The right to terminate a pregnancy is a cherished right among those who are pro-choice. In an effort to support that right, they often portray abortion as a difficult decision, chosen only after anguished contemplation. The reality of abortion is far different. Women have abortions for any reason or for no reason at all. That raises the question: Are there any bad reasons for having an abortion?
I’m not asking whether there are any reasons for abortion that should be made illegal. The right to an abortion, as it exists, requires no reason beyond the mother’s desire for a termination. Since the legal foundation for abortion rests, in large part, on the fact that continuing a pregnancy to term has a higher mortality rate than terminating a pregnancy, the right to choose abortion rests on the mother’s right to preserve her own life. Unless and until pregnancy becomes safer than termination (and there’s no reason to think that it would), the legal right to an abortion is going to remain unchanged.
My question is whether it is possible to make an immoral choice to have an abortion.
Consider:
Many years ago, an acquaintance called to discuss the medical aspects of termination. She confided that she was 7 weeks pregnant and planning to have an abortion.
It was not that she didn’t want a child, or that she couldn’t support one. After all, she had been married for several years and had been talking about having a child next year. It was just that having a baby in April (when she was currently due) was inconvenient. The late summer would be far better. She was planning to have the abortion and then get pregnant three months later when the timing would be right. That’s exactly what she did. She didn’t ask for my opinion and I didn’t offer it, but I couldn’t help wondering if convenience was really a morally justified choice for abortion.
Or:
I worked for a number of years at a clinic that served a particular ethnic community. In that community, boys were valued far above girls. Every set of parents wanted a boy, preferably as the first child. Many patients asked for ultrasound exams with the goal of aborting a female fetus. I consistently declined, pointing out that as a medical professional, I was required to have a medical reason for ordering a medical test.
In the country or origin of my patients, ultrasounds were freely available for the express purpose of identifying and aborting girls because there were less desirable. Is it sexism to abort girls or is it morally justified to use abortion as a means to adhere to cultural norms that value boys above girls?
Or:
An acquaintance was planning an abortion because her fetus had been diagnosed with cleft lip. The lip abnormality appeared to be the only problem; there was no associated cleft palate, a more serious medical condition. In addition, cleft lip is a cosmetic deformity that is easily repaired with plastic surgery. True, there would always be evidence of the repair, but there would be no functional impact of any kind.
The acquaintance understood and acknowledged that the defect was only cosmetic and could be easily repaired. However, she felt she was entitled to a perfect baby. She was honest in her desire to get rid of this imperfect one, and start over again. And that’s exactly what she did. Is it morally justified to have an abortion of a child who will not have a perfect appearance?
Is there such a thing as a bad reason to have an abortion? Or are all reasons, from convenience, to sexism, to desire for a physically unmarred child, valid reasons to terminate a pregnancy?
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I have a related question- when we had our 2 babies, the ultrasound was included as a part of the pre-natal care. It wasn't a specially ordered medical test. I don't understand how you could withhold the ultrasound from the patients. Now I object to anyone who would abort because of the sex of the baby, however I also object to you playing god and being condescending to your patients..
I wonder how the person that thought April was inconvenient is going to feel about 3:00am feedings... at all times of the year?
"I don't understand how you could withhold the ultrasound from the patients. Now I object to anyone who would abort because of the sex of the baby, however I also object to you playing god and being condescending to your patients.."
It happened 20 years ago when the standards for ultrasound were much more stringent. Even so, had the mother asked for an ultrasound to check her baby, I would have ordered it. Once she told me that she wanted it so she could abort her baby if it were a girl, I was not obliged to order it.
"In her world of "keep your laws away from my body" that meant that a fully developed, 8 lb. baby, 1 day from natural birth, could be terminated..."
What's the difference between that and infanticide? Did she address that issue?
"My brother dared me to, so I had to. I'm no chicken! LOL!"
"It seemed like the next logical step in my longstanding shameful self-secret cutting ritual."
"We ran out of cash for food and needed something to roast."
"I heard if you held your breath while you got an abortion you'd, like, get all high and stuff."
"My Mom joined a Satanic Cult, and All I got was this Lousy Abortion!"
