July 7, 2008 8:18
Re: Am I Blue?
Ana raises the question that tests the country's support of abortion rights as no other: How late? Only about 10 percent of all abortions take place after the first trimester. according to the Alan Guttmacher Institute, a non-profit organization whose statistics are considered reliable by both sides of the debate. About 1 percent--that's more than 10,000 a year-- take place after 20 weeks gestation, which becomes uncomfortably close to viability.
Why? The fact is, there are no reliable statistics on that question. When I was covering the abortion issue for the Los Angeles Times nearly 20 years ago, I spent several months talking to women who had terminated their pregnancies in the later stages, as well as to clinicians and ethicists. What I discovered surprised me, because it didn't fit the narrative that either side was offering. These were, by and large, not the tragic cases of fetal abnormality that were so often cited by pro-choice groups; nor were these decisions made as casually as the anti-abortion forces suggested. By and large, according to the women I talked to and to the people who saw cases like theirs every day, women seeking abortion at later stages were doing it either because they were young or they were poor. You don't hear as much about them, because they are people who have very little political clout. But I also doubt that learning about situations such as theirs really addresses the qualms that many Americans have when they consider the prospect of terminating pregnancies when a fetus is close to viability.
I couldn't find a link to the lengthy story that I wrote back in 1990, but if you care to read it, I posted the entire text after the jump:
Los Angeles Times
January 7, 1990, Sunday, Home Edition
THE ABORTIONS OF LAST RESORT;
THE QUESTION OF ENDING PREGNANCY IN ITS LATER STAGES MAY BE THE MOST ANGUISHING OF THE ENTIRE ABORTION DEBATE
BYLINE: By KAREN TUMULTY, Karen Tumulty is a Times staff writer.
SECTION: Magazine; Page 10; Magazine Desk
LENGTH: 5489 words
FROM THE BUSY street, it is easy to miss the little building hidden behind a high stucco wall and a locked gate. Its courtyard is a sculpture garden, where the soothing burble of a fountain smothers the din of the Santa Monica Freeway. Inside, the pastel-washed waiting room could be the lobby of a fancy small hotel. Vivaldi and Chopin play softly from hidden speakers; tropical fish make neon streaks in an oversized tank.
This tranquil spot is where thousands of women have brought their anguish and their desperation. Those who could afford it have sought this place out from Kansas City, Philadelphia, even the Philippines. For here they find an abortionist of last resort -- one who will take the cases that others turn down.
The last of the morning's patients has gone. Dr. James T. McMahon retreats to the chaos of his paper-strewn office to take a call from another physician hoping to refer a patient. "I would say she has no more than one week," McMahon warns. "I wouldn't start that case later than next Monday."
McMahon is one of relatively few doctors in the country who specialize in performing abortions up to 24 weeks, or almost six months, into a pregnancy. He has, in dire circumstances, done them as far as 32 weeks from conception, just six weeks short of an average delivery date. For the most complicated procedures, he charges $8,000. For the easiest and earliest abortions, he charges $500, which is more than double the rate asked at most clinics.
"That's my specialty," this former altar boy says of abortion. "That's my expertise. That's my passion."
McMahon, 51, performed his first abortion in 1972, when California was one of the few states where women could easily get a legal abortion. Fascinated by the technical aspects of the procedure, McMahon gradually began to specialize in it, abandoning plans for a family practice that would have included obstetrics. "I felt that you can't do both. You do a delivery, and then you do a late abortion," he says. "I couldn't take the emotional roller-coaster ride."
As more and more doctors have withdrawn from doing abortions, he has forged ahead, developing new techniques, particularly for the later abortions that now make up about one-third of the 1,200 he does each year. Among the 2,600 or so doctors, hospitals and clinics performing abortions in this country, McMahon is one of fewer than 200 who will take a patient nearing the end of her second trimester.
McMahon says that his conscience and his religious beliefs (he still attends Mass occasionally) have answered the basic questions that arise from later abortions. "I've always been a classic liberal. I believe in freedom in its broadest sense," says the doctor, whose office is decorated with photographs of his own two children. "I frankly think the soul or personage comes in when the fetus is accepted by the mother."
For all his self-assurance, McMahon is keenly aware that the morbid realities of his medical specialty would make him an especially good target for the militants of the anti-abortion movement -- pickets, vandals, those who throw blood on women and plant bombs in clinics. If they could find him, that is. He does not advertise in the Yellow Pages, and he agreed to be interviewed on the condition that the name and exact location of his two offices not be used. He has outfitted his surgical center with hidden, Israeli-made steel shutters that drop over his plate-glass windows at the flip of a switch.
Abortion, no matter at what stage of pregnancy, is an issue that divides modern society as few others do. The vast majority of abortions in this country are performed well before 13 weeks of gestation. But about one in 10 -- around 141,000 a year -- occur after that, according to the latest government statistics. A few thousand of these take place in the final three months -- usually, doctors say, because the fetus is deformed or the pregnant woman's health is at risk.
When a pregnancy is terminated in its later stages, after the fetus has taken a recognizably human shape, already-troubling questions intensify: When does humanity begin? At what point does a pregnant woman's body become not one person, but two? With doctors struggling mightily to give one woman's premature infant a fighting chance at 24 weeks of gestation, is it right to allow another woman to abort her fetus at 23 weeks?
Now that the U.S. Supreme Court is giving state legislatures leeway to rewrite their abortion laws, later abortions are coming under especially close scrutiny. But law and science -- to which society looks for dispassionate judgment on difficult questions -- are constantly shifting and only serve to tangle the issue further.
In the fourth month, a fetus averages 6 inches long and has developed such distinct features as fingerprints. During the fifth month, the pregnant woman may have felt it move inside her. In the sixth month, the fetus, averaging 12 inches in length and 1 1/2 pounds, nears viability, the point at which it is able to live outside the womb with intensive medical care. With each passing week of a pregnancy, biology erodes the comfortable middle ground from under those who insist that they support legal abortion but suppress the urge to add, "up to a point."
"As much as I would prefer to avert my moral gaze, a late abortion forces me to confront the reality of abortion and my own incompletely suppressed doubts," writes ethicist Daniel Callahan, director of the Hastings Center, a medical-ethics research institute in New York. "I suspect that for all but a small minority of those who, like myself, count themselves on the pro-choice side in the abortion debate, the matter of late abortions cannot help triggering distress. It stretches our commitment to the breaking point."
IN THE 17 YEARS since the U.S. Supreme Court's landmark Roe vs. Wade decision, the courts have fairly consistently protected abortion as an option through the first six months of a pregnancy. Now, the high court is moving in the opposite direction, and many on both sides of the debate believe that it is only a matter of time before the court's new conservative majority overturns Roe altogether, throwing the entire matter of abortion back to the states. If it does, the issue of time limits is sure to be one of the most crucial, and possibly the most difficult, for legislatures to decide.
A difficult question, but not a new one. Techniques for abortion are described in medical books that date back more than 4,000 years. For almost as long, it seems, governments, philosophers and theologians have struggled with how to draw the line. Although the Roman Catholic Church now condemns abortion from conception, St. Augustine, whose thinking shaped Catholic dogma during the church's early centuries, believed it was murder only after the fetus formed -- which he defined as 40 days of gestation for a male and 80 for a female. Until 1869, the church held that the fetus was not formed until around 80 days.
The common law of England and its American colonies did not consider abortion an offense until after "quickening," the point at which a woman feels a fetus move within her body. This country's first law banning abortion from conception was an 1828 New York statute.
California's 23-year-old law, unenforced but still on the books, prohibits abortion after 20 weeks. It was superseded by Roe vs. Wade, when the justices dealt with the time-limit question by dividing pregnancy into three-month trimesters. In the first three months, a woman would be allowed to decide whether to have an abortion, with virtually no state intervention. In the second trimester, the government could restrict abortion, but only to protect the woman -- for instance, by requiring that a clinic have certain equipment, or that the doctor have special qualifications. In the third trimester, during which a fetus was presumed to have reached the point where it could survive outside the womb, states could go so far as to ban abortion in all but the rare cases where a woman's life or health is at risk.
The court now seems to be paying less attention to those divisions. In a Missouri case last July, Webster vs. Reproductive Health Services, the court ruled that the state could require doctors to test for fetal viability before performing any abortion beyond 20 weeks, which is at least two weeks earlier than any premature infant has ever been known to have survived. Doctors say such tests are pointless at that gestational age, but the law's clear intent is to discourage later abortions.
In November, Pennsylvania Gov. Robert P. Casey signed a law that would ban abortion after 24 weeks unless the pregnant woman's life is clearly at risk, a significant tightening of the standard set by the Supreme Court in Roe. In coming weeks, other legislatures will begin to convene across the country, and Pennsylvania's new statute seems certain to set the pattern for some of the dozen or so states where anti-abortion sentiment runs high.
Although polls consistently show that most Americans believe that abortion should not be banned entirely, abortion opponents believe that sentiment is on their side when it comes to later abortions.
"I think Americans still can stomach fourth-month abortion," says Susan Carpenter-McMillan, who heads the Right to Life League of Southern California. "In the fifth month and up, it loses a lot of support. I don't think that the majority of Americans realize that abortion after three months is allowed as freely as it is. When they're really educated to learn (that later abortions) are being done for social and economic reasons, they leave their comfort zones."
