Friday, April 20, 2007

My opinion

Responding to my post from a few days ago where I mentioned my dismay over the poorly-reasoned decision by the Supreme Court validating the Partial Birth Abortion Ban Act of 2003, one reader left the following comment:

I don't get how anyone, being either pro-life or pro-choice can be for partial birth abortion. It doesn't even make sense to give the excuse of being for the woman's health, since the child is killed by the doctor as it's actually exiting the birth canal, so I'm not sure what it saves the woman from except having to birth a live child. Have you actually read how it's done? It's a horrific practice, if everyone in this country had to see the procedure done once I'm sure it would be stopped immediately. I understand that the fear is that if ANY rights are taken away, then it's one step closer to stopping legalized abortion. I don't ever see that happening, but I hope that partial birth abortion is done with forever.

Because I believe that there are a lot of misconceptions about this issue – intentionally furthered for political reasons by those who want to undercut a right which profoundly affects women’s lives – I’m going to explain why I hold the view I do. I don’t mean to offend anyone, but I feel strongly about these matters. I don’t want to open up a pro-choice/anti-abortion discussion. If you don’t agree, feel free to speak out on your own blog. I’m not inviting contrary opinions. I’m explaining why I said what I said.

First, the term "partial-birth abortion" is not a medical term. It is not recognized in medical literature, nor is it used by doctors who perform second-trimester abortions. "Partial-birth abortion" is a political phrase designed to inflame the emotions. Period. In fact, the medical community refers to the procedure as "dilation & extraction" ("D&E") or "intact dilation and evacuation." Right out of the starting gate, I have a problem with defining the discussion in terms of the "partial birth abortion" because that term is so biased to begin with. That’s why I also have a problem with Congress purporting to legislate about a medical procedure while framing the legislation in such obvious inflammatory and biased terminology. The wording of the law alone suggests motives which are contrary to the expressed intent of the law.

You’ll remember that the foundation of the right to abortion was stated by the Supreme Court in Roe v. Wade. The central holding of Roe is that up until the point at which a fetus becomes "viable," (or potentially able to live outside of the womb), a woman may lawfully choose to have an abortion for any reason. The court tried to balance the competing interests of women and the government by using trimesters to define the relevant rights: during the first trimester of pregnancy, the state cannot restrict a woman's right to abortion; during the second trimester, the state can only regulate the abortion procedure "in ways that are reasonably related to maternal health"; and during the third trimester when the fetus is deemed to be viable, the state can restrict or ban abortion as it sees fit.

The discussion about the D&E procedure takes place in the context of second trimester abortions, for that is when they are used. But D&E is used rarely, overall: between 85 and 90 percent of all abortions performed in the United States take place during the first three months of pregnancy. So, when people talk about this procedure, they are talking about mid-pregnancy, PRE-viability abortions. And why, you wonder, wouldn’t women wanting an abortion do it in the first trimester? Well, there are significant reasons. Research suggests that adolescents and poor women are more likely than other women to have difficulty obtaining an abortion during the first trimester. Minors may be unaware they are pregnant until relatively late in pregnancy. Poor women’s financial circumstances often prevent them from finding services early in their pregnancies. Further, some women choose to abort their pregnancies when they learn of severe fetal anomalies or confront serious health problems in themselves or their fetuses. Many of those problems cannot be diagnosed or do not develop until the second trimester.

Remember that in our country’s long-standing legal framework, the government may only restrict abortions during the second trimester to protect the health of the woman. A significant number of medical experts say that the intact D&E procedure has been determined to be medically safer for the woman (in certain circumstances) than the alternatives available at this stage of the pregnancy. So, a law which wholly bans this procedure not only runs contrary to Roe v. Wade and subsequent cases, but it also leaves a woman subject to the less safe alternatives. Banning the D&E procedure doesn’t save a single fetus. It simply eliminates one of the safest methods, leaving women exposed to procedures that pose greater medical risk and are, frankly, equally as unpleasant in terms of what happens to the fetus.

And there, I believe, lies the crux of the issue. People react with horror to the concept of "partial birth abortion" because it seems cruel to the fetus. The details of the procedure are horrid... as are the details of every abortion procedure, really. And it’s true: if the standard is cruelty to the fetus, then all abortions are cruel to the fetus. Indeed, the purpose of an abortion is to terminate the life of the fetus. That’s a brutal fact. Any abortion is a horrible act. So, how, logically, can one draw a line? Which abortions are less horrible? The fact that legislators are trying to make these distinctions divorced from medical evidence raises serious concerns because the next logical step is the conclusion that all abortions are cruel to the fetus and must be prohibited.