"I'm going for the Guiness Book of World Records for Most Abortions in a Calendar Year!"
"The Pill makes me fat and my boyfriend hates condoms. This is lots easier and way more fun!"
"I really, seriously cannot afford a new wardrobe right now."
You are not a lawyer, or the Supreme Court, so this argument is weak.
And probably over in the next few years.
It's a legal medical procedure, and you know that. Shame on you, as a doctor, for even posting this.
There are no bad reasons becase there are no good reasons. It's not a bad or good decision, and implying that it is makes you a wing nut.
It's a decision.
What parameters do you choose in your practice in terms of OB-Gyn care ? I'm curious.
"It seemed like the next logical step in my longstanding shameful self-secret cutting ritual."
I know you are joking, but you are not far from the truth for some women. There is some thought that repeated failures to use birth control, and repeated abortions are a form of self abuse, analogous to self-starvation in anorexia, and cutting.
"There are no bad reasons becase there are no good reasons."
So you think it has been perfectly reasonable to abort literally tens of thousands of female fetuses through China, India and Southeast Asia (among other places)? That seems to you to be an entirely legitimate result of the freedom to have an abortion?
In the UK, which has some of the most lenient laws, a woman must obtain the permission of two physicians in order to get an abortion. Surely, there's a few physicians who'd sign off on all abortions, and a few who'd oppose all abortions. But there'd also be doctors like you who'd be in a position to question the morality of cases like the ones you've mentioned here.
But how sickenning.
Really. What an entirely ugly mask on the face of human spirit. I applaud you for your ability to bite your tongue in the office. Certainly, we must judge ourselves morally in this context. The whole thing reeks of Nazi strategies to create a "perfect" race! (besides Miss April)
I couldn't do it. I would have kicked them out of my office. I could not handle listenning to such shallow, insipid talk. (That's why you're a doctor and I'm not)
That being said, you know, if someone were to say, "I just can't do it. I've thought about it and I just can't bear carrying a baby inside me" with no reason whatsoever, I'd have more sympathy. Hey, it's your choice.
But when your reason reeks of self indulgence or an obvious distaste for those with some minor physical "failure"....ugh.
OK, now I'm just disgusted. I'm sorry those views are out there. I'd hope that the majority aren't that way.
Thanks. Great post. Got me rambling.
I believe that we should have the right to choose. But, along with that right comes stupid amoral decisions like the ones you highlighted. I just don't see anyway around it, if in fact we are allowed the right to govern our own bodies.
The alternative isn't acceptable to me.
"There are no bad reasons becase there are no good reasons."
So you think it has been perfectly reasonable to abort literally tens of thousands of female fetuses through China, India and Southeast Asia (among other places)? That seems to you to be an entirely legitimate result of the freedom to have an abortion?'
Obviously not the way you want to put it. But I will not back down on any woman's right to have an abortion. If you choose to paint it that China, India and (!!!) southeast Asia are all aborting on the basis of gender - well, go ahead and show me some statisitics.
Could you answer my question about how you dealt with the question of abortion as an option when you were a practicing ob-gyn?
"In the UK, which has some of the most lenient laws, a woman must obtain the permission of two physicians in order to get an abortion. Surely, there's a few physicians who'd sign off on all abortions, and a few who'd oppose all abortions. But there'd also be doctors like you who'd be in a position to question the morality of cases like the ones you've mentioned here."
I did not realize that.
"Obviously not the way you want to put it."
But that's the what has been happening. Tens of thousands of female fetuses have been aborted because boys are valued above girls.
I think I'm part of a large crowd in feeling (although most people have difficulty expressing this in terms firm enough to stand up in a legalistic discussion) that while a fetus is not a baby, it's not nothing either. A fetus is not a baby and it's not a tumor and it's not an extension of the mother and not even by analogy is it like any of these things. A fetus is like a fetus, and most people, even pro-choice people, seem to feel instinctively that a fetus has a certain amount of value - not more value than the person carrying it, not more value than that person's autonomy, but not no value either. On the other hand, even the most rabid anti-choice believers have difficulty pretending they feel the same emotions for a fetus that they feel for a human baby. I read a thought experiment the other day (and I've forgotten who raised it, sorry) that asked if a dozen fertilized eggs were sitting in a petri dish on a table and a baby were also on the table and the room were on fire and you only had time to grab one, which would you grab? Logically the anti-choice believer would have to grab the petri dish, thus saving 12 lives instead of one life. Does anyone believe anyone but a stone cold psychopath would actually do this?
