Archives for posts with tag: abortion

Is this a bowl of eggs or a a bowl of chickens?

fetilized eggs

The eggs are fertilized, so by the logic of those who believe a fertilized human egg is the equivalent of a human being, this is indeed a bowl of chickens.

And this is a fried chicken:

fried egg

 

The claim that fertilized eggs are human beings reminds me of the joke (often attributed to Abraham Lincoln),

Q: If you call a tail a leg, how many legs does a dog have?

A: Four, because calling a tail a leg doesn’t mean it is one.

One of the main arguments in Hobby Lobby’s case against providing comprehensive contraception is that  morning after pills and IUDs are abortifacients.  Many have pointed out that morning after pills (which are NOT the same as the pills that actual do induce abortion) work by preventing ovulation, and IUDs generally work by thickening cervical mucus and otherwise creating an inhospitable environment for fertilization to occur.  Olga Khazan offers a concise explanation of the whole thing at The Atlantic.

The only method that could possibly meet any definition remotely connected to abortion is the Paraguard IUD, which when inserted up to 5 days after intercourse, appears to prevent pregnancy in ways that no one has entirely determined.  It is remotely possible that one of these ways could be to prevent the implantation of a fertilized egg.

This hypothetical fertilized egg has not developed into an embryo, much less a fetus, even less a baby (or child, adolescent, adult or senior citizen).  You can see slide show showing the process of ovulation to implantation here.  The passion with which some defend the life of a fertilized egg is mirrored only by the passion with which some defend an elephant fetus as a human being (seriously, click the link–the anti abortion crowd passionately defended the humanity of the elephant fetus).  Just in case you are curious, here is a photo of a fertilized human egg:

fertilized egg

And here is a photo of an elephant fetus:

elephant fetus

By the logic of the “personhood” movement, the top image is a person and the bottom image is an elephant.

There are many problems with assigning human status to fertilized human eggs (or elephant fetuses).  But the greatest problem comes when a woman becomes not a human being in her own right, but the vessel for the development of potential humans.

Thus, the argument that Hobby Lobby and others with their beliefs make is that it is immoral for a woman to make her body inhospitable to the implantation of a fertilized egg.  We already know that the methods of contraception that they claim prevent implantation actually prevent fertilization in the first place.  But let’s go ahead and pretend that implantation of a fertilized egg might be prevented.

Why is this a problem?  About half of fertilized eggs do not implant even when a woman is not using any form of contraception at all.  By the logic of the anti-IUD crowd, women should be banned from doing ANYTHING that might interfere with implantation of fertilized eggs.  This might include things such as being underweight.  If a fetilized egg is more likely to implant in heavier women, shouldn;t we force all women to be the ideal weight for implantation?  In fact, if a fertilized egg is a person, and that “person” has the indisputable right to grow inside of another person until it decides it can survive on its own, perhaps we should force all fertile women to take drugs that make implantation more likely.

If women use contraceptives, including IUDs, they are actually less likely to expel fertilized eggs because the eggs are less likely to become fertilized in the first place.  Libby Anne at Love, Joy, Feminism has a great explanation of how using birth control is the best way to prevent the deaths of fertilized eggs/zygotes/blastocysts.  And as I have argued, if we really believed fertilized eggs to be human, we would insist on funeral services and other respectful disposal of them instead of allowing them to pass along with ordinary vaginal discharge (the fertilized egg would be expelled before menstruation; implantation occurs about 5 days after ovulation, but menstruation occurs about two weeks after).

Believing that a fertilized egg is a person does not make it so.  Believing that morning after pills and IUDs cause abortions does not make it so.  And believing that a woman is an obligatory vessel not deserving of human rights does not make it so either.

 

Dr. Patrick Johnson is the director of Personhood Ohio, “an organization committed [to] the restoring the personhood rights of unborn children through an amendment to the Ohio constitution.”

Dr._Patrick_Johnson

In case you are wondering if a woman is a person in Johnson’s intolerant mind, here is the Personhood Ohio argument against abortion:

The Ohio constitution states the following:

Article 1, Section 1: All men are, by nature, free and independent, and have certain inalienable rights, among which are those of enjoying and defending life and liberty, acquiring, possessing, and protecting property, and seeking and obtaining happiness and safety.

Article 1, Section 16: All courts shall be open, and every person, for an injury done him in his land, goods, person, or reputation, shall have remedy by due course of law, and shall have justice administered without denial or delay.

Thus (according to Personhood Ohio):

The Ohio Personhood Amendment will insert Section 16(b):

“Person” and “men” defined:

(A) The words “person” in Article 1, Section 16, and “men” in Article 1, Section 1, apply to every human being at every stage of the biological development of that human being or human organism, including fertilization.

Apparently if one gives constitutional rights to defend life and liberty and obtain happiness and safety to fertilized eggs but not women, then we have personhood.  Because everyone knows that women are not people.

In any case, Johnson has a new obsession, and that is preventing children and married men from seeing women’s breasts.  here is another area in which a woman’s breast becomes separate from the human breast.  All people have nipples and breast tissue.

There are innumerable arguments about the sexualization of women’s breasts being a social construction.  Here are a few points:

In many indigenous societies, women go topless as a matter of course, and the exposure of breasts is incidental to existing.  Here is a woman farming in Cameroon:

woman farming

In the Victorian era, when women’s sexuality was repressed and showing an ankle was scandalous, breastfeeding was a sign of mothering, which was not considered sexual.  Thus, the ankle, not the breast, was sexualized:

victorian breastfeeding

Throughout history, Mary, who was so desexualized that many worship her as a virgin, has been depicted breastfeeding with exposed breasts:

Maria-Lactans-Mary-and-Child-detail-by-Gerard-David-1490-640x784

And going topless on the beach is typical for women of all ages and sizes in much of Europe (not just for the stereotypically sexy).

Yet we have worked Americans into such a tizzy about human women’s breasts that I once had a class of fifth graders completely freak out when exposed to this image:

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This is just black lines.  The person represented doesn’t even have a face.  Yet the very idea of a breast is somehow outrageous.  It is somewhat like thinking one must dress a zucchini in a burquah.  Or like the Shel Silverstein poem about putting a bra on camel humps.