Abortion rights advocates argue that the truth, while not pretty, is not simple, either. The women who seek the latest abortions are often the saddest, most compelling cases: teen-agers who do not recognize the early signs of pregnancy, rape victims too ashamed to come forward, women who learn that they are carrying deformed fetuses, those whose lives and health are jeopardized, and -- perhaps most frequently -- the poor.
"Although these late abortions are infrequent, they are terribly important, because the women who need them need them desperately," says Dr. David Grimes, a USC professor of obstetrics and gynecology who is a leading medical voice in the abortion-rights movement.
Abortion-rights groups agree with their opponents on one point: It is a terrible thing that one in three pregnancies now ends in abortion. (California has the nation's highest abortion rate, 48 abortions for every 1,000 women aged 15 through 44 in 1985, the most recent year for which government statistics are available.)
But they insist that passing laws is not going to end abortion, just force it underground. Instead, they argue, opponents should look to the problems that are behind the more than 1.5 million abortions a year in the United States: contraception that is hard to use or hard to get, inadequate sex education and medical care, child abuse, and poverty that makes it all but impossible for some women to properly raise the children they already have.
IT IS EARLY, BUT already the graffiti-covered storefront office near downtown Los Angeles is almost full. At least 40 women and girls, some visibly pregnant, squeeze onto the hard benches in the stark reception area, waiting for their names to be called. Some struggle to quiet the fidgety babies and toddlers they have brought with them.
Poverty shows sharply here, in their faces, in their clothes and in their weariness. One middle-aged woman is called; a few minutes later, she returns. A sonogram has shown that she is 2 1/2 months pregnant, she tells the woman who is waiting for her. The news does not seem to surprise either of them. They talk about something else.
This Los Angeles clinic no longer schedules appointments because many of these women will not keep them. They come when they can. The people who work at inner-city abortion clinics hear the same frustrating stories over and over. They find that when catching a bus on time is too much to ask of a woman, regular contraceptive use is out of the question. Deadlines -- whether to refill a birth-control prescription or to get an abortion early -- are meaningless.
The administrator agrees to an interview, on the condition that neither her name nor that of the clinic be used. It is a private clinic, run by a former general practitioner, that does about 150 abortions a week. It accepts patients 26 weeks into their pregnancies. Asked the obvious question, the administrator sighs and says, "We have kind of gotten out of the habit of asking why they waited so long."
A 1987 survey by the Alan Guttmacher Institute, a nonprofit research and policy analysis organization dealing with reproductive health issues, indicated that girls under 18, blacks, unemployed women and those covered by Medicaid were far more likely than others to delay their abortions beyond 16 weeks after their last menstrual period.
"This is a poverty issue. Don't let anybody tell you any different. You don't see a lot of middle-class women having second-trimester abortions," says Anne Walshe, the blunt-spoken administrator of a Manhattan abortion clinic that she wants to remain anonymous. Her clinic, one of the nation's busiest, does as many as 16,000 abortions a year. At least half are performed during the second trimester.
Walshe shows little patience for the idea that a later procedure somehow poses a more difficult moral judgment. "What's the difference? Abortion is abortion. The nice folks who are debating this, who want to draw the line and put a limit on gestational age, will just be putting a restriction on poor women. Women who want abortions get them. It will just force the poor women back to unacceptable remedies."
Most Americans, however, do not accept the idea that being poor is reason enough to justify an abortion, even an early one. In a Los Angeles Times poll last year, only 41% answered yes when asked, "Should a pregnant woman be able to obtain a legal abortion if the family has a very low income and cannot afford any more children?"
The realities that Walshe sees every day, she admits, can be unsettling. "These women know they are pregnant, but not until the 16th or 17th week, when the fetus is kicking and bothering them, do they say, 'Oh, I have to deal with this,' " she says. "It's not that these women are bad, or they're wrong. They're just poor. They don't lead organized, routine lives."
If there is any other single factor that inflates the number of late abortions, it is youth. Often, teen-agers do not recognize the first signs of pregnancy. Just as frequently, they put off telling anyone as long as they can. Anti-abortion groups talk a lot about adoption as an alternative to abortion, but the fact is that almost all the teen-agers who have babies keep them, springing a trap that could hold them in poverty for the rest of their lives.
"The doctor does abortions up to 26 weeks because he does not feel he can turn a 12- or 16-year-old away and send her to be a mother," the administrator of the Los Angeles clinic says.
Joyce Strauss, who has worked for 17 years as a counselor and administrator in the offices of Los Angeles doctors who perform abortions, says: "I've literally bought coloring books for a 10-year-old and a teddy bear for an 11-year-old who were having second-trimester abortions because of child abuse. It was especially hard years ago when they were doing saline abortions" -- a technique of inducing labor that is still used by some doctors. "I remember a 12-year-old going through full delivery virtually alone."
21-YEAR-OLD woman who will be called Agnes had a second-trimester abortion at a San Fernando Valley hospital last April. It is still difficult for her to talk about it. As she sits uneasily at a coffee shop, trying to collect her thoughts, she crumples an empty pack of cigarettes and gives the waitress change to bring her another.
"I was strongly against abortions. I'm very strongly against them still, to this day. But why put my kid through it?" she demands, crying again, as she says she has every day for the past two years.
Doctors had diagnosed the 18-week fetus as having a bone deformity, the same one that had killed Agnes' first baby, a boy, only 4 1/2 minutes after his premature birth in 1987. At best, the doctors said, this second one would have to endure numerous operations to rearrange its skeleton, with no guarantee of success. At worst, it, too, would die quickly after delivery. Some might have taken their chances, but Agnes knew right away that she did not want to.
"I thought about the baby. I'd love it, and it would die on me," Agnes says. "Better (to lose it) now."
The abortion itself was 8 1/2 hours of excruciating induced labor. When it was over, Agnes had asked to look at the aborted female fetus. She still sees it when she closes her eyes. "When I saw my little girl, she had eyes, and a nose, and her mouth. Everything looked fine, except her hands and her ears," she says. In those features, Agnes saw the earliest subtle signs of the genetic abnormality.
Now Agnes is pregnant for a third time. It shows a bit under her black leather skirt, although she hasn't told her family. At 18 weeks, she will again have a sonogram that will provide the first indication of whether this one has been twisted by the haywire recessive genes that she and her husband carry. She knows that it is a one-in-four chance, and she has lost with those odds twice before.
"I'm scared. My appointment's coming up, and I'm scared to go," Agnes says. "If they detect anything, that's another abortion for me." She has nonetheless bought stuffed animals, books and other toys, as if by force of sheer optimism she can will the baby to be normal. If it is a healthy girl, Agnes plans to name her Hope.
Some would call her irresponsible, even immoral for continuing this genetic trial and error. But she insists that this is the only way she can have the life she has always wanted. "Marriage is nothing without a family, without kids," Agnes says. "If I could just see one kid healthy, it would be worth it to do it all over again."
Many prospective parents view modern prenatal diagnostic techniques -- now-routine tests such as sonograms and amniocentesis -- as a godsend. Anti-abortion groups, however, say these tests are nothing more than "search-and-destroy missions." "The only reason you are doing this is to weed out and kill those who are disabled or handicapped," insists Dr. John Willke, who is president of the National Right to Life Committee. By that logic, he demands, why not round up and murder the retarded and deformed who are already among us?
California has moved more aggressively than other states to encourage prenatal testing. Since 1986, it has required prenatal-care providers to offer pregnant women a voluntary blood test that detects, through the study of a fetal substance called alpha fetoprotein, signs that a fetus may have certain defects of the nervous system. Officials estimate that this testing program led to about 240 abortions in 1988, out of about 325,000 statewide.
Alpha fetoprotein testing is best done 15 to 20 weeks into a pregnancy. So is amniocentesis, the technique by which the fluid surrounding the fetus is analyzed for signs of genetic problems. Medical science is working to develop tests that could warn of fetal deformity in the earliest stages of pregnancy. The increasingly popular procedure known as chorionic villus sampling, which tests tissue from the placenta, can do much of the work of amniocentesis in the first trimester.
Other methods under study offer hope of detecting abnormalities in the first days after conception, before the embryo plants itself in the uterus. But for the time being, "the most reliable time is in the second trimester," says a leading fetal diagnostician, Dr. Lawrence D. Platt of County-USC Medical Center. "There are things on the horizon, but do I think it's going to be there next week? No."
Platt staunchly defends a woman's right to use as much knowledge as she can obtain to decide whether she wants to continue a pregnancy. "There's a sanctity of life that I respect," he says, "but there's a sanctity of choice, too."
WHEN ROE VS. Wade was decided in 1973, medical science thought itself incapable of saving a baby born before 28 weeks of gestation. Therefore, it seemed that allowing abortion pretty freely up to 24 weeks carried little danger of destroying a viable fetus. Now, however, babies born at 26 weeks are given a 50-50 chance of survival, and a few are surviving at 24 weeks. Medical literature has even documented isolated cases of viable babies believed to have been born at 22 weeks of gestation. Such progress, Supreme Court Justice Sandra Day O'Connor wrote in 1983, has put Roe "on a collision course with itself."
