Abortion in Asia

Local dilemmas, global politics

Erica van der Sijpt

04 Nov 2014

Andrea Whittaker (ed.), Abortion in Asia. Local dilemmas, global politics.New York and Oxford: Berghahn Books, 2010. 253 pp. $34.95. ISBN: 978-1-84545-734-1 (hb).

This edited volume offers a rich overview of abortion practices and policies in a wide range of Asian countries. The detailed descriptions of women’s decisions to terminate their pregnancies and of the local, national, and global politics in which these decisions are enmeshed illuminate the variety and complexity of abortion issues in the selected Asian settings. Despite their different foci and academic approaches, all contributors share a deep concern for women’s access to safe abortion services, and make a strong case for the enhancement of women’s reproductive health and rights. The practical commitment that transpires throughout the entire book places this volume at the intersection of anthropology and public health; the ideological underpinnings of most contributions blur the lines between social science and human rights activism.

After a comprehensive introduction to the book’s topic, region, and approach by the editor, the first set of contributions (chapters 2 through 6) focuses on the intricacies of abortion practices on the ground. Each of the chapters situates women’s decisions to terminate their pregnancies within the gendered social, political, and economic inequalities in which they are embedded. The authors address a diverse range of topics, such as the contraceptive use and abortion decisions of women in Cambodia, the ambiguity of therapeutic late-pregnancy terminations due to foetal anomalies in Vietnam, the structural violence encountered by Burmese migrants working and conceiving unwanted pregnancies in Thailand, the quest for ‘menstrual regulation’ by poor adolescents in urban slums in Bangladesh, and the complexity of women’s choices regarding abortion providers in rural India.

Although the empirical data and arguments presented in these chapters are very different in nature, several crosscutting themes can be distinguished. First, all chapters show that there is no direct connection between the legality of abortion and the safety of abortion practices on the ground. There is no guarantee that, just because abortion services are permitted by the state, they will be safe; yet, services may be accessible and relatively good even if the legal framework is prohibitive. Second, the different contributions to this book reveal that, although religious considerations may affect women’s abortion practices, there is no straightforward relation between religion and the legal frameworks, approaches, or attitudes toward abortion in a country. Instead, interpretations of the moral implications of pregnancy termination, and of the ontological status of the foetus, are diverse and often very ambiguous. Third, the various empirical descriptions illuminate the difficulties and ambiguities underlying the interactions between abortion providers and women seeking their services. As both parties have different power positions, interests, and ideas regarding contraception and pregnancy termination, the abortion encounter is often pervaded by negotiation and power abuse. And fourth, most authors make an explicit link between women’s abortion preferences and practices on the one hand, and gender oppression and more structural forms of violence in society on the other. Reproductive rights, it is argued, are far from being attained in most settings.

The remaining chapters (chapters 7 through 10) move their focus to macrolevel processes of reproductive health policy making and advocacy. Detailed descriptions of such processes in Vietnam, Indonesia, Malaysia, and Thailand illuminate the complex negotiations that inform the implementation of legal and policy reform, and draw attention to the enormous impact of international powers, religious lobby groups, and global funders on national abortion policies and service provision. The chapters show that steps forward, such as developments toward more liberal abortion laws and more accessible and safer services, are not necessarily irreversible. Hence, they end with a call for more comprehensive lobbying strategies in order to secure advances and attain reproductive rights for all.

At the end of the book, Andrea Whittaker reviews the insights gained through these descriptions of local and global politics of abortion, and identifies some issues to be put on the agenda for future research. Topics that she claims this volume has not been able to properly address are, among others, the links between abortion on the one hand and HIV/AIDS or disability on the other; the special needs and desires of adolescents, men, and migrants; the influence of new reproductive technologies on abortion practices; and the consequences of the movement and trade of abortion medicines in the region. 

To these, I would add another important issue. The declared aim of the volume is to ‘situate women’s experiences within their families, social settings and institutions’ (p. 240); moreover, the importance of collective instead of individual interests in the selected countries is repeatedly mentioned. However, surprisingly, almost none of the chapters (the only exception being Tine Gammeltoft’s contribution on therapeutic abortions in Vietnam) offer in-depth descriptions of the social domains of marriage and kinship. And yet, in order to be able to comprehend women’s abortion decisions, we would need to know more about their sexual relationships, local marital norms and practices, existing ethics of motherhood, cultural forms of parenting, notions of descent (defining the belonging of the unborn child), various kinship configurations, and intergenerational relationships in the community. By reducing the description of these aspects to a minimum, and by focusing on practical health-related considerations in abortion decision making instead, the chapters in this book might appeal less to an anthropological audience looking for in-depth descriptions than raise the interest of medically oriented readers working on applied solutions.   

More insight into this social landscape of fertility and women’s navigation of social options and constraints would not only enhance our understanding of reproductive decision making, however. It would also potentially lend nuance to the image of women as ‘powerless and vulnerable’ (p. 108) victims that is at times created in the book. Although I do not deny that women with unwanted pregnancies may find themselves in precarious situations, the conclusions about their passive victimhood, oppression, and suffering seem too quickly reached, and based on shallow descriptions of gendered inequalities at most. More detailed analyses of the microdynamics of social relations and of women’s reproductive tactics within this social fabric would allow the reader to better assess the extent to which women actually lack the reproductive agency for which many authors are making a case in this volume. 

These issues notwithstanding, this edited book does a good job covering the relatively unknown field of abortion in Asia, and could prove to be relevant for anthropologists, sociologists, public health workers, human right advocates, and policymakers with an interest in this domain.

Erica van der Sijpt
Medical Anthropology, University of Amsterdam