In "The Case Against Abortion," New York Times opinion columnist Ross Douthat writes:
"There is no way to seriously deny that abortion is a form of killing. At a less advanced stage of scientific understanding, it was possible to believe that the embryo or fetus was somehow inert or vegetative until so-called quickening, months into pregnancy. But we now know the embryo is not merely a cell with potential, like a sperm or ovum, or a constituent part of human tissue, like a skin cell. Rather, a distinct human organism comes into existence at conception, and every stage of your biological life, from infancy and childhood to middle age and beyond, is part of a single continuous process that began when you were just a zygote."Douthat is not wrong. In fact, I will admit that the biological specifics of abortion are sometimes glossed over by the pro-choice movement, which enables the other side to vilify us as “baby killers” at every turn. As a pro-choice activist, I may be deemed a baby killer (or at least someone who condones baby killers), but I am also someone who checked the What to Expect website every week during my three pregnancies to eagerly see why type of produce my fetus resembled (At 7 weeks, your baby is the size of a blueberry!) and what tissues were developing at each stage. That being said, I am also someone who experienced a miscarriage, and I'd be hard pressed to characterize what emerged from my body as a "baby." Douthat's phrase, however, is "distinct human organism." Again, he's not wrong, but what emerged from my body hardly resembled anything most of us tend to think of when we hear the word "human." Obviously, it's different.
Anyway, Douthat continues in his article:
"This means that the affirmative case for abortion rights is inherently exceptionalist, demanding a suspension of a principle that prevails in practically every other case. This does not automatically tell against it; exceptions as well as rules are part of law. But it means that there is a burden of proof on the pro-choice side to explain why in this case taking another human life is acceptable, indeed a protected right itself."
My initial reaction to this is to tell Douthat: "The pro-choice side has been explaining their side for decades - you just haven't been listening." I am also reminded of a "pro-life" pamphlet that someone left on our doorstep a few years ago that was entitled "Have you thought about what abortion really means?" I muttered to myself "indeed I have" as I dropped the pamphlet in the recycling and practically vaulted over to my laptop to make a donation to Planned Parenthood. But in all fairness, maybe some of us on the pro-choice side could make a better case for why "taking another human life is acceptable," as Douthat put it. Perhaps we could more respectfully acknowledge the counterarguments of pro-lifers and demonstrate to them that we are, in fact, thoughtful about "what abortion really means." Thus, in this blog post, I respectfully accept Douthat’s challenge to take on the “burden of proof on the pro-choice side.” I intend to “explain why in this case taking another human life is acceptable.” In doing this, I will freely adopt the language of the “pro-life” movement, first by actually calling the movement “pro-life” instead of anti-choice, which is REALLY HARD for me to do. Okay, okay, I hear you - if I truly want to be respectful, I need to lose the scare quotes. Whew, okay…throughout this commentary, I will call the movement to ban abortion the pro-life movement. There. Furthermore, I will agree to call abortion killing, as Douthat argues that we cannot "seriously deny" this label. We can call it killing of the unborn (although shouldn’t it be pre-born? Because it’s not like a birth happened and then it was undone...but you never hear pre-born, so we’ll stick with unborn), killing of a person, taking of a human life, even baby killing if you wish. I don’t think it’s appropriate to call it murder because murder is defined as the unlawful killing of another human, and - at least as I write this post - abortion is still lawful throughout most of the United States. Actually, how about we go with Douthat's phrase and call abortion the killing of unborn human organisms? Are we good with that? Great (and now you see my reasoning behind the provocative yet cumbersome title of this post). However, when it comes to the terminology used to describe people who get abortions, "women" is a bit too narrow. So, throughout this writing I will usually refer to such people as "uterus owners," "pregnant people," and "female-bodied people," depending on context (although I suppose this latter term is a little narrow, too).
Now that we’ve agreed on some terminology, allow me to outline the series of arguments that I plan to make in this commentary. First, I will argue that an unborn human and a born human are substantially and meaningfully different from one another (maybe this seems obvious, but I feel the need to be explicit). Next, I will argue that our society as a whole (meaning many, if not most of us) consider the unintentional or accidental death of the unborn to be vastly different than the unintentional or accidental death of a born child. I will further argue that society as a whole (i.e., many, if not most of us) have deemed the unintentional or accidental death of an unborn child to be acceptable. Then, I will argue that killing unborn humans is substantially and meaningfully different from killing born humans. And finally, the heart of my thesis: I will argue that killing unborn humans is acceptable whereas killing born humans is most certainly not (and this will lead us into the weeds of what Douthat means by "acceptable." Acceptable to who? Whose acceptance matters on this deeply personal, intimate issue? The pregnant person or the voters in the pregnant person's state?). But even after doing this, I can't end things there. Instead, I'll end this piece by volleying the issue back to Douthat: I took on the burden of proof to argue why killing unborn human organisms is acceptable, and so now Douthat (and like-minded individuals) should take on the burden of proof to argue why banning abortion is acceptable. In other words, they should scrutinize the full range of devastating consequences of what these policies would actually do and argue for why such consequences are "acceptable." So settle in, people, because this is going to take some time.
Argument 1: The Unborn and Born are Different
I think we can all agree on this point on some level, right? Practically speaking, here in the U.S. we do not formally consider a person as existing until after they are born. I know of no society that recognizes citizens’ conception dates by issuing conception certificates; rather, birthdates and birth certificates are the norm, and I’m pretty sure you can’t claim an unborn baby as a tax exemption or obtain a social security number for them (proposed personhood laws notwithstanding). Obviously, the main difference between the born and unborn is that the unborn are inside a uterus (or a fertility clinic freezer, but let’s put that aside for now), whereas the born are their own separate persons. The unborn are completely dependent upon the uterus-owner to remain alive, whereas the born rely on any number of different caregivers. The unborn pose inherent risks to the uterus-owner, including increased mortality, childbirth injuries, birth trauma, long-term health complications, and perinatal and postpartum depression (among many more) whereas born children do not pose any comparable, direct health or safety risks to their caregivers (although perhaps some would consider financial burden a health or safety risk). Now here, it is tempting for me to go on and on and on (and on) about these risks to the uterus-owner, but so much has been said about this already, and most pro-lifers (my targeted audience for this writing) are not interested in the specifics, so I will move on to a topic that they ARE more interested in: pain and suffering of the unborn.
