UK Ethicists: Ban Fetal Sex Tests In First Trimester

A new paper argues that expectant parents shouldn't be allowed to find out their fetus' sex early in pregnancy — all because of the risk of sex-selective termination

Photo Illustration: Vocativ
Mar 02, 2017 at 1:27 PM ET

Expectant parents shouldn’t be allowed to find out their fetus’ sex in the first trimester, according to a new report published by a group of bioethicists in the United Kingdom. The reason? To protect against the possibility of sex selective abortion. The working paper by the Nuffield Council on Bioethics even argues for an outright ban on non-invasive prenatal testing (NIPT), a form of early genetic testing, being used to reveal a fetus’ sex.

NIPT is a groundbreaking test that analyzes placental DNA circulating in the woman’s bloodstream at around nine or 10 weeks of pregnancy. The test, which is increasingly common in both the U.S. and U.K., is typically used to screen for genetic conditions including Down, Patau, and Edwards syndromes. It’s controversial enough when used solely for those purposes — some critics say terminating a pregnancy based on the discovery of a genetic abnormality discriminates against disabled people — but it can also reveal the fetus’ sex.

The paper, written by a group of academics, takes issue with the possibility of NIPT being used to screen for less serious genetic conditions, which, it argues, might cause expectant parents unnecessary worry or lead to abortion. As such, they argue for major restrictions on how NIPT is used. But it’s the paper’s recommendation on a total ban on early sex testing that stands out.

Early sex testing is an appealing proposition for many expectant parents, who would often otherwise have to wait until around mid-pregnancy for an ultrasound to reveal whether it’s a boy or girl. It’s a largely harmless exercise — well, aside from allowing parents to get a kick-start on gender stereotyping their kids. As Mary Norton, a physician with an expertise in prenatal diagnosis and testing, told Vocativ, most parents are just filled with a need to know. “It’s really not because they’re planning to terminate if it’s not the sex they want,” she said noting that sex selective abortions are uncommon in the U.S. “It really is because people want to know and they’re just curious.” Some might have a sex preference and want time to adjust should things not turn out as they hoped. Others just want to pick out paint swatches for the nursery.

But the Nuffield Council on Bioethics says the potential harms outweigh the benefits. “The consequences of an increase in sex selective terminations in the U.K. are potentially serious, particularly within specific cultural communities, and the medical benefits to a pregnant woman of finding out the sex of her fetus at nine to 10 weeks, rather than at later ultrasound scans, are few,” the paper reads.

The paper does note that the U.K. Department of Health in 2015 “found no substantiated concerns about sex selective abortions occurring in England, Wales and Scotland.” But it points to other research showing a skewed male-to-female ratio among babies of women born in India, where sex selective abortions are more common, and living in the U.K. So, their concern is that sex selective abortion will rise among groups with a cultural preference for one sex over the other.

For that reason alone, they suggest banning early sex testing for all expectant parents. “We recommend that NIPT providers should not offer sex determination of fetuses,” they write. “We believe that the Government should require test providers to neither generate nor report this information … .” They provide an exception only in cases where there are concerns that a fetus might have a significant sex-linked disorder.

The paper has been welcomed by some, but has also encountered strong condemnation. In a statement to the BBC, the British Pregnancy Advisory Service said, “Where any woman is under pressure to produce a male child, the ethical answer is not to deny every pregnant woman the right to find out information about her own pregnancy, but to do our utmost to ensure gender equality and access to comprehensive women’s support services so that women can make their own choice about their pregnancy free from coercion.” It also argued that the report was “permeated by a mistrust of women and the reproductive choices they make.”