Now for Some Complications

 

Some of you have been generously helping out in my quixotic, querulous quest to understand abortion in America. One of the things that prevents me from becoming an enthusiastic Pro-Lifer is the emphasis not just on overturning Roe, but on enacting laws to outlaw abortion either completely, or after a certain gestational age.

I am — as friends already know — a serious baby-person. I feel very protective towards little ones, born and unborn.  I agree that it is dreadful — unconscionable — that we have created a culture in which it is considered normal and even desirable that abortion terminates hundreds of thousands of healthy, normal pregnancies.

What ought to be done about it? If it is made illegal, what happens when a truly terrible situation arises — a genuinely devastating birth defect or a true threat to a woman’s health?

Yes, I know: these situations really are “vanishingly rare.” But rare doesn’t mean unimaginable.

I’m not talking about Down syndrome, here, the diagnosis that so often dooms a fetus all over the civilized world. And I just read of a woman in Australia whose tale of woe lamented the difficulty of securing a late-term abortion (28 weeks) for her unborn baby diagnosed with cleft hand syndrome. Yes, having this deformity is doubtless difficult, but it can be corrected or ameliorated with surgery,  is not fatal or particularly painful and so it was immoral to abort that little baby girl because, as her mother wept, “she would have a hard life because she looked different.”

Still, if you Google birth defects, you can find plenty of genuinely appalling possibilities to keep a pregnant woman up at night (or even a wanna-be grandmother). Some — cleft lip, for example — are often accompanied by comforting examples of the miracles wrought by surgeons. And there are pictures of babies whose facial deformities look like Hallowe’en masks, but in a few, at least, the babies are smiling their goofy, baby-grins at the camera.

But what about those genuinely rare occasions where the fetal abnormalities really are catastrophic? Google Trisomy 13 (Patau Syndrome) or Trisomy 18 (Edwards Syndrome) for examples of birth defects that are painful for the baby,  almost always inevitably fatal, and, for now at least, irreparable? ( Incidentally, I was going to include photos in this post, but decided not to — you can go look if you feel up to it, but I didn’t want to ambush y’all.)

And what about those rare occasions in which an abortion could indeed save the mother from a fairly serious illness if not actually death: a premature rupture of the membranes, for example, or an infection in the fetal membranes. What about a woman diagnosed early in pregnancy with an aggressive form of breast cancer, or with cervical cancer, and delay in treatment — surgery, radiation or chemotherapy — could mean the woman will die?

Yes, I know. Even in these circumstances, no doubt, choices for the life of the fetus are possible. But they aren’t slam-dunk obvious, or at least they don’t seem so to me.

Wouldn’t any law that makes an exception for catastrophic fetal anomaly and life and health of the mother end up being interpreted so elastically that things like cleft hand, or a cleft lip or Down syndrome count as catastrophes and “maternal health” can be  code for “Mom doesn’t want a baby?” Or, conversely, could the law be so enthusiastically enforced that women who miscarry are suspected of having committed a crime?

(You’ll notice I left out rape and incest, as I think those represent a different issue.)

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  1. Nick H Coolidge
    Nick H
    @NickH

    Kate Braestrup: Wouldn’t any law that makes an exception for catastrophic fetal anomaly and life and health of the mother end up being interpreted so elastically that things like cleft hand, or a cleft lip or Downs Syndrome count as catastrophes and “maternal health” can be code for “Mom doesn’t want a baby?”

    Isn’t that exactly what happened? It was decided (I forget which case – Doe v Bolton?) that “health” included “mental health” and a woman’s unhappiness about being pregnant is detrimental to her mental health. Voila – no limits.

