the surveys to national births, we found that 13·5 million female births were missing during the three decades of observation (1987-2016), on the basis of a natural sex ratio of 950 girls per 1000 boys. Missing female births increased from 3·5 million in 1987-96 to 5·5 million in 2007-16. Contrasting the conditional sex ratio from the first decade of observation (1987-96) to the last (2007-16) showed worsening for the whole of India and almost all states, among both birth orders. Punjab, Haryana, Gujarat, and Rajasthan had the most skewed sex ratios, comprising nearly a third of the national totals of missing second-born and third-born females at birth. From about 1986, the conditional sex ratio for second-order or third-order births after an earlier daughter or daughters diverged notably from that after an earlier son or sons. From 1981 to 2016, the sex ratio for second-born children after an earlier daughter decreased from 930 (99% CI 869-990) to 885 (859-912), and that for third-born children after two earlier daughters decreased from 968 (866-1069) to 788 (746-830). The probability of missing girls was mostly determined by earlier daughters, even after considering wealth quintile and education levels. The conditional sex ratio among the richest and most educated mothers was most distorted compared with lower wealth and education groups, and generally decreased with time, until a modest improvement in 2007-16. In contrast to the substantial improvements in female child mortality in India, missing female births, driven by selective abortion of female fetuses, continues to increase across the states. Inclusion of a question on sex composition of births in the forthcoming census would provide local information on sex-selective abortion in each village and urban area of the country. None. For the Hindi translation of the abstract see Supplementary Materials section.

Disability and Reproductive Justice

Since at least the 1960s, public debate over abortion rights has frequently turned to issues of disability. Those who argue for liberalization of abortion laws have often been successful by raising the specter of fetal disability — whether caused by Thalidomide, or rubella, or otherwise. Those who agitate for restricting or banning abortion, by contrast, have often argued that pro-choice advocates devalue the lives of people with disabilities. In the spring of 2019, disability and abortion rights collided at the Supreme Court. Indiana had adopted a law “barring the knowing provision of sex-, race-, or disability-selective abortions by abortion providers.” The Seventh Circuit invalidated that law. In Box v. Planned Parenthood of Indiana & Kentucky, the Supreme Court denied certiorari (though it summarily reversed the Seventh Circuit’s invalidation of a separate Indiana law regulating the disposal of fetal remains). Justice Thomas concurred in the denial of certiorari, but he filed a lengthy separate opinion arguing that the ban on selective abortions was constitutional. He argued that “this law and other laws like it promote a State’s compelling interest in preventing abortion from becoming a tool of modern-day eugenics.” Just a few months earlier, disability and reproductive rights issues had intersected in a very different way in the debate over the nomination of Brett Kavanaugh to the Supreme Court. Disability rights advocates drew attention to an opinion then-Judge Kavanaugh had written in a case in which individuals with developmental disabilities challenged a District of Columbia policy that denied them the right to make decisions about their medical care. The case was Doe ex rel. Tarlow v. District of Columbia. The D.C. Circuit reversed a district court decision enjoining that policy. Judge Kavanaugh’s opinion did not say anything specifically about reproductive rights. He treated the case entirely as one about the (lack of a) right of incompetent persons to consent to medical treatment. But the case itself was very much a reproductive rights case. Two of the three plaintiffs had been forced to have abortions without their consent; they sued precisely to challenge the policy that had taken away their power to choose. Although Kavanaugh had a reputation as a strong “pro-life” judge, here he voted to uphold government decisions to require individuals with intellectual disabilities to have abortions. Debate over disability and reproductive rights has typically focused on the issues raised by Justice Thomas’s opinion in Box — whether fetal disability is an acceptable reason for terminating a pregnancy, and what the law should do about it. Those are important questions. But any full assessment of the intersection between disability and reproductive rights must also address the issues raised by then-Judge Kavanaugh’s opinion in Doe. Disabled people are frequently denied their own rights to conceive, bear, and parent children, whether through forced sterilization or abortion, the denial of assisted reproduction, or the denial of parental rights once their children are born. Some of these practices — notably forced sterilization — are emblematic of the Eugenics Era. But they are not at all confined to the past. Indeed, the practices that prevent people with disabilities from having and raising children — practices like the law Kavanaugh upheld in Doe — are in many ways the disability analogues of the race-based eugenic practices that Justice Thomas himself decried in his Box opinion. This essay offers a fuller consideration of the intersection of disability and reproductive rights. It does so by considering the legal and societal treatment of fetuses and children with disabilities alongside the legal and societal treatment of parents with disabilities. And it does so by bringing to bear insights drawn from two distinct social movements: the disability rights movement, and the reproductive justice movement. The piece argues that, taken together, the disability rights and reproductive justice perspectives offer substantial purchase on the questions raised by Justice Thomas in his Box concurrence. Those perspectives suggest that the questions are serious indeed but that Thomas gave the wrong answer to them. They also suggest that any effort to address the intersection of disability and reproductive rights needs to address the questions raised by then-Judge Kavanaugh’s Doe opinion — and that Kavanaugh, too, gave the wrong answer.

