State legislatures have adopted abortion restrictions that target specific populations of women and pregnancy conditions by banning abortion on the basis of sex selection, race selection or genetic anomaly. These bans stigmatize pregnant people of color who seek abortions by questioning the motivation behind their abortion decision. In recent years, members of Congress have introduced federal legislation that would prohibit abortion based on the sex or race of the fetus.
Historically, sex selection has occurred most frequently in countries where there is a strong gender bias that manifests in a preference for sons. Evidence from the global context indicates that sex-selective abortion bans do not work to prevent sex selection, because these bans do nothing to challenge the phenomenon of son preference or its underlying causes and they are difficult to enforce. Also, sex-selective abortion is only one of several medical methods of choosing the sex of a fetus; others, such as sperm sorting and preimplantation genetic diagnostics, remain legal under state bans on sex-selective abortion. There is broad international consensus that the most effective way to combat sex selection is to implement policies that promote gender equity.
Race-selective abortion bans are based on the idea that women of color are coerced into abortions or are complicit in a “genocide” against their own community.1,2 There is no evidence that women of color seek abortions on the basis of race or that a ban on race-selective abortions would decrease abortions among this group.
While nominally aimed at combating gender and racial discrimination, U.S. bans on sex- and race-selective abortions send the message that women, and especially women of color, cannot be trusted to make their own medical decisions.3 They place women’s motivations for having an abortion under suspicion, thereby opening the door to discrimination toward and racial profiling of women of color and immigrant women. In particular, proponents of sex-selective abortion bans cite limited and inconclusive evidence that sex selection is practiced among some Asian communities in the United States, and proponents of race-selection bans erroneously claim that black women are targeted by abortion providers. Rather than protecting these communities, the laws perpetuate harmful stereotypes and put women at risk by making abortion less accessible. By forcing providers to scrutinize and second-guess women’s reasons for seeking an abortion, the bans discourage honest, confidential conversations and interfere in the provider-patient relationship. As a result, patients may withhold information or be dissuaded from seeking care from providers altogether.4
Similarly, laws that prohibit abortions or provision of information on abortion services in cases of fetal genetic anomaly restrict women’s ability to make decisions that are best for themselves and their families. In 2013, North Dakota was the first state to prohibit abortion in cases of fetal anomaly, including in cases where the fetus has a condition that is incompatible with life and will die before or soon after birth. In 2014, Louisiana enacted a law prohibiting health care providers from providing information on abortion as a “neutral or acceptable option” after a diagnosis or potential diagnosis of a fetal anomaly or genetic condition.