    On a somewhat related note, this article presents an alternative way of looking at controversial issues like abortion – equilibriums and limits. You might find it interesting.

    https://www.theatlantic.com/politics/archive/2018/02/a-better-way-to-look-at-most-every-political-issue/552752/

    • #1
  2. Mate De Inactive
    Mate De
    @MateDe

    Kate, I was where you are. I was default pro-choice and was uncomfortable with making abortion illegal due to many of the examples you bring up in your post. However, as I began to also enter into the argument with myself on this subject, the humanity of the child in the womb and the idea that should we, as mere humans, be the ones to decide who lives and who dies, and what that means to society.  So many cases that I hear of women who have abortions because of deformities and they are things that should not require a child to be put to death, such as down’s syndrome. Also there have been many times that a prenatal diagnosis has been wrong and the child who was supposed to have a fatal deformity, when born was a normal healthy baby. Hard cases make for bad law.

    In my opinion, when abortion is legal, it is a sign of societal collapse. If you look at history, in the civilizations in which  abortion was legal and accepted, the value of life was diminished. Life was cheap and expendable and it took the Christian idea that every human was made in God’s image to get to where we are now in the west that there is a value to life. However, I think we are tossing that away by the acceptance of pretty extreme laws allowing abortion. Even in Europe their abortion laws are much more strict than they are here.

     

    • #2
  3. Mate De Inactive
    Mate De
    @MateDe

    Check out this video of the differences between European abortion laws and abortion laws in the US.

    • #3
  4. Judithann Campbell Member
    Judithann Campbell
    @

    Kate Braestrup: One of the things that prevents me from becoming an enthusiastic Pro-Lifer is the emphasis not just on overturning Roe, but on enacting laws to outlaw abortion either completely, or after a certain gestational age.

    Even if you believe that most pro-lifers are too extremely pro-life, we cannot enact any laws without first winning elections, which is just to say, supporting the pro-life cause does not mean putting pro-lifers in charge of the world forever. Supporting the pro-life cause just means supporting local government and letting the voters decide. In some cases-in many cases, perhaps-the voters will be wrong, but under our system of government given to us by our Founders, the voters are the ones who should decide these issues, not nine un elected judges. Humans being human, voters will unfortunately be wrong about some things, but I will take my chances with the voters over the judges every single time.

    • #4
  5. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Unfortunately, definitions get horrifyingly elastic, Kate…Keep trying, we’ll get there yet.

    • #5
  6. PHCheese Inactive
    PHCheese
    @PHCheese

    Kate 60 Million since 1973.  It must have become a default form of birth control.Terminating the unborn either is or isn’t murder. I can’t personally delude myself that is not murder under any circumstances. I have a friend (no children) that was a profound supporter of abortion. He called me for help asking me to immediately come to his house. It seems his dog had chased a raccoon and severely injured it. However it had managed to secure its self a spot so as the dog could no reach it. He could not reach the dog without fear of being bitten by the raccoon. They were under some steps. It was obvious the raccoon was dying. Just a matter of when. He asked me to take a  shovel and kill it. He said he couldn’t do it. I did kill it and bury it. Later while some adult beverages I asked him how he could be for abortion but not kill a  menacing  rodent. Crickets but we are still friends.

    • #6
  7. Doug Watt Member
    Doug Watt
    @DougWatt

    As a practical matter I think it’s far too late to outlaw abortion in the United States. I believe the fight to prevent taxpayer funded abortion is achievable. Abortion is an elective surgery, but there are rare cases, and they are rare, that there can be pregnancies that endanger the health of the mother.

    These cases are rare because prenatal surgeries and therapies have advanced that makes it possible to save both mother and child. I also understand that the possibility of not having a healthy child is devastating to the parents. Unfortunately DNA is a mystery. The child not only inherits the DNA of their parents, but also have their own unique traits. DNA is not entirely predictable, which is one of the reasons that embryonic stem cell research has produced no groundbreaking cures. Therapeutic cures have come from adult stem cell research.

    I have no easy answer to your questions.

    • #7
  8. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Hello, Mate De!
    I may end up where you are on this… for now I am playing Devil’s Advocate, to myself as well as to all of you!

