Legal but immoral

When it comes to abortion, are the British Pakistanis living in a state of denial?

Legal but immoral

Hina had a decision to make about her pregnancy. She could have had the baby by a man she loved but was not married to and horrified her conservative British Pakistani parents with the news of her pregnancy; or had an abortion, kept it a secret, and moved on in life. She chose the latter, "to avoid a disastrous situation at home," she says.

It was a hard choice. She was 35, mother of one daughter from a husband she was separated from and in a relationship with a non-Muslim man. "My family would have never approved of our relationship - and to tell them I was pregnant… My mom would have killed me!"

Hina came to know about her pregnancy in the fifth week. By ninth week she was sure she had to end it. "My boyfriend and I went to the clinic together, completed the consent formalities and got the fetus removed through the vacuum process," she adds.

In retrospect, Hina thinks though the decision to abort was difficult, the procedure was quite smooth. "It helps to be in Britain where abortion is legal and safe abortion facilities are available. I remember how desperately I wanted to end my first pregnancy in Pakistan from a relationship that was so traumatic. Much to my despair, the doctor forced me to keep the baby. That perhaps is the biggest mistake of my life".

She is determined to end the stigma and misinformation surrounding abortion, in her community in particular, where, she says, "The entire debate surrounding abortion is focused on Islam and honour; oh, what will people say!"

She is sure she will never let her daughter live her experience.

Hina’s voice is rare. Most British Pakistani women prefer to keep their abortions under wraps or murmur about them in private - "not because they regret their decision but because they fear being stigmatised," says Hina.

Taking cue from Hina’s case, one wonders how such religious, social and moral attitudes influence British Pakistani woman when deciding about abortion. Is abortion an option for them? Is pre-marital abortion a taboo? Is abortion a means to contraception, to control fertility?

We do know that abortion is being carried out in the British Muslim community but we don’t know how and how many.

Abortion among the British Pakistanis is a grossly under-reported and under-researched subject. Irrespective of the Abortion Act 1967, that declares abortion legal in the UK (if a number of conditions are met), there is a tendency among the Pakistani community living in the UK to misuse laws, religion and customary practices to control women’s reproductive and sexual rights - in most cases to protect the family honour.

The prevailing mindset on abortion is duplicitous: the practice is condemned on moral and religious grounds but is tolerated as long as it is kept a secret.

There is not much existing research or scholarship on abortion practices among British Pakistani women. The only reference point, which is rather vague, is the record available on the basis of ethnicity. Ethnicity was recorded in the revised HSA4, abortion notification form, for the first time in 2002. Based on the abortion statistics in England and Wales gathered by the Department of Health, ethnicity was recorded on 97 per cent of the forms received for 2014 compared with 80 per cent in 2004 -- the second full year of collection. Of women whose ethnicity was recorded in 2014, 77 per cent were reported as White, 9 per cent as Asian or Asian British and 8 per cent as Black or Black British.

Random interviews with people belonging to the Pakistani British community revealed that attitudes prevailing in Pakistan, where abortion is illegal, allowed only to save the life of the mother, transcend boundaries and perpetuate in the Pakistani community living in the UK. Not only do they bring along conservative perception about abortion, but also inculcate the same values in their children.

"I got pregnant while being in an unpleasant and painful relationship. I just couldn’t have a baby in the situation. I had to end the pregnancy," says Seema Ahmed (not her real name).

Even though her mother is a doctor, Ahmed was not able to disclose to her that she had undergone an abortion by choice. Her sister supported her -- "She accompanied me to the abortion facility. Everything went as planned."

But she felt miserable - anxious and guilty. "Not because I had done something illegal. It was a moral issue. I felt heavy weight of the cultural pressures and social expectations because I am brought up in a conservative Muslim setup."

An activist working with the Pakistani community in West London, who did not want to be named, has observed that women belonging to conservative Muslim families, coming from rural backgrounds, are morally stronger in their approach to abortion. "They go ahead and abort a baby, without second thoughts. It is the middle-class, educated women that feel the social pressure. They think about the option of abortion many times before they actually go ahead with the procedure.

She knows many Muslim women that have had abortion in the UK. "They do it for many reasons," she says. She also knows women who have got it done in advanced stages of pregnancy -- "even in the fifth month, because it helps to live in a country where the abortion laws are liberal. I know if they lived in Pakistan, for instance, they would have to go full term and abandon the child."

