Finding the Nuance in the Abortion Debate

*Note: I want to acknowledge that everyone with a uterus is affected by this topic, regardless of gender identity.

My story

When I was younger, I was taught that an unborn fetus is a “blob” in the uterus, by someone born in the 1950s. I’d seen and experienced sexism, and started to identify as a feminist. I believed in the separation between church and state, and thought abortion limits were a religious overreach. Somewhat matter-of-factly, I figured I was pro-choice. I thought, the church doesn’t belong in peoples’ doctor appointments, especially those outside the church.

Also as I child, I watched, “The Miracle of Life” (1983). If you can overlook the cheesy aquarium-style music, it is a masterpiece. (You can watch the sequel/remake here). It shows arresting photos and videos that elucidate the path from sperm to egg, and the process of fetal development.

Despite it’s religious-sounding title, the film was incredibly secular, implying our evolution from single celled organisms in the ocean. Additionally, the photographer Lennart Nilson, working out of Sweden, did some photography/video using an endoscopy camera in a pregnant woman’s body, and also photographed aborted fetuses. He objected to use of his work by the pro-life movement, and was strictly a-political. His goal was to show the marvelous pathway we take as humans as we develop.

It was amazing to see this inside view of reproduction. I watched cilia guiding the egg to the fallopian tubes, and watched sperm madly swimming to try to make it to the egg. I never understood concepts like selection so well as after viewing that film- all of the checks and balances, and all the criteria that must be met for fertilization to take place. I learned about the division between the fetus and the mother, from the zygote onward: two distinct blood-flow systems. It was better than the hand-drawn sketches I saw in school textbooks.

A year or so after I got married, my husband and I joined a church that supports a pro-life ministry. One of the representatives of the ministry in our church got up in front to give an update, and a paper handout was passed around.

It was full of outrageous, citation-free statistics. I can’t remember them, but it was things like “3/4 women who have abortions have long-term medical problems.”

Even if some of the statistics were accurate, the presentation was fear-mongering and non-scientific. I cringed so hard. I almost wanted to leave our congregation over it. How was this allowed? How were our giving dollars supporting this?

The implication was that God was going to use this ministry to reach women who were contemplating abortion, and convince them not to. Presumably, just the fact that someone was considering an abortion meant she needed spiritual care, and possibly evangelism. Maybe she had sinned, and that was the reason she was pregnant to begin with, which then meant she needed to be encouraged to repent. (?)

Driving on the freeway near our city, I saw billboards calling women who had abortions “murderers.”

Some had pictures of developing fetuses, and information about when heart beats started, etc. It seemed something that would be good for people to know, but to learn outside of a politicized context.

I reflected on how most people don’t know very much about fetal development, and just about the reproductive system in general. I wasn’t taught a whole lot of detail in school, and most people I’ve talked to about it, didn’t have much better education than I did.

I also reflected on how most of the conversation around abortion did not center on whether a fetus was a human being or not, but rather on a myriad of surrounding (important) social issues.

Why was the conversation about abortion about anything other than biology, even though all of the related topics- racism, sexism, bigotry, faith- absolutely mattered?

Would it be possible for conservatives to talk about biology without bringing God into it? Would it be possible for liberals to talk about biology without accusing others of sexism, racism, men controlling women etc?

Could science answer our question in an objective way? More and more, this seemed to be the key to future conversation.

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Something about those posters on the freeway got to me- but not the way the people who put them there intended. I was horrified that women who had gotten abortions were being attacked and harassed, being called murderers.

I was also horrified by the unscientific pamphlets passed out at church. I was overall distressed that almost none of the arguments I was listening to were about biology- they were about a million other things.

I needed to sort through my conflicting feelings about this: on one hand, feminism and the sexual revolution, women’s empowerment, and on the other hand… was there an argument I was missing?

Then one day in a hot car, I decided to Google images of aborted fetuses.

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It was awful. I saw broken bodies. Tiny fingers. Feet. I read about methods used.

I read about a Dr. Bernard N. Nathanson who presided over 60,000 abortions, performing 5,000 of them himself. Dilation and cutterage (D&C) was his specialty. After using ultrasound to watch what happened to fetuses during his clinic’s abortion procedures, he became a pro-life activist, and created the film “The Silent Scream”.

Perhaps those images I’d watched as a child came to mind, I don’t know. But I gained strength in a new conviction.

I got out of the car, and thought, “well, I guess I’m pro-life now.”

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Finding the nuance

And yet, there is nuance.

As much as it would be convenient for the topic of abortion to fit into a neat, tidy, box, it doesn’t.

For example, is all killing murder? What about war? What about euthanasia?

