Who pays the cost?

The Cost of “Choice”
Edited by Erika Bachiochi
Encounter Books, San Francisco, 2004

This is a frankly partisan book, and though subtitled Women Evaluate the Impact of Abortion, it would be fair to say that positive claims for any impact are given short shrift, and the editor is someone who has changed her mind. Changed her mind in what sense? Perhaps the greatest difference between British and American attitudes – and I must make clear that this is not the same as British and American practices – is that while here we regard abortion as a range of moral options, Americans have been polarised by their legal system into only two: for or against. This is an American book (the experience of other countries is hardly mentioned), the editor is American; she was once for abortion and is now against it. Under all circumstances? It is fair to say that this not much discussed.

The landmark decision on abortion in the US was the Supreme Court ruling (which has been strengthened by several subsequent ones) in Roe v. Wade in 1973, five years after the Abortion Act was passed in this country. Both effectively legalised abortion on demand, at any stage in the pregnancy, so that it was it was perfectly permissible to kill someone who, if born, could survive if supported by present-day technology, or even without it (p. 6). Personally I would like to think that such cases are uncommon. However, the on-going US debate on “partial birth” abortion, where parturition is induced so that the emerging baby can more conveniently be killed (p. 19), suggests otherwise. Congress passed a law against it, which was vetoed by President Clinton, but signed by President Bush in 2003; it may yet fail at the Supreme Court, which in 2000 declared partial-birth abortion legal.

Although in this country the matter was debated in Parliament (though without its later ramifications being even suspected) and laid to rest when the Act that legalized abortion passed into law, in the US “the decision of Roe v. Wade launched a civic debacle… [when] the Court abruptly brought this process to a halt (p. xii)”. There is no doubt that this decision, tortuously argued from a “right to privacy” not mentioned, let alone enshrined, anywhere in the US Constitution, was correctly called by one of the dissenting judges “a power grab” and by another “an exercise in raw judicial power”. And if legislatures could be circumvented in this way, where would it all end? In fact, it looks as if this short-circuit “legislation by judiciary” is a one-off. Some constitutional lawyers had their misgivings but at least the men seem, as one of them put it in a burst of frankness, to have “been made to understand that the abortion issue was so important to the women in our lives, and it did not seem that important to most of us (p. 12).” And what, to be cynical about it, could be more convenient for the errant male than to be absolved from the responsibility of paternity by paying for an abortion? So much for the “oppressive patriarchy”. As for the upholders of the, up till then, conventional morality, perhaps their surrender is best typified by the reply of the Jesuit dean of Boston College: “Well you see, Mary Ann [Glendon], it’s very simple. According to Vatican II, abortion is an ‘unspeakable moral crime’. But in a pluralistic democracy, we can’t impose our moral views on other people (p. 11).” Such passivity, of course, is not the stance of a true activist, but perhaps for Catholics, already overcome by the consensus on fornication, adultery and contraception, a defeat on abortion was simply the inevitable continuation of an unstoppable trend, one they were, if politicians, “personally opposed to” but also could do nothing about and even vote for if electorally advantageous.

So much for scene-setting. Twelve women have contributed essays to this book, but it must be said that anyone hoping to see facts laid out in tables, graphs or histograms will be disappointed; there is one table in the text and one in a footnote – and nothing else. But never mind about that; the aims of the group are unclear. It is obvious from the tenor of the articles that all the writers regard abortion as undesirable – that is their reason for their contributions. “Is the unborn child inside or outside the circle of moral concern? That is the heart of the matter.” Such is the rather roundabout statement made in the Preface by a thirteenth woman, University of Chicago Professor Jean Bethke Elshtain. I should prefer the simpler question: “Is the unborn child a human being?” Whether the foetus, at any stage of its existence, has any human rights is uncertain, for these, such as they are, depend entirely on the will of its mother, who can kill it at any time, though it remains criminal to kill it without her consent. Human rights groups, so far as I am aware, have no interest in the subject. Incidentally, it might be noted that the adjective “moral”, both here and in the Jesuit’s statement above, is merely used for emphasis and quite unnecessary.

According to surveys given here, most Americans do regard the unborn child as human and are far from agreeing that it is a mere lump of parasitic tissue, as the more militant feminists tell them it is. Most of them are also unaware that “the right to choose” has been expanded to include abortion on demand. Even many law professors seem surprised when told this is the case (p. 6). Howover this ignornace is less likely in those in a position to know and two-thirds of all obstetricians and gynaecologists refuse to do abortions under any circumstances, especially those young (under 40) and female, the very category that should be most sympathetic to the pro-abortion message. Most abortions are carried out in clinics set up for that purpose which are, from what is said here, far from being supervised, inspected or regulated satisfactorily.