How do the unborn versus born experience pain and suffering? NPR recently reports that medical researchers agree a fetus is not capable of experiencing pain until the third trimester, somewhere between 29 or 30 weeks. There are multiple studies that support this point, notably this 2005 JAMA article concluding that evidence "indicates that fetal perception of pain is unlikely before the third trimester." However, I want to be quick to acknowledge the counterarguments from pro-lifers on this understandably contentious point. If I were a pro-lifer looking for peer-reviewed scholarship to support my belief that the unborn do indeed feel pain, I would offer up this 2020 article from the Journal of Medical Ethics that argues that "neuroscience cannot definitively rule out fetal pain before 24 weeks" because of "more recent evidence calling into question the necessity of the cortex for pain and demonstrating functional thalamic connectivity into the subplate." So, I think it is fair and accurate to say that the issue of late stage fetal pain is not settled science, even though all sides often try to portray it as such. But I also think that it is fair and accurate to claim that on the issue of pain, the unborn and born are different. Similarly, the unborn are almost always unconscious (basically, asleep), whereas the born are fully conscious. I imagine that we could go on for quite a while on this issue, but I'd like to move on.
Next, let's address the philosophical question of whether or not an unborn human has a soul. We could Google-Scholar our asses off and obviously we would never find an answer to this question because it is beyond materialism and comes down to an individual's personal religious or spiritual values. But let's try to consider the spectrum of viewpoints on this. For example, because of their views on pre-mortality, I would presume that some Mormons may believe that the soul enters the zygote at the moment of conception (full disclosure - I'm getting all of this from Wikipedia and I deeply apologize if I am off the mark and/or offensive - it is not my intention). However, that does pose a problem if there is a miscarriage because that means that the soul - God's child - pretty much misses out on living a mortal life in a physical body provided by God. Perhaps some individuals believe that if an early miscarriage occurs, the soul - the spiritual body - gets sent back to heaven to await another chance at being joined with a physical body. This seems to be an important consideration for Mormons because of the following (again, from Wikipedia):
"God the Father's plan for all his children was to provide a way for them to become more like him.[64] Although they were happy living in heaven with God the Father, God's spirit children could not experience the "fulness of joy" enjoyed by him unless their spirit bodies were joined with a physical body.[64][68] God the Father convened a "Grand Council" of all his children to propose a plan of progression, known to Latter-day Saints as the plan of salvation.[69] According to the proposed plan, God would provide an earth where spirit children could receive a physical body."
Some atheists, on the other hand, may believe not just that God does not exist, but also that there is no such thing as a soul - for ANY human, born or unborn. For me personally, as a Protestant Christian (I serve on the vestry of my Episcopalian church), I do indeed believe that all humans have souls, but I have no idea when it joins with the body. From my own experience with pregnancy and miscarriage, I find it really difficult to believe that a first or even second trimester human organism has a soul. Yes, it has its own genetically distinct set of chromosomes, but a soul? I just don't know. A born human on the other hand, yes - I looked into each of my newborn daughter's eyes and although they were unfocused, I just knew (or believed) they had a soul. Also, if we consider that the word spirit comes from the Latin spiritus, meaning "breath" (this is also the origin of respiration and spiracles, the breathing orifices in insects), it suggests an early belief that when a newborn human takes their first breath, they gain a spirit
But who knows, right? None of us can prove the other right or wrong. So now that I am just about as far out of my wheelhouse as one can be, I ask that we please give each other space to hold our individual views on this deeply personal, spiritual/ religious value. For some of us, unborn humans (and even all humans) are soulless; for others, they had a soul before they were even conceived; and still for others, they receive their soul when they take their first breath.
To round out this section, I want to acknowledge what I anticipate to be the broader counterarguments from pro-lifers: Yes, of course the unborn and born are different, but focus on how they are SIMILAR, too. Both are human beings that, if given the chance, will go on to live their lives to the fullest, perhaps changing our world for the better. I hear you, I do, and you're right. You're right. But I'm right, too. All of the differences that I point out between the born and unborn are valid and noteworthy. So having acknowledged the validity of all these points, I hope our mutual respect is still intact so that we can move on to my next argument.
Argument 2: Accidental Death of the Unborn Differs from the Accidental Death of the Born
Let's now consider how the accidental deaths of the unborn versus born are different. First, how risky is it to be an unborn human versus a born baby? Let’s compare mortality rates of the two, in other words, miscarriage rates vs. infant mortality rates (death before age 1; I thought about picking a broader childhood mortality statistic, but decided infant mortality was most comparable). According to a 2021 review in The Lancet, an unborn baby dies (i.e., a miscarriage occurs) every 44 seconds, a rate derived from an annual global estimate of 23 million miscarriages (which is quite conservative because miscarriages often occur without the pregnant person knowing they were ever pregnant). Compare that 23 million to 4 million deaths, the WHO infant mortality estimate for 2018. In other words, unborn babies have a several-fold higher risk of death than do infants of 0-12 months of age. The Lancet review series also found a pooled risk of miscarriage of 15.3% of all recognized pregnancies (emphasis added). But a 1990 study in the International Journal of Fertility estimates that when you account for unrecognized pregnancies "at least 73% of natural single conceptions have no real chance of surviving 6 weeks of gestation." What all these numbers boil down to is the reality that miscarriage - the accidental death of the unborn - is common, much more common than losing an infant. What are the causes of the two mortality rates? According to the CDC, the five leading causes of infant mortality are birth defects, preterm birth, injuries like suffocation, Sudden Infant Death Syndrome, and maternal pregnancy complications. The causes of miscarriage, on the other hand, are less straightforward, and therefore it is more appropriate to list the risk factors associated with miscarriage. According to The Lancet article, "risk factors for miscarriage include very young or older female age (younger than 20 years and older than 35 years), older male age (older than 40 years), very low or very high body-mass index, Black ethnicity, previous miscarriages, smoking, alcohol, stress, working night shifts, air pollution, and exposure to pesticides."
