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4.5 ABORTION
The term "abortion" can be used for both the unintentional and the intentional premature termination of a pregnancy. The unintentional termination of a pregnancy is called abortion if it occurs within the first 4 months; after that time, it is usually called miscarriage. In the nonmedical language of everyday life, however, the word "abortion" most often means the intentional termination of an unwanted pregnancy.
Unwanted pregnancies happen for many reasons. Sometimes people who engage in coitus do not know about contraception, or they are unable to get contraceptives, or the contraceptives they use do not work. Whatever the cause, an unwanted pregnancy often creates very serious problems.
In the case of parents who already have difficulty supporting several children, one more birth can mean misery and despair for the whole family. An expectant mother who is physically weak or who suffers from certain diseases or drug addiction may, by her pregnancy, further endanger her own health or give birth to a sick or deformed baby. A young, unmarried woman may be totally unprepared, unfit, or unwilling to assume the responsibilities of motherhood. Thus, an unwanted birth could be a disaster not only for her but also for the child.
In these and similar cases, a woman may well decide that a voluntary abortion is the only way out. Unfortunately, some women resort to ill-considered, desperate actions and risk their health, indeed their very lives, by trying to abort themselves or by seeking the help of an unskilled criminal abortionist. They do this because our society often makes it difficult to obtain safe abortions. In fact, there is still a passionate debate among many political, religious, and legal authorities as to whether women should have the right to abort at all.
Some of those who argue against abortions do so because they consider themselves friends of the fetus and want to uphold the "sanctity of human life". There can hardly be a motive that deserves to be taken more seriously. Still, the very same motive has led some other people to take the side of the woman who wants to abort and to fight for her right to do so. A reconciliation between these opposing views seems unlikely. It is also obvious that the dilemma cannot be solved by science. There is no scientific way of deciding when a human life begins and under what conditions it may be taken. These are basically moral questions which have to be answered by the individual conscience.
Moral guidance in such matters has traditionally been offered by the various established religions and philosophies. However, their views are not always identical. Some contemporary religious groups favor abortions under certain circumstances and early in the pregnancy, while others are unconditionally opposed to them, considering every abortion to be murder (except to save the life of the mother, in which case it would be self-defense). The Catholic church, for example, maintains today (in contrast to its own teachings during the Middle Ages) that an embryo is a human life "from the moment of conception." However, scientists do not agree as to whether and when such a particular moment should be presumed to occur. In a way, it is a matter of definition. Scientifically speaking, the conception of a human being is best described not as a sudden occurrence but as a gradual, complicated process which begins with the union of an egg and a sperm cell (fertilization) and leads through various stages to the eventual attachment of a growing cell cluster to the uterine wall (implantation). This process is by no means automatic. It depends on a number of interrelated special conditions which are not always present. In some cases, the development takes an entirely different turn, no implantation occurs, and the fertilized egg simply degenerates. Consequently, according to general medical usage, we do not speak of the beginning of pregnancy until the implantation in the uterus has taken place. (For details, see "Conception.")
Until recently, voluntary abortions were prohibited by law in most states of the United States. However, even the most restrictive criminal laws usually recognized the broader scientific view of conception by providing no penalties for the use of "morning-after pills" or intra-uterine devices, which prevent the beginning of pregnancy in spite of possible fertilizations. Indeed, the very fact that such substances and devices are generally considered contraceptives and not abortifacients suggests that the Catholic interpretation is not shared by the public at large. Neither did our laws ever reflect the opinion that abortion is murder. If they had, the penalties for abortionists would have been the same as for murderers: death or life imprisonment. In actual fact, however, the penalties were always much less severe. Moreover, the most important person involved in the crime, the woman who had the abortion performed, was practically never prosecuted at all.
Such curious hesitancy, indeed ambiguity, on the part of the law indicates that the modern secular state cannot support any particular moral or religious viewpoint, but tends instead to seek some position of compromise. In fact, the state, which has to accommodate and protect the adherents of many different and often conflicting beliefs, can meet this obligation only by basing its laws on purely rational considerations. In the case of abortion, such considerations point clearly in one direction: leaving the matter entirety to professional medical judgment and the conscience of the individual.
