Doctors should not tell pregnant women the sex of their baby until 30 weeks into a pregnancy, one physician is arguing, taking a stance that is sure to be controversial.

By not revealing a fetus’ sex, doctors could prevent abortions related to the sex of the baby, according to Dr. Rajendra Kale, interim editor-in-chief of the Canadian Medical Association Journal. The practice of “sex selection,” or the aborting of female fetuses because of a preference for sons, is an issue in several Asian countries, and may also be done by some immigrants in Canada and the United States, Kale said.

“A pregnant woman being told the sex of the fetus at ultrasonography at a time when an unquestioned abortion is possible is the starting point” of sex selection, Kale wrote in the editorial published online today (Jan. 16) in CMAJ.

Currently, most pregnant women in the United States get an ultrasound between 18 and 22 weeks of pregnancy that looks for fetal anomalies, and learn the sex of their baby at that time.

Kale pointed to research in Canada and the United States indicating that immigrants in certain ethnic groups, including people from China, Korea and India, selectively abort female fetuses: couples who have two daughters are more likely to have a son as their third child than would be excepted if left to chance.

Ethical concerns

Two large organizations of doctors — the Society of Obstetricians and Gynaecologists of Canada, and the American Congress of Obstetricians and Gynecologists — agree that sex selection is unethical.

Still, withholding information about the sex of a fetus from a woman is also not ethical, according to the ACOG. “Because a patient is entitled to obtain personal medical information, including information about the sex of her fetus, it will sometimes be impossible for health care professionals to avoid unwitting participation in sex selection,” according to a 2007 ACOG committee report.

But Kale argued that although a woman has a right to information about herself as it relates to her health and medical care, the sex of the fetus is medically irrelevant information, and does not affect the care of the pregnant woman or her unborn child. The only exception should be in cases of rare, sex-linked illnesses, Kale said.

What could be done

While the problem of sex selection in Canada and the United States is likely small, it should not be ignored, according to Kale, a native of Mumbai, India.

The organizations that govern physicians in Canada should adopt policies that limit disclosure of fetal sex by health professionals to after 30 weeks, Kale said.

Pass it on: To prevent sex selection, doctors should not disclose the sex of the baby until after the mother is 30 weeks pregnant.

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