Science, Politics, and Reproductive Rights: The Case of Ultrasound Technology

Science, politics and women’s reproductive rights are not easily disentangled. They often collide to contain and expand women’s rights and freedoms. It is this difficult terrain of science and politics that feminists must negotiate in their struggle to protect women’s interests.

For many years, scientists and activists have argued over whether technology can be neutral. In fact, reproductive technologies are rarely value-free, and have often been deployed for political ends in the battle to control women’s bodies. Indeed, the same technology can be applied to achieve completely opposite outcomes. The use of ultrasound technology (sonogram machines) is a case in point. While ultrasound technology can be a very useful tool in prenatal care, it may also be deployed to serve very different political ends, and its appropriateness may differ depending on the social, cultural and political environment in which it is introduced. The two controversial uses of the ultrasound technique described below graphically illustrate the ways in which the same reproductive health technology can be harnessed to meet quite different ideological objectives.

This past year in the US a bill to equip ‘crisis-pregnancy centers’ with ultrasound machines was introduced in Congress. The AP/Seattle Times reported that the bill would provide three million dollars in federal funding to enable hundreds of “crisis pregnancy centers” to purchase ultrasound equipment.¹ These crisis centers are often located in close proximity to abortion clinics and are designed to discourage women from having abortions. Ostensibly, these clinics provide pregnancy tests and counseling, but in reality they distribute anti-abortion literature and information. Those advocating the installation of ultrasound equipment in the clinics do so with the express purpose of discouraging women from obtaining abortions.²

Antiabortion activists and their congressional supporters believe that “a look inside the womb will dissuade many pregnant women” from choosing to have an abortion. Tom Glessner, the President of the National Institute of Family and Life Advocates, stated: “When they get the information to make an informed choice—once they see the ultrasound—the majority of women [choose] to carry the pregnancy to term,” adding that viewing an ultrasound image of her fetus allows a woman to appreciate “the full measure of what it means to see a live person in the making.”³ Advocates of the legislation state that it would allow pregnant women to receive “more information” about their pregnancies and thereby reduce the number of abortions.

This effort has been criticized by pro-choice advocates who argue that it is a manipulative intervention designed to limit rather than expand women’s choices. They see crisis pregnancy centers as environments that exert undue pressure on women to realize a political agenda which does not have women’s best interests as its motivating concern. The centers do not provide clients with objective information, nor do they provide the space for women to make their own decisions regarding whether or not to carry their pregnancies to term. Abortion rights advocates denounce the use of federal dollars to equip the centers with ultrasound machines as a misuse of public funds. They see this initiative as an inappropriate use of a technology to serve political rather than medical purposes. Kate Michelman, president of the National Abortion and Reproductive Rights Action League, said: “It never fails to amaze me how little respect they have for women’s capacity to understand what goes on in our bodies.” She added that supporters of the legislation “have one purpose in mind—to intimidate women out of choosing abortion and using government money to do that. That is wrong.”⁴

Halfway across the world in India, the ultrasound machines also represent a source of contention and concern. Several years ago, the Indian Government, in response to pressure from feminist groups, passed the Prenatal Diagnostic Technique Act. This Act banned the use of ultrasound and other diagnostic techniques for the purposes of selecting the sex of a fetus. More recently, the Indian Supreme Court ordered the seizure of ultrasound machines from unregistered clinics as part of an effort to crackdown on sex selection tests that are widely used across the country, and typically followed by the abortion of female fetuses. The Court has ordered state governments to impound ultrasound machines in all unregistered clinics due to the “misuse” of the machines.

Despite the government’s ban and several feminist campaigns opposing the use of the test for sex selection, the tests are very popular. The low status of girls and strong son preference explain their continued use despite their being illegal. Son preference is widely justified on symbolic as well as practical grounds. Among Hindus, sons carry the family name and offer oblations for the departed souls of parents. Daughters are seen as a financial drain on a family because of the expenses incurred in childhood and the escalating cost of giving a dowry at marriage. Boys traditionally look after their families in their old age while girls are typically sent to live with the husband’s family. The dominant family pattern in India is patriarchal, patrilineal and patrilocal.

Doctors continue to provide tests for sex selection as they are a lucrative business.⁵ In fact, the tests are so widely used that they are one of the causes of the imbalance in the male/female ratio in India. Nobel Laureate Amartya Sen notes that early results from the 2001 decennial national census of India indicate that “though the overall female to male ratio has improved slightly for the country as a whole, the female-male ratio for children has had a substantial decline.” The female to male ratio for those under six has declined from 94.5 girls per hundred boys in 1991 to 92.7 in 2001.⁶ The decline is very sharp in some parts of the country.⁷ Sen contends that the evidence suggests that “...this change reflects not a rise in female child mortality, but a fall in female births vis-à-vis male births, and is almost certainly connected with increased availability and use of sex determination techniques for fetuses, except when it is a by-product of a necessary medical investigation.” Furthermore, he comments on the fact that the law is often not enforced because of the reluctance of mothers to provide evidence that they used such techniques.⁸ This underlines how deeply son preference is ingrained.⁹

The ways in which the ultrasound is being promoted in the US context—to discourage women from electing to have an abortion—and the ways in which ultrasound is being discouraged in India—because it enables families to abort female fetuses—indicate that what is at issue is not the technology itself but the context and the ways in which it is being deployed. In both cases, ultrasound technology is being used as a tool to influence women’s reproductive choices, and in both cases feminists are concerned about the ways in which the technology is used to coerce and devalue women.

A narrow definition of choice may lead feminists to promote ultrasound technology without qualification. In the US, feminists have focused their efforts on increasing women’s contraceptive choices and expanding access to reproductive technologies. However, in this case an awareness of the political agenda and the particular settings in which the technology will be introduced lead pro-choice advocates to oppose government promotion of ultrasound equipment for pregnancy crisis centers. In India, where challenging reproductive abuses and coercive practices drives the feminist agenda, activists have advocated for a ban on the use of ultrasound technology for sex selection. Their position was based on a keen awareness of the broader cultural and political environment in which such a technology is being used.

In the US, given the anti-choice political environment, ultrasound machines could become one more weapon in the on-going cultural and legal battle being waged against reproductive freedom. In India, the Court’s decision to impound ultrasound machines in unregistered clinics is an attempt to expand women’s rights. In the US case, the state, by proposing the equipping of pregnancy centers with ultrasound equipment, is acting in the interests of anti-choice forces. In India, the Court’s decision to impound the ultrasound machinery is consistent with the demands of Indian feminists.

What these two examples make clear is that feminist activists must constantly maneuver amidst science and politics in their ongoing struggle to ensure women’s reproductive rights and freedom. As the ultrasound debate demonstrates, this is often difficult territory to navigate. It requires activists to educate themselves to understand not only the science behind new technologies, but the social, cultural and political context in which these technologies operate. For it is these contexts that serve to make technology an implement for coercion and control, or a tool to promote human health, rights and freedom.

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