Talking about British Muslims of South Asian origin, including Pakistanis, Bradford-based Imam Alyas Karmani says, "I know Muslim women are having abortion because they are sexually active even before marriage. Their families force them to have abortion because they see it as a matter of family honour. There is also a double standard where the women are stigmatised and often traumatised by this experience whereas men who are responsible bear few of the negative repercussions of their actions and often will deny involvement."

Cousin marriage is common among Pakistanis. Many of them bring brides from Pakistan. According to Alison Shaw, Senior Research Fellow in Social Anthropology at the Ethox Centre, Department of Public Health, University of Oxford and a Senior Associate at the Oxford Centre for Islamic Studies, cousin marriages put couples in a slightly elevated risk of recessive genetic conditions.

Shaw explains that in the UK, in some areas, pregnant women regardless of ethnicity or consanguinity or a family history of a recessive condition are tested for common recessive conditions such as thalassemia. If a carrier test (or a previous birth of an affected child) shows both parents are carriers of a recessive condition they have a 1 in 4 risk of having an affected child. They may then choose to have a prenatal genetic test, and if the test shows the child is affected, they may consider abortion -- "but abortion is rarely a straightforward choice because there is much uncertainty about its religious permissibility, and there is a strong social pressure against abortion from the more religiously conservative," Shaw adds.

In the article titled Rituals Of Infant Death: Defining Life And Islamic Personhood, Shaw examines the implications of competing religious and customary definitions of personhood for a small sample of young British Pakistani Muslim women who experienced miscarriage and stillbirth. She explains in the study that her interviewees expressed considerable disquiet over the idea of medical induced abortion even where fatal abnormality in the fetus had been confirmed by ultrasound scans or genetic tests. The dominant view was that abortion in such cases is murder, for which God will punish the murderer unless it is certain that the mother will die."

Such medical termination of pregnancies, she adds, is sinful and when abortion is carried out, it may need to be concealed from some family members. A couple might simply tell relatives that they ‘lost’ the baby, saying ‘the baby fell’ (bachcha gyr gaya), using the idiom for miscarriage. Occasionally women who choose to terminate an abnormal fetus without the support of a husband or in-laws may arrange for the procedure to take place in a hospital away from the their home town, to reduce the risk of malicious gossip or other harm…"

For Alyas Karmani, the number of clandestine abortions will rise among women of Pakistani origin living in the UK, because of parents’ reluctance to accept their children’s choices in selecting partners and an inefficient sexual health advisory service from a Muslim perspective.

A lot of South Asian Muslim families come to Imam Karmani for advice when their unmarried young girls become pregnant. He tells them that they cannot blame their young men and women for developing sexual relationships because we are not providing them sex education, as a consequence they carry out unprotected, unsafe sex.

"Even though sex education is part of school curriculum in the UK, its quality is very poor. It focuses mainly on contraception and not on the more significant aspects like self-esteem, decision-making, health and wellbeing. Besides, sex education is not mandatory in schools." Thus, he adds, families from conservative Muslim backgrounds withdraw their children and do not provide an alternative where the young ones can access information and discuss the subject that concerns them much.

Significantly, according to Births in England and Wales by Parents’ Country of Birth, 2013, Poland, Pakistan and India were the three most-common countries of birth for non-UK born mothers in 2013. Pakistan also remains the most common country of birth for non-UK born fathers between 2008 and 2013.

British Pakistanis is the third fastest growing ethnic community in the UK. According to the data collected by the Office for National Statistics published in a report titled, Ethnicity and National Identity in England and Wales 2011, after White British at 86 per cent and Indians at 2.5 per cent, Pakistanis constitute 2 per cent of Britain’s ethnic groups. The West Midlands have a higher than average percentage of minority ethnic groups, with Pakistani at 4.1 per cent followed by Indian at 3.9 per cent.

British Pakistani community is a perplexing case study. The prevailing mindset on abortion is duplicitous: the practice is condemned on moral and religious grounds but is tolerated as long as it is kept a secret. There is reluctance to talk about the taboo issue where religion, culture and morality together outline practice and perceptions.

Legal but immoral