Once again, I can anticipate the counterarguments from pro-lifers here. Yes, of course miscarriage and infant mortality are different, but focus on how they are similar. Both are types of death - the loss of human life - and both are awful tragedies. But this counterargument is a great segue into my next point, because now I want to argue that they are not the same level of tragedy because one (miscarriage) has become broadly more acceptable than the other (infant mortality).
Argument 3: Miscarriage - the Accidental Death of the Unborn - Has Been Deemed Acceptable by Society
Aside from merely quantifying miscarriages and associated risk factors, The Lancet review that I mentioned above and the accompanying editorial make a significant argument that should give all of us pause, especially those of us who claim to advocate for the unborn. I'll quote from the editorial:
"For too long miscarriage has been minimised and often dismissed. The lack of medical progress should be shocking. Instead, there is a pervasive acceptance. Not all miscarriages could be avoided, but the insidious implication that miscarriage, like other women's reproductive health issues, including menstrual pain and menopause, should be managed with minimal medical intervention is ideological, not evidence based. This Series should catalyse a major focus on miscarriage for the medical research community, for service providers, and for policy makers. The era of telling women to “just try again” is over."
Allow me to underscore a phrase they use: pervasive acceptance. If we revisit the list of risk factors associated with miscarriage, we see that several of these are things that cannot be remedied (e.g., maternal age, paternal age, Black ethnicity). But this list also includes two things that CAN be easily remedied IF we had the political will to do it: (1) air pollution and (2) pesticide exposure. And yet, how often do we see pro-lifers rallying around such environmental justice causes? I have so much more to say about this, but it's a bit of a tangent, so I'm going to save it for a future blog post.
But let's put aside the broader societal response to miscarriage and instead focus on how individuals feel, experience, and react to the unintentional loss of their unborn versus born children. Now I could search the scholarly literature and dig up studies on grief, mental health, coping strategies, etc., but instead I want to share my own personal experience of pregnancy loss as but one example of the myriad ways that people cope with the loss of the unborn (spoiler alert: my claim here is that for many of us, the loss of the unborn is not a big deal, whereas the loss of a born child is absolutely devastating). When I was 34-35 years old, we tried for 8 months to get pregnant. Many sticks had been peed on and many tears had been shed. Negative. Negative. Negative. Negative. Negative. Negative. Negative. Negative. When I finally saw that positive sign, my heart soared. Finally! But at 8 weeks (Your baby is as big as a raspberry!) I miscarried. It started as a bit of spotting but then over a few hours became bloody clumpy tissue in the toilet and maxi pads (side note: I cannot wrap by head around the laws mandating cremation of fetal tissue. Under such laws, would I have been required to fish the bloody mess out of the toilet or scrape clumps off my maxi pads? Or are these laws only for elective abortions, and if so, why?). That evening Andrew held me as I cried. A couple days later we went for an ultrasound that confirmed what I already knew. But it didn’t take long for feelings of sadness to give way to feelings of hope and even feelings of “this is all for the better.” Immediately after the ultrasound we went out for lunch and even a beer, because goddammit I deserved it after months of teetotaling while trying to get pregnant. Now at least we knew we were fertile and could try again. And it’s actually better that this happened because the baby would’ve been due around Thanksgiving, which is a completely sucky time of year if you’re a college professor like me (tangential rant: what are you supposed to do, have an adjunct or your overworked colleagues take over right near the end of the semester for the last week of classes, final exams, final papers, and getting grades in when you’re the one who’s been teaching all semester? And then your maternity leave is over in the middle of the next semester and you’re supposed to jump back in? I mean, I know it happens, but it’s so much more convenient to take parental leave right AFTER the semester is completely over or right at the START of the semester). So anyway, this miscarriage was actually an opportunity to try for more convenient timing in having a baby.
I'd better pause here because some readers - especially those who have experienced multiple miscarriages and/or infertility - may react to what I just wrote with outrage, disgust, and disbelief. I'd give ANYTHING to have a baby, how can you be so blasé about this? I’ve been in therapy for YEARS because of my miscarriages and I mourn them everyday - must be nice to move on so easily. To those people: I am so, so sorry for what you've experienced. Although I'd like to think I can relate, I can't because I just haven't experienced that kind of loss. My heart goes out to you. But please realize that when I say I'm sorry, I'm expressing heartfelt sympathy - I am not apologizing for my own feelings and reactions to my own experience. My response to my personal situation of pregnancy loss is perfectly legitimate and justified and so is yours. The point I’m making here is this: the myriad ways that many of us mourn the loss of the unborn are vastly different than the ways we mourn the death of a born child. For many of us - myself included - maintaining an aloof and distant attitude toward our early pregnancies (when the risk of miscarriage is high) can help us cope with a pregnancy loss if it does occur (this was the attitude I adopted for my subsequent pregnancies - "don't get too excited, Sandra, this may not stick"). Thus, for many (but not all) of us, miscarriage (again, the accidental death of the unborn) doesn't evoke the same level of grief as the accidental death of a born baby (losing a baby to SIDS, for example). If I lost a baby to SIDS, I wouldn’t think “Oh well, at least we don’t have to change diapers anymore! And we can get some sleep! And we can try for another baby later if we want.” We wouldn’t chuck the dead baby in the trash like I did with the miscarriage remains on my maxi pads. We would have a funeral and grieve for years, likely for the rest of our lives and likely needing counseling to get through it.