Men have breasts, and while people might not like to see them when they are large, they can be exposed with no one challenging the legality of exposure:

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Yet a flat chested women’s breast are somehow obscene:

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Women’s and men’s breasts are not particularly different.  It is actually possible for men to breastfeed.  Seriously.  There’s even a very short, highly amusing movie about it, “Milk Men,” which you can watch here.

But preventing women from exposing their breasts, particularly when exposure is incidental to breastfeeding, is a way to have men define women’s sexuality and thus demand to control women’s bodies.  When people tell women to cover up, sit in toilet stalls, or stay home because they are feeding babies, they are telling women that they cannot be female in public.  They are privileging certain people’s perceptions of a woman’s body over the actual woman in that body.

People have nipples.  Everyone is born with them.  It is not an exciting concept:

nipples

Can you even be certain which of these belong to women and which to men?

Then whose body will you know to control?

There are two legal ways to have an abortion in the United States, through surgery or medication.  Medication abortions are those induced through taking mifepristone pills (which were called RU486 when they were developed).  Mifepristone is not Plan B (levonorgestrel, a synthetic form of progesterone) or Ella (ulipristal acetate, which suppresses progesterone production). Plan B and Ella have nothing to do with abortion; both stop ovulation in order to prevent pregnancy.  Mifepristone causes the expulsion of an embryo in an established pregnancy, much like a spontaneous miscarriage.

There are three main restrictions put on medical abortions in the United States:

  1. Pills must be provided by a licensed physician (not a nurse practitioner, nurse midwife, or other qualified health practitioner)
  2. Pills must be provided through an in-person patient-physician visit
  3. Pills must be provided according to the original FDA protocol (much lower doses of the pills have since been found to be effective)

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White states have the least restrictive policies, and dark green states have the most restrictive.  You can find an interactive version of this map at the Mother Jones website (the map does have some inaccuracies; Iowa and Arizona in particular currently have stays against some of their restrictions).

Restriction #1: Licensed Physicians 

That the pills can only be provided by a licensed physician is a restriction that is not solely promoted by opponents of abortion. It is a restriction in place in states that receive an “A” from NARAL Pro-Choice America on choice related law (find your state’s laws and grade here).

Physicians often oppose legislation that would allow medical practitioners who are not physicians–including midwives, advanced practice nurses, or pharmacists–to provide care that is within their scope of training.  Doctors often make the same argument that abortion opponents make: that they are trying to keep women “safe”  (e.g. doctors protect women from midwifery care in New York; doctors protect people from receiving primary care from nurse practitioners in Texas; doctors protect people from vaccination by pharmacists in Florida).

In her novel The Handmaid’s Tale, a story of a futuristic society in which the United States is taken over by the Christian Right, the characters identify differences between “freedom to” and “freedom from.” If you haven’t read the book, go get it and read it immediately.  In any case, Aunt Lydia, who trains women to accept their role in the new society, says,

There is more than one kind of freedom…Freedom to and freedom from. In the days of anarchy, it was freedom to. Now you are being given freedom from. Don’t underrate it.

“Freedom to” gives women agency and choice.  “Freedom from” restricts them in exchange for safety and protection.  In the novel, “freedom from” involves wearing burkah-like clothing, not being allowed to read, and bearing children for religious couples with political standing.  This supposedly frees women from rape, responsibility, and thinking.

In any case, the paternalistic “protection” of making physicians the only practitioners who can provide medication abortions seems to have an underlying agenda–moral or financial–that has nothing to do with women’s health.

Restriction #2: In-Person Physician Encounter

Telemedicine is increasingly used to serve rural communities in particular.  Many people in rural areas are far from hospitals and other sources of medical care.  You can see in this map that there are large areas without critical access.

hospital access

To provide needed care in the Mountain West, St. Luke’s Health System has established a virtual intensive care unit, which monitors 69 critical care beds in 5 hospitals and provides critical care consultation in 5 emergency departments in Idaho.  Here is a video about it:

Critical care is being offered to people on the brink of death through telemedicine, but some states have seen fit to decide that medication abortions offered through telemedicine are dangerous.  Over the past year, this restriction has generated attention in Iowa, where Planned Parenthood has safely offered medication abortions through telemedicine to thousands of women since 2008.  In September 2013, the Iowa Board of Medicine, made up of political appointees, voted to ban telemedical abortions, in addition to imposing other restrictions and requirements.

Delaying access to abortion care narrows women’s options, as medication abortions are only considered safe through the first 9 weeks of pregnancy.  After 9 weeks, a surgical abortion becomes a woman’s only abortion option (see here for a comparison of surgical and medication abortions).  While there are risks and side effects from medication abortions, most of them are uncomfortable or annoying rather than dangerous.  According to the FDA, no deaths have been directly attributed to medication abortions.

As Jill June, President and CEO of Planned Parenthood of the Heartland, said,

It’s evident that this ruling was not based on the health and safety of women in our state – it was based on politics. There was no medical evidence or information presented to the Board that questions the safety of our telemedicine delivery system. It’s apparent that the goal of this rule is to eliminate abortion in Iowa, and it has nothing to do with the safety of telemedicine. The reality is, this rule will only make it more challenging for a woman to receive the safe health care she needs.  Iowa women deserve to have access to the newest medical technologies and all of the heath care services they need, regardless of where they live.

A judge halted Iowa’s ban through a stay until the court case is settled.  The Iowa legislature, which is controlled by Democrats, was unable to pass a bill to instate the restriction through law; however, this restriction is in place in other states.

Restriction #3: The Original FDA Protocol

The Guttmacher Institute offers this chart comparing the original protocols for administering mifepristone pills established by the FDA, and the newer protocols adopted by the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) based on evidence that has emerged since the FDA’s original approval:

Screen Shot 2014-04-02 at 10.00.16 PM

Abortion opponents have argued that adhering to the FDA protocols protects women, even though the Agency for Healthcare Research and Quality, a government agency as is the FDA, has published guidelines for mifepristone administration in their National Guidelines Clearinghouse.  The following guideline is level A evidence, the highest and most reliable evidence available:

Compared with the FDA-approved regimen, mifepristone-misoprostol regimens using 200 milligrams of mifepristone orally and 800 micrograms of misoprostol vaginally are associated with a decreased rate of continuing pregnancies, decreased time to expulsion, fewer side effects, improved complete abortion rates, and lower cost for women with pregnancies up to 63 days of gestation based on last menstrual period.