Abortion-rights advocates say that until medicine comes up with an artificial womb or some way of speeding fetal lung development, the chance of further progress is nothing more than science fiction. Their argument was bolstered last month with the publication of a study by Case Western Reserve University School of Medicine in Cleveland, which indicated that the survival rate of babies born before 25 weeks' gestation has improved little over the past seven years. In a Supreme Court brief filed last March, a group of leading scientists and doctors asserted that 24 weeks is the "outer limit" of viability, and that there is "no reason to believe that a change in this outer limit is either imminent or inevitable."
Still, science has come far enough to leave some doctors increasingly leery of later abortions. Dr. Phillip G. Stubblefield, chief of obstetrics and gynecology at Maine Medical Center in Portland and former president of the National Abortion Federation, an organization of providers, has suggested that physicians voluntarily limit themselves to doing abortion at no later than 22 weeks, except in cases where the fetus is doomed or the woman's health is threatened.
"I personally will admit that I do find it difficult and painful (to do an abortion in the latter part of the second trimester)," Stubblefield says. "There is the feeling that one is close to viability, and this is something that at some point is wrong."
When doctors have erred, the consequences have sometimes been horrific. Last June, Philadelphia-area obstetrician Joseph L. Melnick was convicted of infanticide for failing to care for a 3-pound, 9-ounce baby girl born alive after he attempted an abortion. The newborn died within an hour of birth. The doctor said he believed his patient, a 13-year-old, was only 18 weeks pregnant. An autopsy showed the gestational age as 32 weeks. Melnick is appealing his conviction.
In the late 1970s, jurors in Santa Ana deadlocked twice in the case of William B. Waddill, a Westminster obstetrician-gynecologist charged with murdering a 2 1/2-pound infant believed to have been born alive after an abortion attempt. During that sensational trial, the Westminster Community Hospital chief of pediatrics testified that he had seen the physician strangle the apparent abortion survivor -- an accusation that Waddill denied. He was freed after the second failure to get a verdict.
Live births during later abortions occur very rarely, and few statistics on them are available. Technology makes it likely that the number has been drastically reduced these days, abortion-rights groups insist.
Increasingly, doctors are using sonograms to gauge gestational age of a fetus before abortion. It is a far more accurate measure than relying on a woman's memory or the feel of the uterus. (Estimating gestational age has often been complicated by the fact that obstetricians speak in terms of the number of weeks since a woman's last menstrual period. Conception usually occurs about two weeks after that, so actual gestational age is two weeks less. For the purposes of this article, references to weeks of gestation are the actual amounts, estimated as precisely as possible by doctors through sonograms and other means.) Still, Stubblefield says, ultrasound in the second trimester may be off by as many as 11 days.
Newer abortion techniques also have made the possibility of a fetus's surviving more remote. However, abortion opponents say this does not lay to rest the basic issue -- the idea that what is a fetus under one set of circumstances is a premature baby under another. Six years ago, several hospitals in the San Francisco Bay area began limiting second-trimester abortions because nurses were refusing to attend the procedures. The nurses said the aborted fetuses looked too much like the "preemies" they were tending elsewhere.
A woman's health, too, is more at risk when an abortion is performed past the first trimester. Abortion opponents often cite cases of women maimed, killed and left infertile by the procedure. However, data compiled by the Guttmacher Institute suggests that abortion poses less than a 1% risk of such major complications as infection and hemorrhage.
The earliest abortions can be finished in five minutes. The patient is usually under only local anesthesia, as suction draws the fetus and surrounding placenta through a tube not much wider than a soda straw. In later pregnancies, the techniques are far more complex, and the risk of death, while still remote, rises sharply.
"There's a great deal of craft to this procedure," says James McMahon, who employs two staff doctors. He doesn't allow doctors to work for him until they have performed at least 600. "Frankly," he adds, "I don't think I was any good at all until I had done 3,000 or 4,000."
Years ago, the most common method of performing later abortions was to induce labor by injecting a woman with saline or the drug prostaglandin. This procedure was used to abort Agnes' deformed fetus. The woman typically has to undergo long, lonely hours of painful labor, sometimes in rooms near those where other women are giving birth.
University of California at San Francisco researchers studied the experiences of doctors, patients and nurses in a 1979 survey of 250 second-trimester abortions done by various methods. "The woman who went through a prostaglandin amnio abortion had a long and painful experience, which made it generally impossible for her to turn away from the reality of her choice," they wrote. "Most of the amnio subjects described the product of labor as a 'baby' and . . . found the unremitting quality of the labor pain more difficult than childbirth. Anger at the attending physician for being unavailable was prominent."
Nurses also objected because they were left to tend to the patient during this ordeal and to the aborted fetus afterward. On the other hand, the researchers wrote, some doctors preferred these amnio abortions because they offer "relative noninvolvement." One doctor who used only the prostaglandin amnio method told them: "Killing a baby is not a way I want to think about myself."
These days, the most frequently used second-trimester abortion procedure is the least traumatic to many women, but also the bloodiest and most unpleasant for the doctor. It is known as dilatation and evacuation, or D and E.
The entire procedure may take as many as four days. A day or more before the surgery, a woman's cervix is dilated. The patient is under light general anesthesia for the actual procedure, so she usually has little sense of what is happening as the fetus is dismembered inside the uterus and removed with forceps.
McMahon has developed his own method that he calls intrauterine cranial decompression. He arranges the fetus so that he can remove it feet first. Before the skull emerges, he "collapses" it by inserting a three-millimeter instrument known as a cannula and extracting its fluid. By keeping the fetus intact, he says, he runs less risk of internal injury to the woman.
"I want to deal with the head last, because that's the biggest problem," he adds levelly. "From my point of view, the fetus is a potential problem to the patient."
WHEN CAROLINE got pregnant the first time at 15, she did not know she had any options. Her mother ordered her to go live with her boyfriend, so she did. Not that it bothered her much. "It was great to get out of the house," she says, laughing.
A few years later that relationship was over and Caroline was struggling as a single mother of two in a drug-infested New York housing project. Determined that she would be out of that place before her son started school, she managed to get her high-school equivalency and two years of college. It was enough to land her a $23,000-year administrative job at one of Wall Street's biggest financial firms and move her into a relatively safe apartment in Brooklyn.
It's still tough, but at 25, Caroline is proud of her skill at handling millions of dollars for the firm's customers. All around her are exhilarating opportunities and intoxicating possibilities. If she can only finish college, Caroline says, "In 10 years, I'll be an executive. I'll have my own secretary."
But those plans could have been derailed last year, when Caroline discovered she was pregnant again -- with twins this time. She had been off the pill for a few weeks and risked sex with her boyfriend "only once." She tried to get to the clinic early, but the demands of work and motherhood forced her to cancel three appointments. "I was prolonging it so much, I was just desperate," she says.
"I don't feel guilty," she says of her abortion at 18 weeks. "I feel that life begins when a baby is born." She says that she doesn't regret having had children, but she often wonders what her life would be like if she had not. If her daughter ever faces a similar choice, "I wouldn't do what my mom did to me," Caroline says. "I don't want her to say, 'What if?' I want my children to dream."
Does her attitude show a society where craven self-interest has obliterated any regard for human life? Should she have faced the consequences of what she admits was her own mistake? "No one understands unless they were in my position," Caroline says. "I fell into a trap once. I won't fall into another trap."
And that, say those who support legal abortion, is what the entire debate is about: Whether a woman can control her own life, lay her own plans.
Still, the Hastings Center's Callahan says, "at some point, the fetus does gain moral standing, and at that point, its rights take precedence over the right of a woman to destroy it." He believes that this point lies somewhere in the second trimester, between 12 and 24 weeks.
And while others might draw the line differently, Callahan writes: "If the notion that abortion is a morally difficult issue is anything more than sheer rhetoric, it must be so because of a recognition, however inchoate, that such a point exists."
Reader Comments (69)
KT writes:
...By and large, according to the women I talked to and to the people who saw cases like theirs every day, women seeking abortion at later stages were doing it either because they were young or they were poor.
Or, uneducated. Uneducated about safe sex practices. Don't you think KT that I can be poor, I can be young and immature, but is there an excuse in the United States in 2008 to be un-educated about safe sex practices? about contraceptives? about abstinence?
Posted by Rustydog | July 7, 2008 8:53 PM
"The fact is, there are no reliable statistics on that question"
I wonder why that would be. Which agenda is helped by ignorance (literal not pejorative)?
Posted by Paul-no not that one | July 7, 2008 8:53 PM
Is what was true then, true now (by now I mean just before the ban went into effect)?
Karen, there's a great diarist over at Kos, Dr. William Harrison, who is an abortion care provider. He write powerfully on the subject of access to abortion, and I recommend reading his posts on the subject.
I also think he would make an good and valuable source for a longer piece on this topic .
If you can't find his writing, let me know on this thread and I will look them up and post links.
Posted by Casey Morris | July 7, 2008 8:55 PM
KT, what do you think of Jay Carney using Roger Stone as a source on his blogpost on Crist as VP?
Does it bother you, as a woman, or as journalist (or as a civilized thinking person) that Carney gives credibility and a link to the misogynist who gave us the anti-Hillary 527 group, C.U.N.T.?