This is also the direction followed by the U.S. Supreme Court in 1973 when it declared most then-existing state laws banning abortion to be unconstitutional. The court recognized every woman's right to obtain an abortion in the first three months of pregnancy while reaffirming the right of the state to safeguard health, maintain medical standards, and protect potential life. Consequently, the Supreme Court decision allows the individual states to regulate abortions after the third month of pregnancy to the extent that the regulation reasonably relates to the preservation and protection of maternal health. Only after the fetus has reached viability (i.e., the ability to survive outside the mother's womb) may a state continue to prohibit abortions altogether except for the purpose of preserving the life or health of the mother.
It is perhaps useful to remember that the former restrictive abortion laws had been enacted late in the 19th century mainly for medical reasons. At that time, an abortion was a dangerous operation which could easily lead to the death of the woman. In the meantime, however, medical procedures have been perfected to a point where early abortions can be considered quite safe. As a result, the state can now treat such abortions as a private matter and greatly reduce its protective interference. This legal stance does, of course, by no means imply that abortions are desirable. The highest court of the land merely recognizes that it is unwise to make them crimes. Those who are convinced that abortion is murder are still free to reject it for themselves. This is entirely as it should be because forced abortion as well as forced motherhood are incompatible with the ideals of equality, freedom, and self-determination. In the past, these ideals had to remain largely unrealized. Indeed, when it came to abortion the most blatant inequality was a fact of everyday life. Women who could pay for a trip to another state or another country with more liberal laws were not prevented from having a safe and legal abortion any time they wished. It was mainly the poor and uneducated who suffered the consequences of unwanted births or dangerous criminal abortions.
In the meantime it has become apparent, however, that for many Americans the landmark decision of the U.S. Supreme Court has not settled the issue. In fact, there are many individuals and organizations demanding a "right to life" for the unborn and working for a constitutional amendment to criminalize abortions once again. One can assume that much of this campaign is inspired by the highest possible ideals, and there can hardly be any question that, as a matter of principle, abortions are not to be welcomed or taken lightly. Any decision to abort is an unfortunate, hard choice at best. Furthermore, even if one disregards the embryo or fetus, an abortion is always a medical operation for the potential mother which may result in complications. Few sensitive people, therefore, would like to see the practice encouraged as a neutral routine procedure. It would seem much more preferable to arrive at a situation where abortions become unnecessary. Yet the only policy that could reach this goal would be the methodical and nearly universal use of contraception. Consequently, those who want criminal laws against abortion remain unconvincing (and even seem hypocritical) as long as they fail to encourage contraception. (And, let it be noted, such encouragement would have to go well beyond the now "acceptable" standards.) It would seem that, in the meantime, the Supreme Court decision provides a reasonable and practical, and therefore defensible, solution to an unresolved moral dilemma.
It remains to be seen how the various state legislatures will respond to this decision. Fortunately, one fact is already clear: Every woman in the United States who wants a legal abortion can get one if she really tries. Under no circumstances should she put herself in the hands of an unskilled, criminal abortionist, or try to abort herself. The only sensible course of action is to seek a legal, medically competent abortion in a hospital or in a doctor's office. In many cities, the Planned Parenthood offices, women's liberation groups, or free clinics offer the necessary advice and assistance. If no local help is available, information and referral will be provided by Planned Parenthood Federation of America, 810 Seventh Avenue, New York, N.Y. 10019, telephone (212) 541-7800 and the Center for Reproductive and Sexual Health, 10 East 21st Street, New York, N.Y. 10010, telephone (212) 758-7310.
Remember:
• If you are considering an abortion, get expert counseling.
• The earlier an abortion is done, the better.
• You can have a legal and safe abortion in a hospital or in a doctor's office.
• Do not seek the help of an unskilled, criminal abortionist.
• Do not try to abort yourself.
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