I have argued against non-FDA-approved use of Pitocin to induce labor electively.  However, there is no evidence base for the use of Pitocin for non-medically indicated deliveries.  As you can read in my previous posts (here and here), Pitocin is a high-alert medication with many dangerous side effects.  Its elective use has no known benefit other than convenience.  The new guidelines for mifepristone use, on the other hand, are based on evidence and involve giving a woman less medication rather than more.

That legislators would ignore a large, reliable body of scientific research does not inspire my confidence in their understanding of safety.  If they really care about the health and safety of women and babies, restricting off-label Pitocin use would be a much more effective technique.

It should be noted that while a law was passed in Arizona imposing this restriction and was upheld by a federal judge in Tuscon on April 1, 2014, the 9th Circuit Court of Appeals issued a stay on the legislation on April 2.  Thus, the only state implementing this restriction as of April 2014 is Texas.

If you view yourself as a human rather than a political pawn, you might want to say so.  If you value your freedom to rather than your freedom from, you might consider fighting for that freedom.  And if you are a woman in Texas who cares about her health, you may want to move.

Cosmopolitan (really!) has published an amazing interview with Dr. Katharine Morrison, the physician who worked with the abortion provider Dr. Barnett Slepian, who was murdered by “pro life” activist James Kopp in 1998.  She subsequently took over the Buffalo Women’s Clinic where they practiced.  In the intervening years, she developed an interest in homebirth as a women’s rights issue and decided to open a birth center so that her clinic would truly offer comprehensive reproductive services in a woman-centered environment.  It is only the second birth center in the entire state of New York (the other is in Brooklyn).

Unlike many obstetricians who vociferously oppose homebirth, Morrison has actually witnessed homebirths.  And as has happened with other obstetricians who have taken the initiative to learn about homebirth midwives and attend homebirths, she underwent a conversion.  She says that she went to a meeting led by Certified Nurse Midwife (CNM) Eileen Stewart, who was giving up her homebirth practice because she couldn’t find a collaborating physician.  Morrison recalls,

It occurred to me that, although I had delivered 2,000 to 3,000 women, I had never actually seen a natural birth.

Some obstetricians insist that it is ridiculous to say that OBs are not familiar with natural childbirth.  They will have to take this up with Dr. Morrison.  In any case, she asked Stewart to take on a few clients and agreed to be the collaborating OB.  Here is her response to the experience:

It’s a different culture of birth. A woman isn’t subjected to anything she doesn’t want. She doesn’t need an IV [for drugs or fluids]. She can eat and move around. No one’s checking her every hour. She can go at her own pace, and even have a water birth. There’s no rush to cut the umbilical cord as there is at a hospital. And if labor is progressing slowly, no one’s pressuring the patient to have a C-section, as can happen at a hospital. All of these things were part of my routine in my previous practice. But when I saw this woman-centered care, I was hooked.

Although Morisson is opening a freestanding birth center, not a homebirth service, she observes the similar reactions of those opposed to abortion and those opposed to homebirth:

The same contempt that people have for women choosing to terminate a pregnancy and the person providing that care, I’ve seen for women who want to have natural births and for the women providing them. It’s this idea that these women are selfish and insufficiently caring about these babies.

Women generally care passionately about being good mothers and having babies who will have all of the resources they need to grow to be thriving adults.  How and when to bring a child into the world are two sides of the same coin.  Women’s autonomy in deciding where and how to give birth is just as important as autonomy in deciding whether to give birth at all.

Read the whole interview: “Meet the Doctor Who Opened a Natural Birthing Center in Her Abortion Clinic

There is an excellent piece in the Huffington Post by United Church of Christ minister Rev. Emily C. Heath

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(FYI I am not in any way affiliated with the UCC).

Heath offers a 10 question quiz to determine whether your religious liberty is being threatened.  Here is the quiz:

My religious liberty is at risk because:

A) I am not allowed to go to a religious service of my own choosing.
B) Others are allowed to go to religious services of their own choosing.

A) I am not allowed to marry the person I love legally, even though my religious community blesses my marriage.
B) Some states refuse to enforce my own particular religious beliefs on marriage on those two guys in line down at the courthouse.

A) I am being forced to use birth control.
B) I am unable to force others to not use birth control.

A) I am not allowed to pray privately.
B) I am not allowed to force others to pray the prayers of my faith publicly.

A) Being a member of my faith means that I can be bullied without legal recourse.
B) I am no longer allowed to use my faith to bully gay kids with impunity.

A) I am not allowed to purchase, read or possess religious books or material.
B) Others are allowed to have access books, movies and websites that I do not like.

A) My religious group is not allowed equal protection under the establishment clause.
B) My religious group is not allowed to use public funds, buildings and resources as we would like, for whatever purposes we might like.

A) Another religious group has been declared the official faith of my country.
B) My own religious group is not given status as the official faith of my country.

A) My religious community is not allowed to build a house of worship in my community.
B) A religious community I do not like wants to build a house of worship in my community.

A) I am not allowed to teach my children the creation stories of our faith at home.
B) Public school science classes are teaching science.

In response, many commenters on the article objected to Rev. Heath’s dichotomies.  I have reposted all quotes as the authors wrote them (including errors).

Ready 1923 says,

My religious liberty IS at stake when the govenment forces religious institutions and employers to cover contraception and abortifacients against their deeply held religious beliefs, or face crippling fines.

cfisher 000 says

Fixed it for ya:
A) I am being forced to subsidize with my money an activity (sometimes murder) I religiously object to
B) I am unable to force others to not use birth control.

Stephen Schaefer says

I didn’t see the option on number three for “I am being forced by the government to finance the murder of an innocent human being”

Let’s leave aside the arguments about whether the federal government actually provides funds for abortion (it does not).  And let’s also leave aside the fact that we know that birth control does not act as an abortifacient.  Let’s suppose instead that tax payer money was indeed going to fund abortion and contraception, even non-existent contraception that did act as an abortifacient.  Surely people can protest that–it’s any American’s right to have an opinion, to state it, and to use legal means to try to get others to adopt it.

