Tag Archives: abortion/reproduction

Does Europe Have a Sex Selection Problem?

Excess under age-60 female mortality in less developed countries is estimated to add up to 3.9 million missing women worldwide (World Bank, 2011).  A large proportion of this is due to sex-selective abortion practices.  The practice occurs most commonly among poorer families in societies where boy children are given greater economic and social status than girl children. In such a context, the transition to smaller families can lead parents to choose boys over girls. Notably, female fetuses are most likely to be aborted when the first child born is a girl.

The table below shows the countries with the most skewed ratios at birth in the world. While there is naturally a slightly higher sex ratio of boys to girls — between 1.04-1.06 — ratios above that are considered to be altered by technology due to gender preferences for boy children.

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The reason we find this newest 2013 data of particular interest is that, despite the popular Western focus on Asia, the practice occurs in more European countries. Perhaps most striking is the central European country that ranks at the top of the list—Liechtenstein. This strikes us as odd, given that Liechtenstein has never made this list in the past. Perhaps this is a data collection error (in very small populations, as also in Curacao, the results can be skewed). But we are surprised that no journalists have picked up on the fact that the worst offending son-preference country in the world is now, allegedly, a European country.  We contacted the CIA to ask them about this possible data anomaly but have not yet heard back.*

On the other hand, if the Liechtenstein data is accurate, this would be a very interesting story indeed, especially since Liechtenstein has the most restrictive laws against abortion in Europe.  A quick scan of gender equity policies in Liechtenstein shows that women there were not legalized to vote until 1984, indicating that it is not the most gender egalitarian of European countries.

In any case, whether Liechtenstein’s inclusion in this disreputable list is a data error or not, the other European countries on the list are legitimate.  They have been high for many years, and a recent report on Armenia, for example, documents longstanding norms in gender preference.  The disproportionate focus on birth sex ratios in China and India no doubt reflects their status as the #1 and #2 most populous countries, which means a much greater overall impact in sheer numbers.  Nevertheless, our point stands.  Why has the disproportionate inclusion of non-Asian countries on the above-list gone virtually unmentioned by journalists?

Do Developed Western Countries Prefer Boys?

Americans often think of parental sex preference as a thing of the past, or a problem in developing countries. After all, the U.S. sex ratio at birth falls in the normal range, at 1.05. This is in spite of the curious American cottage industry in sex-identification home use kits, such as the Intelligender, the GenderMaker and the Gender Mentor.

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In surveys, American parents report an ideal of two children and equal preference for boys and girls. However, American gender preferences manifest themselves in more sneaky ways. A 2011 Gallup poll showed that, if they were only able to have one child, the highest preference was for a boy.  These results are little changed from the same Gallup question asked of Americans in 1941.

To return to a point made in an earlier post on skewed sex ratios, Americans may not be so different, after all, in their gender preferences from the countries in the above table.  The crucial difference, she noted, is that some Asian countries are more enabled to act on their boy preference than others. It appears we should now be including some European countries in that “enabled” group as well.

* Neither the United Nations, Population Reference Bureau, nor the World Bank have published 2013 statistics yet for comparison to the CIA data.

Jennifer Lundquist is an associate professor of sociology at the University of Massachusetts, Amherst who specializes in stratification and social demography.
Eiko Strader is a PhD student in sociology at the University of Massachusetts, Amherst who studies inequality in labor markets and the welfare state.

Why Male Pregnancy Matters

The reproductive health police are at it again, and this time they’ve got the gender and sexuality cops with them.  Despite the CDC reporting a decline in teen pregnancy across ethnic groups, public health and privately funded campaigns are popping up across the U.S. aimed at chastising, shaming, and blaming teenage mothers.

And now, the city of Chicago has gotten in on the act. Not satisfied with the traditional images of cheerleading teenage mothers with babies strapped to their chests, or wailing toddlers scolding their mothers for being too poor or too single, or even pop music icons who assure young women that motherhood ‘sucks’ even more than high school, the city of Chicago has decided to get creative. The Chicago Department of Public Health has created a series of posters featuring shirtless young men with apparently pregnant bellies – below the caption “Unexpected?”

 TPPI Bus King Sample2

Ok, I get it. The campaign was designed to communicate the fact that most teen pregnancies are, yes, unexpected, and that teen fathers should bear an equal responsibility for said pregnancies. But as someone working at the interstices of narrative, health, and social justice, I am less concerned with wondering if teen pregnancy is ‘bad’, or even if shame and/or shock are effective motivators for behavior change (which I would argue they are not, check out Brené Brown’s eloquent argument). What concerns me is what other work such images are doing. In other words, what additional cultural stories is this campaign telling, and are those narratives socially just or unjust?