The closest I was able to come to fathoming what it must be like to lose a child was when Liana was in the hospital at 5 weeks old being scheduled for emergency surgery. The procedure was relatively simple and low risk, but I couldn't help imagining the worst and...there are just no words. But let's compare that to a scenario of losing Liana at 5 weeks gestation (Your baby is as big as an orange seed!) Well, I probably wouldn't have even known I was pregnant at 5 weeks, but if I did and then realized that I miscarried, I don't think I would've given it a second thought. I was too busy chasing after (and still breastfeeding) a lively 16 month old toddler, I would've been well aware that I'm at risk for a 2nd miscarriage since I already had one, and I would've thought "it's all good, we should probably space out the kids more anyway." You may be thinking, But aren't you glad that you didn't miscarry or abort Liana? Well of course, NOW I am, but if that had happened I wouldn't know what we had missed out on. I find it extremely useless to speculate about all sort of "what if?" scenarios, because where does it stop? (what if Andrew and I had never met? what if MY parents had never met?" etc.) Anyway, I digress. The main point: both miscarriage and infant death are losses, but I argue that they are enormously different and that miscarriage is a more acceptable, more tolerable type of loss for many (but not all) of us because many (but not all) of us value the lives of the unborn differently (not necessarily less than but differently) from how we value the lives of the born. And this doesn’t make us evil, immoral, horrendous baby-killing monsters. I hear some of you vehemently disagreeing, but I think I’ve argued all I can and I need to rest my case on the issue of accidental deaths of the unborn vs. born.
Argument 4: Killing Unborn Humans is Different Than Killing Born Humans
Keep in mind that my goal in this particular section is to be matter-of-fact and not yet touch on the issue of morality or "acceptance." I've already covered how the born and unborn experience pain and consciousness differently, so, let's compare the methods and circumstances under which unborn humans are killed compared to born humans. I'll start with the issue of born humans and limit it to babies (infanticide) in the U.S. According to the CDC, homicide is the 13th leading cause of death among infants (<1 year old) in the U.S., with 10 times as many deaths occurring on the first day of life compared to any other time of life. The CDC report does not get into the specific causes (which are likely outlined in the full text of this study), but they do state that "Infant homicides occurring within the first 24 hours of life (i.e., neonaticide) are primarily perpetrated by the mother, who might be of young age, unmarried, have lower educational attainment, and is most likely associated with concealment of an unintended pregnancy and nonhospital birthing... After the first day of life, infant homicides might be associated with other factors (e.g., child abuse and neglect or caregiver frustration)."
Now let's turn to abortion - the killing of unborn humans. Over 90% of abortions occur during the first trimester (size ranging from a vanilla bean speck to a lemon). 54% of abortions are medication induced. The way this works is a pregnant person takes a mifepristone pill to block progesterone, and then takes a misoprostol pill to stimulate uterine contractions. The effect of this varies a bit from person to person, but most pregnant people experience bleeding and tissue expulsion similar to my own miscarriage. But what about surgical abortions? And what about those small percentages of abortions that are carried out in the second trimester (size ranging from a navel orange to pomegranate at Week 24, generally considered close to viability)? There are two types of surgical abortions: (1) suction abortion (or vacuum aspiration) in which suction is used to remove the unborn human and associated tissue, which can be done up to 16 weeks (baby is the size of an avocado); (2) Dilation & Evacuation (D&E), which uses both suction and medical devices to remove an unborn human of 16 weeks gestation or later. Let's now focus on those second trimester abortions (which again, make up less than 10% of all abortions) and who is having them. According to a 2011 study, "certain groups of women are overrepresented among second-trimester abortion patients. These groups include women with lower educational levels, black women and women who have experienced multiple disruptive events in the last year, such as unemployment or separating from a partner."
Once again, I can anticipate what pro-lifers are thinking - and actually, pro-choicers, too. Understandably, when we read the facts I've outlined above, our minds and hearts quickly jump to the topic of the next section - whether any of what I've described here is morally acceptable. So let's do this.
Argument 5: Killing Unborn Humans is Morally Acceptable
I know what the pro-lifers are thinking. Sandra, read aloud the heading of this section. Do you realize what you just wrote? Do you actually think that killing unborn humans is morally acceptable and that furthermore, you can convince ME of that abhorrent notion? Yes, I DO realize what I just wrote, I DO believe this, but I would be ridiculously delusional if I expected to change anyone's mind on this issue (Douthat does come across as somewhat open-minded about abortion in his column, but it's hard to know if that's genuine). But although I'm not changing any pro-lifers' minds about abortion, maybe - just maybe - I can shift (or slightly nudge?) how pro-lifers think about ME and other pro-choice advocates. Maybe I can convince the pro-lifer who left that "Have you thought about what abortion really means?" pamphlet on my doorstep that I've been not just thoughtful, but also empathetic and even spiritual and prayerful in my position, even if they will never agree with it. So, here me out, please.
Right away, we need to address second trimester D&E procedures because this is where so many of us draw the (albeit fuzzy) boundary line between what is morally acceptable and unconscionable. For this very reason, second trimester D&E's are also the scenarios that pro-lifers love to frame as representative of ALL abortions, despite the fact that it makes up such as small percentage (but I hear you: "small percentage" doesn't matter when we're talking about innocent human babies being brutally slaughtered." Did I read you right?) We often hear the polling statistic that 6 in 10 American adults say that abortion should be legal in "all or most cases," but another way to frame the polling data is that the top poll response has consistently been that abortion should be "legal only under certain circumstances." We know that individuals' perspectives on abortion are more nuanced than these polls can fully reveal, and what I'm getting at here is that second trimester D&E procedures is likely common ground here, a line of what is "morally unacceptable" recognized by both pro-lifers AND pro-choicers.
Well, what do YOU think, Sandra? Your overall argument is that killing unborn humans is "morally acceptable"...does that REALLY extend to using forceps and suction to violently remove an unborn baby - a vulnerable human life - from a uterus, perhaps causing pain and suffering to the pomegranate-size fetus in the process? I've spent a lot of time thinking about this, and here's my honest, likely-unsatisfying-to-you answer: my personal opinion DOES NOT MATTER unless we're talking about my pregnancy. This is why I passionately believe that abortion at ANY stage is not something that can be legislated by uninformed politicians.