Euthanasia

I’m personally in favor of the right for competent adults to choose euthanasia. I recently learned of someone connected to our family who chose to die by refusing food and water. What I heard about what that process was like for him was ghastly. People should not be forced to suffer like that when we have ways to painlessly put an end to suffering.

So what about unborn children who have horrifying conditions that mean they are going to die a painful death upon birth? Every situation is different, and I’m not saying I would personally choose abortion if I were faced with that. However, it is a chink in the armor, a hole in the box. What if a growing baby has Potter’s Syndrome, and is going to be born without lungs, and will painfully suffocate at birth?

Rape and incest arguments have never particularly swayed me, because of my understanding (based on blood-flow barriers) of the fetus and mother being distinct. “My body, my choice” hasn’t swayed me, because I do not see the fetus as part of a mother’s body (that’s why her immune system compromises itself during pregnancy, so she won’t reject the foreign body). My initial support of abortion rights was based on the separation between church and state, and a lack of clarity about what fetuses looked like (the movie I’d watched faded in my memory).

To save the mother’s life

Another spot of nuance in the conversation is how to protect the lives of women whose pregnancies are dangerous. I’m not a doctor, but I know that women have died due to abortion bans that prohibited treatment that would have saved their lives. So rather than one death, there are two deaths. That is not clear-cut.

Treating all abortions as the same, even if they are viewed as equally good or bad

Additionally, I do think it is false to say that all abortions are the same, whether the “day after” pill, or a late-term abortion. The words we use need to acknowledge nuance, even if the conclusions we personally draw at the end remain unchanged.

Even if you believe that every form of abortion is allowable, or every form of abortion is “wrong,” including birth control that prevents implantation of a fertilized egg, speaking as if they are all the same creates a sense of false equivalency. For example, implying that fetal suffering is the same when comparing a late term abortion with a medicine that prevents implantation of a fertilized egg would not acknowledge differences in those scenarios, even if the conclusions you draw at the end remain the same.

Potential consequences of establishing legal personhood of fetuses

And then there is are the real-life potential consequences of outlawing abortion, and of establishing legal personhood of fetuses. What if women could undergo criminal investigation for having a naturally-occurring miscarriage? What if pregnancy becomes something under governmental surveillance, to determine whether the mother is acting “appropriately” to support and protect the life of the fetus? Where would the boundaries lie? What if the mother needs to take chemotherapy, and it might harm the fetus, but it also might not?

Not black and white: grey.

We all need to acknowledge nuance, both on the left and on the right

Bans on abortion are likely to undergo intense legal fights, especially given all the variance and nuance within the issue- yet most people ignore that nuance. And there are all of those other issues at the heart of the conversation: sexism, racism, classism, bigotry, faith, judgment… and very little biology. There is going to need to be some balance, and some acknowledgement of the nuance, from all sides.

Pro-choice and pro-life groups have a tendency to ignore much of the nuance in the abortion debate. Whether it’s equating all types of abortion including up until the day of birth, or ignoring the imperfection of law and harms that abortion bans can cause, both need to take a step toward the center.

The path forward

So where to from here?

What do we all share?

A desire to make abortion unnecessary.

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I don’t know anyone, including all of the pro-choice people I know, who actually would be excited to go through the process of having an abortion. Though the outcome may be desired, I don’t know anybody who thinks the process is pleasant.

I think that we as a nation can agree that ideally, we should prevent the situations that lead to abortions being considered.

So, let’s do that work!

If all the effort currently put towards pro-life outreach, materials, and clinics were instead focused on the these goals, I am convinced that mountains could be moved.

1. Prevent unintended pregnancy. Improve sex education and safe, effective birth control access. Improve research funding to develop even better birth control methods. Consider removing requirements for parental consent for minors to receive certain types of birth control.
2. Prevent negative healthcare outcomes, both for fetuses and for moms. Improve health care access, lower health care costs, and improve health care quality and equity.
3. Work to end poverty. No one should worry about their ability to care for a coming child.
4. Increase support for victims of domestic violence.
5. Create systems to help spouses better manage their physical, mental, and emotional health, to prevent them becoming violent, to begin with.
6. Prevent rape.
7. Prevent incest.

I’m sure others can add to the list.

Patch the holes in the social safety net

During Barack Obama’s presidency, abortion rates in the US were the lowest since Roe vs. Wade. Improving access to healthcare and to insurance-covered contraception helps. Research has shown that abortion bans produce a huge amount of collateral damage, that tends to effect those the most who have the least support and resources. Patching the holes in the social safety net works.

Improve reproductive education

In addition to improving sex education, I think we need to work harder to educate young people better about biological facts about what happens in the womb- not from a partisan place, but an unbiased, factual place. Education in this area is severely lacking, as it’s not considered essential in most schools that I’ve seen (and, ironically, anti-abortion activists are often the same people fighting against improvements in sex ed that might actually cause people to think about abortion differently than I once did- that fetuses are “blobs”, for example).