No Effect of Selective Maturation on Fruit Traits for a Bird-Dispersed Species, Sambucus racemosa.

Selective abortion, also called selective maturation, is a phenomenon wherein maternal plants selectively mature ovules that have the potential to grow into higher-quality fruits, such as those that contain more seeds. We hypothesized that the effects of selective maturation on fruit traits could be influenced by the dispersal mechanism. However, to date, limited studies have been conducted on selective maturation in bird-dispersed fruits. Unlike self- or wind-dispersed species, bird-dispersed species would not selectively mature fruits that contain more seeds because they are not preferred by birds. Here, we investigated the effect of selective abortion on the fruit traits of a bird-dispersed species, elderberry (Sambucus racemosa L. subsp. kamtschatica). We performed a flower-removal experiment. Half of the inflorescences on each individual tree were removed for the treatment group, whereas the control group was not manipulated. We found that the flower-removed trees showed higher fruit sets, suggesting the existence of resource limitation. The number of seeds per fruit did not increase by the experimental treatment. Additionally, the control individuals did not produce larger fruits. The lack of effects on fruit traits supported our hypothesis that the effect of selective maturation on fruit traits may differ among species with different dispersal mechanisms.

Figuring India and China in the Constitution of Globally Stratified Sex Selection.

The advent of techniques of sex selection that rely on assisted reproduction led to a questioning of whether sex selection should be deemed always and everywhere unethical. While China and India are normally associated with condemned practices, they are also implicated in processes that constitute globally stratified sex selection inclusive of its more valued form, often referred to as family balancing. Through an application of Ong and Collier's concept of global assemblage, I demonstrate how family balancing, which has taken on a "global form," is tied to an "assemblage" of factors related to the anti-natal, population control contexts that have been pervasive in Asia. Three simultaneously occurring processes since the mid-1990s constituted stratified sex selection: the surfacing of China and India as figurative counter examples in deliberations of ethics on new techniques; active (inter)national surveillance of sex ratios as well as denunciation and criminalization of sex selective abortion in China and India; and the role of China and India in neoliberalizing population control and developing globalized markets in reproduction. Accounting for globally stratified sex selection requires a more robust interpretation of ethics that rethinks disciplinary approaches just as much as relativist ones in which respect for individual autonomy tends to overtake all other concerns.

Diferencias epidemiológicas podrían explicar la mayor mortalidad infantil de Chile comparada con Cuba

Cuba has the lowest infant mortality rate in Latin America, while Chile has an infant mortality rate above the average of Organization for Economic Cooperation and Development (OECD) countries.To compare the epidemiology of infant mortality between Chile and Cuba in order to find characteristics that may explain the differences found.Comparative analysis between Chile and Cuba of infant mortality rate, causes of mortality, live birth weight, and maternal age, in 2015.Cuba had a lower infant, neonatal, early and late mortality than Chile, with no differences in post-neonatal mortality. Chile had a higher infant mortality due to, alterations of the nervous system, urinary system, chromosomal alterations, respiratory distress syndrome, and disorders related to the short duration of gestation. Chile had a higher frequency of mothers ≥ 35 years old and live births weighing <2,500 g. The possible effects of health inequities could not be analyzed due to lack of data.It is possible to attribute the lower infant mortality rate in Cuba to: selective abortion due to congenital malformations and chromosomal anomalies, lower epidemiological risk of the Cuban pregnant population, and lower frequency of live births with low birth weight.