But let’s also imagine a society with an “opt out” method of paying for Federal services.  For instance, Quakers and others are strongly against all wars for religious reasons.  While they are able to opt out of fighting in wars in accordance with their religious beliefs, they are not able to opt out of paying for them.

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People are opposed to all kinds of things that Federal taxes pay for, from subsidies for dirty energy to food aid for poor people (depending on one’s political persuasions).  But we have a Federal budget that pays for all kinds of things, some of which we like, and some we don’t.  Some we REALLY, REALLY don’t.  And yet we are all expected to pony up for the whole package anyway.

If your religion supports supports marriage equality for same sex couples, your tax money still went to defending DOMA.  If your religion is say, The Church of the Holy Cinder Block, your taxes still fund federal construction projects that treat cinder blocks as mere building material.

Even within the realm of health care, many people have health care dollars paying for processes they may oppose religiously, morally, or ethically. I personally object to high costs of pregnancy and birth interventions that also lead to high infant and maternal mortality.  We also pay for all kinds of care we ourselves may not use, such as Medicare for the elderly.  Those of us under 65 don’t even know if we will live long enough to use Medicare (or if it will still be around if we do).

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In fact, plenty of public money (state and federal) goes to anti abortion and anti-contraceptive activities, such as the $170,000 spent on funding South Dakota’s anti-abortion law, or the $650,000 Texas has spent fighting for anti abortion laws over the last two years, or similarly huge pots of taxpayer money spent in North Dakota, Idaho, and Kansas.  I do not support any of this spending, and neither do many others.  Yet our tax money supports fighting for laws that we oppose.

It is unfortunate that we do not all agree on how collective tax money should be spent.  Consensus among 300+ million people is unlikely, which is why we have a system of representative government.  If you want to pay for all of what the government provides on a piecemeal basis, only funding what you want, use, or support, you need to stop living in a country with other people in it.

I am away for a bit and leave the following to stimulate your mind and feminist sensibilities in my absence:

Updates on Marlise Munoz (see Living Wills are Not for Incubators)

Recent Thoughts on enforcing the Contraceptive Mandate (see Contraception and Forced Pregnancy and Reproductive Health, Undue Burden, and the Church of the Holy Cinder Block)

New Abortion Restrictions (see Questions from Priests for Life and “Hard’ Questions about Abortion)

 

cinderblock

Before a woman has an abortion, it is not considered and “undue burden” for her to endure a 72 hour waiting period (not including weekends), submit to (and pay for) a medically unnecessary ultrasound, or undergo a more dangerous abortion procedure when legislators find the safer procedure too gory.

On the other hand, for religious institutions that wish to be excluded from the ACA’s contraceptive mandate, filling out and sending a short form is too much to ask.

The New York Times ran an editorial, “Mistaken Ruling on Contraception” on 12/26/13 in which they describe the ruling of Federal District Court Judge Brian Cogan (a G.W. Bush appointee).  Cogan ruled in favor of two high schools and two health care systems that “requiring religious-affiliated entities to inform insurance administrators that they wish to exclude contraceptive coverage — which some already do” is  “a ‘substantial burden.’”  The editorial further points out,

This case is among dozens challenging the birth control mandate. The Supreme Court agreed to hear two cases involving secular for-profit companies. What Judge Cogan missed, and the justices need to recognize, is the threat to religious liberty comes from employers trying to impose their religious views on workers.

I have discussed the imposition of religious beliefs on others in Catholic hospitals, where health care workers are not only prohibited from performing certain procedures, such as abortion, but are prohibited from telling patients that such procedures are an option, even when withholding such information is life-threatening to the patient (see full post here).

It seems religious beliefs are accommodated when they suit a lawmaker’s personal world view.  If we think about it, what would happen if all religions were accommodated on the same terms?  People have already raised the issue that Jehovah’s Witnesses do not believe in using blood transfusions and that Christian scientists do not believe in using allopathic health care.  Yet the government has, on occasion, stepped in and forced people with such religious beliefs to accept allopathic health practices, and practices supported by Christian Scientists are not automatically covered by insurance.

When we begin accommodating or persecuting those of specific religions, exempting them from law or forcing them to abide by it, how are those decisions made?  If I form (as a constitutional law professor once suggested to me) the Church of the Holy Cinderblock, am I allowed to demand that I can take my cinderblock to the doctor?  What if my church mandates abortion for everyone who already has two children–can I impose that on others?  What if my religion mandates that my life and health take precedence over those of a fetus–am I exempt from abortion restrictions in the law so that I may follow my religious practices?  What if my religion supports male circumcision?  Female genital cutting?  Should I be able to mandate not only that I can keep these practices, but that insurance must pay for them?

What if the Church of the Holy Cinderblock develops a wealthy following that allows it to buy comprehensive health care systems, some of which are the only health care available in a certain region.  Would it be acceptable that people who do not bring a cinderblock with them will not be treated?  Would it be acceptable for my church to tell doctors that we do not believe in antibiotics, so they may not prescribe them, nor may they tell patients where to get them, nor may they tell patients that in their medical opinion, antibiotics are a life-saving treatment?

What if the Church of the Holy Cinderblock wanted to implement all of these policies, and all the health system had to do was have someone fill out a short form and send it to the insurance administrators?  Could my church legitimately argue that filling out a form was unduly burdensome?

Or would the legitimate argument be that not offering standard heath care options at a healthcare institution is burdensome for patients?  That there is a burden in not knowing that a health care institution is more interested in imposing its values on patients than allowing them to make informed decisions about their health?

Does Brian Cogan see a moral quandary in allowing women to die in the name of religion–even if you fill out a form first?

Or perhaps covering health care practices such as contraception are seen as unduly burdensome on a society that prefers not to regard women as full human beings.

A few months ago, I answered a list of “hard” questions about abortion that Trevin Wax of the Gospel Coalition said are never asked of pro-choice candidates.  I have found a similar list at Priests for Life, this one with the more provocative headline, “PRO-LIFE QUESTIONS FOR PRO-ABORTION PEOPLE.”  Really, nobody should be answering these questions because there is almost no one who is “pro-abortion.”  I am going to give them the benefit of the doubt and assume that they really mean people who are in favor of abortion remaining legal and that they are just linguistically clumsy.  Thus, I will answer their questions, which they say “were taken from the 1990 Life Activist Seminars by Mark Crutcher.”

