Abortion is often referenced today in the context of the healthcare of the mother. Despite the fact that, as groups like Live Action have persuasively pointed out, abortion is never necessary for the health of the mother (early labor might be needed, and the fetus may not survive, but intentionally ending the life of the preborn child in the womb is never medically necessary), hearing Planned Parenthood’s “abortion is healthcare” mantra on repeat has led many to accept the thinking that abortion is necessary for women’s health.

But recent laws outlawing abortion for eugenic reasons are bringing greater scrutiny to what exactly many are justifying as healthcare.

According to an Ohio law, doctors are prohibited from performing abortions if the mother has informed the doctor the reason is out of fear of her child having Down Syndrome. A panel of judges stopped the law from being enforced last fall, but this April, a U.S. Circuit Court of Appeals reversed the decision, allowing the law to be enforced again.

Laws like this are a part of a trend of abortion restrictions for cases when the choice is made for eugenic reasons, such as due to the preborn child’s race, sex, or disability. According to the Guttmacher Institute, eleven states have similar laws restricting abortions for similar reasons. These laws bring into sharp focus the conflict between abortion advocates and disability-rights advocates. When abortions are permitted or encouraged for reasons of a preborn child’s risk of disability, for instance, it sends a message to already-born people with disabilities that their lives are less valuable.

Eugenic abortion made headlines when Iceland boasted that it is has a near-zero rate of children born with Down Syndrome. Further reflection reveals the country’s Down Syndrome numbers are low not for reasons of treatments or cures for the congenital abnormality, but for reasons of prenatal testing and elective abortion. In a December 2020 Atlantic report, Sarah Zhang interviewed Grete Fält-Hansen, a mother of a Down Syndrome child who makes herself available to share her experience with moms carrying children with Down Syndrome who are considering terminating their pregnancies. While Fält-Hansen passes no judgement on those who choose to abort, Karl Emil, her high-functioning 18-year-old son with Down Syndrome, is acutely aware that people are judging whether lives like his are worth living. “The decisions parents make after prenatal testing are private and individual ones,” writes Zhang. “But when the decisions so overwhelmingly swing one way—to abort—it does seem to reflect something more: an entire society’s judgment about the lives of people with Down syndrome. That’s what I saw reflected in Karl Emil’s face.”

In the United States, prenatal genetic testing has become a staple of prenatal care, especially for moms over the age of 35. The testing can identify if the preborn child has chromosomal abnormalities such as Down Syndrome or other conditions, as well as the risk estimate that the child could be born with a disease like Cystic Fibrosis. While this is treated as a basic part of maternal and prenatal care, the increase in genetic testing has not correlated with advances in treatment for prenatal children conceived with these conditions; the only option many women are offered upon probable diagnosis is to terminate the pregnancy. (You can find my story of such an option being suggested to me here.)

This is why laws like the one recently reinstated in Ohio reveal a problem not just in abortion clinics, where women are provided abortions for any reason, but in mainstream OBGYN medicine. While laws like that in Ohio prohibit doctors from completing abortions if the woman seeking abortion has disclosed a eugenic motive, these laws are based on a premise that the idea of eugenic abortion would not be coming from the doctor or healthcare professional but from the mother, to which a doctor shouldn’t comply. In other words, it starts on a premise that abortion for eugenic reasons is unbefitting of a medical provider and has no place in healthcare. Which makes some sense since the medical profession is supposed to support the health of patients, without discriminating some people as being more “fit for care” than others.

Abortion, which qualifies the life in the womb as based on personal choice, continues to disrupt that starting medical assumption. Still, with more states outlawing eugenic abortion for purposes of race, sex, or disability, one can hope that at least in some places, there might be a return toward this basis of care.