Posted by Casey Morris | July 7, 2008 8:59 PM
And that, say those who support legal abortion, is what the entire debate is about: Whether a woman can control her own life, lay her own plans.
KT
The abortion debate has changed for me over the years, once the real agenda was fully fleshed under this administration. The heart of the deabte is no longer whether a woman can control her own life, her career etc. The debate for me is really now about the the inappropriate role of the state in a women's physical autonomy.
The same pharmacists who refuse to fill birth control prescriptions, have no problem ringing up condom sales.
They aren't simple going after Roe. They are going after Griswold v. Connecticut. This concludes with the wingnut fantasy of somehow reversing Marbury v. Madison.
But the other area it seeps into, when you are discussing when and how life begins, is when and how life ends. If I don't have autonomy over my body, then what is the future of hospice? Or palliative medicine for terminal patients, for that matter?
The implications seem much larger to me, than simply eight men who think because they put on a black dress every day to go to work, they know what it feels like to be a woman. I know trannies in Santa Monica who wear the same uniform to work, and have no problem understanding the difference between sex and gender.
The issue really gets to the heart of physical autonomy which, has thus far, been expressed in terms "privacy".
Posted by Casey Morris | July 7, 2008 9:08 PM
I think it's odd that the republican nominee goes days without making a public utterance.
Of course I only get my news here, I'm not missing anything am 1?
Posted by Paul-no not that one | July 7, 2008 9:09 PM
Well Rusty, yes, they can...especially with the current policy in the U.S. of funding abstinence-only sex education to the exclusion of all others.
An argument could be made that no one can live in America without hearing of birth control and condoms; but hearing about them and being able to purchase them and use them properly are completely different things.
Posted by Lulu Lulu | July 7, 2008 9:20 PM
KT,
There more I read about this subject, the more I realize there is only one person who should decide about having an abortion...the woman herself.
It is no one else's business. Though provoking post.
Thank you.
Posted by Andy from Massachusetts | July 7, 2008 9:23 PM
Casey, comparing the men on the SC with Santa Monica trannies = EPIC WIN.
Posted by FastEddie | July 7, 2008 9:27 PM
Thanks for reposting this piece Karen.
There's a lot to think about, so I'm not ready to spout off just yet.
Posted by stuart_zechman | July 7, 2008 9:30 PM
They aren't simple going after Roe. They are going after Griswold v. Connecticut. This concludes with the wingnut fantasy of somehow reversing Marbury v. Madison.
This is not about abortion. This has never been about abortion. If it were about abortion there would be a condom in every evangelical pew, and Sunday School for kids approaching and in puberty would include a section on preventing pregnancy. They would be working with Planned Parenthood to reach out to kids to help them avoid unwanted pregnancies, and would be exploring the teaching of same-sex sexual exploration as an outlet for pubescent desire.
If they really believed abortion was murder, they would be doing all they could to limit unwanted pregnancies. They don't. They engage in policies that encourage unwanted pregnancies. This not about protecting fetuses. It is about controlling women's reproductive decisions.
Posted by jayackroyd
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July 7, 2008 9:54 PM
KT here--
Thanks for the comments.
Rusty: I'm mystified, too. I don't think it is lack of education, when you consider the high percentage of women who have more than one abortion. When reporting this story, I came across an instance where a woman was coming to a mid-town Manhattan abortion clinic for her SIXTH second-trimester abortion. The explanation: It didn't occur to her to catch the bus until she felt the baby move. Using birth control also requires having a certain amount of order to your life.
P-NNTO: The basic stats are kept by the Centers for Disease Control, which does not ask the doctors who report them about the motivation of the women who seek the abortions. Also, they rely on doctors estimates for figuring out what stage of gestation the abortions are performed.
Casey: The ban I think you refer to covers a specific abortion procedure--called "partial birth" by the right-to-lifers--but does not directly deal with the stage of pregnancy at which it occurs. My research on this story and others suggested that, despite the name, it occurs more in the second trimester than the third. By the way, what Dr. McMahon calls "intrauterine cranial decompression" in this story may have been the first mainstream press description of what would later be called "partial birth abortion." He was one of the first doctors ever to do it. I had no idea at the time what a huge issue it would become.
Posted by karen tumulty | July 7, 2008 9:54 PM
When reporting this story, I came across an instance where a woman was coming to a mid-town Manhattan abortion clinic for her SIXTH second-trimester abortion.
One of the things that ticks me off about NARAL, and their hard line attitude toward these issues is the failure to recognize that people who behave like this upset a large majority of Americans. Fortunately, it is a small, very small, minority who behaves this way. It would be a mistake to make policy around an expectation that women, as a rule, would treat second trimester abortion as a birth control measure.
Posted by jayackroyd
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July 7, 2008 10:01 PM
They aren't simple going after Roe. They are going after Griswold v. Connecticut. This concludes with the wingnut fantasy of somehow reversing Marbury v. Madison.
Followed no doubt by a complete do-over on the whole Revolution so that we can get ourselves a King and make John Yoo's wildest fantasies come to fruition.
Posted by FastEddie | July 7, 2008 10:06 PM
I've always been of the mind that, while I would not choose to abort(were I a woman), I'm not going to tell women they can't. That's the whole point of 'choice' isn't it?
There's the question of the father, though. If my wife wanted to have an abortion (she wouldn't because she's of like mind to me), I'd like to at least be consulted/have my opinion listened to/known.
But how often in these cases does the father know, or even care? And where do you draw the line between the man's input, and the man making the decision for the woman?
I know when I'm a father, the talk I'll give my kids will basically be 'this is why you shouldn't have sex yet *gives the reasons why*, but for god's sake, if you do it? use a #$!@ condom.'
I'd probably even suggest that I'd give them one.
Abstinence only education just doesn't work - it needs to be part and parcel of prevention education, condoms and birth control.
Because, honestly? People get horny, especially teenagers, and they don't always listen to their adults. They SHOULD, especially if you're raising them right, but it's better to be safe, than sorry. (and that's how I was raised - to damn well use a condom when I started having sex!)
But yeah, it's a really, really complex issue, that I don't think either side will every fully agree upon.
Posted by SniperCT | July 7, 2008 10:26 PM
Thank you, Karen.
That was a very informative (and, in many ways, very depressing) article. I don't see many in depth examinations of the subject.
Posted by Lynn Anne | July 7, 2008 10:32 PM
One of the things that ticks me off about NARAL...
jayackroyd:
One of the things that ticks me off about NARAL is that they're populated at the executive level on down by shrill dolts and incompetent clowns, and that they've never been able to accomplish anything politically other than their permanent role sucking the establishment (and direct mail) fundraising teat.
Oh, and they've also accomplished making themselves (and the rest of us non-lifers) look like total lunatics and/or fools to everyone in America who hasn't spent more than five minutes thinking about any of it.
Don't you just love when the Concerned Women for America appear at a televised press conference in which they (chuckle and) hold up NARAL flyers circa 1990 that proclaim "DAVID SOUTER WILL KILL WOMEN: STOP THE SENATE FROM CONFIRMING BACK ALLEY DEATH SENTENCES!", only to be interrupted by NARAL-tee shirted protesters shouting "JOHN ROBERTS WILL KILL WOMEN! STOP THE SENATE FROM CONFIRMING BACK ALLEY DEATH SENTENCES!"?
Don't you just love Kate Michelman being totally unable to coherently defend her position across from Kate O'Beirne on MTP?
Don't you just love their endorsement of Joe Lieberman?
Don't you just love NARAL?
Posted by stuart_zechman | July 7, 2008 10:34 PM
"Ana raises the question that tests the country's support of abortion rights as no other: How late?"
Actually, the one that tests me is why do anti-abortion groups do everything they can to stop measures like access to birth control and education?
It tells me they aren't really interested in making sure there are fewer abortions and are not honest brokers.
Posted by flounder | July 7, 2008 10:37 PM
Digby had a very interesting historical perspective on this question. Once again we've been sold a bill of goods.
http://digbysblog.blogspot.com/2008/07/distress-by-digby-theres-lot-of-talk.html
In the 1980s, in order to solidify their shift from divorce to abortion, the Religious Right constructed an abortion myth, one accepted by most Americans as true. Simply put, the abortion myth is this: Leaders of the Religious Right would have us believe that their movement began in direct response to the U.S. Supreme Court's 1973 Roe v. Wade decision. Politically conservative evangelical leaders were so morally outraged by the ruling that they instantly shed their apolitical stupor in order to mobilize politically in defense of the sanctity of life. Most of these leaders did so reluctantly and at great personal sacrifice, risking the obloquy of their congregants and the contempt of liberals and "secular humanists," who were trying their best to ruin America. But these selfless, courageous leaders of the Religious Right, inspired by the opponents of slavery in the nineteenth century, trudged dutifully into battle in order to defend those innocent unborn children, newly endangered by the Supreme Court's misguided Roe decision.
It's a compelling story, no question about it. Except for one thing: It isn't true.
[...]