We need to think empathetically of a person who finds themselves in a situation where they are seeking a second trimester abortion. A few years ago Samantha Bee did a pretty hilarious bit debunking the myth of what she called "procasti-bortion": the notion of a person who's pregnant for weeks and weeks, carelessly living their life, partying and livin' it up before eventually deciding "Nah. Not into this." The 2011 study I cited above suggests that the reality is more likely to be a person in a very desperate situation, with the unwanted pregnancy being just one of multiple traumatic events that are throwing their lives into turmoil. And we also have to consider that late term abortions also occur in the case of WANTED pregnancies. Pete Buttigieg made comments that went viral a couple years ago, which I will quote here:
"So, let's put ourselves in the shoes of a woman in that situation. If it's that late in your pregnancy, that means almost by definition you've been expecting to carry it to term. We're talking about women who have perhaps chosen the name, women who have purchased the crib, families that then get the most devastating medical news of their lifetime, something about the health or the life of the mother that forces them to make an impossible, unthinkable choice. That decision is not going to be made any better, medically or morally, because the government is dictating how that decision should be made."
What Buttigieg's comments touch on, of course, is the issue of "termination for medical reasons" (TFMR) - the heart-wrenching choice to end a pregnancy so that the unborn child will not suffer from their devastating (almost always certainly fatal) anomalies. The Washington Post recently covered the topic, including a profile of the growing online community to help support TFMR families in their grieving. Importantly, the Post article notes that the Texas abortion law and similar laws do not make the distinction between "normal" abortion and TFMR, which can make an already awful situation just excruciating. As Buttigieg said, "That decision is not going to be made any better, medically or morally, because the government is dictating how that decision should be made." Similarly, the Post article states "when it’s TFMR parents themselves who have espoused antiabortion beliefs, the grieving process becomes more complicated." The podcast/ radio show This American Life featured just such a case last December. I think Rebecca Shrader's story should be required listening for anyone who thinks abortion is a black-and-white issue.
God. I need to take a break, people. Deep breaths. Okay.
So, TFMR helps us understand how (warning: understatement ahead) not all abortions are equal. Now let's shift the argument to whether killing "early stage" unborn humans is morally acceptable. A few years ago I was listening to a talk program on NPR. I can't remember if it was 1A with Joshua Johnson or Fresh Air with Terry Gross, but I do remember that one of the guests was a pro-life OB/GYN. She made the moral equivalency argument that abortion at any stage is no different than killing an 8-year-old child. The host was incredulous, saying something along the lines of "Wait, you mean to tell me that you think aborting a pregnancy is on the same level as shooting an 8-year-old in the head?" The guest held her ground and assured the host that yes, that was exactly how she views abortion - it is no different than killing a born child.
This interview always to mind when I think about the "fertility clinic on fire" moral dilemma. You've probably heard this before: a fire breaks out in a fertility clinic and you only have two viable choices: (1) save a box of 1000 viable human embryos or (2) save a 5-year-old child (and note that claiming that this is a ludicrous, unrealistic scenario is not an option). The scenario is intended to be a "gotcha" to the life-begins-at-conception crowd. We would imagine that, logically, the pro-life OB/GYN above would choose the embryos, because if the lives of the born are morally equivalent (equally valuable) to the lives of the unborn, this dilemma becomes a simple matter of 1000 versus 1 - save 1000 lives and sacrifice the 1. But of course most of us do not view the embryos as equivalent to born children. For me, I would be skeptical that all 1000 embryos really are viable and really will result in healthy, born babies. The 5-year-old, on the other hand, is a sure thing. Now it should be noted that some pro-lifers argue that this dilemma does not negate their pro-life position, but I find such arguments pretty weak...although it does make me ponder re-tooling the dilemma to feature a pregnant person versus a woman nursing a newborn - THEN who do you choose? And what does it mean about our moral calculus if we feel the need to ask how far along is the pregnant person?
Anyway, in arguing that killing unborn humans is morally acceptable, I see my specific points falling into two categories: Category #1: the assertion that many of us do not value the unborn in the same way that we value born children, and Category #2: plenty of other considerations need to be weighed against the lives of these unborn humans that we value differently. So now I think it's important to reiterate and then elaborate upon some of the points I've already made. I'll start with Category #1 points (and you know what? Forget the fertility clinic fire moral dilemma. It's kind of dumb and I don't need it to support my argument):
(1) The collective lack of concern surrounding miscarriage is telling. It shows how we, as a society, REALLY feel about the unborn. Pro-choice advocates love to point out the hypocrisy of the pro-life movement, in that, from a policy perspective, social conservatives only seem to care about a child in utero, but once it's born, they have no interest in supporting policies to improve healthcare, poverty, education, etc. of both the child and the parent. These arguments are justified and have been made many, many times. But I'm making a different argument here: I argue that pro-lifers only care about the unwanted unborn. They do NOT care about the (presumably) wanted unborn because they do not view them as vulnerable...BUT THEY ARE! Again 23 million unborn babies are spontaneously aborted (i.e., miscarried) every year, and yet - compared to the efforts to end elective abortion - we can't be bothered to stop and ask if something can be done about this. We've come to equate "elective abortion" with "preventable abortion" and "spontaneous abortion" with "unpreventable abortion" and - if you REALLY think about it, THIS MAKES NO SENSE! Rather than getting hung up on the elective vs. spontaneous distinction, if we really want to save the unborn, we need realize that very few elective abortions are actually preventable (no matter if Roe fall and no matter what bans are passed), whereas quite a few spontaneous abortions, may, in fact, be preventable. Furthermore, it is likely that many (even most?) of the spontaneous abortions were wanted pregnancies, whereas presumably very few of the elective abortions were (TFMR are the exception, of course). I realize that I’m veering off on a tangent here, but let me continue for a bit: I argue that we need to re-think the way that we save unborn humans. Pro-lifers may argue that This is a valid point, but the two are not mutually exclusive. We can ban abortion AND do more to prevent miscarriage, including fighting for environmental justice. My response to that is yeah, we COULD do both...but we're not. At all. Actions (or lack thereof) speak volumes, including actions that actually WORSEN the problem - for example, laws reducing conception access and the possible criminalization of miscarriage. These are enormously important issues, but I digress - much more on all this in a future post.