Priests for Life also adds the following:

Note: Priests for Life engages in respectful dialog with those who disagree with us on abortion. We invite supporters of legal abortion to answer the following questions. If you write to us, we will respond to you, and will be glad to answer questions of your own.

I do plan to submit my answers to them and will update the blog when/if they respond.

(1) “Pro-abortionists say that outlawing abortion would restrict a woman’s right to privacy. Is that right absolute? Does somebody’s right to privacy exceed another’s right to live?”

I’m not sure who these pro-abortionists are, but perhaps you mean the Supreme Court judges who decided Roe v. Wade?  There are many people who favor keeping abortion legal who don’t think the SCOTUS decision was particularly well constructed or that the right to privacy is really the basis for the right of a woman not to be forced to remain pregnant and give birth against her will.

(2) “If what you say is true and the issue isn’t really abortion but a woman’s right to control her own body, why doesn’t your agenda include drugs and prostitution? Aren’t laws against those just as restrictive to a woman’s right to choose what she will and will not do with her own body, as laws against abortion are?”

Some people (including those who support legalization of abortion) do believe in legalizing drugs and prostitution.  There are also different ways to go about legalization.  In Sweden, they have had reasonably good experience with legalizing prostitution but outlawing its solicitation, so all the blame goes on the John. California’s relaxation of marijuana laws has not caused any increase in crime and seems to have decreased drunk driving.  However, each of those issues has its own complexities, as does the abortion issue.  For instance, you believe in forcing women to use their organs to support the development of what you believe to be a full-fledged human being.  Do you also believe in forced blood donation?  Liver donation?  Other organ donation?  Hooking a person in need of dialysis up to a healthy person’s kidneys?  Have you engaged in any of these things other than giving blood, even on a voluntary basis?  If not, why not?

(3) “Why is it that the very people who say the government should stay out of abortion are the same ones who want the government to pay for them?”

That’s an oversimplification.  Most of us do not want the government deciding what health care procedures we can and cannot access.  People who have private insurance certainly wouldn’t expect the government would pay for any healthcare procedure they need.  Many do believe that government funded health care should not exclude certain medical procedures because some people have a  religiously-based objection.  I am sure that you would not want blood transfusions or allopathic heathcare to be made illegal because some religious groups object.  What if my religion deemed procedures others need or want to be immoral?  Should I be able to have anything I don’t like excluded from Medicare and Medicaid coverage?  Should we not fund health care for the needy in order to avoid these debates?

(4) “Abortion advocates say they are in business to help women. Other than offering to kill their children for them, what are you doing?”

I have never offered to kill anyone’s child.  A fetus is not a child, any more than a senior citizen is a child, and in any case, I am not an abortion provider.  As for what I do for women, I work full-time on an initiative to prevent preterm birth, the leading cause of infant mortality.  Infant mortality is higher in the United States than almost any other developed nation.  Even when babies survive a preterm birth, they often face lifelong consequences, such as respiratory problems or blindness.  Causes of preterm birth, such as preeclampsia and placenta previa, can also kill or gravely injure mothers.  I work to get lower-income women exemplary prenatal care beginning early in pregnancy so that they have the best chance to be be healthy and have healthy babies.  I also publish research on best practices for maternal-infant health care. Other than trying to force women to birth, or make them feel guilty that they didn’t, what are you doing?

(5) “Pro-abortionists say that the unborn child is part of the mother’s body. If that is so, why does it have a completely different genetic code and often a different blood type? How do you explain the fact that it has it’s own immune system? Why is it male about half the time?”

Well, if it’s not part of the woman’s body, what is it doing in there, and why can’t she have it removed?  The placenta also has separate DNA from the pregnant woman, so does that make it a person?

(6) “If we use the absence of brain waves to determine that a person’s life has ended, why shouldn’t we use the presence of brain waves to determine that someone’s life has begun?”

I don’t know that everyone has the same definition of the end of life, so I’m not sure the parallel is accurate, but most anti-abortion sites I have explored say that fetal brain waves are detectable by day 40 of gestation.  Does that mean you think an abortion before day 40 would be acceptable?

(7) “Since you say that your interest is in protecting women, what is your position on these at home, do-it-yourself, abortion kits now being offered by many abortion advocates? Also, do you feel it’s ethical for them to advise women to avoid the gynecologist’s office for not only these procedures, but regular check-ups as well?”

I have no idea of what you are talking about.  Women can only get mifepristone from a licensed provider (generally a doctor, but in some states is can be an APN).  A woman also has to have her pregnancy date confirmed to get the pills because they don’t work after about 9 weeks–that’s something a medical professional has to do.  Basically, the only way to get these pills without seeing a doctor or APN is to get them illegally.  Some women do this where abortion is illegal (e.g. Chile) or where legal abortion is difficult to obtain (e.g. South Texas).  So it seems it is the anti-abortion crowd who is steering women toward do-it-yourself abortion.

(8) “We are now seeing the unborn being treated for disease, given blood transfusions and even operated on. When a doctor does one of these procedures, who is the patient?”

These doctors are called maternal-fetal medicine specialists because they must operate on the woman to operate on the fetus.  The woman is the primary patient because she is the one who must consent to the procedures, and no one has the right to make her undergo them if she chooses not to.

(9) “Pro-abortionists try to justify their actions by saying that, while the unborn may be human, it’s not a ‘person’. Can you give a detailed description of the differences?”

I haven’t heard this particular argument.  I’d have to see how the “pro-abortionist” constructed and justified the idea.  It would be helpful if you had some sources.  I’ve also never met a pro-abortionist–it seems they would be a pretty obscure group of people.

(10) “Pro-abortionists base a significant part of their argument on the concept of viability. Can you give me a description of what it means for someone to be viable?”

Can the fetus live a life independent of the woman in whom it began its gestation?  If it can live without her in particular, then obviously it is viable.

(11) “Does it bother you that abortion is legal after the point where medical science has evidence that the unborn child feels pain?”

Science generally indicates that pain sensors are not developed until later in gestation than abortions are performed (with very rare exceptions).  It is my understanding that pain medication can be provided for the fetus in those unique cases.