As this fantastic take-off from the Media Literacy Project shows, the primary problem with the Chicago campaign is its deeply trans-phobic narrative:

In the frame of the advertisers, the pregnant bellies in the ads are solely female while the rest of the body is solely male. The contrast is supposed to cause discord in the viewer, yielding feelings that the image is “disturbing” or “unexpected,” as the ads say. However, sex and gender are much more complicated than the advertisers understand. Transgender boys and men can become pregnant. Calling their bodies disturbing perpetuates a culture of ignorance, prejudice, and violence against transgender people.

The truth is, bodies which do not look traditionally ‘female gendered’ can and do become pregnant (consider the much publicized story of Thomas Beattie, for instance, a transgender man who bore three children) while bodies which do look traditionally ‘female gendered’ sometimes can or do not.

Philosopher Judith Butler asserted that gender is nothing more than a series of repetitive performances; behaviors which, in cis-gendered (not transgendered) people, are often so subconscious as to feel ‘natural.’ But simply consider that the gender-coding of many such behaviors have changed over time. Hairstyles, clothing, and work-home-balance are all easy examples. Requiring at the very least a working uterus, pregnancy is one type of public ‘performance’ that still appears ‘naturally female.’ Therefore, ‘male pregnancy’ can be a subversive act, as with the work of cyber-artists Virgil Wong and Lee Mingwei, where, as feminist science scholar Donna Haraway would say, one ‘queers what counts as nature.’

But that’s not what is going on here. As with the broadly comic absurdness of male pregnancy in films like Arnold Schwarzenegger’s Junior, this anachronistic Chicago campaign actually reinforces a traditional gender binary while essentializing pregnancy as a function of only cis-gendered female bodies. In doing so, the campaign defeats its own stated purpose. By looking at these posters, cis-gendered boys won’t feel like pregnancy can happen to them. Rather, they will scoff, or laugh at the ‘absurdness’ of male pregnancy, reassured that their (utterly and fixedly ‘masculine’) bodies are ‘safe’ from such conditions. More devastatingly, the cis-gendered general public looking at these images will have their own prejudices and expectations about male pregnancy reinforced: as something ‘unexpected,’ shocking, and ‘unnatural.’

Additionally, like other individual-level ‘shaming and blaming’/’shocking’ campaigns, this Chicago anti-teen pregnancy series deflects attention from more systemic understandings and structural changes: from finding funding for affordable and accessible reproductive health care, to anti-poverty work, to programs which support LGBTQ youth. While they may satisfy the need for a ‘moral panic’ among us middle-aged people as we ‘clutch the pearls and think of the children,’ what such anti-teenage pregnancy campaigns don’t do is actually increase the well being of our young people – be they male or female, cis- or trans-gendered.

Cross-posted at Adios Barbie.

Sayantani DasGupta is a faculty member in Narrative Medicine at Columbia University. She is the editor of Stories of Illness and Healing: Women Write their Bodies,  co-authored The Demon Slayers and Other Stories: Bengali Folktales, and authored Her Own Medicine: A Woman’s Journey from Student to Doctor.

Does Abortion Cause Infanticide?

Cross-posted at Montclair SocioBlog.

Does “the abortion culture” cause infanticide?  That is, does legalizing the aborting of a fetus in the womb create a cultural, moral climate where people feel free to kill newborn babies?

It’s not a new argument.  I recall a 1998 Peggy Noonan op-ed in the Times, “Abortion’s Children,” arguing that kids who grew up in the abortion culture are “confused and morally dulled.”*  Earlier this week, USA Today ran an op-ed by Mark Rienzi repeating this argument in connection with the Gosnell murder conviction.

Rienzi argues that the problem is not one depraved doctor.  As the subhead says:

The killers are not who you think. They’re moms.

Worse, he warns, infanticide has skyrocketed.

While murder rates for almost every group in society have plummeted in recent decades, there’s one group where murder rates have doubled, according to CDC and National Center for Health Statistics data — babies less than a year old.

Really? The FBI’s Uniform Crime Reports has a different picture.

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Many of these victims were not newborns, and Rienzi is talking about day-of-birth homicides — the type killing Dr. Gosnell was convicted of, a substitute for abortion.  Most of these, as Rienzi says are committed not by doctors but by mothers.  I make the assumption that the method in most of these cases is smothering.  These deaths show an even steeper decline since 1998.

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Where did Rienzi get his data that rates had doubled?  By going back to 1950.

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The data on infanticide fit with his idea that legalizing abortion increased rates of infanticide.  The rate rises after Roe v. Wade (1973) and continues upward till 2000.