(2) Personal feelings of detached aloofness toward the unborn are normal, common, justified, acceptable, and even therapeutic in some cases. The point I was trying to make in oversharing my personal experiences with miscarriage and pregnancy is this: my feelings, emotions, and reactions in response to my experiences were completely legitimate, justified, reasonable, respectable, and acceptable, and so THEREFORE we should allow, respect, and withhold judgement from ALL people as they grapple with their own personal experiences and perspectives surrounding their pregnancies (i.e., unborn humans). Let me put this another way: do you judge or disparage me for my personal feelings of aloofness toward my own unborn that were SHAPED BY MY PERSONAL EXPERIENCE WITH MISCARRIAGE? If the answer is no, you don’t judge or disparage me, then can’t we extend that same consideration toward ALL pregnant people in how they feel about their own unborn? If the answer is yes, you DO judge or disparage me, then you can go to hell - I have no use for you. Ack, wait, sorry! I forgot that I’m trying - really trying! - to be fair-minded and respectful in this piece. Okay, okay, don’t go to hell. But perhaps you could prayerfully reflect on ways to become more empathetic.
(3) Some people are spiritually or religiously motivated to kill unborn humans. Once again, I realize this sentence seems outrageous (remember, I'm trying to consistently use the language of pro-lifers, so instead of "religiously motivated abortion" it's "kill unborn humans."). Anyway, hear me out. Recently I came across a person's abortion story that I found really compelling. I can no longer find it, but the essence of it was: I told my child to stay in heaven, I'm not ready for you yet. I have faith that we will meet when the time is right. If one reads through the personal narratives on Shout Your Abortion they'll find many similar stories of faith and abortion, including the belief that their child will wait for them, the belief that abortion is part of their spiritual journey, and the role that abortion played in their journey to becoming a pastor. The reason I find these stories compelling is they make me once again ponder the question of when a soul enters the human body. As a biologist, I know that each fertilization of an egg by a sperm results in, as Ross Douthat put it, "a distinct human organism," but heck, I'll go further and call it a genetically distinct human organism that has never before existed and will never exist again. But to me (and many of us?) that doesn't matter as much as the SOUL...the spirit, the human essence. It is beyond science to know when, from where, and how our souls came into our bodies. Even if we dove into the the neuroscience/ developmental biology nitty gritty of the developmental origin of human consciousness (like this study I cited early) the question of the human soul is not one that can be answered (although I do trust that theologians and philosophers could school me on this). So why can't we allow pregnant people to act according to these beliefs? Because, I hear you pro-lifers arguing, if we use that "religious freedom" logic, then we should condone ANY religiously motivated killing, which is obviously absurd. Killing is killing, no matter the reason. Indeed, I'm reminded of the awful double murder that was the centerpiece of Jon Krakauer's book "Under the Banner of Heaven." Brenda Lafferty and her 15-month-old daughter Erica Lafferty were brutally murdered by Ron and Dan Lafferty because Ron claimed to have received a revelation from God instructing him to remove Brenda and Erica. Just about everyone would agree that this crime was horrendous and immoral. Again, I anticipate that pro-lifers would be quick to equate this crime with that of spiritually- or religiously-motivated abortion, and of course, I would counter with...well, pretty much everything I've written so far. It's a false equivalency. An unborn human is not the same as a born human, killing an unborn human is not the same thing as killing a young mother and her 15-month-old child, and killing an unborn human is not only acceptable to the pregnant person, but it can be a spiritual act of love. I know, I know, I know, but try try to wrap your head around that possibility.
(3) Reason #3 continued and elaborated. If readers are still with me at this point, I hear their collective sigh: Sandra, give it a rest already, you're not changing anyone's mind on this! Look, I'm well aware of that, but I have so much more to say about pregnant people and their spiritual or religious perspectives toward their pregnancies. You may have heard some pro-lifers argue against abortion because they claim to be "abortion survivors" (this may sound like I'm changing topics, but I'm not, you'll see). Their stories involve their mother attempting to or seriously considering aborting them, and so understandably these people - these survivors - are grateful that their mothers' abortions were unsuccessful and that they were given a chance at life. These stories are important and meaningful and I do not wish to minimize or downplay them in any way. But I do want to offer another narrative alongside them. Our family friend I'll call Emily is alive today BECAUSE her mother had an abortion (in the pre-Roe era) about a decade before Emily, an only child, was born in 1980. And this is where spiritual or religious beliefs come into play as we consider God, the human soul, and fate. Let's play the "coulda shoulda woulda" game! What if Emily's mom had not had the abortion? Yes, there would probably be a 10-years-older, genetically different person than Emily alive right now, but would it still be Emily's soul - her human essence - or a completely different human soul instead? When Emily's mom - a practicing Catholic - had her abortion, did she think "go back to Heaven, love, I'm not ready for you yet?" Or maybe you're thinking about the possibility that if it weren't for the abortion, then Emily WOULD still have been born AND she'd have an older sibling. But I can tell you that seems next to impossible given the circumstances of Emily's mom's life when she had the abortion (very young, going through a divorce, etc.). I know I said previously that playing this "what if?" game is kind of useless, but perhaps it does help us consider how we can value and respect different individuals' connections to abortion (e.g., both abortion survivors AND folks like Emily).