    If the question in these really awful cases isn’t whether the child will die, but rather when and where the child will die. I think it’s possible that there could be a situation in which it actually serves some purpose to terminate the pregnancy sooner rather than allowing it to terminate itself later.

    One option could be to go back to the old “yes or no” panels of the pre-Roe years.

    Parents who find out, at 16 weeks, that the child the mother is carrying has a birth defect could meet with the panel who would then discuss with them whether an early termination of the pregnancy would be one of the options in their particular case. In the case of the cleft-hand, the answer would be no…along with lots of information about what is available in terms of remediation and therapy after the baby is born. In the case of a baby with all of his organs outside his body, or a significant anencephaly or whatever, they could say “well, you could deliver the baby now, and let him go… ”

    There is plenty of precedent for this in the conversations doctors have with the family members of ill or badly-injured persons in the ICU. I’ve been part of a few of these myself. The doctor explains all the findings, there’s often a second opinion, a social worker or other supportive person is there along with clergy, and then the next of kin make a decision. (One of the choices is never “let’s just pull Granny’s legs off and crush her skull.”)

    • #8
  9. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Encouraged by prenatal therapies/surgeries, cord-blood transfusions, adult stem-cell research, as well.  Limiting the time-frame in which abortion is available/eliminating taxpayer funding – not to mention the change in public opinion among the young – seem like areas for hope.

    • #9
  10. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Nanda Panjandrum (View Comment):
    Encouraged by prenatal therapies/surgeries, cord-blood transfusions, adult stem-cell research, as well. Limiting the time-frame in which abortion is available/eliminating taxpayer funding – not to mention the change in public opinion among the young – seem like areas for hope.

    I do wonder, Nanda, whether that’s where the action is—that is, in encouraging the already existing change in public opinion. I read a book called In Necessity and Sorrow; a Year in an Abortion Hospital”  and was surprised to read that, as of 1975 at least, people still didn’t know that a baby is moving around inside its mother long, long before the mother can feel it. Women who presented themselves to the hospital for an abortion would lie and say they hadn’t felt the baby move, as if they would be forced to concede the humanity of the child if they admitted they’d felt that wriggle.

    The author of that book, Magda Denes, repeatedly asserts that she is pro-choice (or was, I guess; she died some time ago) but she doesn’t spare herself or her readers the details that would make anyone feel distinctly…ambivalent. At best.  A survivor of the Holocaust who was hunted by Nazis as a child, she makes the obvious connections when it comes to pushing a certain class of people out of the circle of concern before killing them.

     

    • #10
  11. CB Toder aka Mama Toad Member
    CB Toder aka Mama Toad
    @CBToderakaMamaToad

    Kate, one of my friends who faced such a difficult pregnancy as you describe told me about Be Not Afraid, an organization of parents with difficult prenatal diagnoses. Here’s a link to their website.

    • #11
  12. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Kate Braestrup (View Comment):
    Hello, Mate De!
    I may end up where you are on this… for now I am playing Devil’s Advocate, to myself as well as to all of you!

    If the question in these really awful cases isn’t whether the child will die, but rather when and where the child will die. I think it’s possible that there could be a situation in which it actually serves some purpose to terminate the pregnancy sooner rather than allowing it to terminate itself later.

    One option could be to go back to the old “yes or no” panels of the pre-Roe years.

    Parents who find out, at 16 weeks, that the child the mother is carrying has a birth defect could meet with the panel who would then discuss with them whether an early termination of the pregnancy would be one of the options in their particular case. In the case of the cleft-hand, the answer would be no…along with lots of information about what is available in terms of remediation and therapy after the baby is born. In the case of a baby with all of his organs outside his body, or a significant anencephaly or whatever, they could say “well, you could deliver the baby now, and let him go… ”

    There is plenty of precedent for this in the conversations doctors have with the family members of ill or badly-injured persons in the ICU. I’ve been part of a few of these myself. The doctor explains all the findings, there’s often a second opinion, a social worker or other supportive person is there along with clergy, and then the next of kin make a decision. (One of the choices is never “let’s just pull Granny’s legs off and crush her skull.”)

