Late Night Essay on: Abortion

Over the past couple of months, there's been two commentaries in the Chicago Sun-Times that really made me pause—perhaps for different reasons.

Start with John O'Sullivan's May 30 piece, entitled "Do you really know our abortion law?":

As someone who goes to political dinner parties on both sides of the Atlantic, I have the following two experiences on a regular basis:

Experience One:

American liberal: "Our American obsession with abortion is so embarrassing. Why can't we be like Europe? They're much more sophisticated. It's not even a political issue there."

Myself: "Well, that may be because the laws in most European countries are much stricter than those in the United States. Women have no constitutional right to an abortion. In Britain, for instance, except in cases of severe handicap, abortions are not permitted after the 24th week of pregnancy."

American liberal: "What! That's barbaric."

Experience Two:

European sophisticate: "You Americans are too absurd -- your fundamentalist Christians, all this political fuss about abortion. How do you explain such an obsession?"

Myself: "Well, that may be because the courts have ruled that there can be no restrictions on a woman's right to an abortion. An abortion can be performed on a fully viable fetus -- even, in the case of partial-birth abortion, as the baby is leaving the womb."

European sophisticate: "What! That's barbaric."

Pretty gimmicky little lead, but I was interested to see where this was going:

In other words, what people think about abortion -- more precisely, what they think they think -- is strongly influenced by what they know. But the ignorance of most people, including usually well-informed people like my dinner-party companions, about a topic that has been as controversial for as long as abortion does seem to call for explanation.

Ramesh Ponnuru provides exactly that in his new book, The Party of Death (Regnery Publishing), about the politics of abortion, stem cell research and cloning. (Full disclosure: Ramesh is a friend and the senior editor on National Review magazine, which I used to edit.)

Okay, stop right there. Ramesh Ponnuru? (Full disclosure: Ramesh is not a friend and he really didn't impress me when he was on the Daily Show last month, which I watched where I used to edit.)

Ponnuru deals, first, with the nature of people's ignorance. Most Americans, let alone most European sophisticates, have no idea that the landmark Supreme Court decision, Roe vs. Wade, establishing a constitutional right to abortion, means that a woman can obtain an abortion right up to the moment of her baby's birth. When this claim is advanced, they point out that Roe specifically insists that states may regulate abortion in the second trimester and prohibit it in the third trimester.

But Roe also states that states can neither ban nor regulate abortion in cases where a doctor certifies that a woman's life or health would be adversely affected. And in a second Supreme Court judgment, Doe vs. Bolton, delivered that same day, Justice Harry Blackmun wrote that the doctor's medical judgment should be exercised "in the light of all factors -- physical, emotional, psychological, familial, and the woman's age -- relevant to the well-being of the patient." In brief: unfettered choice posing as a clinical decision.

Roe and Doe together allow a woman and her doctor to have a legal abortion for any reason at any time before birth, and arguably even during birth. The courts have confirmed this in countless cases, but especially in those striking down state and federal laws to prohibit or regulate "partial birth abortion" -- i.e., the procedure in which a baby is partly delivered and, while in the birth canal, has his or her skull crushed and his or her brains sucked out.

And that was just about where I lost it. I shook my head reading the rest of the op-ed, still stuck on that rather cheap way of portraying things. Pro-Lifers really like to hammer that one home: the "partial birth" argument is the ace up their sleeve. And, hey, if Ann Coulter can sneak a mention of it into her recent conversation with Matt Lauer—it must be a good argument, right?

But set aside the partial birth thing one moment. A little more than a month before I read this piece, Melissa Simon wrote this in the Sun-Times on April 24 under the headline, "Who decides fate of 13-year-old rape victim?: I hope that politicians and voters will consider the facts about abortion.":

I was appalled when I heard South Dakota's governor declare that he signed an abortion ban into law because "unborn children are the most vulnerable and helpless persons in our society." As an obstetrician-gynecologist working at a major teaching hospital in Chicago, I treat women and girls every day who are in desperate need of reproductive health care services, ranging from abortion to counseling about contraceptives and prenatal care. One day is seared in my memory forever as an example of why the services we provide—including safe, legal abortions—are so essential.

My first patient that day was a scared, 12-year-old girl who was 22 weeks pregnant and wanted an abortion. She came into the clinic sucking her thumb and gripping her mother's hand. The girl claimed to have a boyfriend in the eighth grade. She had no knowledge of or access to contraception and had never been taught about sex either at school or at home.

Next, I treated a pregnant 13-year-old who had been raped by a 19-year-old man. She came to our clinic accompanied by her mother, while her seven younger brothers and sisters were in school. I will never forget the shame and fear in this young girl's face as she clutched her teddy bear and told me her story.

My third patient was another 13-year-old, who had been molested by her mother's boyfriend and was 23 weeks pregnant. She was brought into the clinic by a cousin. As I listened to this girl's story, I began to cry.

And after just reading that, I almost did, too ...

When I think about "the most helpless and vulnerable people in our society," I see the faces of the three young girls I treated in that one heartbreaking day. What compassion are we showing when we force a frightened girl to become a mother at age 13? When we prevent girls and boys from learning about contraception, setting them up for unintended pregnancies that could easily have been prevented? These girls need empathy and treatment, not laws and regulations that prevent them from getting the health care services they need.