(1) The high likelihood that the unborn human experiences no pain or suffering during the abortion factors into my calculus. Yes, I know the "high likelihood" thing is a sticking point for some pro-lifers, but you know what? I often find this disingenuous because the most staunch pro-lifers who make this argument about the fetus feeling pain are also the ones that support extreme abortion bans like the one in Texas - a law that is preventing abortion even when the desire for the abortion is to end the pain and suffering of an unviable or severely compromised fetus. If pro-lifers really cared about pain and suffering, they would trust the experts (i.e., medical providers and researchers) to make these calls and would refrain from pushing extreme legislation that leaves no room for compassion, nuance, and privacy that TFMR families (and all of us) deserve.
(2) The known certainty that many uterus owners DO, in fact, endure pain and suffering during pregnancy, labor, childbirth, and the post-partum period factors into my calculus. For people who have birthed a child, every single one of their birth stories is unique and personal. Therefore, I have no idea what it’s like to have a C-section or epidural or other type of medication-assisted birth, and my idea of what unmedicated (i.e., “natural”) childbirth is like is, obviously, only informed by my own experiences and is not necessarily representative of all or most natural childbirth experiences. So with that disclaimer, here’s what I can say about labor and childbirth. IT. FUCKING. HURTS. No, no, no, no - you don’t understand. IT REALLY….REALLY…REALLY…REALLY FUCKING HURTS!!!!! And you have no clue - absolutely NO CLUE - when it will end. For those who haven’t experienced it - even those with a uterus, I would argue - it is impossible to imagine what it’s like. And here’s the thing: I voluntarily signed up for this. Even after 20 hours of labor and birth with Annabel, there was no question in my mind that I would do the same for my next baby. For me, it was the perfect birth experience and the happiest day of my life. If that seems incongruous with the pain, it all comes down to the fact that everything that happened was MY. CHOICE. And here’s another thing for which there is no question is mind: forcing a pregnant person to carry a pregnancy they do not want and undergo a labor and childbirth experience that they do not want is ABJECT EXCRUCIATING BODILY TORTURE. Full stop. (Epidural, C-section, and other specifics DO NOT MATTER. If it's not their choice, then it is TORTURE).
(3) The inherent risks to the uterus owner discussed previously (pregnancy-associated mortality, childbirth injuries, birth trauma, other long-term health complications, and perinatal and postpartum depression, among many more) factor into my calculus. Again, I shouldn't need to elaborate here. So much has already been said on these topics precisely because they MUST factor into our discussion of forcing people to carry unwanted pregnancies. But, okay, really quick, let me reach into this grab-bag of life-altering negative pregnancy consequences to find just one thing to highlight...aha, how about this one? Did you know that pregnancy-associated intimate homicide is a thing? I didn't until now.
So this - all of this, all 10,000ish words of it - is my argument for why abortion is morally acceptable, or as Douthat put it “why in this case taking another human life is acceptable.” Once again, I'm not naïve and deluded about changing any minds on this. I’m fully aware that I’ve laid out the argument of why it’s acceptable to me (and, apparently, millions of other people). I wrote all of this even though Douthat's has not addressed the question of why the "acceptability" of abortion matters beyond each individual, of why it should matter to voters in the pregnant person's state. But even if pro-life readers are unconvinced about the "acceptable" part, have I at least made a convincing claim that abortion is...can we say..."ethically murky?" And if so, perhaps you would agree that the ethical murkiness surrounding elective abortion places it is a similar gray area as other forms of human killing that much of our society has implicitly or explicitly deemed acceptable, including the death penalty (when we know that flaws in our justice system have led to the execution of innocent people), euthanasia, and - this isn't killing but is still quite apt - allowing people to die while awaiting organ donations (when their lives could be saved by simply legislating away the bodily autonomy of compatible donors)?
"Burden of Proof" on the Pro-Life Side: The Case for Banning Abortion?
And so now, I punt the issue back to Ross Douthat and like-minded individuals. I would love to hear "The Case for Banning Abortion" laid out in a way that carefully considers the counterarguments proffered by the pro-choice movement. Let's outline a few of those counterarguments, shall we?
1) Overestimates of the number of "babies saved." The average annual rate of elective abortions in the U.S. is 890,000 (not 63 million). Let's assume an "optimistic" (in the pro-lifer's mind) scenario of a nationwide ban that effectively ends all 890,000 abortions each year. That's 890,000 lives saved! However, we can estimate from The Lancet miscarriage study that about 15.3% of those, or 136,170 would have miscarried anyway. That still leaves 890,000 - 136,170 = 753,830 babies saved. Wow, sounds pretty good.
2) Increased maternal mortality. The flip side of this impressive 753,830 is that now we have to apply the U.S.'s atrocious, rock-bottom ranked pregnancy-related mortality rate of 17.3 deaths per 100,000 live births. So that's 753,830 divided by 100,000 times 17.3 equals 130 uterus owners dead. Per year. But this is such a small number compared to the 753,830 that it really shouldn't give us pause, right? My kids just watched "Shrek" yesterday, and there's a quote from Lord Farquaad that's incredibly appropriate here: "Some of you may die, but it's a sacrifice I'm willing to make."
3) Pregnancy-related health complications. I've already listed and discussed these twice, but it bears repeating. So - all together now! For the uterus-owners who do survive, they are vulnerable to childbirth injuries, birth trauma, other long-term health complications, perinatal and postpartum depression, pregnancy-related homicide, and more.
4) More self-managed abortions. The reality is that uterus owners of unwavering resolve but little means will find a way to bypass the bans and end their pregnancies. Even as lawmakers work to ban abortion pills in their states, "invisible abortion" is and will continue to be a growing reality. While self-managed abortions in the 21st century are safer than they were pre-Roe, they are still not as safe as legal abortion. The May 14, 2022 editorial in The Lancet was blunt about the sobering reality: "The fact is that if the US Supreme Court confirms its draft decision, women will die. The Justices who vote to strike down Roe will not succeed in ending abortion, they will only succeed in ending safe abortion. Alito and his supporters will have women's blood on their hands."
