Second trimester abortion in Viet Nam – ban or not ban- By Phan Bich Thuy
For the past 10 years imbalances in sex ratio at birth (SRB) has become a major concern in Vietnam. In order to solve this problem the government has adopted certain policies prohibiting use of technology to diagnose fetal sex thus advocating for gender equality. Even though, some policy makers believe that banning second trimester abortions would be a solution for imbalances in SRB. This point of view has raised several arguments in Vietnam, the current article highlights the root causes of the issue and discusses measures that can improve the imbalance in SRB.
Why there is an imbalance in SRB?
- Firstly, son preference is a common phenomenon in Vietnamese culture. Traditionally, men maintain the family lineage, earn life for their families, and take care of parents in old age. Although the roles of men and women are changing in the current society, son preference is still a dominant practice in Vietnamese society.
- Secondly, modern technology is used to identify the fetal sex by ultrasound and testing chromosome through amniotic fluid and aborting the female fetuses.
- Thirdly, two children policy influences the couples’ reproductive decision. If they prefer son they will try their best to have at least one male child.
Who need second trimester abortion? According to a research done by Maria Gallo and Nguyen Cong Nghia (2006) women may need second trimester abortion for different reasons:
- 53% second trimester abortion belongs to adolescents and young unmarried women.
- 80% second trimester abortion belongs to women who are not aware of their pregnancies before 12 weeks gestation. This group includes women who have irregular menstrual periods such as adolescents, breastfeeding mothers, women on medical treatment, women at premenopausal age and women who have poor knowledge about menstruation and pregnancy.
- Often women are detected with fetal abnormalities, which leads to their decision to terminate their pregnancies.
- Some women face difficulties to access early abortion: due to their work/study, geographic barrier, or inability to bear abortion cost.
- Very few women (less than 10%) have reasons for their abortion related to selecting the fetal sex.
What are consequences of banning second trimester abortion?
- Since the reasons for women seeking abortions are varied, banning second trimester will be a barrier for more than 90% women who are in need of abortion and are not related to the fetal sex selection.
- Banning second trimester abortion will increase the number of abandoned babies since their parents can not take care of their unwanted babies.
- Most importantly, banning second trimester abortion will increase complications and deaths related to unsafe abortion. According to WHO; in its 2008 report, the more restricted the abortion laws in a country, higher are the deaths attributable to unsafe abortion
In Vietnam, abortion has been legal up to 22 weeks of pregnancy since the 1960s. With efforts by the policy makers and civil society the maternal mortality rate (MMR) came down to 58.3 per 100,000 live births in 2010. If second trimester abortions are banned women in need of abortion services will seek for this service at illegal and unsafe places which will increase the rate of complications and maternal death.
How to tackle the root causes of imbalance SRB? Based on the root causes of imbalance SRB, here are some solutions to solve this problem:
- Educating and advocating to enhance gender equality. Helping people to recognize the roles of women in families and the society. Women should be provided with opportunity to study and work, and have the ability to care for parents in old age.
- Policies to support the families who have only daughter/s such as social welfare policy for the elderly parents.
- Since Vietnam has achieved fertility rate of 1.85 children born per woman, shifting from the birth control approach with “two children” policy to giving the right to individual and couple to decide freely and responsibly the number of their children, will be a very effective solution.
In conclusion, second trimester abortion is just one of the techniques to be applied for fetal sex selection. Banning second trimester abortions not only an inadequate measure to solve the problem but also leads to serious consequences including increased MMR. Therefore, to solve the imbalances in SRB its imperative to address the root causes mentioned above rather than banning the second trimester abortion.