Sex-Composition of Living Children and Women’s Fertility Desire in Vietnam

Objective: To investigate the relationship between sex-composition of children and women’s fertility desire in Vietnam. Materials and methods: Using data from the 2014 Vietnam Multiple Indicator Cluster Survey (MICS), we investigate the association between sex composition of children and desire for additional children among women in reproductive age (15 to 49 years) across Vietnam (N=5,605). Results: Multivariate logistic regression models showed statistically significant association between sex composition of children and women’s fertility desire, after controlling for social norms of fertility preference, demographic and socioeconomic factors. For each group of women (those with one child, two children, and three or more children) women with no sons are more likely to have higher fertility desire compared to women with at least one son. However, women with both son (s) and daughter (s) tend to have lower fertility desire compared to those who have all sons. Conclusion: Vietnam’s traditional cultural norm of son preference has a strong influence on fertility desire. Besides, mix-gender preference is also documented. The government should enforce the law more strictly regarding the prohibition of ultrasounds to detect fetal sex to reduce the feasibility of sex selection abortion. In addition, the government should improve the social ideology of the role of women in the family and society through mass media.

Epidemiological difference could explain the higher infant mortality in Chile compared with Cuba

BackgroundCuba has the lowest infant mortality rate in Latin America, while Chile has an infant mortality rate above the average of the Organisation for Economic Co-operation and Development (OECD) countries. ObjectiveTo compare the epidemiology of infant mortality between Chile and Cuba in order to find characteristics that may explain the differences found. MethodComparative analysis between Chile and Cuba of infant mortality rate, causes of mortality, live birth weight, and maternal age, in 2015. ResultsCuba had a lower infant, neonatal, early and late mortality than Chile, with no differences in post-neonatal mortality. Chile had a higher infant mortality due to, alterations of the nervous system, urinary system, chromosomal alterations, respiratory distress syndrome, and disorders related to the short duration of gestation. Chile had a higher frequency of mothers ≥35 years old and live births weighing ≤2.500 g. The possible effects of health inequities could not be analysed due to lack of data. ConclusionsIt is possible to attribute the lower infant mortality rate in Cuba to: selective abortion due to congenital malformations and chromosomal anomalies, lower epidemiological risk of the Cuban pregnant population, and lower frequency of live births with low birth weight.

Buds, Bugs and Bienniality: The Floral Biology of Eschweilera tenuifolia (O. Berg) Miers in a Black-Water Flooded Forest, Central Amazonia

Research Highlights: Our study establishes the biennial nature of flowering intensity as a life-time energy-conserving strategy; we show unexpectedly high flower:fruit ratios despite extensive predation of buds and flowers by insect larvae; ‘selective’ bud abortion may be a key annual energy-saving strategy. Background and Objectives: We aim to explain the strongly biennial flowering pattern of Eschweilera tenuifolia, an ecologically key tree species of Amazon blackwater-flooded forest, inundated for up to nine months annually, and with large flowers (6 cm in width). Materials and Methods: We quantified the insect infestation of central Amazonian Eschweilera tenuifolia buds and flowers; we measured nectar production from flower opening onwards, examined flower duration and monitored pollen theft. We tested the role of infestation in bud abortion, nectar production and fruit production initiation. Results: Our study shows extensive predation of buds and flowers by insect larvae, as well as selective abortion of heavily infested buds, and limited loss to pollen thieves which fed largely on infertile fodder pollen. Nectar production peaked in the morning, with no nocturnal nectar production recorded. Sucrose levels were similar to congeneric values (mean 37.4%), and near-constant during production. Flower duration (4–5 days) was longer than reported for other congenerics. Conclusions: Insect infestation of buds can play an important role in regulating flower:fruit ratios, thus setting limits on individual total seed set. Individual Eschweilera tenuifolia appear to invest highly in reproduction every second year. Extended flower duration may be a strategy to enhance pollination success, but increases overall reproductive investment. Abortion of heavily infested buds may minimize allocation of energy to malformed flowers, which have a lower chance of attracting pollinators, thus functioning as a short-term energy-saving strategy. Additionally, biennial flowering in E. tenuifolia is likely to be an energy-conserving response in a highly physiologically-challenging environment. Thus, E. tenuifolia exhibits energy-conservation strategies at two divergent temporal scales.

