The One Question Missing from the Abortion Debate
The debate over the value of fetal human life is gridlocked. Here's what we need to be asking instead.
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For many prolife advocates, the most important question surrounding abortion is when does human life begin?
Medically and scientifically, this is a straightforward question with a precisely definable answer. A new human being with its own sex, blood type, and DNA begins to exist at the moment of conception. These facts are not even truly disputed (except by pro-choice advocates who are ignorant of the real reasoning on their side of the argument).
As Senate Bill 158 summarizes: “Physicians, biologists, and other scientists agree that conception marks the beginning of the life of a human being—a being that is alive and is a member of the human species. There is overwhelming agreement on this point in countless medical, biological, and scientific writings.”
Even vehemently pro-choice advocates such as philosopher Peter Singer do not debate conception as the beginning of human life: “Whether a being is a member of a given species is something that can be determined scientifically, by an examination of the nature of the chromosomes in the living cells of the organisms [...] There is no doubt that from the first moments of its existence an embryo conceived from human sperm and egg is a human being” (Practical Ethics).
The question routinely up for debate is at what point does a human being begin to matter?
This is the question that has prolife and prochoice advocates at a standstill. Despite excellent research and philosophical arguments demonstrating the logical incoherence and rampant injustice that result from attempts at justification of delays or even removal of moral status of certain human beings based on lists of qualifying criteria, prochoice advocates continue to argue that some lives do not matter -- at least, not as much as other lives.
And this tends to be where the dialogue (if it manages to remain civil enough to be termed so) stagnates, gridlocked over whether or not fetal human life has value.
This is the crux of the issue over which debate has raged for more than 50 years (some might even call it an ancient debate, dating to the early Christian moral code articulated in the Didache prohibited abortion as early as the first century), however --
This debate isn’t going anywhere. As we continue to lose political common ground and our very ability to partake in civil discourse, to remain open-minded to what “the other side” has to say, we run the risk of merely repeating ourselves or rehashing fancier but ultimately rebooted arguments that resound no further than our own echo chambers. If we want to make headway and change hearts, we, the pro-life community, need to start changing our tune.
We need to change tactics. We are not combatants; we are missionaries. If we want to change hearts, we need to start speaking the language of those whom we wish to evangelize. Our pleas on behalf of the unborn have fallen on deaf ears. While we are still very much their advocates, our tactics need to change. We need to build bridges with women and prochoice advocates who fear a world without abortion. We need to change the discussion. We need to start by asking a new question.
The real question we need to be asking is the question that is missing from the abortion debate: is abortion good for women?
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And before we start rhapsodizing on its effects on immortal souls, let’s remember that the goal of opening this conversation is seeking common ground. By and large, prochoice advocates sincerely believe that abortion is not only good for women, but essential to their freedom, equality, and flourishing as persons. That is the assumption we need to address.
Suppression of Information
So, is abortion good for women? Of course not. Unfortunately, some of the major organizations responsible for disseminating information about these risks appear unwilling to disclose them. The American Psychological Association (APA) prominently declares, “Research has shown that having an abortion does not increase a woman's risk for depression, anxiety or post-traumatic stress disorder,” only to go on in that same paragraph to explain away the evidence of mental health issues experienced by some women after abortion as “related to co-occuring risk factors.” The APA also denies the reality that some women experience post-abortion stress syndrome (PASS).
Certainly, if we are on the side of women and not the abortion lobby, we would do well to articulate these risk factors and their potential effects so as to provide women with an opportunity for informed consent rather than to obscure these facts with a blanket denial of any metal health effect whatsoever.
The American College of Obstetrics and Gynecology (ACOG), a professional organization that actively advocates for expansion of abortion access and the repeal of the Hyde Amendment, advises women: “Abortion does not increase the risk of breast cancer, depression, or infertility.”
Planned Parenthood’s website makes similar assurances: “For more than 30 years, substantive research studies have shown that legally induced abortion does not pose mental health problems for women.” Regarding long-term side effects, Planned Parenthood summarizes:
Unless there’s a rare and serious complication that’s not treated, there’s no risk to your future pregnancies or to your overall health. Having an abortion doesn’t increase your risk for breast cancer or affect your fertility. It doesn’t cause problems for future pregnancies like birth defects, premature birth or low birth weight, ectopic pregnancy, miscarriage, or infant death.
This is not the standard way in which medical risks are disclosed. For any medical procedure other than abortion, women are given precise facts. More appropriate is disclosure of precise percentages, which, as it turns out, are not zero. Careful review of the literature shows that abortion is associated with significant increases in risks for depression, anxiety, substance-abuse, infertility, miscarriage, preterm delivery, sexual disfunction and breast cancer.
These prochoice organizations offer several reasons for discounting studies that point to these risks, most often some critique of the research methods. For instance, one analysis of the conflicting research surrounding risks associated with abortion found that far fewer women reported having an abortion than the number of abortions we know took place within the same time period; only 47% of women disclosed their past abortions. Researchers attributed this failure to disclose their abortions to forgetfulness on the part of the women surveyed, termed “selective recall bias.” The obvious bias in the research here is the assumption that the women who failed to disclose their abortions did so out of some kind of abortion amnesia rather than an intentional decision on their part to withhold that information. A better response to this data might be follow-up research into the reasons why women choose to hide their past abortions.
Even if all of these studies were flawed, a more honest disclosure to patients would be to say that some evidence of these risks exists, and that the research is inconclusive. What is in women’s best interest is more research, better research, not flat-out denial of the risks.
Why are these organizations hesitant to provide women with the facts they need to make informed decisions surrounding abortion?
