What Are The Right Reasons For Terminating A Pregnancy?

By Sital Kalantry,  Clinical Professor of Law at Cornell Law School and author of Women’s Human Rights and Migration: Sex-Selective Abortion Laws in the United States and India.

The Chicago-based Court of Appeals for the Seventh Circuit heard an appeal from Indiana last month which will decide whether a state can specify the reasons a woman can terminate her pregnancy. The law in question, signed in March 2016 by then-Governor Mike Pence, prohibits a woman from aborting a fetus on the basis of its sex, disability (including Down syndrome), race, color, national origin, or ancestry.

The lower court, the U.S. District Court Southern District of Indiana, found that the reason-based bans are clearly unconstitutional under Roe v. Wade and Planned Parenthood v. Casey. That court found a state may not prohibit any woman for terminating her pregnancy before viability for any reason. The court also found the portion of the law that required abortion providers to inform their patients of the anti-discrimination provisions and the types of abortions those provisions prohibit and a portion of the law related to fetal tissue disposition were also found to be unconstitutional. The State of Indiana has now appealed this decision, bringing it to the Seventh Circuit.

Ten states have laws to punish doctors for performing an abortion knowing the woman is seeking it because she doesn’t want a child of a certain sex. There are injunctions in place in three of those states. For example, the sex-selective abortion ban in Arkansas was enjoined by a lower court because it was likely unconstitutional. In 1984, Illinois was the first to adopt a ban on sex-selective abortion, but the state eventually agreed to limit the statute only to abortions post-viability after the U.S. Supreme Court’s decision in Casey in 1993. Other states have other forms of reason-based restrictions: North Dakota and Ohio bans disability-selective abortion and Arizona has enacted a race-selective abortion ban.

Reason-based bans are sweeping the nation, particularly sex-selective abortion bans. If states are allowed to limit the reasons for which a woman can terminate a pregnancy, it will drive a huge hole into reproductive choice. Women will be subject to questioning about their motives, an inquiry that can be humiliating and invasive for someone already embarking upon what is likely a difficult decision. When medical professionals face criminal penalties for performing an abortion for the “wrong” reasons, this creates a strain on the doctor patient relationship, and jeopardizes the quality and accessibility of health care services overall.

The state of Indiana and other advocates for reason-based bans on abortion claim that the bans are needed to address discrimination in society. Using misinterpretations of narrow demographic data, anti-abortion advocates have even convinced some pro-choice legislative representatives that the bans on sex selection are needed to prevent widespread abortion of female fetuses among Chinese Americans and Indian Americans. This dominant (and false) narrative misrepresents data in order to play upon feminist concerns related to the desire of some people in some Asian countries to have at least one son. Playing on this stereotype has been successful: over half of state legislatures and the majority U.S. House of Representatives have voted to consider bans on sex-selective abortion.

Anti-abortion groups have also received support from some disability rights groups for bans on disability-selection abortion. An amicus brief in the Indiana case submitted by Down Pride, Saving Down Syndrome, Fondation Jérôme Lejeune, and Women Speak for Themselves, argues that permitting disability selective abortion risks eliminating entire communities of people with disabilities. This disability-selection ban would also prevent abortions for women whose fetuses have been diagnosed with severe disabilities and may require life-time medical care or whose children may die soon after birth.

Anti-abortion advocates also claim that race-selective abortions are needed to prevent the disproportionate rate of abortion among African American and Latina women. Indeed, some African American pro-life groups, such as the National Black Pro-Life Coalition, have spoken in support of such bans. Although the disproportionate rate of abortion among some minority groups is an issue worthy of examination, the notion that minority women are racially discriminating against their own fetuses is absurd, and cannot sustain a straight-faced discussion.

 The U.S. Court of Appeals for the Seventh Circuit should find pre-viability reason-based bans to be unconstitutional under Roe and Casey. The constitutional status of post-viability bans is less clear. In light of the most recent reproductive rights case, Whole Woman’s Health, the Seventh Circuit may undertake a cost/benefit analysis if it applies the “undue burden” test to post-viability sex-selective abortion bans. In such a scenario, pro-choice advocates could argue that sex-selective abortion bans in particular will create a tension in the relationship between a medical professional and her patient, could lead to racial profiling by medical professionals, and will burden the rights of women who desire to obtain non-selective abortions. Importantly, the composition of the justices and whether or not they follow the dominant narrative put forth by anti-abortion activists (for example, that such bans are necessary to prevent widespread sex discrimination amongst Asian Americans) could also have a great impact on the ultimate decision of the Court.

If the Seventh Circuit decides that the Indiana reason-based bans are constitutional, many states will rush to limit the specific reasons for women obtaining abortion. The result may well be a Handmaid’s Tale-esque dystopia, where only a few are deemed to be the “right” reasons. Perhaps we will be headed in the direction of many of our South American neighbors that permit abortion only in the case of rape and to save the life of the mother. No matter how the Seventh Circuit rules, the case is likely headed to the U.S. Supreme Court. If reason-based bans are deemed to be constitutional, it will significant restrict women’s reproductive choice in many ways.