(12) “Why is it that abortion advocates say they want women to have all their options, but they then fight so hard against laws requiring totally informed consent?”

I’m not sure what you mean here.  I would love better informed consent.  For instance, women should be told that continuing a pregnancy (rather than having a legal abortion) drastically increases their risk of contracting hypertension or diabetes, being a victim of domestic violence, having abdominal surgery, having their vagina surgically cut, urinary incontinence, fistula, and dying, among many, many other complications.  I’m not aware of anyone telling women this whether they want to have an abortion or continue their pregnancies.

(13) “What rights do you feel a father should have in an abortion decision?”

For this one, we need to separate rights from ethics.  It is not within anyone’s rights to make a decision for another competent adult.  However, if a man and woman are in a relationship and the woman gets pregnant, her ethical choice would be to discuss the pregnancy and any choices about it with her partner (as long as she wasn’t putting herself at risk for domestic violence or reproductive coercion).

(14) “Why is it that pro-abortionists fight so viciously to keep parents from having a say in whether their minor daughter has an abortion or not?”

Where are these proabortionists?  Maybe they are all so vicious that they do not live with others in polite society.  Why should a parent be able to force a minor to be pregnant and give birth?  That carries enormous health and psychological consequences.  Forcing pregnancy and birth on a minor sounds like child abuse to me.  Most girls do tell at least one parent about their plans for abortion.  If a parent can force a daughter to give birth, should the parent also be able to force a daughter to have an abortion?

(15) “If pro-abortionists are mainly concerned with the health and safety of women, why do they fight so hard against medical standards as legitimate out-patient surgery clinics?”

I am in favor of any standards that are demonstrated to improve women’s health.  To test the value of these standards, we would need to do randomized control trials (or at least observational studies) of women receiving services in clinics that did and did not meet the standards of out-patient surgery clinics.  As far as I know, most of the requirements introduced in law regarding abortion clinics have no demonstrated value, and no one is interested in researching the issue because medical complications from legal abortion are so unusual.  Can you point me to the studies that show the benefit of each “medical standard” as applied to the provision of safe abortion services?

(16) “Let’s look at a hypothetical situation: two women become pregnant on the same day; six and a half months later woman A has a premature, yet healthy, baby; woman B is still pregnant; a week later each decides she doesn’t want her baby. Why should woman B be allowed to kill hers and not woman A?”

Well, in most cases at 6.5 months, a pregnant woman can’t just walk into a clinic and have an abortion.  There are few places where she can get one, and it is expensive.  So it seems we would need to know her reason–did she find out that her fetus had a disorder that would lead to inordinate suffering and an early death?  Is she risking her own life or health if she continues the pregnancy?  But let’s say she was a perfectly healthy woman with a perfectly healthy fetus who just didn’t want to be pregnant any more.  It would seem odd to me that anyone would carry a pregnancy that far and not want it, so it would be important to be very careful to make sure that the woman was of sound mind and wasn’t being coerced.  If all conditions were met, I would say that she could have an induction or cesarean (whichever was safer) in a facility ready to receive a very premature, live infant, but it’s hard to imagine this situation happening at all.

(17) “If it became absolutely clear to you that the unborn child is a living human being, would you then favor outlawing abortion?”

If it’s a “living human being,” then abortion is not necessary–it can be birthed and someone else can care for it if the mother doesn’t want to.

(18) “Why don’t we each look at the downside of our respective positions? Have you ever thought about what the ramifications are if you are wrong?”

I’m not sure what you mean…I do not want anyone to have an abortion who does not want one, so what would the ramifications be?  I think other social policies in this country that are punitive to poor women and to mothers in particular turn many women toward having abortions they don’t really want.  I think the ramifications of our current social policies are immoral.

(19) “When it was first discovered that the brain cells of aborted babies were a potential treatment for Parkinson’s Disease, the ABC NEWS program, NIGHTLINE, carried a story about a woman who’s father suffered with this malady. She wanted to be impregnated with the sperm of her father, for the purpose of creating a child, which would then be aborted, and it’s parts used to treat him. Do you see anything wrong with this?”

We are going back to the law vs. ethics issue.  I do not think it is ethical to get pregnant intentionally if you do not want to have a baby.  However, that doesn’t mean I would want to law to step in to make this decision for others.  You might also fix the usage error in your question (whose vs. who’s).

(20) “Should a woman be allowed to have an abortion for absolutely any reason, such as sex selection, selective reduction, or job promotion? If not, when not?”

I think it is important to work to change society so that women are never put in this position–having one sex valued over the other, having ridiculous numbers of embryos implanted during IVF, or pregnancy discrimination on the job.  Coercing women into giving birth is not the answer to these problems.

(21) “I am going to take the liberty of characterizing your position, and then I want you to tell me where I’m wrong. You want abortion to be legal right up to the moment of birth, in other words for all nine months of pregnancy; for any reason whatsoever, for no reason whatsoever; for a minor girl of any age, without parental consent, without even parental knowledge; and if she can’t pay for it, you think the taxpayer ought to. Is there anything inaccurate about that statement?”

Well, yes.  Lots of things.  I do not think we should force women to be pregnant.  I also think that if the fetus can live outside the pregnant woman, there is not reason not to let it live.  Situations in which women want to abort viable fetuses are rare, and I think the cases of women doing so “for no reason” are close to non-existent.  A late term abortion is a lengthy, painful, expensive, and difficult procedure–it seems like there would have to be a good reason to have one.  Coerced pregnancy and birth are unethical for everyone, minor girls included.  In my ideal world, we would have universal health coverage, so I suppose the government would be paying for abortion just like it pays for all other health care.  But under the current system, I think insurance, including government issued insurance,  should cover abortion the way it covers any other procedure, and that the government should step in financially as it does with any other health care procedure (which is generally not at all).

On the flip side, let me characterize your position: you believe that abortion should be illegal from the moment of fertilization, in other words, before implantation has even occurred; that abortion should be illegal for any reason whatsoever, including a woman’s life or health; that it should be illegal for a female human being of any age and in any condition, even girls under age 10; that parents should be able to force their minor daughters to give birth at their own discretion (whether or not they plan to pay for their daughter’s care or to care for the resulting infant); that parents have the right to know about a daughter’s abortion even if they will kill her as a result; and that all health insurance should be privately paid, meaning that those in need may have no access to quality healthcare.  Is there anything inaccurate about that statement?