An Informed Alternative
Perhaps it is because when women are truly informed about the risks associated with abortion, they make dramatically different choices. CompassCare is a Planned Parenthood alternative in New York state. It is not a pro-life pregnancy center; they still perform abortions. What differentiates their practice from Planned Parenthood is the basic medical care and counseling they offer to their patients. CompassCare seeks to address the statistics that 84% of women felt they did not receive adequate counseling prior to their abortion, and that 64% felt pressured. Their strategy consists of offering free ultrasounds, STD testing, and a full disclose of the risks of abortion. The outcome is that 33% of their patients choose abortion, as opposed to the 94% reported by Planned Parenthood.
What is the information that CompassCare’s patients have access to information that leads 61% more of their patients than their Planned Parenthood counterparts to choose parenthood over abortion? Here’s some of the data on risks to women’s health associated with abortion.
Review of the Risks
Breast Cancer: Despite denials of a correlation by abortion advocates, common sense tells us there ought to at least be a correlation between abortion and an increased risk for breast cancer owing to that fact that that early initiation of breastfeeding is positively correlated with a decreased risk for cancer (something that no one is disputing). Sure enough, studies have shown a 44% increase in risk for breast cancer after a single abortion, rising to 76-89% after multiple abortions.
Infertility: Complications from abortion include scarring leading to Asherman’s Syndrome and incompetent cervix, both of which can result in difficulty carrying pregnancies to term. In patients who present with incompetent cervix, 75% had a history of procedures requiring forced dilation of the cervix. Women who have chlamydia at the time of an abortion have a 23% chance of developing pelvic inflammatory disease within 4 weeks, a condition that leads to increased risks of infertility, ectopic pregnancy, and chronic pain.
Risks to future babies: Studies point to an increased chance of preterm birth of 25-27% that rises to 51-62% after multiple abortions, with a 71% higher chance of a very early preterm birth prior to 26 weeks.
The APA has identified abortion as a “human right” since 1969, 4 years prior to its establishment within American society with the decision of Roe v. Wade. They continue to deny any mental health risks associated with abortion, despite the fact that their own research shows a strong correlation for women with existing mental health problems prior to abortion. In other words, abortion exacerbates symptoms for those patients for whom the APA ought to show the most concern.
Rather than seeking the truth, their approach seems to be to give no ground. But for those willing to dig a little deeper, there’s no denying the link between certain factors and risks. The fact is that evidence suggests an 81% incidence of mental health problems in women who have undergone abortion, 10% of which is directly attributable to abortion.
In addition to the research, anecdotal evidence supports the idea that abortion is a traumatic experience for many women, the effects of which last for years. Project Rachel and other such ministries respond to the pain voiced by so many women who deeply regret choosing abortion. The denial of their pain by the APA, ACOG, Planned Parenthood and others is tantamount to the systematic denial of women’s reports of sexual assault and harassment for so many years prior to the #metoo movement. If we are to avoid repeating our past mistakes, it is imperative that we listen to those women who have the courage to speak out about their trauma, realizing that their voices likely represent a small portion of the women who suffer silently as a result of abortion.
The denial of women’s stories of abortion trauma is tantamount to the systematic denial of women’s reports of sexual assault and harassment for so many years prior to the #metoo movement.
The underlying assumption that contraception and abortion are necessary for women’s equality is that mothers are not capable of attaining success equivalent to that of men. This can certainly become true in a self-perpetuating way, such as a corporate environment in which women lose jobs because of pregnancy, are denied promotions or more challenging caseloads because they “won’t have time,” and in which maternity leave and flexible work schedules are limited or excluded altogether. It also becomes true in a world where women are penalized for stepping in and out of the workforce to prioritize motherhood.
And while these are very real structural injustices in need of correction, they are also indicative of a particularly narrow definition of success. If our measure of a successful life is defined by the amassment of achievements, professional milestones, and large salaries, then it stands to reason that the “successful” in life will be those who dedicate the greatest portion of their time and attention to the achievement of those accolades. By this definition, those who choose to dedicate themselves to alternative goals are at a “disadvantage” to achieving this type of success.
What happens when we shift our focus to virtue, happiness, work-life balance, and flourishing relationships? The fact is that many women choose motherhood with full awareness that they are making a different choice about how to spend their limited time on earth — not in pursuit of a corporate American dream. These women know that they do not have to reach the pinnacle of career achievement in order to live happy, meaningful lives, and they certainly do not have to rely on abortion to do so.
Women do not need abortion to reach a career-centered measure of success either, for that matter. Testifying to this fact is the Amicus Brief in the Dobbs versus Jackson case submitted by scholars Teresa Collett, Helen Alvaré and Erika Bachiochi, signed by 240 female scholars and professionals in favor of the argument that women don’t need abortion for equality with men. If we need further examples that mothers are indeed capable of reaching the pinnacle of success in their careers, we need look no further than one of the recipients of that Brief, mother of seven Supreme Court Justice Amy Coney Barrett.
What women really need, more than abortion, are policies that work in favor of families rather than against them. Some examples of family-friendly policies include those adopted by outdoor clothing company Patagonia, including paid family leave, on-site childcare, and the encouragement of nursing during meetings.
Where Do We Go from Here?
If we hope to challenge existing assumption and convince prochoice advocates that abortion poses harm to women, we have an uphill battle ahead. It begins with lifting up the stories of women willing to speak up about how they have been harmed by abortion. We can start advocating for, conducting, and funding better research, as well as advocating for policies that reduce the perceived need for abortion. In the United States, 49% of women seeking abortion live below the federal poverty level. What if instead of insisting on the necessity of abortion, we gave women genuinely free choices about whether to raise their babies by empowering these mothers to imagine an alternative to life in poverty? These are the issues we need to raise and the data we need to produce if we are to link arms with wider circle of advocates in our fight against abortion.