But that hardly settles the issue. Yes, as Rienzi says, “The law can be a potent moral teacher.”  But many other factors could have been affecting the increase in infanticide, factors much closer to actual event — the mother’s age, education, economic and family circumstances, blood lead levels, etc.

If Roe changed the culture, then that change should be reflected not just in the very small number of infanticides but in attitudes in the general population.  Unfortunately, the GSS did not ask about abortion till 1977, but since that year, attitudes on abortion have changed very little.   Nor does this measure of “abortion culture” have any relation to rates of infanticide.

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Moreover, if there is a relation between infanticide and general attitudes about abortion, then we would expect to see higher rates of infanticide in areas where attitudes on abortion are more tolerant.

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The South and Midwest are most strongly anti-abortion, the West Coast and Northeast the most liberal.  So, do these cultural difference affect rates of infanticide?

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Well, yes, but it turns out the actual rates of infanticide are precisely the opposite of what the cultural explanation would predict.  The data instead support a different explanation of infanticide: Some state laws make it harder for a woman to terminate an unwanted pregnancy.  Under those conditions, more women will resort to infanticide.  By contrast, where abortion is safe, legal, and available, women will terminate unwanted pregnancies well before parturition.

The absolutist pro-lifers will dismiss the data by insisting that there is really no difference between abortion and infanticide and that infanticide is just a very late-term abortion. As Rienzi puts it:

As a society, we could agree that there really is little difference between killing a being inside and outside the womb.

In fact, very few Americans agree with this proposition. Instead, they do distinguish between a cluster of a few fertilized cells and a newborn baby. I know of no polls that ask about infanticide, but I would guess that a large majority would say that it is wrong under all circumstances.  But only perhaps 20% of the population thinks that abortion is wrong under all circumstances.

Whether the acceptance of abortion in a society makes people “confused and morally dulled” depends on how you define and measure those concepts.  But the data do strongly suggest that whatever “the abortion culture” might be, it lowers the rate of infanticide rather than increasing it.

* I had trouble finding Noonan’s op-ed at the Times Website.  Fortunately, then-Rep. Talent (R-MO) entered it into the Congressional Record.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Health Care Costs, Greed, and “Socialism”

Cross-posted at Montclair SocioBlog.

The Washington Post has provided some data on medical costs across a selection of countries (Argentina, Canada, Chile, and India in grey; France, Germany, Switzerland, and Spain in blue; and the U.S. in red). The data reveal that American health care is very expensive compared to other countries.

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No wonder the US spends twice as much as France on health care.  In 2009, the U.S. average was $8000 per person; in France, $4000.  (Canada came in at $4800).  Why do we spend so much?  Ezra Klein quotes the title of a 2003 paper by four health-care economists:  “it’s the prices, stupid.”

And why are US prices higher?  Prices in the other OECD countries are lower partly because of what U.S. conservatives would call socialism – the active participation of the government.  In the U.K. and Canada, the government sets prices.  In other countries, the government uses its Wal-Mart-like power as a huge buyer to negotiate lower prices from providers.  (If it’s a good thing for Wal-Mart to bring lower prices for people who need to buy clothes, why is it a bad thing for the government to bring lower prices to people who need to buy, say, an appendectomy? I could never figure that out.)

There may also be cultural differences between the U.S. and other wealthy countries, differences about whether greed, for lack of a better word, is good.  How much greed is good, and in what realms is it good?  Klein quotes a man who served in the Thatcher government:

Health is a business in the United States in quite a different way than it is elsewhere.  It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.

So we Americans roll along, paying several times what others pay for medical procedures, doctor visits, and drugs.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Public Opinion about Abortion 40 Years after Roe v. Wade

Yesterday was the anniversary of the landmark Roe v. Wade decision. On January 22, 1973, the U.S. Supreme Court handed down the landmark case establishing women’s right to an abortion (though not an unrestricted right).

The Pew Research Center released some data on current public knowledge and opinion about abortion in the U.S. They found that well under half (44%) of younger people — those under 30 — knew what Roe v. Wade was about. A quarter said they didn’t know, and a third thought it was about another issue. This was a much lower level of familiarity than older age groups:

Abortion is still certainly a contentious issue, but it may not be quite the galvanizing cultural flashpoint it once was. Indeed, fewer people seem to see it as a critical issue. A growing percent of respondents say that abortion isn’t all that important — now over half say so:

That seems to indicate a lessening of the intensity of the culture war surrounding abortion. That could mean less intensity in opposition to abortion (most respondents thought it should be legal, though many personally thought it was morally wrong), but it may also lead to less resistance to the types of restrictions on clinics that leave abortion technically legal, but so difficult to access that it’s a hollow legality.