The womens’ rights movement blossomed at a time when our knowledge and understanding of fetal development was at an earlier developmental stage than it is now. The person who once taught me about fetuses being “blobs” has said that technology has changed rapidly. The ability to take high quality pictures of growing fetuses using ultrasound machines, some even worthy of picture frames, is something that has only existed in recent years.

Law

Do I think the law can play a role, in attempting to prevent abortions, especially non-life-threatening situations?

If the only reason abortion is sought is to avoid having a baby, then from an ethical perspective, perhaps yes, because of the biological evidence I have seen for the life of the growing fetus. But I struggle to think of a way to do this that won’t risk potentially putting a woman in danger when a doctor refuses to provide her an abortion because he or she does not deem the situation sufficiently life-threatening.

I admit that though I would love to say I trust women to do what’s right for them, I also know that people have differing access to educational materials about fetal development, and will have differing understandings of it. Times have changed, and technology has changed. I once thought of fetuses as “blobs,” and I know I’m not alone in that. Doctors can also hide the truth of what happens during an abortion from pregnant people, or exert pressure.

I’m sure experts can speak more to that issue, as well as people who have been in those situations themselves.

In terms of asking “what’s right, and what’s wrong,?” my ethical barometer does lean towards the side of protecting the fetus, when the only reason for abortion is not wishing to have a baby. But whether the law should be used is another issue.

Laws are not equally applied to everyone, and doctors inevitably show bias in terms of what conditions “warrant” an abortion, as well as their willingness to perform it. Additionally, making something illegal brings in consequences- such as jail- that disproportionately tend to affect marginalized communities.

So this is an example of another grey area. I’ll be honest about my double-mindedness about it, as I’ve sometimes stood strongly against any laws that could limit abortion, and then I read case studies from people who describe their reasons for having had abortions as being things that would not warrant killing an adult person- ie financial costs of additional kids- and I revisit the question.

That’s partly while I feel IF any laws are in place to limit abortion, they must occur WITH the additional social safety net supports I outlined above.

With the amount of money currently pledged and spent in pro-life activism, a whole lot can be done.

Ethics of legal limits

Even acknowledging the reality that different moments from conception to fetus formation may have different ethical implications, there are times when killing someone is the ethically right thing to do. So the ethical question of whether abortion should have legal limits is this: will the harm done by placing certain legal limits be greater or less than the reduction in harm done to the unborn?

It’s not about whether it’s “right or wrong,” it’s about what will result in the least amount of harm. And this isn’t a question that should be answered by politicians, or even by people like me. It’s a question that should be answered by doctors, medical ethicists, and social ethicists. It’s also not necessarily a blanket “yes” or “no,” but something that may vary depending on what metrics are used, what timelines are used for pregnancy, etc. Many of these metrics are quantifiable. Unfortunately, qualified people are not currently the people making the decisions, but perhaps that can be changed.

Amends from pro-life groups

I do think an immense amount of harm has been done by pro-life groups, and some churches, in the name of defending the unborn. Pregnant people have been dehumanized, and the variety of situations they face oversimplified.

In fact, religious over-reach has in some ways, I think, clouded the understanding many have about what happens in the womb. People who have been beat over the head with Bible verses about God knowing us in the womb are unlikely to view any information about fetal development as unbiased. With Christians bringing religion into the mix, what data can you trust?

And so I think a public repentance and amends-making from church and other pro-life groups is needed, especially those responsible for picketing and negative billboards.

The nuance to be found here is this: look to biology to determine what you believe about the beginnings of life. Don’t let the unkind attacks of others push you to a place of being unwilling to learn or look at data about what happens in the womb, because of the ways those things have been used as a battering ram in the past.

I hope that wounds can be healed, and grey area found.

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So that’s where I am, and that’s where I think we, as a nation (the US) need to move forward to.

Acknowledging the nuance, from both directions, is necessary. Improving unbiased, biology-based reproductive education is necessary. We need to treat abortion as something multi-faceted, acknowledging the differences a fetus goes through in different stages of development, both from the perspective of those seeking to ban abortion, and the perspective of those seeking to allow it in every single circumstance and stage.

We need to talk about those grey areas, without resorting to “black and white” thinking.

We need to work together to improve peoples’ lives, and work to reduce the circumstances that often lead to people being faced with a very difficult choice of how and whether to proceed with their pregnancies.

And ideally, those who are ultimately making decisions of law should be those qualified to quantify and assess the ethical implications of any limits placed on abortion, attempting to assess net harm reduction within a system that is deeply imperfect, in which those with the least power often carry the heaviest burdens.

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