So yeah, I believe there are bad reasons to have an abortion. I'm probably going to differ from you in that I feel the cleft lip is a fine reason - that particular mother did not need to bring that particular baby into the world. It wouldn't have been fair to the baby to be born to her. Which says a lot more about the mother than about the baby.
A.T., you are being a lunatic here. My support of reproductive choice is not causing what you described above.
Given your extreme beliefs, I wonder if you will provide any alternative choice to a pregnant woman? I wonder what you do as a Dr.?
I think your reproductive beliefs should be prominent as an Ob-Gyn.
Specifically about this subject and...I'll read it.
Take care.
"I think I'm part of a large crowd in feeling (although most people have difficulty expressing this in terms firm enough to stand up in a legalistic discussion) that while a fetus is not a baby, it's not nothing either. A fetus is not a baby and it's not a tumor and it's not an extension of the mother and not even by analogy is it like any of these things. A fetus is like a fetus, and most people, even pro-choice people, seem to feel instinctively that a fetus has a certain amount of value - not more value than the person carrying it, not more value than that person's autonomy, but not no value either."
You're right. A lot of people feel that way, but it is difficult to determine how best to give expression in the law to that sentiment. We've taken the easy way out by allowing anyone to have an abortion for any reason, but most of us don't think that all reasons are morally supportable.
"just tell me what you believe"
Why? What difference does it make what I believe? It's not about me; it's about the reasons for abortion.
It seems like (correct me if I'm wrong) that in your last comment you might be blending the morally unacceptable reasons to have an abortion into the law.
If women need a "good" reason to get a legal abortion they will choose a reason from a list of acceptable reasons.
But maybe this isn't where you are going?
"Obviously not the way you want to put it."
"But that's the what has been happening. Tens of thousands of female fetuses have been aborted because boys are valued above girls."
I really want to know what your take is on reproductive health, birth control and how you're practicing. Are you retired? My curiosity is not going to wane.
Your considerations: 1) I find this one incalculable in its coldness. I offer that the woman in question be committed and examined to try and treat her sociopathic tendencies. Someone who does this has no business being a mother. 2) No. Period. China's currently having a lil problem due to this; namely that their precious sons have no women to marry. 3) This is the most justifiable of your examples, although I'm still going to say no. My closest friend was born with a cleft lip and had to have the surgery. This hasn't affected him at all, in fact he's considered very handsome and had quite a list of girlfriends in high school. Someone who wants to abort because of something like this needs to be educated what the condition really is.
So, as an M.D. who blogs here, could you answer my questions?
"I guess I should have said your beliefs as a medical doctor. Or practicioner."
Those are irrelevant to this discussion. We're not discussing me; we're discussing the reasons for abortion.
Hmmm. Let's look at the juxtaposition of these statements:
"In an effort to support that right, they often portray abortion as a difficult decision, chosen only after anguished contemplation."
I would think that abortion often is a difficult decision. Meaning I would guess in the MAJORITY of cases. But I'm no expert here; maybe I'm wrong?
"The reality of abortion is far different."
So it's not often a difficult decsions? What proportion of your patients displayed as little anguish as those in your examples? 50%? 10%? 1%? For what proportion was it a difficult decision? What data do you have to back up this assertion?
"Women have abortions for any reason or for no reason at all."
Yes. And people do all kinds of things for little or no reason at all. But the MAJORITY of people do not. Should we eliminate the rights of the majority because of the abuses of a tiny minority?
Also what would you consider a GOOD reason for an abortion? Maybe the recent situation in Brazil?
- Brazilian Catholic Church contests abortion for raped 9-year-old. The 9 yr old, 80 pound child was carrying twins following an alleged rape by her stepfather, who reportedly has been abusing her since she was 6 yrs old.