And that comes back around to the issue of the rights of the woman. In the face of substantial medical evidence that the D&E may be the safest medical alternative for women in certain circumstances, banning the D&E procedure because of its cruelty to the fetus puts the welfare of a pre-viable fetus ABOVE the welfare of the woman carrying it. That thought process not only runs counter to the fundamental principles underlying long-standing law, but it has troubling implications for women.

So, I have a problem with trying to choose which abortion procedures are "good" and "bad" when that judgment is based on the treatment of the fetus, and not on what is safe and medically appropriate for the woman. I have a problem with legislators pretending to protect women, while in reality they’re ignoring substantial medical evidence, not acting based on what is reasonably necessary for the woman’s health, and chipping away at significant rights. I have a problem with the Supreme Court ignoring long-standing legal principles, disregarding medical evidence, and cloaking moral judgment in bad legal reasoning.

And to address the comment specifically, I don’t think anyone is actively FOR "abortion," let alone FOR "partial birth abortion." Like many others, I am for the right to choose whether to bear a child. I am for the availability of safe medical procedures that permit women to control their own bodies. I am for keeping government out of the decision about whether a woman will or should carry and bear a child. I’m also for letting medical decisions be made by medical professionals. I believe that doctors, not legislators, should be in charge of determining which medical procedures are safest and most appropriate under the patient’s specific circumstances.

To me, saying one is "against" this procedure is like saying one is "against" lobotomy, or amputation, or organ removal. They’re all brutal, unpleasant, difficult procedures. No one would choose them if they weren’t necessary. Of course I know what the D&E procedure involves a fetus. But I don’t believe that a non-viable fetus has a right superior or even equal to the right of the woman carrying it.

I know that these are controversial, emotional matters. These are my opinions. And we are all entitled to our own opinions.


  1. Anonymous5:10 AM

    This comment has been removed by a blog administrator.

  2. I am 68 years old. I lived through the era of abortion being illegal. Did it mean there were no abortions? NO! It meant that there were botched back alley abortions that caused permanent damage or the deaths of women who were desperate to avoid the complications of an unwanted pregnancy. Sometimes women resorted to using coat hangers and other means to void a pregnancy.

    I hope we do not have to go back to those days. I am not pro-abortion, but I am very much pro-choice. The government needs to stay out of a woman's right to decide what happens to her body.

    Thank you Diane for your thoughtful post about this.

  3. Diane, you put this so very clearly, thank you. I agree with you wholeheartedly, and wish that more people would listen with an open mind to the facts instead of the political hyperbole.

  4. I now understand that the alternative method to intact dilation and evacuation is very dangerous. It probably will be used and cause more harm to the woman with a health problem than the now banned procedure.

    Thank you for your thoughtful words.

  5. Dianne
    This is very well said. I think this and Gerrie's comments should be read by all women under a certain age. They haven't lived with the awareness of what women rights have been gained in the last 40 years to enable them to live as they are now. Of course, all historians probably say that same thing too.

  6. Jane Ann9:10 PM

    My Protestant then-15-year-old daughter is normally reserved. But the day her parochial school teacher opined in class that "the world is divided into two groups: those who are Pro-Life and those who are Pro-Abortion" was the day her political and activist heart was mobilized. She raised her hand and vehemently declared that being Pro-CHOICE did NOT mean "Pro-Abortion," and she did not agree to being characterized that way. Her teacher had the grace to acknowledge the correct distinction ... and I am so proud that 16 years later she still quietly asserts her convictions.

    Excellent post. But, actually, Cathy, it's been 34 years ... why are we still debating this, and why are the most vocal usually men?

  7. I think it's always more difficult to write than to speak an opinion to another person, it is for me anyway. Since we convey so much by our tone and manner, something written can seem very different than it would if spoken.
    I think that by writing about the subject in your blog, you are inviting people to reply. As long as they're replying in a respectable manner, I'm not sure why a contrary opinion is a problem. Otherwise it sounds like you only want people who agree with you to reply.
    I am very familiar with abortion and its effects, I have several friends who have had first and second term abortions. All of them regret their decision to abort, I won't even go in to what effects it had on them, physically and emotionally. In most cases they were young and were pushed into it by their boyfriends or parents, and the abortion clinics weren't real big on giving the facts of the procedure in those days (mostly the 70s). Every woman needs to make her own decision in these matters, and they need to be educated so they have no doubt what is involved. I respect everyone's right to their own opinion, but it needs to be an informed opinion when it's something this important and life-changing. I just hope everyone who reads this goes back to your April 19th post and clicks on the link to the Supreme Court Decision and reads it ENTIRELY. It tells exactly what the procedures involved are, and anyone that wishes to have an opinion in this needs to understand exactly what an "intact D&E" is.

