Global Women’s Health, Commodification, and the Abortion Debate

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In 2012 CBHD’s annual conference explored the theological roots of human dignity and the various ways in which our culture—both domestically and globally—subverts human dignity, particularly the dignity of women and girls. In the first plenary address at the conference, Executive Director Paige Cunningham related several heart-wrenching stories of women who have experienced gender-specific mistreatment.

In one story, Paige described how a 30-year-old mother of two boys in Gujarat, India died giving birth to a child an American woman was paying her to carry as a surrogate.[1] As Paige said, “This was a woman who died having a child that others very much wanted.” Another woman, also from India, was beaten to force her to abort her baby—her sixth pregnancy—because the baby was not a boy. This “woman died because she was carrying a baby nobody wanted.”[2]

International surrogacy, coerced abortion—these are just a few of the ways in which women around the world are treated as less than human, as objects, a means to another’s end.

The numbers alone are startling. Every day, 1600 women die of preventable complications from pregnancy and childbirth.[3] More than half of the 33.3 million people living with HIV around the world are women, and over 75% of these women live in sub-Saharan Africa, where their children are at risk of contracting HIV as well.[4] Violence against women remains pervasive. And we are all familiar with the tragedy of sex-selective abortion, which has recently drawn attention from the mainstream media—perhaps most notably in 2010, when the Economist devoted its cover to the issue of “gendercide,” calling attention to the 100 million girls missing worldwide, now estimated at more than 400 million.[5]

Behind each of these statistics is a suffering woman or girl, made in the image of God, who is worthy of our compassion and our action. To be sure, there are also many men who suffer horrific indignities throughout the world. But women and girls remain particularly vulnerable to injustice, due in part to the commodification of their reproductive capacity and in part to cultural discrimination that has been entrenched for centuries.

Women are worth more than their wombs. Women and girls have inherent dignity that both encompasses and goes beyond their reproductive capacity.

At first glance, global women’s health may not seem to be a bioethics issue, but a fundamental ethical concern—the subverted dignity of women and girls—is at the root of many of the health challenges they face. In 2011, Paige traveled to India to co-teach a workshop in basic bioethics for a group of 20 Indian doctors, nurses and chaplains. One of the obstetricians she met told Paige about a pregnant woman who faced an aggressive form of cancer. Situations like these pose challenging ethical dilemmas for any physician: Do you treat the cancer with chemotherapy, putting the baby at risk, or do you try to save the baby and risk losing the mother? Unfortunately, the answer was quite simple for the patient’s husband: he wanted an ultrasound for his wife. If the baby was a boy, he wanted to save the boy. If a girl, then he wanted to save his wife.

But the commodification of human life, the human body and women’s reproductive capacity is not just a problem “over there.” In this country, and in the church, we need to have a serious conversation about the ways in which we have been complicit in the “the culture of commodification.” As Paige mentioned in her talk, even the language we use about children suggests possession and objectification: we “have” children. We feel entitled to them. Evangelicals in particular have been so eager to embrace life as the antidote to the evil of abortion that we have not given adequate reflection to the ethical implications of many assisted reproductive practices, including gestational surrogacy and IVF.

We must also examine the ways in which we may have allowed the cultural values of individualism and autonomy to seep into the church and distort our own views of human dignity.

Even in the absence of active mistreatment by other humans, the effects of the Fall place women and girls in circumstances that challenge their dignity. Obstetric fistula, maternal mortality and other health challenges plague women in developing countries. Around the world, children miss weeks of school due to malaria, and girls miss school due to a lack of sanitary products that would enable them to attend during their menstrual cycles. Missed educational opportunities translate into missed economic opportunities, perpetuating cycles of poverty.

In much of our domestic political conversation about abortion, reproductive technologies and biotechnology, we have focused attention on the life and worth of the unborn child. As the argument goes, abortion is wrong because it kills nascent human life; embryonic stem cell research is wrong because, again, human life is destroyed in the process.

In many of these conversations—despite the intentions and efforts of those behind the political scenes—the “rights” of the unborn child or the embryo are pitted against the “rights” of the woman, the mother, or the patient. There are several disturbing consequences to this reductionistic debate, one of which is that the pro-life movement has been quite effectively branded as “anti-woman.” And despite a concerted effort to challenge this stereotype, it persists, as evidenced most recently by the somewhat successful efforts to label opposition to the so-called Health and Human Services (HHS) contraception mandate as a “war on women.”