A small but powerful group of extremely conservative politicians is working to ban abortion, deny emergency contraception to victims of rape, and teach young men and women that abstinence from sex is their only option to prevent pregnancy and sexually transmitted diseases. If these trends continue, I expect I will face many more heartbreaking days treating women who are the victims of policies that deny them access to safe, evidence-based health care.

Here are some facts that I wish more politicians would consider: Abortion is one of the safest medical procedures performed in the United States. Because abortion is so contentious, it has been widely studied and scrutinized, and we know that the risk of death or complications from either medication or surgical abortion is very low -- lower, in fact, than the risk of dying from childbirth. Mental health concerns are often raised as an objection to abortion, but while some women report feelings of sadness or guilt after having an abortion, their most prominent response is relief. We know from examples around the world that banning abortion only hurts women by driving the procedure underground and increasing the risks of substandard care.

Thirteen states are currently considering laws similar to South Dakota's ban on abortion. As these bills are debated in statehouses across our country, I hope that politicians and voters will consider the facts about abortion. We need to step away from political rhetoric and religious orthodoxies, and ensure that all Americans continue to have access to safe health care. The decision to have an abortion is a highly personal one and should be made by a woman, in consultation with her family and her doctor. When politicians decide what health care a 13-year-old rape victim can receive, they do nothing to resolve the problems that led to her pregnancy.

I agree that our society has an obligation to protect our most vulnerable and helpless persons. But banning abortion is not the solution. It is time for Americans to stand up in support of comprehensive sexuality education, access to contraceptives and scientifically based medicine. Let our society be remembered for its compassion and objectivity, not for the harm we have caused to countless women and girls.

Melissa Simon is an obstetrician-gynecologist specializing in family planning, and a member of Physicians for Reproductive Choice and Health.

And while Simon's column preceded O'Sullivan's, this morning's letters to the editor in the Sun-Times made me feel a little better when it began with "Got abortions all wrong":

In "Do you really know our abortion law?" [column, May 30], John O'Sullivan purports to compare the laws regulating abortion in the United States and western Europe. O'Sullivan's piece, however, more aptly displays the author's ignorance of abortion law, his willingness to mislead readers and his refusal to examine the real question: why abortion rates in the United States are much higher than in western Europe.

O'Sullivan's misunderstanding of abortion law is stunning. For more than 30 years, the U.S. Supreme Court has consistently upheld a woman's right to abortion, but not without limitations. Furthermore, the Supreme Court has upheld the right of states to ban abortion after fetal viability (usually at about 24 weeks of pregnancy) except when the life or health of the woman is at stake.

Perhaps most telling, recent statistics collected by the Centers for Disease Control reveal that more than 90 percent of all abortions performed in the United States occur during the first trimester of pregnancy, approximately 10 percent occur in the second and less than 2 percent of all abortions occur after 20 weeks of gestation. O'Sullivan's decision to paint a picture of "unfettered" access to abortion throughout all stages of pregnancy is not only misleading but untrue.

The author goes on to compare the rarity of unintended pregnancies in the Netherlands because of "comprehensive sex education and widespread access to contraceptives" to the U.S., where "half of all pregnancies are unintended, abstinence-only until marriage programs that do not discuss contraceptives except to say failure rates abound ..."

Perhaps at one of O'Sullivan's next dinner parties he could start a discussion about why the United States is failing when it comes to pregnancy prevention instead of vilifying women who choose abortion.

Lorie A. Chaiten, director,
Reproductive Rights Project,
ACLU of Illinois

Okay, we all know abstinence-only education is a total joke. Add it to the "better in theory" list.

But the abortion debate regained its intensity the minute President Bush got word he'd be picking a new Supreme Court justice. And now that Republicans who voted against the abortion ban in South Dakota are getting voted out, it's becoming more and more obvious that too many people don't want the church and the state to be two separate things anymore. It just keeps getting scarier.

I say that because I remember abortion being one of the issues where it didn't seem to matter what I thought inside the church. One night, at the church's weekly educational session for the high school kids, we discussed abortion.

Like most kids I knew at school—all of us knowing no better about the topic—repeated the same line about "only in cases of rape or incest." And when the church's youth leader stood with his microphone on the stage at the end of the evening and asked us if we thought abortion should be legal, of course the girl from school who was just as smart or creative as anybody—even moreso—immediately said aloud, "Only in cases of rape or incest."

We took the bait.

Sure, it's sad and unfair that a woman became pregnant against her will, the leader admitted. But, isn't it just as sad and unfair to that baby to end its life?

And I looked to my left, then to my right. Every person seated in the audience was nodding. It was weird ... eerie ... cult-like.

But imagery like the scene O'Sullivan described regarding partial birth abortion is played out as though it's the moral trump card: Any other position advocates murder.

Of course, that's a wild distortion I wish would go away. Of people I've known who have had to go through this procedure, absolutely none have made the experience sound emotionally painless. As Chaiten notes, third trimester abortions are far from common, but however you break down the percentages, I imagine pretty close to 100 percent didn't want to be in their situation. And a similar percentage probably found no joy in the process.

I don't understand the logic of the pro-life movement sometimes. I get that they believe that banning abortion would, in their minds, save millions. But it would ruin millions of others too. And if the zealots who think that outlawing this procedure would solve a major problem, I wish they'd realize just how many more such a decision would cause.