In November 1990, for reasons that I still don't entirely understand, I was invited to attend a conference in Washington sponsored by the Ethics and Public Policy Center, a Religious Right organization (though I didn't realize it at the time).... In the course of one of the sessions, Weyrich tried to make a point to his Religious Right brethren (no women attended the conference, as I recall). Let's remember, he said animatedly, that the Religious Right did not come together in response to the Roe decision. No, Weyrich insisted, what got us going as a political movement was the attempt on the part of the Internal Revenue Service (IRS) to rescind the tax-exempt status of Bob Jones University because of its racially discriminatory policies. (Quotes from book by Randall Balmer)
All this concern for pre-birth and so little for post-birth. I grew up when there was still an orphanage in my home town. I always wonder why the Inquirer has a column every week profiling a child very much in need of adoption.
The people who are so frantic about limiting a woman's choice are often the same who are unwilling to help pay for aid to dependent children and children's health insurance, not to mention birth control education as others have pointed out. Is it any wonder than women panic when faced with the birth of a child they can't afford?
My question to the fanatics is always if you care so much about life, how many unadoptable children have you adopted?
Posted by ivb | July 7, 2008 11:03 PM
I was raised as a conservative evangelical Christian and participated in right to life marches and clinic protests. I went to a liberal arts college and received a great education. I eventually settled on believing in a woman's right to choose, while saying that I would never make that choice. I practiced safe sex.
And in 2003, in a quick succession of events, including a car wreck, thousands of dollars of medical bills, loss of one job, no car, unemployed, still searching for another job... I ended up pregnant.
I tried. I was 23 years old in a big city with lousy public transportation, and no family. I knew I was pregnant almost right away when the morning sickness hit. I got up everyday and applied for jobs at every place within walking distance. I couldn't find a job. College educated, I was too ashamed to apply for welfare. My tiny savings started to dwindle... and I started the process of selling everything I owned... trying to just get through until I found a employment. I sold my furniture. My electronics. My textbooks. My books. I sold my blood. One month passed and then two. And then three. I still thought I could make it. I called to set up an appointment with a midwife. I hadn't seen a doctor yet.
And then there was nothing left to sell, and I started literally starving. By the end of four months... I had LOST thirty pounds. And I didn't have a job. And I didn't know how I could win. And I didn't know how I could bring a child into a world when I couldn't even save myself.
So when someone who barely knew me, but knew I was pregnant, knew I was out walking every day in 100 degree heat trying to sell scraps to pawn shops, offered me the money and the ride to get an abortion, I got online, looked at all the pictures, said my goodbyes, made my peace with myself, my maker, and the life inside me... and had an abortion at 20 weeks.
I will never forget that day. And I will never apologize. Because I believe I made the most heartfelt, heartbroken decision I could make. And also the hardest one imaginable. And I will always grieve. But always be thankful I had that choice.
So there's your true story. For what it's worth.
Posted by Elena | July 7, 2008 11:59 PM
Elena, thank you for your story. I think it's necessary for those who just can't understand why a woman would wait to hear stories like this. I'll bet many of those women who wait are hoping that they can go through with the pregnancy, but eventually realize it won't work. Those who can't understand that should try getting a job when they're pregnant. And yes, having a job is pretty important if you hope to give birth in a hospital, because almost no one can pay full freight for even an uncomplicated birth.
And a whole lot of pregnancies and births AREN'T uncomplicated. If you have to keep your job, and you're horribly sick everyday (I've known women who had to be hospitalized because they threw up so much), and you have other kids, what are you going to do? Get fired (and yeah, really, workers get fired all the time because they're sick, or because they're pregnant) or decide that you have to get an abortion to keep the job and food on the table?
Nine months is a long time. You can start off with all sorts of dreams and fantasies about how you're going to make it work, and then you get sick, and the father disappears, and your mom who you thought would help decides to move, and you lose your job and can't get another, and your lease is up and not renewed, and you develop some second-trimester problem like gestational diabetes.. and you decide you can't make it work. This is not criminal, and shouldn't be, and since this country provides virtually no social safety net to help families in trouble, often the most sensible and family- positive decision is to end the pregnancy. And sometimes you don't reach that decision early. What's the alternative?
I for sure would never think to make that decision for anyone else. For every "sixth third trimester" type, I can match you with brave women who need to make tough choices and do.
Posted by pippin | July 8, 2008 12:24 AM
Elena: My wife had a miscarriage, and was utterly torn up about it for a while. In comparison, I can't fully imagine the heartbreak you must have felt making a decision like yours.
I hope you've since recovered.
Posted by Mr. Nice Guy | July 8, 2008 12:28 AM
Elena, thanks so much for sharing your story.
KT, that's an amazing and heartbreaking article. Thanks for posting it.
I wonder how the recent medical advances in diagnosing genetic disorders, both in fetuses and parents, effects the composition of late-term abortion cases. I hope enough people have access to PGD to avoid scenarios like that couple with the recessive genes for the skeletal disorder.
Posted by Rose | July 8, 2008 12:39 AM
Turning from tragedy to farce, and wholly OffTop:
Wolfson's signing with Fox. Batting practice, anyone?
Posted by FlownOver | July 8, 2008 12:45 AM
This is a hard thing to say, especially after a story like Elena's. Please take this as it is intended: a plea for others to help me understand something which I can not possibly hope to.
For a long time, I've been pro-choice. "What right do I (or anyone else) have to tell a woman what to do with her body?" I thought.
But this argument couldn't hold up to more scrutiny. I pride myself on being logical, a trait with a natural tendency toward emotionless that it impossible with a topic as emotionally charged as this. But there I was, re-analyzing my position.
"Well, yes," I thought, "the baby is *inside* the woman's body. And the pregnancy has an undeniable effect on her (for the rest of her life, most likely)."
But the baby is a person. And how can I reconcile in my head that an abortion isn't killing this person, even if their very life itself is debated? Those two truths seem mutually exclusive as a pro-choice person: abortion isn't killing, but where there was a person, now there isn't.
I believe the state should never sanction the death of any of its citizens. And I can't reconcile the fact that legal abortions do exactly that.
Help me to understand that. How is an abortion not murder? And I apologize to those who have made the decision - I do not mean to demonize you. I am honestly asking a question.
We have to draw the line somewhere - we have to define life as beginning at some defined point, don't we? If its when a child becomes independent of its parents, then isn't it 13, or 17? (Or in my case, 22?) On the other end of the spectrum, is it when a cell first begins to divide on its own, moments after conception?
I don't believe it's either of those polar ends of the spectrum, but I don't know where the line is!
I know what could happen if Roe v Wade were to be overturned (scarily possible with the current Supreme Court). One of the most disturbing images I've seen is a bumper sticker of my step-mother's: a picture of a hanger with a NO symbol over it, and the caption "We Won't Go Back."
I'm sorry, I've rambled. But I suppose I wanted to show the depth and breadth of thought I've given this unbelievably sensitive topic.
Back to my earlier question (and again, I apologize): how is abortion not murder?
Please don't just flame me, though it might be tempting. Please help me to understand.
Posted by DaveR | July 8, 2008 12:59 AM
Karen Tumulty asserts that the Alan Guttmacher Institute is "a non-profit organization whose statistics are considered reliable by both sides of the debate." ROTFLMAO. An arm of the country's largest abortion mill is "considered reliable by both sies of the debate"? Let me guess: The Alan Guttmacher Institute, like Barack "For the first time in my adult life, I am really proud of my country" Obama, supports the killing of children who survive abortions. Right?
Posted by texte | July 8, 2008 1:03 AM
Dave -- it's a fair question, and I'm not offended -- because you obviously have taken time to think critically through the issue from multiple angles. There's more I would say... but way beyond the scope of this forum.
I think in the end though, you illustrate the power of choice -- not just one choice, but multiple choices -- ultimately the individual ability & obligation to think & reason & judge and form conclusions -- which as much as we may try to reach some sort of working policy for social & political life (which will ALWAYS be uncomfortable & awkward where life & death are concerned: think death penalty, euthanasia, gun rights, etc, etc...) -- in the end decisions about morality & ethics & right & wrong -- always takes place inside an individual's head.
And maybe that's the point.
Posted by Elena | July 8, 2008 4:06 AM
Way I see it: if they outlaw abortion, we go back to coat hangers and knitting needles in back alleyways, with girls and women dying from infections, being rendered infertile. Even fleetingly considering that scenario is horrible - I cannot imagine the horror of actually going through with it. So we can't ban abortion - because that can't happen to our daughters, sisters, girlfriends. I think that every alternative to abortion should be considered, but like Elena's story illustrates, sometimes abortion is the only option.
Posted by Codie | July 8, 2008 5:11 AM
Karen - this is truly an exceptional article.
I really appreciate the discussion here. It seems to me that the great difficulty is that both "sides" to the debate have been mortally afraid of the slippery slope. And yet, those of us who are firmly pro-choice must admit that there's a time when abortion is too late. (Like a week before the baby is due - would you still allow an abortion then?) So it would be good if the pro-choice side could promote discussions of when it is too late, and why.
It's clear from your article that late term abortions get experienced as a birth. I wonder how many of those poor and young patients have had that thoroughly explained to them. How many would then choose to carry a baby to term if there were financial, emotional, and psychological support systems in place for them?