One key reason these efforts have been successful is that the church does, in fact, have a mottled history when it comes to defending the dignity of women. But, cultural and historical misappropriations aside, Scripture powerfully – and often counter-culturally – witnesses to God’s very personal love for women and their role in his story of cosmic redemption. Throughout history, God has used women to expand his kingdom and provide justice for the oppressed. And God directly and repeatedly commands his people to care for vulnerable women and children.

Efforts to advance human dignity on behalf of women are indeed being pursued around the world, by Christians and non-Christians alike. But these efforts are often undercut by lack of regard for the unborn and the dignity of motherhood. Many of the leading advocates for global women’s health are also advocates for increased access to abortion in the developing world. In fact, many women’s health activists insist on expanding access to abortion as a means of lowering maternal mortality, despite evidence that other factors appear to be of more relevant significance.[6]  Abortion rights advocates have participated so prominently and vocally in the work of promoting child and maternal health globally that when Christians hear the words “global women’s health,” many immediately become suspicious that legalizing abortion is part of the agenda.

Yet it is not enough for Christians simply to fight the export of abortion to the developing world, important as that is. We must also demonstrate our care for women and girls around the world by taking action to rectify the many injustices they suffer. This may mean a more concentrated mobilization of resources to deliver needed public health interventions, such as skilled birth attendants and insecticide-treated bed nets. It also means investing in research to ensure that our efforts are evidence-based, credible, and strategic.

For this reason, as part of CBHD’s initiative on global women’s health Her Dignity Network is a cooperative endeavor whose mission is to promote the full dignity of women and girls around the world by eradicating exploitation and gender-based health disparities. Our goal is to connect individuals, organizations, funding sources and policymakers together around discrete issues of vital importance to this mission.

Focusing attention and resources on women’s health issues around the world is critical for several reasons. First and most importantly, upholding the dignity of women and girls is part of displaying an authentic witness of the heart of God to the world.

Second, it lends credibility to our efforts to stop abortion and guide biotechnology away from utilitarian, commodifying applications. We have the opportunity to engage in a virtuous cycle, where consistent application of the principles of human dignity leads Christians to fight injustice in all its various—sometimes subtle—manifestations. Our efforts to fight these injustices lend greater credibility to our defense of human dignity in other areas such as abortion, stem cell research, and euthanasia.

Third, it provides a bridge to reach younger Christians who are concerned about social justice and human dignity but are disaffected, for a variety of reasons, with the “culture wars” of their parents’ generation. Many young believers are working for organizations to promote women’s health without realizing they may be inadvertently supporting a pro-abortion agenda.

Global women’s health issues are bioethical issues. Our efforts to prevent maternal mortality must be grounded in the same ethical framework as our efforts to halt genetic selection or the production of “designer babies.” This framework enables us to evaluate how advances in technology may further increase the risk of global gender-specific discrimination. Ultrasound, for instance, appears to facilitate sex selective abortion in cultures where male children are preferred to female, and IVF has ushered in both the selection of embryos based on sex, and the global business of gestational surrogacy.

The fundamental, unifying principle that enables us to navigate these complex issues is human dignity, grounded not in human choice or autonomy but in the compassionate, caring heart of God for the people he created.


[1] Times News Network, “Surrogate Mother Dies of Complications,” The Times of India, May 17, 2012, (accessed January 28, 2013) and “Surrogate Mom Sees Her Premature Son, Dies Soon After,” Daily News & Analysis, (accessed January 28, 2013).

[2] Ashok Das, “Man Beats Wife to Force Abortion,” Hindustan Times, April 3, 2012, (accessed January 28, 2013).

[3] “Fact File: 10 Facts about Women’s Health,” World Health Organization, (accessed January 28, 2013).

[4] “Gender Inequalities and HIV,” World Health Organization, (accessed January 28, 2013); “Aids Worldwide,”, (accessed January 28, 2013).

[5] “Gendercide: The Worldwide War on Baby Girls,” The Economist, March 4, 2010, (accessed April 4, 2011).

[6] Elard Koch, John Thorp, Miguel Bravo, Sebastián Gatica, Camila Romero, Hernán Aguilera, and Ivonne Ahlers, “Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007.” PLoS ONE 7(5): e36613. doi:10.1371/journal.pone.0036613 (accessed April 30, 2013).