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Israeli women - Jewish, Muslim and Christian - are apparently taking advantage of the country's relatively liberal abortion law to undergo prenatal testing for defective fetuses at public expense and abort healthy fetuses because they already have "too many" girls or boys at home.
The apparent use of prenatal testing for sex selection and abortion is revealed by Bnei Zion Medical Center gynecologists and geneticists in an academic article published in the August edition of the Israel Medical Association Journal (IMAJ) called "Chorionic Villous Sampling: Differences in Patients' Perspectives According to Indication, Ethnic Group and Religion." The Abortion Law allows a legal abortion for victims of rape and other illicit sexual relations; women under 18 and over 40; if the fetus is "defective"; and if having the baby would endanger the woman's physical or emotional health.
It does not allow a fetus to be aborted if it is healthy but the parents don't want another child of the same sex as their existing children. A legal abortion is permitted only with approval from a special committee comprised of a social worker, gynecologist and other professionals.
The researchers studied 7,544 pregnant women referred to the Haifa hospital for prenatal diagnosis. Of these, 239 actually underwent chorionic villous sampling (CVS), a prenatal test in which a small amount of tissue is removed from outside the sac where the fetus develops. The tissue is meant for diagnosing or ruling out certain birth defects, but it can also determine the sex of the fetus. The test generally is performed between 10 and 12 weeks after a woman's last menstrual period - several weeks earlier than amniocentesis, in which amniotic fluid with cells from the fetus is removed from the sac.
The test carries a small risk of miscarriage and reportedly may even cause congenital defects in a healthy fetus. The procedure is included in the basket of health services paid for by the health funds in women over 35 or others who have a high risk of having a fetus with genetic defects such as Down Syndrome.
The researchers, Dr. Ron Gonen, Hanna Dare, Chedva Zuck, Svetlana Friedman and Ruth Merkshamer, said the women ostensibly underwent the CVS because of advanced maternal age - Down Syndrome is more common among older mothers - and anxiety about fetal defects. When they did an analysis of ethnic group, religion and family data, they found there was a "significantly high proportion of unbalanced families" - having three or more children of the same gender - among women who underwent the CVS.
There was a "significant excess of males" among the Jewish families and a significant excess of females in the Arab families. Christian Arabs chose CVS more often than the other groups, the authors suggest.
"Jewish women may have utilized CVS for family balancing of both sexes, while non-Jews may have utilized CVS for balancing families with more than three daughters."
"Though there were very few women who mentioned gender selection as the reason for the test, it is reasonable to assume that in many of the cases, these requests were covert, with women requesting prenatal testing on the basis of anxiety or advanced maternal age."
The researchers suggest that CVS is being used illegally for abortion of a fetus of an undesired sex, but that "as long as CVS is available, even without a sound genetic indication, gender selection cannot be prevented."
Health Ministry deputy director-general Dr. Yitzhak Berlovich, who had not yet read the IMAJ article on Wednesday but did so at The Jerusalem Post's request, said the ministry will study the issue over the the next few days, adding that it "has serious implications and requires consultation." If women are getting abortions purely for sex selection, as is claimed, "it violates the Abortion Law and instructions of the ministry director-general regarding sex selection of fetuses. Perhaps abortion committees were not aware of the real reason for some applications."
Dr. Mordechai Halperin, the ministry expert in charge of medical ethics who also read the article, said the ministry has not yet taken an official stance but that he personally regarded the revelation as "shocking. Killing healthy fetuses because families have 'too many' of that sex is immoral, violates universal ethics and indicates moral decline. And public money used for performing CVS in these cases could otherwise have been used to treat cancer patients, for example."
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