    Re: Ethics committees, Kate, see mine here for problems when the personal morphs into protocol.

    • #12
  13. Mate De Inactive
    Mate De
    @MateDe

    Hey Kate, I understand what you are taking about I have a friend who had a son with Tay Sachs and it was horrible. But I still think we need to err on the side of life even with the hard cases. Even with a panel of doctors to help determine what to do we would need to know, what are the incentives. With prenatal testing now there are many cases of deformities that are ambiguous. But the doctors push for an abortion because there are liabilities on the doctor if the baby is born deformed and none of the baby is aborted, even if the test isn’t certain the deformity is fatal or even exists 100%. The doctor is incentivized to err on the side of abortion due to the liability on them. This is why I would rather err on the side of life

    • #13
  14. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    PHCheese (View Comment):
    Kate 60 Million since 1973. It must have become a default form of birth control

    Oh, definitely. Kids believe that birth control is far more effective than it too-often is. They are encouraged to think of sex as something people just do—recreationally, or for “empowerment” or  as a getting-to-know-you exercise. But the stakes are so high, especially for girls. They have abortions…and then have to live with what they’ve done.

    Kids whose parents wouldn’t trust them to buy a bus ticket by themselves are being equipped with IUDs and sent forth to do what comes naturally.

    • #14
  15. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Mate De (View Comment):
    Hey Kate, I understand what you are taking about I have a friend who had a son with Tay Sachs and it was horrible. But I still think we need to err on the side of life even with the hard cases. Even with a panel of doctors to help determine what to do we would need to know, what are the incentives. With prenatal testing now there are many cases of deformities that are ambiguous. But the doctors push for an abortion because there are liabilities on the doctor if the baby is born deformed and none of the baby is aborted, even if the test isn’t certain the deformity is fatal or even exists 100%. The doctor is incentivized to err on the side of abortion due to the liability on them. This is why I would rather err on the side of life

    Huh! Are doctors never sued for wrongful abortion? I should think that, at least on occasion, it turns out that the baby wasn’t catastrophically deformed, after it’s too late?

    I also think about all the things that aren’t visible in tests (yet) that might make any baby seem less than adequately perfect to an anxious mother.

    Those panels of doctors would only work if the understanding was that we’re all heavily biased towards life. When my grandson was in the NICU, the doctors tried to be clear about what his prospects would be if he survived. These were not good, to put it mildly…but the presumption was still that, all other things being equal, his parents (and grandparents) wanted him to live. As it turned out, that wasn’t an option, so we went with “a good, peaceful death.”

     

     

    • #15
  16. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    CB Toder aka Mama Toad (View Comment):
    Kate, one of my friends who faced such a difficult pregnancy as you describe told me about Be Not Afraid, an organization of parents with difficult prenatal diagnoses. Here’s a link to their website.

    Good to know!

    • #16
  17. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Judithann Campbell (View Comment):
    Supporting the pro-life cause just means supporting local government and letting the voters decide.

    I phrased it inartfully—you’re right. I am fine with overturning Roe for this and other reasons—indeed, I’d vote and argue for it.

    The question is whether, were I Queen of the World, would making abortion illegal be the best course of action given the imperfect knowledge and capacity of human beings? Or the least-bad, at least?

    • #17
  18. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Nick H (View Comment):

    Kate Braestrup: Wouldn’t any law that makes an exception for catastrophic fetal anomaly and life and health of the mother end up being interpreted so elastically that things like cleft hand, or a cleft lip or Downs Syndrome count as catastrophes and “maternal health” can be code for “Mom doesn’t want a baby?”

    Isn’t that exactly what happened? It was decided (I forget which case – Doe v Bolton?) that “health” included “mental health” and a woman’s unhappiness about being pregnant is detrimental to her mental health. Voila – no limits.