Well? Personally, I would say that is a GOOD reason for an abortion. Do you agree? Or does this fall into the situation of "any reason or for no reason at all."
I'm sorry for wandering away from the topic of abortion, but with all that said, I believe ALL reasons for an abortion are bad....even in the case of an ill Mother. Now, before you get angry and indignant about it, let me explain. If a pregnant woman is deathly ill, the doctors should do all they can do to heal her...including prescribing medications and treatment that MAY harm the unborn child if that's truly the best route for the Mother's health. If in the process, the baby dies, that is NOT considered an abortion. The mother's life should be considered first, unless she chooses to offer up her life for the life of the baby.
I get so tired of hearing about the "woman's" rights....what about the "baby's" rights? You can call the baby within the womb a "fetus," but that doesn't take away the life within that womb. A "fetus" within the womb may not look exactly like you or me, but neither does a hundred year old person. Many changes and transformations take place from conception to old age. Abortions are selfish, thoughtless and completely unethical.
There are no good reasons to have an abortion....only bad reasons.
So, as an M.D. who blogs here, could you answer my questions?
"I guess I should have said your beliefs as a medical doctor. Or practicioner."
Those are irrelevant to this discussion. We're not discussing me; we're discussing the reasons for abortion.
A few thoughts:
Much about motherhood is inconvenient. If you're going to abort your baby based on the month in which it would be born, you're probably not ready for the realities of parenting. Illnesses and accidents, for example, cannot be scheduled.
China recently discovered that the gender imbalance in their country led to all kinds of undesirable social issues. According to their long-term studies, the lack of available young women for normal adult relationships led to gang violence, dramatically increased crime and a rise in homosexuality. China changed their one-child policy to a two-child policy in hopes that parents would have and raise at least one female child in order to restore the gender balance. Who's to say that the same imbalance and resulting problems can't happen here?
The Nazis thought that it would be good to have a blond-haired, blue-eyed race. Technology is advancing to the point that we will soon be able to genetically test for a whole host of traits: eye color, hair color, height, intelligence, athletic ability, etc. What's to stop women from having as many abortions as necessary to get a perfect, made-to-order baby born at the most convenient time?
An acquaintance of mine claimed to be "allergic" to all forms of birth control, and had no interest in using the rhythm method or giving up sex. At last count, she had 6 kids and 8 abortions. She's probably still going; I wouldn't know. I ended my visits when I discovered that I was unable to keep my mouth shut when she began describing her "inside-out" uterus that had been "ripped to shreds" from the abortions and pregnancies. She said that her doctor told her that she wouldn't survive another abortion or birth; I'm ashamed to say that I wasn't all that unhappy about that prospect. Nor is that attitude rare. Another acquaintance described a conversation in which a bunch of women at an abortion clinic were comparing the number of previous abortions they had. One said 7, another 9. They seemed to think it was funny.
These women should also consider the potential social consequences of these actions. What happens if they can't get pregnant again after having had an abortion for a silly reason? That's potentially a life-altering event. Your husband may not be so happy with you, especially if he has to whack off into a jar on a regular basis in order to attempt IVF. Neither will the grandmother who desperately wants grandchildren after reflecting on the fact that you had the chance and threw it away over nothing. Your friends might not be so sympathetic to your plight either. Your entire support network may disappear, and support is something you'll need if you're involuntarily infertile.
We desperately need a compromise. We cannot continue to allow women to use abortions as birth control; nor as a device to schedule parenthood by a few months; nor to allow for "perfect" children. Abortion rights cannot be absolute and without consequences. We need to introduce some morals before it's too late. Is it your body, and your choice? Yes, it is. But you're also making the choice to engage in the acts that lead to pregnancy. If you're not willing to accept the potential results, you need to examine the alternatives to abortion. Like abstinence. Birth control, in many, many forms. The morning after pill. The new version of the IUD, for longer-term birth control without the need to personally insert anything or remember to take or apply anything. There really aren't many valid excuses for a woman to become pregnant if she doesn't want to be.
