Vietnamese fetuses, deformed and stillborn as a result of Agent Orange.
A child at the Ba Vi orphanage, part of the third generation of Vietnamese victims of Agent Orange and other chemicals used by the U.S. military a half-century ago.
In my book Sex and Herbs and Birth Control I made a glancing reference to the risk of birth defects as a possible reason why women and their partners might decide to abort a fetus. But I did not touch upon the ethical issues surrounding such decisions.
Recently I read Tine Gammeltoft’s Haunting Images: A Cultural Account of Selective Reproduction in Vietnam. Vietnam has an exceedingly high incidence of fetuses with catastrophic abnormalities, a large proportion of which are the legacy of the use of Agent Orange and other toxic chemicals by the U.S. military during the Vietnam War. These chemicals are still causing massive congenital defects three generations later. Many of the affected fetuses are stillborn (see illustration). But many abnormalities are detected in utero by the routine 3D and 4D ultrasounds that pregnant women, terrified by the possibility of bringing a malformed infant into the world, feel compelled to undergo. In her book Gammeltoft studies Vietnamese women, their extended families, and their health care providers as they deliberate whether to carry to term a fetus labeled by ultrasound experts as severely abnormal.
Gammeltoft’s interviewees overwhelmingly decide to abort their pregnancies for a complex set of reasons including confidence in the recommendation to abort given them by medical professionals; knowledge of the inability of their government to offer financial support for the disabled (and thus an awareness of the emotional distress and economic hardship the care for such a child would impose upon its entire extended family); and the fear that impaired offspring can never attain full personhood, since in Vietnam personhood is thought to entail responsibilities and reciprocal obligations that the severely handicapped are unable to fulfill. In deciding to abort, the women and their families are taking what they see as the only humane option.
It could also be argued that the Vietnamese women’s decision to abort their damaged fetuses is analogous to the decision of a rape victim to abort her pregnancy. Even in parts of the world with extremely restrictive abortion laws, termination of a pregnancy caused by rape is often legal because the woman in that case is a victim of violence and abuse. Analogously, in the Vietnamese case the woman’s desire to terminate her pregnancy is a result of the chemical bombardment of her family during the War — a form of abuse that is as barbaric as rape.
Interestingly, Vietnamese disability rights advocates do not oppose abortions performed under these circumstances, in part because they see the future of an Agent Orange victim as bleak indeed.
In late 2000, in my capacity as Director of the Kovalevskaia Fund (see http://kovfund.org), I met with then-Vice President of Vietnam Nguyễn Thị Bình. Outgoing U.S. President Bill Clinton had just visited Vietnam the previous month, and Vice-President Bình talked to me about the problems of the children born with birth defects and about her unsuccessful attempt to persuade President Clinton that the United States should take financial responsibility for those affected by Agent Orange and their families — who were, after all, victims of war crimes committed by the U.S. Without a massive infusion of support for cleanup of the toxic areas and improvement of the health care available for the severely disabled, Vietnamese women will continue to see abortion as their only rational option.