Gwen Sharp is an associate professor of sociology at Nevada State College. You can follow her on Twitter at @gwensharpnv.

Poverty Poses a Bigger Risk to Pregnancy Than Age

Cross-posted at Family Inequality and The Atlantic.

The problem of income inequality often gets forgotten in conversations about biological clocks.

The dilemma that couples face as they consider having children at older ages is worth dwelling on, and I wouldn’t take that away from Judith Shulevitz’s essay in the New Republic, “How Older Parenthood Will Upend American Society,” which has sparked commentary from Katie RoipheHanna RosinRoss Douthat, and Parade, among many others.

The story is an old one — about the health risks of older parenting and the implications of falling fertility rates for an aging population — even though some of the facts are new. But two points need more attention. First, the overall consequences of the trend toward older parenting are on balance positive, both for women’s equality and for children’s health. And second, social-class inequality is a pressing — and growing — problem in children’s health, and one that is too easily lost in the biological-clock debate.

Older mothers

First, we need to distinguish between the average age of birth parents on the one hand versus the number born at advanced parental ages on the other. As Shulevitz notes, the average age of a first-time mother in the U.S. is now 25. Health-wise, assuming she births the rest of her (small) brood before about age 35, that’s perfect.

Consider two measures of child well-being according to their mothers’ age at birth. First, infant mortality:

(Source: Centers for Disease Control)

Health prospects for children improve as women (and their partners) increase their education and incomes, and improve their health behaviors, into their 30s. Beyond that, the health risks start accumulating, weighing against the socioeconomic factors, and the danger increases.

Second, here is the rate of cognitive disability among children according to the age of their mothers at birth, showing a very similar pattern:

(Source: Calculations made for my working paper)

Again, the lowest risks are to those born when their parents are in their early 30s, a pattern that holds when I control for education, income, race/ethnicity, gender, and child’s age.

When mothers older than age 40 give birth, which accounted for 3 percent of births in 2011, the risks clearly are increased, and Shulevitz’s story is highly relevant. But, at least in terms of mortality and cognitive disability, an average parental age in the late 20s and early 30s is not only not a problem, it’s ideal.

Unequal health

But the second figure above hints at another problem — inequality in the health of parents and children. On that purple chart, a college graduate in her early 40s has the same risk as a non-graduate in her late 20s. And the social-class gap increases with age. Why is the rate of cognitive disabilities so much higher for the children of older mothers who did not finish college? It’s not because of their biological clocks or genetic mutations, but because of the health of the women giving birth.

For healthy, wealthy older women, the issue of aging eggs and genetic mutations from fathers’ run-down sperm factories are more pressing than it is for the majority of parents, who have not graduated college.

If you look at the distribution of women having babies by age and education, it’s clear that the older-parent phenomenon is disproportionately about more-educated women. (I calculated these from the American Community Survey, because age-by-education is not available in the CDC numbers, so they are a little different.)

Most of the less-educated mothers are giving birth in their 20s, and a bigger share of the high-age births are to women who’ve graduated college — most of them married and financially better off. But women without college degrees still make up more than half of those having babies after age 35, and the risks their children face have more to do with high blood pressure, obesity, diabetes, and other health conditions than with genetic or epigenetic mutations. Preterm births, low birth-weight, and birth complications are major causes of developmental disabilities, and they occur most often among mothers with their own health problems.

Most distressing, the effects of educational (and income) inequality on children’s health have been increasing. Here are the relative odds of infant mortality by maternal education, from 1986 to 2001, from a study in Pediatrics. (This compares the odds to college graduates within each year, so anything over 1.0 means the group has a higher risk than college graduates.)

This inequality is absent from Shulevitz’s essay and most of the commentary about it. She writes, of the social pressure mothers like her feel as they age, “Once again, technology has given us the chance to lead our lives in the proper sequence: education, then work, then financial stability, then children” — with no consideration of the 66 percent of people who have reached their early 30s with less than a four-year college degree. For the vast majority of that group, the sequence Shulevitz describes is not relevant.

In fact, if Shulevitz had considered economic inequality, she might not have been quite as worried about advancing parental age. When she worries that a 35-year-old mother has a life expectancy of just 46 more years — years to be a mother to her child — the table she consulted applies to the whole population. She should breathe a little bit easier: Among 40-year-old white college graduates women are expected to live an average extra five years compared with those who have a high school education only.

When it comes to parents’ age versus social class, the challenges are not either/or. We should be concerned about both. But addressing the health problems of parents — especially mothers — with less than a college degree and below-average incomes is the more pressing issue — both for potential lives saved or improved and for social equality.