I believe that if we leveled some restrictions on abortion, we'd have less unwanted pregnancies happening in the first place. Some ideas:
Allow abortion without limitation in the event of rape, or imminent danger to the life of the mother (none of that pregnancy-is-more-dangerous bull; you play, you pay). Limit the number of abortions per woman by establishing a secure national database and requiring photo ID with a social security card. Require parental notification (not consent)for minors. Parents have the right to know what's happening with their children; they can be an excellent source of support and guidance (exception to the notification clause for minors with abusive parents), and can assist with birth control to avoid a repeat pregnancy. Enact laws requiring detailed explanation of birth control methods in schools (for teens, with opt-out clause) while also promoting abstinence; allow teens to obtain birth control at school (through school based health centers or required school visits by providers); provide thorough, honest and detailed information regarding abortion, including potential physical, social, emotional and mental-health consequences. Use ultrasounds, amniocentesis and genetic testing for diagnostic purposes only; prevent providers from presenting patients with details not directly relevant (sex, genetic traits not resulting in deformity or disease, etc.). Establish a national education campaign regarding medications, herbal supplements and anything else that can potentially interfere with birth control.
I don't know what the answers are. But I do know that someone needs to figure some out, the sooner the better.
You're not a wing nut.
Healthcare practitioners are allowed to have opinions. They are also allowed to decide whether or not they're going to perform certain procedures, including abortions. There are many OB/GYNs and family practice docs who refer their patients elsewhere for abortions, and there's absolutely nothing wrong with that practice. In fact, I'd go so far as to say that it's better that way. If I personally believed in having an abortion, I would want it to be done by an experienced provider with experienced assistants, none of whom would later be at risk for an emotional crisis because of my decision.
By the way, are you aware of the fact that nurses often have the gruesome job of piecing the aborted fetus back together in order to ensure that every part was removed and no infection will result? I couldn't imagine forcing someone to do that because of me if their personal beliefs prohibited the practice.
Dr. Amy is doing nothing wrong. I'm not really sure why you have chosen to attack her, rather than genuinely participate in the questions she's raised.
I assume from your posts here that you are vehemently pro-choice. I'm interested to know--legality aside--whether you believe there's nothing wrong with aborting because you'd rather have your baby in July than April?
As for the matter of gender-based abortions: this is true. As I stated in my post, China is experiencing some serious social issues because of this practice. They also have orphanages overflowing with the female children lucky enough to have had parents who didn;t just abandon them out in some rice paddy, as is often the case. There is also the issue of infanticide of females, often done by inserting needles through the soft spot on an infant's skull and into the brain. If you Google this subject, you're going to find plenty of material. If you'd rather have someone do it for you, I'm happy to link some articles to back up my posts.
I'm not trying to take away anyone's right to do what they want with their own body, but we need to accept that people must take some responsibility for their own actions. We also need to seriously examine potential issues that await us down the road, and develop methods to deal with them before things get out of control.
It was struck down in 1988. Decades earlier a doctor, Henry Morgantaler, opened a private clinic in direct defiance of this law. He was tried numerous times for murder, but they could never find a jury that could reach a consensus and convict him. Eventually the Canadian Supreme Court realized it was a waste of time, that there would never be any consensus on this issue, and that it had to respect the right of women to make a personal moral choice.
I agree. Some people see the fetus as life, some see it as only collection of muscle and cells. There are good arguments for both. And there always will be. So the real question is whether it will ever be ethical or moral to take decision out of the hands of the mother.
I don't. Where consensus is impossible, this should remain a private moral choice.
There are, however, many terrible reasons to conceive a child.
Falls under my second premise. Failure to a) use effective birth control, or b) accept the potential consequences of intercourse are lousy reasons to conceive. Once an unwanted child is conceived, one can argue any number of ethical and practical points for and against abortion, but simply not wanting the child is a "good enough" reason for abortion.
Seems to me the initial failure (conception) is unequivocally bad, morally and practically.
"When is RU486 going to come out here?"
Chemical abortion is widely available here and has been for some time. Contrary to the expectations of proponents, it is distinctly unpopular. That's because it takes longer, is more painful, and requires the woman to look at what has been aborted.
