Two Views on Abortion

There were at least two kinds of responses to last week’s blog on the anniversary of legalizing abortion in America. Because of limited space I can only share one view this week. The other I will share next week. The first comes from a medical doctor in the Caribbean. The second, from a religious scholar who lives in the United States.

I mulled over your latest blog and thought I would share some thoughts with you based on my work with young, and not so young, women in the Caribbean and Latin America. This piece is not intended to sway you but to present another perspective on the issue.

Like you, I wish we never had to have abortions - that no woman would ever make the decision to terminate a pregnancy - even if that decision might place her at physical, emotional, or moral risk. But, abortion has been with us as far back as 1550 BCE – the first recorded case of abortion was found in the Ebers Papyrus. Even before we had medically safe ways of terminating pregnancies, women found ways to do the procedure themselves – whether by drinking noxious potions, or striking themselves in places that they hoped would dislodge the fetus, or inserting herbal tampons or sharp implements into their uteruses expecting to remove the fetus. These practices persist even today among poor women.

In the absence of medically safe and legal abortion services, women who try to abort a pregnancy either die or end up in hospital with morbidities that render them infertile or worst. (Until recently, the majority of poor women on the gynecological ward of public hospitals in many Caribbean countries were women seeking post abortion care.) I should mention that there is an inverse relationship between maternal mortality and morbidity rates (related to abortions) and access to safe abortion services – that is, where access is poor, rates of abortion-related mortality and morbidity are high. Please note that ‘safe’ abortion is not the same as ‘legal’ abortion. In much of the Caribbean, not including Barbados and Guyana where terminations are legal in certain circumstances, women can get safe abortions from private practitioners. The so called ‘back street’ practitioners persist – they are more affordable for poor women.

Who are these women who will go to these lengths to terminate a pregnancy? The literature will tell you that a minority (less than 10%) of women who seek abortions are “repeat offenders”. They are women who, although they are sexually active and do not desire a, or another child, are not doing anything to prevent a pregnancy. The remaining 90% of women who seek abortions have: experienced a failure in their contraceptive method; been raped; or - mistimed or inconvenient pregnancies (woman has many children, woman is in school, woman has to protect a career, relationship with husband or partner is not healthy, woman is pregnant for a man who is not her husband, etc.); or pregnancies which, if carried to term, would place them at physical risk; or pregnancies that would result in a physically ‘defective’ child; or a fetus that has died.
When we read this list we may be tempted to make the judgment that the women who have abortions are women of loose morals. After all they have not followed the prescribed way – they may not have waited until marriage to become sexually involved, or may not have been faithful to their marriage partner, or committed some other moral infraction.

I have counseled single and married women who are ardent Christians who made one stupid decision and now are faced with carrying a pregnancy they rather not have. I have watched them struggle. Many would rather commit the sin of abortion (for which they can ask and receive forgiveness) than face the unforgiving wrath and vengeance of the church family. There have been cases, where the woman has kept her baby but left the ‘church’.

In my limited experience, contrary to conventional wisdom, the decision to terminate a pregnancy is not a decision that the majority of women make easily or cavalierly –in fact, the majority of women who have abortions have only one. A woman’s motivation to have the procedure is personal and most times outweighs the immediate, as well as the perceived long term consequences. What I’ve observed, however, is that where a woman has access to pre-termination education and counseling and post abortion services that are non-judgmental, she can make a decision about her pregnancy outcome that leaves her with no regret.

As a public health practitioner, I take the position that I would rather provide the woman who chooses to terminate a pregnancy the opportunity to do that in an informed and medically safe (and legal) way than have her dead or ill /damaged because of a self-directed or poorly executed intervention. As a Christian, I pray I will not be in a position to have to make that decision and for humility and the spirit of non-judgment for those who feel that they must.

The writer agrees that most abortions are as a result of lifestyle choices. However, she believes greater compassion and forgiveness are necessary. Please read last week’s blog. You must also read next week’s response to this perspective.