“It’s another girl — my family expects a son. I want to end this pregnancy”

A request to terminate a pregnancy because of the fetus’s sex sits on a difficult ethical and legal line that must be navigated with compassion and without judgement of the woman. Abortion solely on the grounds of fetal sex is not lawful — the Abortion Act contains no ‘sex of the fetus’ ground; terminations are authorised only on specified grounds (such as risk to the woman’s physical or mental health) — so a termination requested purely for sex selection cannot be provided on that basis (DHSC guidance, 2014), and you must be honest about this while making clear the woman is not the wrongdoer — since 29 April 2026 a woman acting in relation to her own pregnancy commits no offence under the abortion law of England and Wales (Crime and Policing Act 2026 s241). The dominant clinical issue, however, is the coercion behind the request: "there would be consequences / I don’t have a choice" signals possible domestic abuse, coercive control or honour-based pressure, and a woman pressed by her family to end a pregnancy, whose own wishes are not yet known, is potentially a victim, not an offender — so prioritise her safety and autonomy. Screen for domestic abuse and coercive control sensitively and safely (ensuring she is alone, with a safe word and safe contact route on video), assess immediate risk to her and her existing children (DASH; MARAC where risk is high), and recognise reproductive coercion and coercive control as forms of abuse and crimes. Disentangle her own wishes from the family’s demands — would she continue the pregnancy if safe? — and assess her mental health honestly rather than as a workaround for sex selection; if, free of pressure, she still wants a termination, she can be assessed by an abortion service, whose two doctors decide whether a lawful ground applies. Offer support and safeguarding (domestic-abuse services/IDVA, safety planning, counselling, safeguarding for her and her children, honour-based-abuse pathways — MARAC, police and the Forced Marriage Unit where relevant, never family mediation) with appropriate confidentiality, and be culturally sensitive without ever excusing abuse. The hidden agenda is coercion, fear and possible danger; respond with compassion plus honesty plus safeguarding — neither colluding with sex selection nor abandoning her to cold legalism.