5) More second-trimester abortions. The reality is that uterus-owners of unwavering resolve and sufficient means will ultimately access the abortion they seek. But in doing so they will encounter long waiting lists, long travel distances, and other barriers to access, as we've seen with the fallout of Texas' law. As abortion provider Dr. Alison Block explains, this means "would-be first-trimester procedures that are outlawed in one state become second-trimester procedures in another." Indeed, some women's stories show how this is already happening because of the Texas law. Yikes, not what pro-lifers intended.
6) Increased trauma for those who seek to terminate for medical reasons. Remember, abortion bans like the one is Texas make no exceptions for fetal anomalies, the future fertility of the mother, or similar circumstances. I could reiterate what's already been said, but please, just read this.
7) Unknown impacts on future fertility and future children. Oh wait, I already mentioned this in #6, didn't I? Eh, I think it bears repeating.
8) Reversals of gender equality progress on issues such as poverty, education, healthcare, and more. This has been highlighted over and over and over, so no need to elaborate here.
Again, I can anticipate the pro-lifers' counterarguments. You said it yourself - hundreds of thousands of babies will be saved, and among that number will be plenty of happy success stories that you can't ignore. Some women will be grateful that they had their initially unwanted children. Parents of children put up for adoption will be grateful as well. Their lives will be forever enriched and blessed by these initially unwanted children. And once again, I can't deny that you're right. You're right. But I'm right, too. Everything I've outlined above will undoubtedly happen, at least to some extent (hopefully, the U.S. will get its act together and do something about the U.S.' abysmal maternal mortality rate, but given our political track record on meaningful healthcare reform, I'm not holding my breath). So you have to ask yourself, are these consequences "acceptable" to you? Ross Douthat, a busy, reputable NY Times columnist does not have the time or the bandwidth to respond to the likes of me, but if he did, rather than titling his column "The Case for Banning Abortions" perhaps he would consider something more descriptive. I'm sure he'd like to title it "The Case for Saving 753,830 Babies," but considering how generous I was with my title of this blog post, I'd suggest he title it "The Case for Seizing the Bodily Autonomy of 890,000 Pregnant People and Allowing 130 of Them to Die and All of Them to Be Physically and Psychologically Oppressed." Provocative, yet accurate, no?
Is Reconciliation Possible?
No.
I think we can agree that for many of the factors that I enumerated above, it's hard to put a solid estimate to them, especially for items #4 and #7. Considering that, it's no wonder that we will never come to an agreement on this endlessly contentious issue, and this is despite the fact that we do have a common goal, believe it or not: to reduce the number of abortions. No one grows up thinking "Gee, I hope to have an abortion one day!" Pro-choicers argue that the focus should be on reducing unwanted pregnancies (because that would safely address ALL of the issues I outlined above), whereas pro-lifers - or at least the politicians representing them - focus only on abortion bans and even promote policies counterproductive to reducing unwanted pregnancies; that is, banning or reducing access to contraception. Talk about unconscionable.
In a recent New York Times column, Columbia University linguists professor John McWhorter writes that he doesn't think pro-lifers are evil or bad people, even though he is "disgusted that the Supreme Court seems poised to make it more difficult in many cases, and practically impossible in others, for American women to terminate an unwanted pregnancy." It's taken me a while to arrive at the same place, but ultimately I agree with Dr. McWhorter. Pro-lifers, I don't hate you. But I do fear you. I'm TERRIFIED of you and the powerful politicians (Supreme Court justices included) who are advocating for your position, arguing that my moral compass must bend toward yours. I know, once again, I can anticipate your counterargument: Well, WE are terrified, too. We're terrified that the slaughter of innocent babies will be allowed to continue. Okay. Noted. But now let me argue this: you, pro-lifer, have absolutely no reason to fear for your own PERSONAL day-to-day life, health, and well-being. On the other hand, millions of female-bodied people of reproductive age (or soon-to-be-reproductive age, my small daughters included) have VERY GOOD REASON to fear for these very things. Let's consider two scenarios centering around a person with an unwanted pregnancy. In both scenarios, you don't know this person, they don't know you, and your two paths will never, ever cross. In Scenario 1, Roe is codified and abortion is accessible everywhere. So, this person takes a bit of time off work to drive a short distance to have a simple, medication abortion. They are quickly back to work, moving on with their life as if the pregnancy never happened. And YOU, pro-lifer, are none the wiser. What happened with them has ABSOLUTELY NO IMPACT on your own life and well-being. But now let's imagine Scenario 2 in which abortion is banned. What will this person do? Possibilities range from the ideal fantasy (they are forced to carry their pregnancy to term, but it all ends up great because they put their child up for adoption OR decide that parenthood is the right choice for them, after all) to the unthinkable horror (my mom's college suitemate who died from a botched abortion pre-Roe). Whatever happens, however, the reality is that YOU, pro-lifer, are none the wiser. What happened with them has ABSOLUTELY NO IMPACT on your own life and well-being. In other words (because there are SO MANY different ways to state this), my pregnancy has EVERYTHING to do with me and NOTHING to do with you.
Darn it. I told myself I would end this piece on as conciliatory and respectful a tone as possible, but I think I've failed (understandably, perhaps). And I've certainly rambled and strayed from my original thesis, the argument that killing unborn human organisms - abortion - is morally acceptable. As I re-read my own writing, I realize that my argument has become this: even if abortion is NOT morally acceptable to some, criminalizing it on any level (state or federal) won't make it go away or force some peoples' moral compasses to bend towards others. As my own daughters near their reproductive years, I pray to God that we can figure out a more just way to reduce - or even eliminate - abortion (although abortion will never be completely eliminated because of TFMR and also, like, reality) and show compassion and EMPATHY to pregnant people. Maybe we can begin to shift the pro-life or "save the unborn" movement to include the WANTED unborn, too, rather than merely the unwanted unborn, and rally around environmental justice issues to reduce preventable miscarriages (not to mention improve the quality of life for born humans, as well). This will be the topic of my next post.
Thanks for reading.