  8. Ah yes, it seems that this is such a political issue, when it should be about people's individual rights. I am definitely pro-choice, but I also agree with the previous person: a lot of young people are not given enough information. I wish more support was provided for assisted adoption and that in this day and age it was acceptable to society for women who decided they didn't want their baby for whatever reason could be assisted to carry to full term and then give their baby to the thousands of couples/individuals desperate for a baby of their own. Then I'd be happy!

  9. This is a very emotional issue, indeed, and so many personal matters come into play in what each person’s view is. I don’t think anyone really convinces anyone else, either. For the most part, I think one’s views on the subject of a woman’s right to choose whether to have a baby or not is shaped by our individual values and experiences and the extent to which we are able to imagine and feel compassion for others in different circumstances.

    For those who say that everyone who has an abortion suffers physically and emotionally, I’d suggest that you can’t speak for every woman and every circumstance. I know quite a few women very well who had abortions for significant reasons, and while they suffered anguish at the time because they recognized the seriousness of their decisions, they don’t regret what they did. They made carefully considered decisions and were well informed, and knew why they were doing what they did.

    For those who say that young people are not given enough information, I’d suggest that you do some investigating. I’ve worked with Planned Parenthood and other organizations and I know that many places where abortion is offered give significant information and require counseling before an abortion is done. And maybe one piece of the solution, for those who believe that the information is inadequate, is NOT to restrict the right to choose, but to lobby HARD for women of all races and religions and socio-economic levels to be given clear, accurate, non-biased information if they are considering abortion. Of course, a desperate teenager – pregnant through incest, maybe, or afraid to tell her unsupportive parents about what has happened to her – who resorts to dangerous non-medical “home” methods isn’t going to get ANY information.

    I can also add that I have several friends who regularly volunteer as escorts for women who are afraid to go into abortion-performing medical clinics (for initial appointments, consultations, or abortions) because of the ferocious, mean, and violent actions of pro-life “protestors” trying to keep women out of those clinics. Those actions aren’t about making sure people get more information – they’re about preventing them from getting information and necessary medical services by violent and cruel means.

    And, I’d add, how can you consider the agony of women who chose an abortion and later regretted it without also considering the lives of women who would have chosen abortion but were not able to get one? Their lives are seriously impacted, forever. There aren’t statistics to track them, or to measure the emotional and physical costs on them and those around them. And the lives of the children? Why don’t we ever consider that cost? We know that a child who grows up without loving people around him, with abuse, without parents who are prepared to and able to care for him, sustains damage. Even with abortion legally available, there are SO many children in the US who are living in foster care, waiting for adoption, needing families and not having them. Why would we require women to have babies they don’t want and can’t care for?

    I don’t understand how people who want abortion to be severely restricted or outlawed, in the interest of protecting an unborn fetus, seem to stop their concern as soon as the child is born. Why aren’t they pushing their religious and political leaders to fight hard for full health care for all children and families? Why aren’t they fighting for subsidized child care and preschool? Why aren’t they fighting for solid funding for public school education? After school programs in inner city neighborhoods? More affordable college education for every kid? Making adoption available to parents who really want kids, single, gay, or straight? Imagine if the energy of pro-life individuals and organizations was also directed to improving the lives of LIVING children and families. Not only would the social structure for kids and families be stronger, but the argument for forcing women to bear children they don’t want would at least be a bit more credible.

  10. Boy, I agree especially with your last comment. There's a lot of people out there who "respect life until birth." They're so worried about stopping abortion, they don't try to help the living or prevent the killing that's going on right now through the war and lack of gun-control.

  11. An excellent discussion of a charged topic. So many misconceptions fueled by people who won't ever have to make that sort of choice in their lives. I'm a big supporter of Planned Parenthood. Not all terminations can be avoided, but if I can help make a woman safer from the start, I'm going to put as much effort as I can there.

    Nicely done.

  12. I wish I could express myself as well as you have, because you said exactly what I feel. No one is Pro-Abortion. No one. How silly of them to suggest otherwise. Thanks for a very thoughtful post.