Culpable Ignorance, Professional Counselling, and Selective Abortion of Intellectual Disability.

In this paper I argue that selective abortion for disability often involves inadequate counselling on the part of reproductive medicine professionals who advise prospective parents. I claim that prenatal disability clinicians often fail in intellectual duty-they are culpably ignorant about intellectual disability (or do not disclose known facts to parents). First, I explain why a standard motivation for selective abortion is flawed. Second, I summarize recent research on parent experience with prenatal professionals. Third, I outline the notions of epistemic excellence and deficiency. Fourth, I defend culpable ignorance as the best explanation of inadequate disability counselling. Fifth, I rebut alternative explanations. My focus is pregnancies diagnosed with mild or moderate intellectual disability.

Response to commentaries on ‘Expressivism at the beginning and end of life’

I appreciate all of the commentaries for their careful and thoughtful engagement with my article. Because of limited space, I can only focus on some criticisms and cannot develop my...

Expressivism at the beginning and end of life

Some disability rights advocates criticise prenatal testing and selective abortion on the grounds that these practices express negative attitudes towards existing persons with disabilities. Disability rights advocates also commonly criticise...

Race Selective Abortion Bans: A New Way to Prevent the Elimination of Minority Groups in the United States

This article will address whether race selective abortion bans infringe on a women’s right to obtain an abortion when the state has a compelling interest in protecting against the elimination of a race through modern day eugenics. Section I discusses how abortion jurisprudence has developed over time. Section II discusses race selective abortion bans. Section III examines and analyzes selective - abortion bans, specifically race-selective abortion bans. Section IV presents numerous solutions for addressing the high abortion rate in different community settings and the prevention of abortion being used as a form of modern-day eugenics. The objective of this article is to educate on the current status of race selective abortion laws in the United States, and to place that knowledge in the context of the history of the eugenics movement.

An Audit of Loss of Pregnancy as an Answer to Differentiated Sex Ratio

Context: Abortion and unintended pregnancy in India is on the rise, and a large proportion of these unintended pregnancies end up in induced abortion. The soaring rate of abortion among Indian women can be influenced by a plethora of reasons. Aims: 1) To identify the rate of second trimester abortion2) To determine the reasons behind second trimester abortions Settings and design: An audit of all the abortions in a district of South India was conducted. Material and methods: The data was obtained from the records of abortion reported in the year 2018 from the District Health Office and analysed. Statistical analysis used: Descriptive statistics Results: Majority of the pregnant ladies with abortion (55.73%) were aged between 21-30 years and abortions in second trimester were observed to be comparatively higher (50%). Among the myriad of reasons found for second trimester abortions, spontaneous abortions contributed to around 30% while 11.92% had no cause mentioned. Conclusion: A high rate of second trimester abortion throws suspicion towards sex selective abortions.

Hi-tech Sexism? Evidence from Bangladesh

Abstract With the advent of modern technology for fetal sex determination, selective abortion is found to be responsible for a significant number of “missing women” in countries like China and India. Using a competing risk hazard model, we investigate whether son preference translates into selective abortion and accounts for any of the “missing women” in Bangladesh. Data suggest that son preference leads to shorter birth intervals if previous births are girls. For example, if the first birth is a girl, the odds of having another child each quarter is about 15% higher and the birth interval is about 2 months shorter for more educated urban women in recent years (1990–2011). However, there is no evidence that selective abortion contributes to missing women in Bangladesh.