    On a somewhat related note, this article presents an alternative way of looking at controversial issues like abortion – equilibriums and limits. You might find it interesting.

    https://www.theatlantic.com/politics/archive/2018/02/a-better-way-to-look-at-most-every-political-issue/552752/

    That is a useful one, isn’t it!

    • #18
  19. Full Size Tabby Member
    Full Size Tabby
    @FullSizeTabby

    I would separate the cases of fetal anomaly and maternal life. As @nickh pointed out in Comment #1, “maternal health” has already been interpreted to provide no limits. But, if it were reinstated as a real requirement, I would not worry too much about it being used to create a problem for a really high risk situation for the mother. Various laws already deal with the fact that there are circumstances in which a death is inevitable (often some accidental series of events) and we may have to choose who is going to die. I am confident that we can work something out.

    I just don’t like the marginal cases causing us to excuse the completely unnecessary slaughter of the many cases about which there is no doubt.

    • #19
  20. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Judithann Campbell (View Comment):
    Even if you believe that most pro-lifers are too extremely pro-life,

    I don’t. I think pro-lifers have by far the stronger argument, and I think it is good for the country to have them continue to press it. At the moment, it is what keeps Americans from ignoring the issue altogether, and since ignoring it is more comfortable, without Pro-Life we would go with the default.

    I wonder if there could be such a thing as a candidate who would say: “Look, let’s come up with a serious, good-faith effort to drive the abortion rate down. Here are my suggestions…”

    I have to believe that everyone not employed by Planned Parenthood (et al)  really does want abortion to stop. Indeed, I should think that we could all agree not only that we want abortion to end, we want it to end because it has become unthinkable. So a candidate could say “what more do we need to do to make abortion not seem like the only choice?”

    But then…PP has some deeeeeep pockets.

    • #20
  21. Mate De Inactive
    Mate De
    @MateDe

    No, I don’t think I made myself clear. There have been doctors who have been sued if a child is born with a deformity or fatal illness but if the child is aborted we don’t know if the test was correct or not because the child is dead. I have several friends who were told their child had an abnormality or deformity and was pushed to have an abortion. They refused and their kids were fine. The tests aren’t always conclusive and there maybe babies aborted due to abnormalities that are actually perfectly healthy

    • #21
  22. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Full Size Tabby (View Comment):
    I would separate the cases of fetal anomaly and maternal life. As @nickh pointed out in Comment #1, “maternal health” has already been interpreted to provide no limits. But, if it were reinstated as a real requirement, I would not worry too much about it being used to create a problem for a really high risk situation for the mother. Various laws already deal with the fact that there are circumstances in which a death is inevitable (often some accidental series of events) and we may have to choose who is going to die. I am confident that we can work something out.

    I just don’t like the marginal cases causing us to excuse the completely unnecessary slaughter of the many cases about which there is no doubt.

    Exactly. That’s the problem, isn’t it? Abortion isn’t seen as a truly extreme response to a genuinely dire situation, but as a quotidian necessity for the average woman living out her ordinary life.

    • #22
  23. Doug Watt Member
    Doug Watt
    @DougWatt

    Mate De (View Comment):
    Hey Kate, I understand what you are taking about I have a friend who had a son with Tay Sachs and it was horrible. But I still think we need to err on the side of life even with the hard cases. Even with a panel of doctors to help determine what to do we would need to know, what are the incentives. With prenatal testing now there are many cases of deformities that are ambiguous. But the doctors push for an abortion because there are liabilities on the doctor if the baby is born deformed and none of the baby is aborted, even if the test isn’t certain the deformity is fatal or even exists 100%. The doctor is incentivized to err on the side of abortion due to the liability on them. This is why I would rather err on the side of life

    Ob/Gyn’s have huge liability concerns. The small Catholic university I attended has an outstanding nursing school. One of the benefits of attending a small school is you run into people you haven’t seen for years at weddings and funerals. I ran into an old friend at a wedding.