Elena - your story is heartbreaking,and there's nothing in it that makes me think you were irresponsible, or "shouldn't" have had an abortion. You would surely have qualified to have an abortion under restrictive guidelines that require a threat to the health of the mother. And I grieve for you that there were not resources available so that you had options. Your story makes it clear that "pro-choice" is often about not having a choice.
It would also be great if the pro-life side (it's hard for me to call it pro-life) had the courage of their convictions, and did what they could to promote life after birth as well as before it. Jayackroyd is right that this is often not about abortion for them, either. Often it's about a punitive moral position about sex.
Posted by KathyR | July 8, 2008 6:28 AM
About 30 years ago I went to a renewal conference (a cursillo)with Roman Catholic and Episcopalian women, and priests and lay leaders from both denominations. The first time a Roman Catholic priest got up to speak he said "The first thing I want to say to you is that all your babies who died before they were baptized have not gone to hell."
A great wailing of grief and relief went up from this group of women. I was astonished both that there were apparently that large a proportion of the Roman Catholic women who had either had an abortion or a stillbirth, and that they carried that sense of judgment on their children and themselves.
I have absolutely never understood how a denomination that was so not pro life as to preach for centuries that a loving God had consigned to eternal damnation fetuses and babies that hadn't gotten baptized, could then preach to the rest of us about the sacredness of the beginnings of life.
So it has sometimes seemed to me that the Roman Church "discovered" a pro-life position and had to rethink their theology about salvation in the process. Fortunately, many Roman Catholics are also rethinking the issues of life after birth, and affirming with renewed strength that being pro-life includes issues of poverty and war.
Posted by KathyR | July 8, 2008 6:46 AM
KT here--
Elena, yours is truly a heart-rending--and, sadly, typical--story about late abortion. You were both young and poor and leading a life where things felt out of your control. You made mistakes of desperation and denial. And ultimately, you made a decision that, if we can believe opinion polls, most people would condemn. Still, few of us know how we would act if we -- or our daughters-- were in the same spot. I had been covering abortion for about a year when I wrote the story I posted here, and it was the one that sent me to my editors to ask for a new assignment. I realized I just didn't want to think about it any more.
Texte: Yes, Guttmacher started as part of Planned Parenthood, but their statistics are well respected on both sides, and are often cited, for instance, by the National Right to Life Committee.
Posted by karen tumulty | July 8, 2008 6:59 AM
Under reported story of the day
http://www.nytimes.com/2008/07/08/us/politics/08mccain.html?hp=&pagewanted=print
Some excerpts:
"Mr. McCain is uncomfortable firing people or banishing them entirely. His orbit remains filled with people who have been demoted without being told they are being demoted, like Mr. Davis, who continues to hold the title of campaign manager even as Mr. Schmidt manages the campaign. Yet, Mr. McCain inspires uncommon loyalty in those who serve with him — hence the willingness of Mr. Murphy to consider coming back into the McCain campaign, despite his own rather brutal history of enmity with Mr. Davis."
--NYTimes
"All of this intrigue breeds discouragement among even those former McCain associates who do not dispute the notion that voters now might be getting an early glimpse of the messy, unstructured way in which a McCain White House might be managed. They are hard-pressed to explain why Mr. McCain tolerates this — or encourages this — or why he has trouble cutting ties with people who have not served him well over the years. "
--NYTimes
Just think of a McCain White House run like his campaign staff...it gives me the willies.
Maverick indeed.
Posted by Andy from Massachusetts | July 8, 2008 8:26 AM
Why do some abortion enthusiasts claim that abortion is a "difficult" decision? Abortion enthusiasts consider their most holy religious sacrament (i.e., abortion) the equivalent of clipping their finger nails. Do these same people "grieve" after clipping their finger nails? Doesn't the abortion lobby know that storks magically create human beings and then drop off the newly created human beings at hospital maternity wards?
Posted by texte | July 8, 2008 8:40 AM
KT here--
Texte: here's an example of what i was talking about regarding guttmacher:
http://www.nrlc.org/press_releases_new/release011503.html
Posted by karen tumulty | July 8, 2008 9:06 AM
Texte, I hate to break it for you, but I don't think your strawman is real. No one thinks like that. Thus you can't really argue against him.
I know, it's very sad, but I thought you should know.
Posted by Ozzie
|
July 8, 2008 9:07 AM
If you haven't already, I highly recommend picking up a copy of Freakonomics by Steven Levitt. His chapters on the relationship between abortion and crime are remarkable and incredibly relevant to a debate on poverty, education, and abortion.
Studies support the notion that the vast majority of abortions happen to poor uneducated women and that had these women gone to full term and delivered the child, it would statistically be much more likely to live a difficult and violent life.
I'm not saying that abortion is good, or even necessary (nor does Levitt), but if we hope to deter women from deciding to have abortions, greater support must be given to the women and the child (including but not limited to entitlement programs, free healthcare, reliable adoption services, a better foster care system, etc.).
The religious right can attempt to legislate abortions away, but nothing will change until the rich bastards who demand that abortions end contribute enough to ensure that services are provided for women and children. If you're looking for someone to blame for abortions in America blame yourself if you've done nothing to help end the underlying conditions convincing women to get abortions.
Also - for those saying there should be no reason women shouldn't be able to use contraceptives and prevent pregnancies, I direct your attention to the millions of dollars Bush is pissing away on abstanence only education.
Posted by Disenfranchised_Libertarian | July 8, 2008 9:07 AM
We have to draw the line somewhere - we have to define life as beginning at some defined point, don't we?
Therin lies the problem. Our moral sense insists that there is a sharp line somewhere. But in physical reality no such sharp line exists. Even conception itself doesn't happen in an instant but takes a non-trivial amount of time to accomplish.
Posted by Paul Dirks
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July 8, 2008 9:42 AM
Thank you for the article KT.
This is a hard issue. I worked as a foster care worker for DSS for ten years. I've seen what happens to many of the kids that come into this world unwanted -- or more to the point -- to parents who are unable to care for them.
It is really frustrating to me that the Right condemns abortion, but trys to undercut every social program like welfare, foodstamps, etc... that would make it possible for someone to be able to parent a child in a minimally acceptable fashion.
I've watched kids grow up in foster care because people don't want to adopt children of color, kids born addicted to drugs or with fetal alcohol syndrome, or with other special needs. After ten years, I had the children of my former foster children coming into care. It is an endless, brutal cycle with no easy answers.
Posted by TeresaKopec | July 8, 2008 9:53 AM
I also find it noteworthy that the same people who are most energetic in wishing to outlaw abortion are usually the ones who are most entusiastic about desiring and promoting warfare. (Official Catholic doctrine marks a strong exception to that generaization.)
The easiest conclusion I can draw from this is that there is a sliding scale along which people can be sorted based on their reaction to the question, is suffering noble or a good thing?
Posted by Paul Dirks
|
July 8, 2008 9:55 AM
This is a remarkable thread, and I think that Karen's fine writing and respectful attitude towards her commentors shows the side of blogging that most of us tink of when we think of blogging. A reasonable discussion among reasonable people. So thanks, Karen.
Next, KT, I don't think that most people polled actually would condemn Elena's choice.
Here's a different path to take in the conversation: What role, if any, should men having in the abortion debate. How do they fit into this picture. Should the rate of "deadbeat dads" have any impact on whether or not women should have abortion as an available option?
What would be your comprehensive proposal to reduce the number of abortions in the US. Jayack has already proposed some thoughtful ideas.
The point of my post here, is that we can use thoughtful discussion to move to meaningful solutions. And we can't simply look to politicians and policy makers to solve these problems. If that were possible, we wouldn't still have them some forty five years after Roe v. Wade.
And again, I would assert, and would love to hear some feedback from KT, on the issue of the crossover of choice and right to die/assisted suicide issues.
Dave- I appreciate your thoughtful question and will take some time this morning to try to answer you just as thoughtfully.
Right now, I have to take my miracle son to swimming lessons. Yes, that's right, my son was a miracle baby, and I am still pro choice. Yes, after years, surgeries, miscarriage, etc., I had a miracle baby, and I am still, maybe even more committed to pro-choice than ever.
Posted by Casey Morris | July 8, 2008 10:00 AM
I agree, Casey Morris...this is the first time I've ever seen an online conversation about this topic that represents what abortion actually is: a difficult, uncomfortable choice where no one has easy answers.
That said, I will say that it also represents the opinion of most abortion-rights advocates I know--rather than blithely encouraging pregnant women to terminate pregnancies, they recognize that it's an unbelievably personal situation that no one can understand except the people who are in it.
Posted by Lulu Lulu | July 8, 2008 10:19 AM
Bravo. This (along with the preceding thread) is one of the best discussions I've seen here in quite a while.
The abortion debate has for too long been dominated by ideologues on both sides with no interest in seeking a consensus position. We're seeing a range of opinions here, but most posters seem to accept that this is not an easy, black and white issue. The American people will not willingly accept a ban on abortions. They will also not willingly accept abortion on demand up till the time of birth. (And yes, abortion for "emotional distress" is effectively abortion on demand.) Unfortunately, there is no obvious point between those extremes at which to draw the line. That, however, does not mean that a line cannot be drawn. We need to tune out the shrill extremists and work on finding a set of criteria that satisfies a majority. That's democracy.
