Genomic resource centre

Gender and Genetics

Unsafe Abortion

Unsafe abortion figures into a discussion on gender and genetics because women may seek to terminate a pregnancy in which the foetus has been diagnosed with a genetic disorder. WHO defines unsafe abortion as a procedure carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.(95) Due to the fact that unsafe abortions are also often illegal abortions, it is difficult to collect accurate data concerning the rates of unsafe abortions. There is also no available data on what proportion of unsafe abortions are related to fetal abnormality. The figure below demonstrates the potential relationship between the availability of prenatal diagnosis (PND) and unsafe abortion. In relation to this figure, it should be borne in mind that not all legal abortions will be safe, nor all illegal abortions unsafe.

Many countries do permit pregnancy termination for fetal abnormalities including China, Cuba, Cyprus, India, Sri Lanka and South Africa. (96) Some religions have assumed a flexible approach to abortion for fetal abnormality, especially in situations where it can be done early. (97) Iran provides premarital screening for thalassemia and permits abortion for thalassaemia within the first 16 weeks of pregnancy, in accordance with the 1990 Islamic Fatwa. (98) Other Islamic countries including Pakistan, the Maldives and Palestine have endorsed similar resolutions. (99)

However in other regions, such as Latin America, abortion for fetal abnormalities is still widely prohibited. In countries where abortions are illegal, women seeking to terminate the pregnancy because of a fetal abnormality must do so illegally and in often unsafe conditions.

A range of congenital disorders, such as Edwards syndrome, Patau syndrome, and Tay Sachs are not able to be managed effectively. Some couples who find out that they are pregnant with a fetus affected by these disorders prefer to terminate the pregnancy.

PND and unsafe abortion in Brazil

PND and unsafe abortion in Brazil

PND and unsafe abortion in Brazil
Abortion is illegal in Brazil, except in cases of rape or life-threatening risk to the mother. (100) Such limitations restrict the utility of prenatal diagnosis, especially in public hospitals where foetal ultrasound is often provided. (101) In Rio de Janeiro, many babies born with severe congential anomalies die in hospital, and contribute substantially to mortality and morbidity rates in Rio de Janeiro State. (102) Courts in Rio de Janeiro and elsewhere in Brazil, however, have allowed abortion in situations where fetal anomalies [are] ‘incompatible’ with life outside the womb.” (103)
Still, the genetic practice of prenatal testing and screening is highly charged in Brazil and confirmation of a foetal abnormality does not guarantee the legal right of the prospective parents to an abortion. As a consequence, some women with affected pregnancies resort to illegal abortions which are often unsafe. The risks to health and life associated with these unsafe abortions lead Horovitz et al. to argue that pregnancy termination for foetal anomalies should be legalized in Brazil. (104)
In Brazil, those women who can afford to pay for a safe abortion often choose to terminate an affected pregnancy without health or legal ramifications. However, most pregnant women who discover that their fetus is affected with a congenital disorder, must choose between continuing the affected pregnancy or an illegal, probably unsafe abortion, with the associated social, legal and physical risks. (105)