    She spent some time as the head nurse at the Hutchinson Cancer Center in Seattle, and then went on to medical school. She told me she was leaving her practice as an Ob/Gyn. She said her malpractice insurance was too expensive, and she did pro bono work for poor pregnant women. Some of her patients smoked, drank alcohol, and did drugs during their pregnancies, and although she told them to stop their high risk behavior, and they did not, they would sue her because they did not have the perfect child.

    The real moral of this story is that unlike police officers, there is always a lawyer around when you need one.

    • #23
  24. Nanda Panjandrum Member
    Nanda Panjandrum
    @

    Kate Braestrup (View Comment):
    Huh! Are doctors never sued for wrongful abortion?

    Suing for “wrongful birth” of a special-needs child is becoming more common; it may lead to yet another aspect of ‘defensive medicine.’

    • #24
  25. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Nanda Panjandrum (View Comment):
    Re: Ethics committees, Kate, see mine here for problems when the personal morphs into protocol.

    I love this. It’s a keeper.

    • #25
  26. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    Mate De (View Comment):
    No, I don’t think I made myself clear. There have been doctors who have been sued if a child is born with a deformity or fatal illness but if the child is aborted we don’t know if the test was correct or not because the child is dead. I have several friends who were told their child had an abnormality or deformity and was pushed to have an abortion. They refused and their kids were fine. The tests aren’t always conclusive and there maybe babies aborted due to abnormalities that are actually perfectly healthy

    Ah, right. Silly me—in order to realize that the kid is fine, the kid has to either be alive and demonstrably fine or…at the very least…be autopsied after the abortion by a disinterested party.

    Here is the question I would have for a pro-choice person bringing up the fatally-flawed baby argument: if a child is going to die anyway…is it ever necessarily better for the child to die sooner rather than later? In other words, is the kid suffering while in utero?

    • #26
  27. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    By the way, Mate De, there do seem to be an awful lot of situations in which parents are “pushed” to have abortions when there’s a problem with the baby, anecdotally at least.

    • #27
  28. Full Size Tabby Member
    Full Size Tabby
    @FullSizeTabby

    Kate Braestrup (View Comment):

    Mate De (View Comment):
    No, I don’t think I made myself clear. There have been doctors who have been sued if a child is born with a deformity or fatal illness but if the child is aborted we don’t know if the test was correct or not because the child is dead. I have several friends who were told their child had an abnormality or deformity and was pushed to have an abortion. They refused and their kids were fine. The tests aren’t always conclusive and there maybe babies aborted due to abnormalities that are actually perfectly healthy

    Ah, right. Silly me—in order to realize that the kid is fine, the kid has to either be alive and demonstrably fine or…at the very least…be autopsied after the abortion by a disinterested party.

    Here is the question I would have for a pro-choice person bringing up the fatally-flawed baby argument: if a child is going to die anyway…is it ever necessarily better for the child to die sooner rather than later? In other words, is the kid suffering while in utero?

    I would expect the “pro-choice” person to answer, “Yes, to minimize suffering.” But I would answer that we don’t have perfect knowledge. But, that is also a justification for euthanasia. And, we don’t know what lessons of God (or life, if you want to stay away from overt religion language) we might learn along the way. At that point, we truly are playing God.

    • #28
  29. Mate De Inactive
    Mate De
    @MateDe

    Kate, I have been on this journey as well and it took me a long time of arguing and thinking of scenarios and the one that took me the longest to reconcile was the one concerning babies with fatal illnesses or abnormalities.

    • #29
  30. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    CB Toder aka Mama Toad (View Comment):
    Kate, one of my friends who faced such a difficult pregnancy as you describe told me about Be Not Afraid, an organization of parents with difficult prenatal diagnoses. Here’s a link to their website.

    Oh my, Mama Toad. That website is really wonderful.

    I hadn’t realized how anxious looking at all the photos of little squirts had made me until I watched a few of the Be Not Afraid videos. I’m a little teary, of course, having learned again (I’m a little thick, God: sorry) Oh right! The answer is love. It’s always love.

    • #30
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