The spread of Catholic hospital systems has been a concern for some time.  In 2011, the Sierra Vista Health Center called off a merger with a Catholic hospital system because they would then have to “abide by Catholic ethical and religious directives,” which would mean they could “no longer do abortions, even when the mother’s life is in danger, and they [could] no longer perform sterilizations or provide contraception.”

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RH Reality Check reported on Mercy Hospital in Colorado, where “Chief Medical Officer Dr. John Boyd… [told cardiologist Dr. Michael] Demos in a meeting that he shouldn’t mention abortion at all to a patient, even if a pregnancy is a threat to a woman’s life.”

In May of 2013, The Daily Kos reported, “the rapid consolidation of smaller, rural and even teaching hospitals by expanding Catholic chains is putting women’s reproductive health—and sometimes their lives—at risk. Thanks to these mergers, acquisitions and strategic partnerships, decisions about contraception, abortion, sterilization and live-saving care aren’t being made by patients and their doctors, but by bishops.”

As Stephanie Mencimer explains in Mother Jones,  Catholic hospital takeovers affect much more than just abortion:

Abortion services are always quick to go when a Catholic hospital takes over, but the changes go much further. In many cases, doctors are prohibited from prescribing birth control, and hospital pharmacies won’t sell it. Doctors may even be told not to counsel patients about it. Catholic hospitals have been reluctant to offer emergency contraception to rape victims, and when they do, they first require a pregnancy test to ensure the woman was not pregnant before the assault. The bishops’ guidelines forbid tubal ligations and vasectomies. They also extend to end-of-life care: Catholic hospitals may ignore patients’ requests to be removed from feeding tubes or life support, even if those wishes are expressed in living wills. And many states allow religious hospitals to discriminate against gays and lesbians, both as employees and as patients.

Mencimer notes that “Catholic hospitals are required to follow health care directives handed down by the US Conference of Catholic Bishops—a group of celibate older men who have become increasingly conservative over the past few decades.”

Now the ACLU is suing over Catholic hospitals’ health policies, and they aren’t suing the hospitals, they are suing the bishops.

The case was spearheaded by the case of a woman in Michigan, Tamesha Means.  In 2010, 18 weeks into her pregnancy, her amniotic sac ruptured–normal during labor, but not good when it happens prematurely (it is called preterm premature rupture of membranes or PPROM).  According to a New York Times story by Erik Eckholm,

Her fetus had virtually no chance of surviving, according to medical experts who reviewed the case, and in these circumstances doctors usually induce labor or surgically remove the fetus to reduce the mother’s chances of infection.  But the doctors at Mercy Health, Ms. Means said, did not tell her that the fetus could not survive or that continuing her pregnancy was risky and did not admit her for observation.  She returned the next morning, bleeding and in pain, and was sent home again. That night she went a third time, feverish and writhing with pain; she miscarried at the hospital and the fetus died soon after.

University of Wisconsin obstetrician Dr. Douglas W. Laube called it a case of “basic neglect.”  In a report on National Public Radio by Julie Rovner, he said,

A woman who is 18 weeks pregnant and who presents with these symptoms, the same that Ms. Means had, should be told that there’s virtually no chance that her fetus will survive and that continuing the pregnancy puts her at risk, and that the safest course of treatment would be to terminate the pregnancy.  From the outset, Ms. Means should have been given this information at the very least.

Richard Garnett, a law professor at Notre Dame, a Catholic University, responded to the news of the ACLU suit saying,

[T]o sort of claim that it is negligence for the bishops to be issuing directives reminding Catholic hospitals what the church’s teachings are with respect to things like abortion and sterilization are, that is a stretch.  That seems to me to be adopting a strange notion of tort responsibility — that religious teachings become legal negligence.

But it’s not just a reminder–it’s a threat, as discovered by nun and Catholic hospital administrator Margaret McBride.  Sister Margaret sat on an ethics committee that approved a first trimester abortion for a woman with a condition that made pregnancy life threatening. The Huffington Post reported the response of Bishop Thomas J. Olmsted, head of the Phoenix Diocese:

I am gravely concerned by the fact that an abortion was performed several months ago in a Catholic hospital in this diocese. I am further concerned by the hospital’s statement that the termination of a human life was necessary to treat the mother’s underlying medical condition.  An unborn child is not a disease. While medical professionals should certainly try to save a pregnant mother’s life, the means by which they do it can never be by directly killing her unborn child. The end does not justify the means.

According to HuffPo, “Olmsted added that if a Catholic ‘formally cooperates’ in an abortion, he or she is automatically excommunicated,” which is exactly what happened to Sister Margaret, along with losing her job.

The ACLU reports on why the organization has taken the case and why it is targeting the bishops rather than individual hospitals:

Across the country, women face the risk of mistreatment as a result of the Directives. This happens often despite the fact that doctors want to give their patients the proper care and information, if only they were allowed to. Indeed, studies show that over half of OB/GYNs working in Catholic-sponsored hospitals have run into conflicts with the Directives.

One doctor describes a miscarrying patient who was dying before his eyes, septic, with a 106 degree fever, her eyes filling with blood. But even though she was in danger, and the fetus had no chance of survival, because of the Directives, the hospital’s policy wouldn’t let the doctor treat her by terminating the pregnancy until the fetal heartbeat ceased of its own accord.

Another doctor describes a situation where a woman in the first part of her second trimester arrived at the hospital with a hand sticking out of her cervix. But the fetus had a heartbeat, and so the Catholic-sponsored hospital forbids the doctor from ending the pregnancy. Instead, she was forced to send her patient to a facility 90 miles away. Doctors are also barred from giving their patients full information about their treatment options.

According to the ACLU, “The bishops aren’t doctors, and yet they issue rules that tie doctors’ hands, preventing them from giving their patients full information about their health care options and, in some cases, preventing them from providing medically appropriate care.”   So when the bishops “remind” those at Catholic hospitals about Catholic teaching, what they are actually saying is that one must follow the teaching or risk being fired (and also being excommunicated if one is Catholic).  That is not religious teaching.  That is an ultimatum.

