Selective Abortions: The Intersection of Disability and Reproductive Rights

On May 28, 2019, the United States Supreme Court rejected a provision of an Indiana law prohibiting abortions on the basis of the fetus having a mental or physical disability. The justices wrote that their decision was based on the rights guaranteed by Roe v. Wade and not in support of selective abortions. Although Indiana legislators wrote this law to push an anti-abortion agenda, disability-selective abortions do send a harmful message that impaired children are not worth having. Activists for the disabled community are fighting for an intersectional approach to reproductive rights, but the public discourse around abortion remains split between the pro-choice and pro-life movements. We must bring the topic of disability into this conversation and radically change our definition of body normalcy to create an inclusive society. 

The types of bodies that are most frequently aborted reveal the larger social implications of selective abortion. In the early 2000s, Iceland introduced prenatal screenings that allow mothers to detect chromosomal anomalies before birth. The Landspitali University Hospital in Iceland revealed that close to 100 percent of Icelandic women chose to terminate their pregnancy upon receiving a prenatal diagnosis of Down syndrome. Other countries are not far behind: the estimated termination of fetuses detected with Down Syndrome is 67 percent in the United States, 77 percent in France, and 98 percent in Denmark. The categorization of Down Syndrome as a serious congenital defect serves as justification for these abortions, sending an unequivocal message about which bodies are valued and which are perceived to be better left unborn. 

The pro-life movement exploits the disability rights movement by capitalizing on this issue of selective abortion. Advocating for reproductive freedom and protecting the rights of the disabled community should not be mutually exclusive. The solution is not to prevent the termination of disabled fetuses but instead to challenge the idea that children with disabilities are undesirable. The normalization of disabilities as deformities is socially constructed, which begs the question: what exactly is a disability?

The primary paradigm used to frame disabilities is known as the “individual model.” The individual model assumes the “problem” of a disability stems from the innate physical and psychological limitations of an individual. Able-bodiedness is seen as the standard and is used as a justification to fix, treat, or cure non-normative bodies with medical treatments and technological enhancements. The harmful notion that conditions like Down Syndrome are worth terminating is a product of the individual model. 

People with “disabilities” have challenged these value judgements of their cognitive and physical capabilities. In the 1980s, the Union of the Physically Impaired Against Segregation challenged the notion that disabilities are innate by introducing the “social model of disability.” This model posits that disabilities are caused by the way society is organized and makes a strong distinction between an impairment and a disability. An impairment is defined as having a defective limb, organ, or mechanism of the body, while a disability is the disadvantage or restriction of activity caused by social structures. In other words, an individual may lack the ability to hear, but they are ultimately disabled by social institutions that exclude them from fully participating. This model rejects the concept of body normalcy and instead views all bodies as intrinsically valuable. Through this paradigm, people are not born disabled but are disabled by social constructions that place more merit on certain bodies. The social model has the central goal of forming a society where everyone is given the equal opportunity to thrive regardless of the body in which they were born. 

Although disabilities are socially constructed, it is inevitable that an ‘able-bodied’ person will have a social advantage over a disabled person. Prospective parents receiving a prenatal scan with the positive results of a disability grapple with the reality of raising a child with financial, emotional, and social burdens. Parents do not want to bring a child into the world who will face severe disadvantages and limitations. The social model is not oblivious to the current paradigm of disability that society operates within, but it challenges parents to embrace body diversity and love their children unconditionally. We should reject the tendency to hold preferences towards abled bodies during prenatal scans and work towards improving the lives of people with disabilities. 

There is no simple resolution to reducing the high termination rates of impaired fetuses but the first step is to include the topic of disability within the discourse on reproductive rights. Selective abortions should not be conflated with the anti-abortion agenda, but they should not be overlooked. We must adopt the social model of disability to embrace physical and cognitive differences and support families and their children living with disabilities. An equitable society can only exist if human worth is not equated with able-bodiedness. 

Jungwoo Park