Posted by Robert Sullivan | July 8, 2008 10:33 AM
"It is really frustrating to me that the Right condemns abortion, but trys to undercut every social program like welfare, foodstamps, etc... that would make it possible for someone to be able to parent a child in a minimally acceptable fashion." -TeresaKopec, well said.
DaveR, I'm not sure I have much of a response to your post, but I just want to say that I really appreciate your compassionate and thoughtful approach to this issue. I guess my main response is that we can't even afford to have the discussion you're talking about as a society until we give all women the means to take care of their children.
And I second Disenfranchised_Libertarian's recommendation of Freakonomics. Contrary to the popular perception, Levitt actually takes a fairly anti-abortion view; Much of the Right has completely distorted his thinking.
"Here's a different path to take in the conversation: What role, if any, should men having in the abortion debate. How do they fit into this picture." - Casey Morris, on the last thread Corinthia made a number of suggestions for how to make men as responsible as women. They were almost all radical and unfeasible! But it's interesting because almost everything she was suggesting is essentially what we're already doing to women. Women have huge responsibilities and, contrary to the movement's name, very few choices. Maybe in our search for solutions we should seek to expand those choices. I think that would start with free daycare, subsidized housing, and good public transport.
But it's hard to imagine Obama or McCain giving a speech talking about the need for those programs in order to help single mothers. The Democratic party is only advocating slightly more choice on this issue than the Republicans are. Whatever you think about the merits of abortion, the sad truth is that abortion is the price low-income women pay for tax cuts to the rich and the subsidies to Haliburton.
Posted by Rose | July 8, 2008 11:08 AM
KT here again--
Another thing that is fascinating about this debate (and one reason I felt it was okay to post a story that I wrote so long ago) is how little public opinion on the issue has changed in the 35 years since Roe. People still have the same qualms they ever did, and think abortion has become too easy, even as they overwhelmingly support the basic right, especially in the early stages of a pregnancy. Here is another story I wrote with Viveca Novak on the 30th anniversary of the decision:
http://www.time.com/time/magazine/article/0,9171,409575,00.html
Posted by karen tumulty | July 8, 2008 11:25 AM
My whole thing with the abortion issue is that I don't believe for a second that making abortion illegal will make abortions disappear. It may reduce the numbers slightly (not by much if going by any historical documentation). It also creates the problem of what do we do to people who have abortions anyway. Do we put them in jail? If a doctor is faced with performing the abortion or letting the girl do it to herself with a clothes hook is he culpable? I don't have a problem with society pressuring people into having unwanted babies. I don't have a problem with you saying it's amoral and wrong. I do have a problem with saying its illegal because then people have to suffer even more.
Posted by Shambly | July 8, 2008 11:34 AM
I would like to second TheresaK's and DisLib's statements, which speak to two issues about this debate that have always flummoxed me- to Theresa's point, the fact that most of the most vehemently "pro-life" individuals care only about a fetus in the first three trimesters of pregnancy. After that point, they're on their own. In reality, the "pro-life" movement is "pro-BIRTH." Most don't give a damn about the child once it is living and breathing on its own. They fight against the social safety net almost as vehemently as they fight to force women to carry fetuses to term. And, as another poster mentioned, the idea of aggressive war claiming the lives of innocent children and adults in far away lands doesn't seem to earn their disapproval, either.
On Freakonomics, it strikes me as fairly obvious that forcing more unwanted children into the world (through across-the-board abortion bans) is going to have a net-detriment to society. The rich will always be able to have abortions, legal or illegal, but the ones who would bear the brunt of these laws would be overwhelmingly poor and uneducated. This would likely feed the cycle of poverty and violence in underprivileged neighborhoods.
I don't think anyone wants an abortion. And it is shameful to use abortion as a form of contraception. But, as others have noted, the "pro-life" lobby also isn't so keen on contraception and safe sex education, either, which as far as I'm concerned serves to forfeit whatever high ground they claim on this contentious issue.
Posted by Piper | July 8, 2008 11:41 AM
Perhaps if more conversation could be both as passionate and compassionate as this thread, we might get somewhere as a community.
Perhaps it would help if all sides could agree that abortion is not ever a great choice and so we should all do as much as we can to minimize the likelihood that women would choose abortion as a way out of their predicament.
This is never going to fit on a bumper sticker, and would need to be as comprehensive as looking at every facet of public life - how we educate, how we provide services, how we stigmatize, how we deal with the crime rate, how we support children, mothers, and fathers, how we deal with violence against women and children, how we hold up sometimes violent men as role models, how we view helping women, infants and children as welfare, but don't view replenishing the beaches of the wealthy as welfare. Is there any end?
Posted by KathyR | July 8, 2008 11:48 AM
Thank you KT. These two posts (h-t to AMC) have been excellent and thoughtful.
Having read the comments, I went back and re-read Obama's statements- in light of the discussion, they seem pretty reasonable. Given the intensely personal nature of this topic, I think "reasonable" may be what we want at the executive level.
Posted by BMB | July 8, 2008 11:57 AM
texte - I've been among those who have been interested in more conservatives commenting here, and sometimes some of your comments are right on point. But I don't get why you say things like "Abortion enthusiasts consider their most holy religious sacrament (i.e., abortion) the equivalent of clipping their finger nails" Could you possibly believe any part of that? I find that hard to believe, so you sound like you're trolling, and most of us don't have a lot of patience for that. You're not going to lead anyone to reassess a position, (which actually happens on occasion here) with inflammatory language like that. And if you really do believe that statement then you're so misguided that increasingly people will just skip over your comments.
Posted by KathyR | July 8, 2008 11:57 AM
I just want to add to KT's earlier comment about repeat abortions not being caused by a lack of education. I agree. Nearly everyone over the age of 15 knows about birth control, and if they don't they will find out after they have an abortion. In addition, I had some experience with young women who have multiple abortions, and it was clear to me that they started out on that path before they were teenagers. We start to become the kind of people who don't take unnecessary risks, are moderately well organized, and are not extremely self-destructive, as children. So I am very skeptical about the effectiveness of high-school or post-abortion counseling. The education needs to start at a much younger age, and no, that doesn't mean sex ed for 7 year-olds. It means teaching boys and girls to become adults who respect themselves and take basic precautions, throughout every area of their lives.
At first glance it does seem amazing that there is this small minority of women who keep having abortions, some of them late-term. But once you see it in terms of a larger pattern of low self-esteem and the lack of hope and opportunity in their lives, it isn't so surprising. I've seen some women who want their next pregnancy to work out differently, so they keep getting pregnant even though nothing has really changed in their lives. It's easy to judge these women, but that possibility of a pregnancy that the father will take responsibility for, or will work out in some other way, is often the only real source of hope in their lives, because they can't see how to improve their life in other ways.
So I agree that at the core this issue of multiple abortions - which is a very small minority of the total number of abortions - is one of education, but not in the way we typically think of it.
Posted by Rose | July 8, 2008 12:22 PM
Rose - very well said, and maybe the closest to getting at the root of the issue that anyone has. In fact, as I reread it, it's remarkably concise, thoughtful, and thorough.
Posted by KathyR | July 8, 2008 12:34 PM
DaveR: I think I have come to the heart of your internal struggle from this passage of your post:
But the baby is a person.
At what point is a "baby", a "person"?
Clearly, even after a baby is born, it lacks any number of rights that we assign to adults. Under the law, we can and have tried young children for murder and treated them as adults. But are they, in fact, adults? Their brains and physiological development are certainly not adult. If they were, then there would be little need for pediatricians or clinicians who specialize in adolescent medicine.
So what, if any, are the rights before birth? Because if you are equating a fetus with a baby, then you are giving this "person" a whole set of rights.
Okay, let's start there--does this person have the right to, say, food stamps before birth, so the mother could get good nutrition?
Does the pre-born baby have rights to social security, if the father is shown to be of the age to be able to collect social security?
What other rights does this pre born person have, and should there be instance wherein those rights are going to be guarded by a court assignment of a guardian ad litum, perhaps, if the mother doesn't go for regular medical check ups? If the mother doesn't go for regular check ups, is the mother able to be charged for neglect?
If the child has a right to healthcare, say under a SCHIP program, does the pre-born child have a right to this program as well?
What government agencies do you propose to overlook and oversee the welfare of these pre-born folks? How much government money should be spent on this per year? If the government won't pay for contraception or abortion, what should it pay for with regard to these pre-born folks?
So, those are some of the implications, but are those implications relevant when thinking about abortion? If it's wrong to have an abortion, and abortion is murder, what crime is being committed when you condemn children to lives of poverty (currently a problem in America), no healthcare (don't get me started), overcrowded classrooms, inequal levels of access to education et cetera.
The argument for getting rid of welfare, if you remember Reagan, was the [black] "welfare queens" who were having babies just for the welfare payments. But that point of view surely depends on some sort of ignorance, since over 50% of abortions performed in the US, are done so on white women. So now we have babies with no social net to protect them. How is that an improvement?
So really, it's not just abortion, or midterm abortion, etc. If you think abortion is murder, then you also have an affirmative responsibility to consider what role government should having in "providing for the general welfare of the public", as our constitutionally defined role of government should be.