Women should not have to pay with their dignity, their autonomy, their health, and their lives to support someone’s religious philosophy.  If Catholic hospitals cannot appropriately and responsibly treat women, then they cannot treat human beings.

There has been a small flurry of news about misinformation and outright lies women hear at crisis pregnancy centers, including pieces at Salon, Think Progress, and NARAL‘s new Tumblr blog Exposing Fake Clinics. Salon identifies 4 medical myths women heard:

  1. Birth control is a mini abortion every month.
  2. Abortion causes breast cancer.
  3. Abortion causes infertility.
  4. Birth control causes cancer.

Rather than just calling a lie a lie, let’s also look at the truth.  This post will cover the myth of the monthly mini-abortion.

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Unless they are pregnant, healthy women of reproductive age menstruate regularly.  While there are extreme religious perspectives that advocate eschewing contraception so that (married) women will get pregnant as often as possible, even these groups do not call normal menstruation a “mini abortion.”  And while some religious groups hold to the “Every Sperm is Sacred” philosophy derived from the sin of “onanism” (Onan got in trouble with God for “spilling his seed”), the sin there is the spilled sperm, not a “mini abortion.”

So where does this statement come from? Barrier methods of birth control kill sperm (e.g. spermicides), block the cervix (e.g. diaphragm and cervical cap), or collect the sperm for disposal elsewhere (e.g. condoms).  The only way to perceive using these methods as a mini-abortion would be to consider the prevention of potential pregnancy as somehow aborting.

There are those who believe the moniker “pro life” means constantly trying to get pregnant in order to produce more “life”  (otherwise you are just “anti-death”), but as there is no fertilization involved in barrier methods, there is no basis for their being considered abortifacients. The only other way to tie barrier methods to abortion would be the argument that contraception leads to an abortion mentality.  Arland Nichols at the Catholic Magazine Crisis explains:

Blessed John Paul II observed in Evangelium vitae, “[t]he life which could result from a sexual encounter thus becomes an enemy to be avoided at all costs, and abortion becomes the only possible decisive response to failed contraception.” A solution had to be found; abortion access was necessary to “clean up the mess.” Ironically, it is often claimed that contraception reduces the need for abortion, but the sordid history and abortion numbers that climb with contraception access tell a very different story. The expansion or legalization of abortion in a country is almost always preceded by introduction or acceptance of contraception. Contraception is the proverbial Trojan Horse.

If contraception is a Trojan Horse that brings abortion with it, then any method of birth control would somehow be an abortion “carrier.”  This view is not limited to Catholics.  So the idea is that contraception is like abortion because certain religious groups mentally link the two.  That still doesn’t mean that barrier methods in any way cause a physical abortion.

The more typical anti-contraception, anti-abortion crowd primarily gets revved up over hormonal contraception (e.g. the Pill, the Shot, the Implant, and particularly the “morning after” pill) and IUDs. Hormonal methods (including the morning after pill) work primarily by preventing ovulation.  The IUD works primarily as a spermicide (there’s the sacred sperm problem again) or by thickening the cervical mucus to block sperm. The problem comes when caveats like these, from the International Planned Parenthood Federation, are raised:

In very rare case, IUDs prevent implantation which is considered a contraceptive not an abortifacient effect.

Injectables also make the endometrium unfavorable for implantation if fertilization does occur.

Science tells us that pregnancy does not begin until implantation.  Even if one wishes to ignore this definition, there is an increasing body of evidence indicating that hormonal methods in particular do not prevent implantation.  Still, these caveats lead to proposals like an Ohio bill that would ban both abortion and many contraceptive “drugs or devices”:

The bill’s definition of “abortion services” also includes “drugs or devices used to prevent the implantation of a fertilized ovum,” which could effectively ban coverage of birth control pills, intrauterine devices (IUDs), and emergency contraception.

People at the extreme end of the anti abortion movement get very, very upset about un-implanted fertilized eggs (which are actually blastocysts by the time they implant, which some anti-abortion extremists believe gives the cells more moral legitimacy). They regard the un-implanted cells as a dead baby.  Except they really don’t, because if they did, all vaginal discharge would have to be inspected so that proper funerals could be held for the millions of “dead babies” that don’t implant, regardless of whether or not a woman is using birth control.

Even more to the point, the prevention of ovulation and the prevention of sperm meeting egg prevent millions of “dead babies”–according to the anti-abortion set, no fertilization=no “baby.”  The best explanation of this paradox of opposing birth control and mourning un-implanted blastocysts comes  from Sarah via Libby Anne’s amazing blog, Love, Joy, Feminism:

  • In a group of 100 women not on birth control: 16 zygotes will “die” each month
  • 85 dead zygotes per 100 women by the end of the year
  • In a group of 100 women on birth control: 0.15 zygotes will “die”
  • 2 dead zygotes per 100 women by the end of the year

Sarah concludes,

[T]aking birth control makes a woman’s body LESS likely to dispel fertilized eggs. If you believe that life begins at conception, shouldn’t it be your moral duty to reduce the number of zygote “abortions?” If you believe that a zygote is a human, you actually kill more babies by refusing to take birth control.

In addition to the dead zygotes, women naturally expel a large number of fetuses through “spontaneous abortion”–aka miscarriage.  Depending on when the blastocyst implants, up to 80% of fetuses can be spontaneously aborted.  Though miscarriage can be very difficult and sad, very few people have full-fledged funerals for a fetus in the way they would for a baby who had been born (the Duggars excepted).

If the fetus were really a “baby,” we would consider miscarriages to be preterm births and we would regard a miscarried fetus as we would a deceased child.  But even anti-abortion extremists don’t generally view a fetus this way.  In fact, people don’t even refer to un-implanted blastocysts as “miscarriages.”

So to sum up,

  1. Barrier methods do not allow for fertilization
  2. Hormonal methods and IUDs  are designed to prevent fertilization
  3. Un-implanted fertilized ova/blastocysts are naturally expelled among women not using birth control much more often than among women using birth control, and no one in the anti-abortion community seems to care.
  4. Abortion, spontaneous or not, is only called abortion (or miscarriage) after implantation has occurred.

Thus, when it comes to birth control, there is no abortion involved, mini or otherwise.

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