Maintenance of high inbreeding depression in selfing populations: Two-stage effect of early- and late-acting mutations

High estimates of inbreeding depression have been obtained in many plant populations with high selfing rates. However, deleterious mutations might be purged from such populations as a result of selfing. I developed a simulation model assuming the presence of mutations at two sets of loci, namely, early- and late-acting loci, and the selective abortion of embryos coupled with ovule overproduction. In the model, early-acting loci are expressed during embryo initiation, and less vigorous embryos are aborted. Late-acting loci are expressed after selective abortion ends; the surviving embryos (seeds) compete, and some of them form the next generation. If mutations are allowed to occur in both early- and late-acting loci, both types increase in frequency in populations with high selfing rates. However, this phenomenon does not occur if mutations occur only in the early- or only in the late-acting loci. Consistent results are observed even if the total number of loci in which mutations are allowed to occur is the same for simulations with both early- and late-acting loci, only early-acting loci, or only late-acting loci, indicating that the presence of both types of loci is the causal factor. Thus, the two-stage effect, or occurrence of both early- and late-acting mutations, promotes the maintenance of these mutations in populations with high selfing rates.

Genetic Selective Abortion: Still a Matter of Choice

Jeremy Williams has argued that if we are committed to a liberal pro-choice stance with regard to selective abortion for disability, we will be unable to justify the prohibition of sex selective abortion. Here, I apply his reasoning to selective abortion based on other traits pregnant women may decide are undesirable. These include susceptibility to disease, level of intelligence, physical appearance, sexual orientation, religious belief and criminality—in fact any traits attributable to some degree to a genetic component. Firstly, I review Williams’ argument, which claims that if a woman is granted the right to abort based on fetal impairment, then by parity of reasoning she should also be granted the right to choose sex selective abortion. I show that these same considerations that entail the permissibility of sex selective abortion are also applicable to genetic selection abortion. I then examine the objections to sex selective abortion that Williams considers and rejects, and show that they also lack force against genetic selection abortion. Finally, I consider some additional objections that might be raised, and conclude that a liberal pro-choice stance on selective abortion for disability entails the permissibility of selective abortion for most genetic traits.

Savvy Surrogates and Rock Star Parents: Compensation Provisions, Contracting Practices, and the Value of Womb Work

Abstract:What is the value of surrogate labor and risks, and how is it negotiated by participants as they contract within an unsettled baby market? This article presents novel data on compensation, fee, and bodily autonomy provisions formalized in surrogacy contracts, and the experiences of actors embedded in exchange relations, as they emerge in a contested reproductive market. It combines content analysis of a sample of thirty surrogacy contracts with 115 semi-structured interviews conducted in twenty states across the United States of parties to these agreements, attorneys who draft them, counselors, and agencies that coordinate matches between intended parents and surrogates. It analyzes the value of services and medical risks, such as loss of a uterus, selective abortion, and “carrier incapacity,” as they are encoded into agreements within an ambiguous field. Surrogacy is presented as an interactive social process involving law, markets, medicine, and a variety of cultural norms surrounding gender, motherhood, and work. Contracts have actual and symbolic power, legitimating transactions despite moral anxieties. Compensation transforms pregnancy into a job while helping participants make sense of the market and their “womb work” given normative flux. Contracts are deployed by professionals without informed policies that could enhance power and reduce potential inequalities.

СЕЛЕКТИВНЫЕ АБОРТЫ КАК ФОРМА НАРУШЕНИЯ РЕПРОДУКТИВНЫХ ПРАВ ЖЕНЩИН

The article raises the question of legal ways to protect women’s reproductive rights when committing an artificial termination of pregnancy by gender. Selective abortion is a social disease that has a long history and is still relevant today. A review of the issue began with a study of the occurrence and development of this phenomenon in Russia and foreign countries. In addition, the causes and consequences of elective abortion are clarified, and ways to deal with them are investigated. Also proposed are measures to improve this situation in Russia and the world.