Dave, I think as a scientist. To me, what we are talking about is a collection of cells. We aren't anywhere close to "person" country yet. And the person that is carrying that collection of cells, clearly has a superior set of rights to those of blastocysts.
And what of the safety of the mother? It's far safer to have an abortion, even in the second trimester, than it is to carry a pregnancy to term.
And what of RU-486. Nowadays, many first and early second term abortions can be performed with medication, not procedurally. Does that change the mental picture for you? If women are simply taking a medication that causes their bodies to abort a fetus, does that change things?
And finally, when I think of people' willingness to let the state determine what happens in my uterus, I think of the reaction at school board meetings when they want to enact a dress code. OUTRAGE. How dare the school system decide what my child can or can't wear on his/her body? Hmm, it just seems odd to me that a number of the same people who think the dress code is a bad idea, think it's okay to make decisions for my reproductive organs. And the same goes for any number of the believers in the absolute sacredness of Second Amendment, again, have no problem making decisions for my uterus. Guns, yes. Abortion, no.
But here's a question for you to consider, Dave--do you think that outlawing abortion, which, by defining life beginning at conception, or your definition of "person" hood, would reduce the number of abortions?
When you consider outlawing abortions, what other undesired collateral effects do you think that such a law would have, on women's health, with number of abortions, the lives of the now to be born children, if there are any, demands on public services, etc.
If we are talking about the effect of pro choice, shouldn't we also talk about the effects of no choice?
Posted by Casey Morris | July 8, 2008 12:38 PM
One last thought about the quality of this thread and the one before--
Besides the respect of our hosts Ana and KT towards their commentors, I'd also say this thread pretty clearly points out that people are willing and desirous of having meaningful discussions of difficult issues that require depth and thoughtfulness.
I would love to see a few most posts on actual political ISSUES that folks and discuss, and far fewer threads with reporters intepreting politicians and keeping us up to the second with silly and meaningless horserace posts. Unless, of course, it's to make fun of meaningless horserace posts.
Posted by Casey Morris | July 8, 2008 1:00 PM
Andy - great link to the Nagourney article (even if OT). I think McCain is more interested in running for President than in being President. I think he likes sitting around with people he likes and shooting the breeze, hence the bus and the BBQ. Politico, BTW, says that Murphy has given a deadline of tomorrow for the McCain camp making a decision about him. (And I can't really see McCain being excited about what looks like an ultimatum, even if from a friend, so I'll be surprised if Murphy ends up there.)
I've mixed feelings about Murphy in the campaign. I think he's likeable, and not rabid, and he's described as not being interested in Rovian politics. The Rovian attacks are being fairly effective, I think, so if they're to continue one can only hope they are so unrestrained that McCain looks even more pinched and negative than he does now. And if Murphy comes on and changes the tone, they'll just shift the Rovian stuff to the RNC and the 527's. So it's probably better for Obama that it remain more closely identified with McCain.
Posted by KathyR | July 8, 2008 1:04 PM
Casey - oops - didn't mean to post a meaningless horserace comment right after your comment. I'm with you on being "willing and desirous of having meaningful discussions of difficult issues that require depth and thoughtfulness." But the silly horserace posts don't offend me in the mix. They're inside baseball for those of us who love baseball. And as infuriating and silly as some of them apparently are, there are unfortunately a few million people making decisions based on the character-revealing fluff, rather than the substantive issues.
So it's okay to gently bypass them and wait for the substance.
Posted by KathyR | July 8, 2008 1:10 PM
Just a couple of things I think haven't been brought up yet, but I am unable to write coherently about - How many abortions come about by husbands, boyfriends etc... all but forcing women to go to the clinic?
Also what are the feelings about the law considering the unborn fetus a "life" in cases of homicide? i.e. double murder charges when someone kills a pregnant woman.
I do think, however the back alley abortion argument has changed. Society’s perceptions about single mothers have changed significantly from the 40s and 50s
Posted by JpJ | July 8, 2008 1:19 PM
A bit off topic, but I can’t resist:
Rose: “on the last thread Corinthia made a number of suggestions for how to make men as responsible as women. They were almost all radical and unfeasible! But it's interesting because almost everything she was suggesting is essentially what we're already doing to women. Women have huge responsibilities and, contrary to the movement's name, very few choices.”
Rose, you’re usually the soul of reasonableness, but I’m going to call you on that one.
A man makes a choice when he chooses to have unprotected sex. Those arguing against reproductive rights for men argue that having made that choice, a man forfeits the right to any further role other than to pay a large chunk of his income for the next eighteen years if the woman chooses to have the child.
A woman makes the same choice when she chooses to have unprotected sex. Unlike the man, she also has the choice to terminate the pregnancy anytime in the first three months without anyone challenging her legal right to do so. Under most circumstances, she can terminate the pregnancy well after that point. If she chooses to have the child, she can choose to raise it (collecting the aforementioned chunk of the man’s paycheck) or to put it up for adoption. If the former, she makes virtually all choices regarding how the child is raised, despite the fact that he is paying half of the expenses. If the latter, in some states the father of the child doesn’t even have the right to claim the child if the mother doesn’t want him to have it.
Ok, carrying a child to term is not easy, and raising a child is just plain hard work, and both are huge responsibilities – but they are choices that the woman makes. Do you really want to compare the choices available to men and women?
Posted by Robert Sullivan | July 8, 2008 1:28 PM
Very provoking article KT, and equally matched discussion. Thanks for both.
Personally, i dont understand why the right concern themselves with issues that would, by their own definitions, never come up in their lives (ie abortion, gay marriage). Don't like gay marriage? Don't marry a homosexual. Don't like abortions? Don't have one. But at least have the common sense to know that every person is not like you, and someone who disagrees with you is not automatically wrong.
I agree that bigger issue is the timeline, of when is too late? Some of the right would say that before you've even lit a cigarette, there is a third person in the room. Some of the left would say its her body, all 9 months. I can't draw the line, myself.
I do think, its a choice for a woman, and hopefully her man, to make with their doctor, based on their situation.
-Elena, thank you for your story.
Posted by nyleharris | July 8, 2008 1:32 PM
"Abortion enthusiasts consider their most holy religious sacrament (i.e., abortion) the equivalent of clipping their finger nails" Could you possibly believe any part of that?
While texte is engaging in hyperbole when comparing an embryo to a fingernail clipping that weakens his or her point, this argument ("it's just a part of my body") was certainly made in the 70s.
This, and the "RU 486 is murder" argument illustrate something related to Casey's observation that ordinary people not engaged in the use of this issue to inflame differences recognize how difficult and nuanced it becomes. The media have made it more difficult to engage in a realistic dialogue because they prefer to make it Randall Terry vs Kate Michelman, rather than an analysis of what really happens in people's lives.
Nobody honestly believes that an embryo is just a piece of tissue. Nobody honestly believes abortion is murder. (This became starkly clear in ND, when the penalty was set at five years in jail for the doctor, and no penalty for a pregnant woman who obtained an abortion). Clinton captured the majority view best: safe, legal and rare. That this issue has been used to sow divisiveness and polarization, when, in fact, people largely agree is a sad testament to our politics.
Posted by jayackroyd
|
July 8, 2008 1:48 PM
jayackroyd: "That this issue has been used to sow divisiveness and polarization, when, in fact, people largely agree is a sad testament to our politics."
Yes. Well said.
Posted by Robert Sullivan | July 8, 2008 1:53 PM
A couple of comments:
The question of what role the male (or the fetus' father) has in all this is an interesting one, and I haven't seen it really discussed at much length myself. I was once asked (by a male) whether the male should (legally) have any say at all in a woman's decision to have an abortion, and my immediate response then (and now) was "No." He then asked why, if it was entirely a woman's decision on whether to bring a life into the world, that a man then should be held fiscally responsible for that child, ad infinitem, once born, since he had no say in the birth decision? I think I responded that the man's decision point/area of control was at the time of the sex act, but (then and now) I'm not sure that's a really satisfactory answer. It's an interesting topic.
I do want to add, though, that I think some of the focus on demonizing members of the pro-life movement doesn't really resolve anything (for me) with respect to what are really the core & difficult ethical and other issues related to abortion. The absence of adequate social & support services is also a critical issue -- an issue on which society needs to focus funds & energy, but again (to me) it is a morally distinct issue from whether and when society should permit abortion.
So, it doesn't really work (for me) to argue that "these anti-choice people don't care about the baby after its born, so they have no right to speak out against abortions" -- or, indeed, "the anti-choice movement sucks & sucks hard, so there is no need to examine where and when abortions present ethical or medical or legal issues that need to be examined openly and honestly." While there are many in the anti-choise movement that I might despise and detest on a personal level, that doesn't really answer or address my feeling that, on the one hand, a woman's right to have a safe abortion in the first trimester is such a fundamental and critical right that we must focus, focus, focus on the Supreme Court, but that, on the other hand, a fetus that has been in a woman's womb for, say, 8 months is NOT just a collection of blastocytes. Or that aborting a fetus that has been in a woman's womb for 8 months is NOT just a woman doing whatever she wants to her own body, and it is NOT the medical, legal or moral equivalent of a gall bladder operation.
Indeed, consider a logical extreme. Imagine a mother who murders her infant, leaving it to die in a garbage can in an alley. Is that wrong? Is it fals