That the Chinese have had a history of aborting female fetuses is fine. The social consequences are the price the society pays for having a fixation on male progeny. Now, not so many girls are being aborted.
"The reality of abortion is far different."
No, it's not. You seem suggest that women who have abortions are cavalier and irresponsible, just like you suggested that women with kids who leave their husbands are cavalier and irresponsible. You threw out a few anecdotes and no data. Crap.
"You seem suggest that women who have abortions are cavalier and irresponsible,"
What percentage of women who have an abortion have already had one in the past? What percentage of abortions are accounted for by women having their second, third, or fourth abortion?
Let me guess. You have no idea. Why not do a little research and report back to us?
"What percentage of women who have an abortion have already had one in the past? What percentage of abortions are accounted for by women having their second, third, or fourth abortion?"
Why is this a relevant question? How is taking this into consideration respecting the autonomy of the patient?
sickofstupid wrote:
"By the way, are you aware of the fact that nurses often have the gruesome job of piecing the aborted fetus back together in order to ensure that every part was removed and no infection will result? I couldn't imagine forcing someone to do that because of me if their personal beliefs prohibited the practice."
I find it hard to believe that a nurse all of a sudden found themselves involved in abortions without knowing that this was a job duty. No one forces that nurse to work in a capacity where she will find herself participating in abortions. There are other jobs. If a nurse finds that the only job available to her is one where abortions will be a job duty, that nurse needs to decide whether the benefit of earned income out ways the cost of violating their morals. But this is a personal decision.
I used to be straight up pro-life, but then I got older, and learnt more, and saw freinds who had abortions for heart-rending reasons cry over the babies they wished they could have had.I think it is bad to have an abortion if it's an "easy choice", not to say that in some cases the reasons are not so clear cut that there is a clear desicion, but it shouldn't make it easy.
I have considered abortion myself, and have come to the conclusion that there would have to be some pretty dire circumstances for me to be able to go through with it, I can't fathom what could make a woman laugh over the number of abortions they've had.
Abortion as birth control is at best reckless and at worst moraly reprehensible and potentialy fatal, some people it seems should just keep their legs shut.
The problem with legislating on a matter like this is the wide spectrum of opinions, democracy is hard when there is no modal group. My way of approaching the subject is to state what i think, and in no way try to imply that anyone should agree. That includes physicians, noone should be forced to carry out an abortion on another. There will always be people willing to carry out an abortion to match the reason of the person who wants one.
I'm not accepting your statement that it's "...because it requires the woman to look at what's been aborted."
Approval by the FDA took a long time,never mind making it legal, and many women don't know that it's available for them.
And I'm willing to continue the discussion with anyone. Wing nuts included.
Check me out!
"What percentage of women who have an abortion have already had one in the past? What percentage of abortions are accounted for by women having their second, third, or fourth abortion?
Let me guess. You have no idea. Why not do a little research and report back to us?"
I'm not making any claims. Your quote above suggests that women are OFTEN being cavalier about abortion.
YOU are the one claiming that the portrayal of "abortion as a difficult decision, chosen only after anguished contemplation" is a lie.
YOU are the one claiming that "the reality of abortion is far different," without providing a shred of evidence beyond a few anecdotes to back this up.
I'm challenging you to prove it, instead of spewing out shaming, unsubstantiated crap. Instead of painting women who go through abortions as callous, carefree and cold.
And I'm saying you can't. Because you're full of crap.
Because here is the data.
MYTH: Women are using abortion as a method of birth control.
In fact, half of all women getting abortions report that contraception was used during the month they became pregnant. Some of these couples had used the method improperly; some had forgotten or neglected to use it on the particular occasion they conceived; and some had used a contraceptive that failed. No contraceptive method prevents pregnancy 100% of the time.
If abortion were used as a primary method of birth control, a typical woman would have at least two or three pregnancies per year - 30 or more during her lifetime. In fact, most women who have abortions have had no previous abortions (52%) or only one previous abortion (26%). Considering that most women are fertile for over 30 years, and that birth control is not perfect, the likelihood of having one or two unintended pregnancies is very high.
"Judgemental assholism"