Abortion complications

Andrew Sullivan wrote:

I want to reiterate my personal moral opposition to legal late term abortions. I understand the awful tragedies and complexities involved. I know too that most of these children would die soon anyway - or be subject to grueling operations with many risks. I just find the ending of human life to be something we avoid as much as we possibly can. And we need to find many more ways to facilitate contraception, the morning-after pill, and adoption to make these tragedies much rarer than they are.

Mark Kleiman is befuddled:

Sorry, I can't make sense of this. "Contraception, the morning-after pill, and adoption" are relevant to the problem of fourteen-year-old girls who conceal their pregnancies until they start to "show." (Even then, it takes a colder heart than I can master to say to a middle-school girl who is carrying her father's child that she has to go through the pain —and, at that age, danger— of childbirth to bear her half-brother.)

But the whole "safe, legal, and rare" formula offers nothing to women who are carrying fetusus which, if carried to term, would face short, agonizing lives, or women whose pregnancies will kill them if not terminated, or women whose fetuses die inside them. (Yes, doctors are afraid to do dilation and extraction — the famous "partial-birth abortion" — even when the fetus is already dead.) Making late-term abortion illegal condemns them to horrors no one should have to face, and I for one don't have much patience with those willing to impose those horrors on others in order to salve their own consciences.

What Dr. George Tiller was doing (as one of only three physicians in the country) desperately needed, and needs, to be done. An appropriate memorial to him, and rebuke to his killer and those who egged his killer on, would be to enact policies to make certain that the services he had the courage to provide will be provided by others.

A Dish reader wrote:

When I was pregnant with my second child, this is what happened to me. I was in the middle of the "feel good" sonogram at 21 weeks when the technician made a funny face and said that she was having difficulty getting some measurements. Her supervisor came in and took over, after asking me whether I had any other children and whether they were normal. And then I spoke with the radiologist, who was blunt and dour, and helped me get an immediate referral to Children's Hospital, where, several specialized sonograms later, we got as grim a verdict as I could possibly have imagined: a severe brain defect, a severe heart defect, other highly unusual but not easily interpreted "signs" of impairment, including structural or neurological deficits associated with swallowing and other motor functions. It all pointed to chromosomal anomaly, but, too bad for me, it wasn't possible to get definitive diagnosis in the time frame I had to make up my mind to obtain a legal termination.

My choices were to do nothing, undergo termination with less than definitive diagnosis, or wait for the definitive diagnosis, and then go to New York or Colorado, or, I guess, Kansas.

Technology has made the chromosomal test a lot quicker than it used to be. My doctor was very helpful -- telling me to consider what I would do if the amnio cam back normal, because even if chromosomally normal, we were looking at a grim prognosis. I also had the help of a genetics counselor who told me that she often found herself in the position of trying to keep people from overreacting in the face of alarming information -- accentuating the positive, if you will, but she had to admit that in my case, there was no positive information. So we did what we could to sort out the information we had, and we realized that there was almost no chance that the baby would live.

If she lived at all, she was destined for debilitating and probably inexplicable pain and suffering (at least three and probably more major surgeries), and a short life. There would never be any surgery for her brain defect, and if she was chromosomally abnormal, most doctors would refuse to do surgery, and she would simply be allowed to die. When we scheduled the termination, they did an amnio to get the definitive diagnosis, which turned out to be a rare and unsurvivable trisomy (#22 if you are interested -- it is so rare that the geneticist got a little excited because she had never personally seen it). The last time I saw her on the sonogram screen, her heart rate had decelerated to below 100, which is abnormal for a fetus. I believe that she was sustained as far as she was by me, and that she was already starting to die.

I was haunted for a while that I had to decide before I knew for sure that death was inevitable, and once I got over the grief of having done that, the experience only deepened my belief that abortion should be the province of individual men and women. I think I speak for a lot of people when I say that I have concluded that a decision to undergo abortion or continue a pregnancy is often made instinctively, with a nearly primal conviction that it is the right thing to do under the circumstances. Trying to impose a rigid moral framework based on an extreme notion of equality of personhood doesn't even begin to speak to the complexities of what most people experience when trying to decide this question for themselves.

I found this enlightening, and I urge you to read Mark's first link, by hilzoy, who gathers more such stories.

I've long been pro-choice on individualist, anti-state-intervention grounds—while possessing no small amount of personal distaste for mothers who undergo "irresponsible" mid and late-term abortions—i.e. "they should have used protection, but it's their decision, and the state shouldn't be involved, the blood's not on our hands, etc."

However, for these late-termers, as Andrew knew, "most of these children would die soon anyway - or be subject to grueling operations with many risks." I did not know this—I never took the time to familiarize myself with cases of people seeking late-term abortion of the kind Dr. Tiller provided.

Our Lady of Perpetual Outrage warned us to "prepare for whitewashed hagiographies of Tiller’s career as an abortionist." Well, such things are probably being spread around, but the stories here do not sound hagiographical to me. They seem tragically real, personal, and affecting—to the point where I think reading them has made me more staunchly pro-choice.

In the past, I've mostly been interested in decrying the theocratic underpinnings of pro-life conservatism. My position was more an anti-statism, defense of secularism, and opposition to the ludicrous idea that personhood begins at conception—not so much actual support for most abortions.

But these stories confirm for me the intuition that—however late in the term—abortions are personal decisions to be made by mothers, doctors, family, and perhaps spiritual advisors—not state legislatures or political activists.