How Can This Be 'Pro-Life'?

Three questions for abortion opponents celebrating the end of Roe v. Wade.

A question for you, dear reader:

You’re in a hospital and a fire breaks out in the obstetrics ward. You can hear the sirens of the fire engines approaching, but it’s clear that they won’t arrive in time. Some new moms and pregnant women are rushing out, but one woman is lying on her stretcher under anesthesia and will soon burn to death. So do you:

A.)  Rescue the woman, saving her life?

B.)   Leave the woman to die but grab a couple of trays of frozen, discarded embryos from the freezer, thus saving a few dozen zygotes?

Versions of this thought experiment have been around for a while, and of course almost anybody would save the woman’s life. I think that’s true as well of the Supreme Court justices who ruled to overturn Roe v. Wade, yet today’s ruling favors embryos over moms. That feels fundamentally wrong to me.

Photo: Lorie Shaull, Wiki Commons

With today’s ruling, abortion is now illegal in nine states, according to The New York Times tracker. Twelve more states are expected to restrict abortion, and that may happen in nine others. All told, abortion may become inaccessible in about half of America.

So let me ask abortion opponents three questions:

First, if the goal is to reduce the number of abortions, then do you really think this is the most effective and humane way to do so? The advanced country with arguably the lowest abortion rate is not one with a draconian approach to abortion, but rather the Netherlands – with about 8.6 abortions per 1,000 women between the ages of 15 and 45. That’s lower than the abortion rate even in states like Texas and Louisiana that have worked to effectively ban abortions.

The Netherlands has a low abortion rate because the Dutch have excellent comprehensive sex education and excellent access to birth control. The upshot is fewer unplanned pregnancies and thus fewer abortions.

In the United States, about 45 percent of pregnancies are unplanned. That’s better than it used to be (51 percent) but still a reflection of low use of reliable contraception.

As best we can tell from surveys, young people have sex at about the same rate as European kids, but get pregnant three times as often. That’s because the United States lags in both sex education and in contraception access. What’s most important in contraceptive access is long-acting reversible contraceptives, or LARCs, such as implants and IUD’s.

Obamacare did improve access to LARCs, and as a result the abortion rate has gone down in America. If the anti-abortion lobby wanted to celebrate a president who actually reduced the abortion rate significantly, it should be toasting President Obama. He provided a model of reducing abortion numbers by helping young people reduce unplanned pregnancies – and this is one of the great successes of social policy. The teen birth rate has gone down 60 percent since the modern peak in 1991, and that in turn has improved high school graduation rates and college attendance rates.

So abortion opponents had a pathway to reduce abortion numbers that would have been effective and wouldn’t have invaded the most private sphere of a couple’s decision making. They didn’t take it.

Second, won’t medication abortion undermine what you’ve achieved judicially? Already a majority of early abortions in the United States are conducted with medication, not with surgery, and the share is rising steadily. In red states, women who want abortions increasingly won’t go to a clinic but will simply take pills that are almost impossible to keep out.

The normal procedure for a medication abortion consists of taking two different pills, and this is highly effective in inducing a miscarriage that is indistinguishable from a natural miscarriage. When the pills are taken up to nine weeks, they are effective 99.6 percent of the time; medication abortion is much safer than delivering a baby.

One of the two pills, mifepristone, is used just for abortions and thus is more difficult to access. But the other, misoprostol, has other uses (including stomach ulcers for men and women alike) and thus is widely available. Produced in India, misoprostol pills are available over the counter in many countries for less than $1 a pill – and misoprostol alone is about 85 percent effective in inducing a miscarriage.

Thus in many places where abortion is banned, misoprostol circulates widely and is used by itself to induce abortions. So following today’s abortion ruling, some women will be able to obtain mifepristone and misoprostol by mail from overseas or other states, and in addition a black market is likely to develop for misoprostol pills smuggled in from Mexico, Haiti and elsewhere. That’s what I’ve seen in other countries.

Third, won’t there be a backlash at this intrusion into family matters? Some rape victims won’t be able to get abortions and will tell heartbreaking stories of being forced to carry the rapist’s child. Some women won’t be able to get abortions and will die in childbirth. Some women will be forced to carry to term fetuses with malformations that lead to a child’s painful death shortly after birth.

In Poland, for example, a woman named Izabela Sajbor had a fetus with a severe abnormality that made it unlikely to survive pregnancy. But under Poland’s restrictive abortion laws, she was not permitted to terminate the pregnancy, even when her water broke at 22 weeks. She knew that without the abortion, she was in danger of sepsis.

“My life is in danger,” she wrote in a searing set of text messages to her mother and husband that were reported by The New York Times. “They cannot help as long as the fetus is alive thanks to the anti-abortion law. A woman is like an incubator.” Hours later, she died.

How can that be pro-life?

That’s why I find today’s ruling so sad. My plea to those campaigning against abortion: Why not work with people across the political spectrum to reduce the number of unwanted pregnancies – and thus the number of abortions – by improving sex education, by supporting teen pregnancy prevention programs and by making effective contraception more available?

We’re unlikely to find ourselves in a burning hospital, forced to choose whether to save the life of a mom or of a tray of frozen embryos. But as a country we are making a choice, through the Supreme Court ruling today, and we’re siding with embryos over women. That’s unconscionable.