Philip N. Cohen is a professor of sociology at the University of Maryland, College Park, and writes the blog Family Inequality. You can follow him on Twitter or Facebook.

Women, Sexuality, and the HPV Vaccine

Cross-posted at Sociology Lens.

A number of researchers suggest that the marketing and advertising of Gardasil has been aimed at girls and women instead of boys and men. In this post I discuss two contradictory messages aimed at women through these advertisements.

The first type of ad focused around the protection of young girls. The makers of Gardasil imply that being a good parent means vaccinating your daughter and therefore protecting her from cervical cancer (an observation also made here at Sociological Images). For example, one advertisement read, “How do you help your daughter become one less life affected by cervical cancer?” Another advertisement had a similar sentiment, stating “Your daughter can’t possibly know the importance of the cervical cancer vaccine, but thankfully, she has her mother” (source).

This narrative of protectionism is not surprising. In other contexts, like sex education debates, the discourse about adolescent sexuality, and in particular, girls’ sexuality, reveals a desire to protect their “innocence.”

The other type of ad moves away from the narrative of protectionism and focuses on empowerment and choice. One ad stated, “I chose to get vaccinated after my doctor to me the facts” (source). Another ad read, “I chose to get vaccinated because my dreams don’t include cervical cancer” (source).

Instead of focusing on the ways in which girls and women can be protected, the ads suggest that girls and women need to protect themselves. It seems like the advertising department at Merck (the makers of Gardasil) recognize that they needed another strategy if they wanted to appeal to young women who feel empowered about their sex lives.

These two strategies are opposed to one another. One strategy suggests that girls and women need to be protected, while the other strategy relies on the ability of girls and women to be active and educated decision makers. Merck is tapping into two gendered narratives in order to sell to as many people as possible. This is, of course, the way that advertising works. But it does reveal the different, and sometimes contradictory, cultural ideas about women’s sexuality, ideas that advertisers will draw on in order to make a profit.

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Cheryl Llewellyn is a Ph.D. candidate in sociology at Stony Brook University.  She writes for Sociology Lens, where you can read her post about the feminization of the Gardasil.

Framing Breastfeeding: Grumet Graces Another Cover

Along with “work/life balance” and other tired topics, an evergreen issue in the media remains the controversies surrounding breastfeeding.  Less than six months ago, Jamie Lynne Grumet lit up the blogosphere by posing for the cover of TIME Magazine while breastfeeding her standing toddler.  Outcry included pronouncements that the image was almost pornographic, psychologically damaging to her child, and exploitative of her white, twenty-something good looks.  The drama of the image worked as the magazine flew off shelves and was named one of the top ten most controversial covers by the New York Daily News.

Within the “lactivist” community there seemed to be double-edged concern — on one hand, glee that an image of a breastfeeding woman was so publicly displayed — on the other, anger that the image so clearly did not depict the intimacy and bonding between mother and child that they insist breastfeeding promotes.

Sensing an opportunity to “set the record straight” as well as launch their own uptick in cover attention, the nonprofit quarterly magazine Pathways to Family Wellness persuaded Grumet to pose for them, this time surrounded by her husband, adopted son, and cradling her nursing naked now 4-year-old child in her lap.  The inclusion of other family members changes the image from one of solo defiance to a message about her family system.  On the cover, Grumet still looks directly at the camera, not at her feeding child, but her glance is far from defiant.

Grumet agreed to pose again in order to send a different message about breastfeeding, one she preferred.  Grumet has said that this image portrays toddler breastfeeding more realistically, “incorporating the husband and siblings.” Yet, the multicultural family portrait has its own sense of staging.   The idyllic family pile-on seems hardly part of everyday life, much less every feeding.  Both images – part of the wider debate over breastfeeding — are carefully crafted to tell a particular story.

Some critics have mentioned that while Grumet’s intention may have been to reframe the image of breastfeeding, perhaps unwittingly again, she has contributed to the fanning of the flames around this issue. Others have accused her of “milking the moment.”   The breastfeeding support website KellyMom tracked down the three other mothers who were all photographed for the TIME cover. KellyMom interviewed them about their experiences during the shoot, then reaction to, and fallout from the cover.  Unfortunately, given the nature of the debate, individual women can often seem like pawns in these ever-intermittent media storms.

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Elline Lipkin, PhD, is a Research Scholar with UCLA’s Center for the Study of Women.  She is the author of Girls’ Studies and The Errant Thread, recipient of the Kore Press First Book Award for Poetry. She tweets at @girlsstudies.