It also seems to be a fact that the number of abortions in the US is falling, though only slightly – from 1.36 million in 1996 to 1.31 million in 2000. Proportionately, this decrease is not great, but it might be noted that it is twice the number (200,000) of illegal abortions estimated to have been carried out annually before Roe v. Wade. For some readers, it may be a defect in the book that these abortions, which represent 25% of all annual US pregnancies, are not classified in any way, by age, race (it is well known that abortions are disproportionately high for black women), or economic status or at what stage or trimester in the pregnancy they are carried out. Perhaps these data are more difficult to find than I think they ought to be: a quick (amateur) google did not give quick results, and those only from 1974 until 1994, at www.abortiontv.com/Misc/AbortionStatistics.htm. These did, however, show a definite shift from younger to older women during that time, and (confirming the statement given above) an even more definite one from white to black, presumably correlated with the progressive disintegration of black families during this period.

There are two consequences of abortion examined here, additional that is to the elimination of the foetus: psychological trauma and subsequent ill-health. It is probably not too harsh to say that the evidence for the first more than verges on the anecdotal. No one can deny that many women bitterly regret their abortions, whether undergone willingly or under coercion, and suffer greatly. But the evidence here was not gathered by sampling, but by solicitation (e.g. p. 87), and there is no mention of those others who may have had no regrets, didn’t suffer and felt only relief. However it is only fair to mention that, in a study based on Finnish statistics, post-abortion suicide was three times the national average for women in the same age-group, which itself was twice the rate for those who had given birth, taking the following year as the time interval (p. 96). It may well be objected that causal does not follow from correlation, and that a woman who has an abortion may have other problems, leading to both abortion and suicide. Yet only the heartless can dismiss the possibility that the prevention of the first might prevent the second.

In the matter of subsequent health problems we are undoubtedly on firmer ground. The evidence for a link between abortion and breast cancer seems well-documented and two authors who believe in it (Shandigian and Lanfranchi) discuss it at length, including the endocrinal mechanism by which the one may cause the other. However, the extent to which the link is still controversial is indicated by their admission that the American College of Obstetricians and Gynecologists did not support their position. On the other hand there is evidence, again anecdotal, that academics are reluctant to discuss the link in the milieu they expect to attain professional advancement, while learned bodies ban discussion of it at their conferences as “too political” (p.85). According to one study (numbers not given), there is an increased hazard for women who have a family history of breast cancer. All pregnant teenagers from such families who aborted their first pregnancy developed breast cancer by the age of 45 (p. 67 and 75). Would this information give such a pregnant teenager pause? The chances are that she would never hear about it.

In the end we confront the question this book does not really face, but which the reader inevitably asks: what is to be done about the 1.31 million abortions per annum? If the nation is comfortable with this, is there nothing more to be said? If it uneasy about it, as surveys seem to show, though in a non-urgent sort of way, then pro-lifers can hope to get their way, to the extent they limit their demands to what is politically possible. For it does not seem unreasonable to suppose that a country as rich as the USA, and from where women travel as far as China to find a baby to adopt, can afford to absorb this hypothetical surplus, or at least some of it. Can this potential supply be manipulated to meet this demand? Can a social climate be generated where abortion is not a first option? The mere suggestion arouses hostility; even organized attempts to persuade pregnant women not to abort seem to face an uphill task. For example, the California affiliate of the National Abortion and Reproductive Rights Action League (NARAL) got First Resort, a “pregnancy care service” with this purpose closed down (p. 37), and, of course, such services are entirely privately financed. So, to be sure, are the pro-abortionists, but they do not have to provide any “care services” beyond pointing applicants in the direction of abortionists, who will do what is wanted for the money. It would probably also not be wrong to say that they are by far the better organized, and have the backing, explicit or implicit, of mainstream women’s and feminist organizations.

If it would take too long to develop a general social climate in which the unwillingly pregnant were persuaded to give birth, and their unwanted children could be reared, perhaps the answer would be legal coercion to restore the status quo ante 1973. Once the clinics where most abortions are carried out came under State supervision and law enforcement, something could probably be done by legislation to introduce limits which the public would not only expect, but welcome. The situation would inevitably be messy, with “shopping around” between States with lax and severe laws, but would be the only method by which a realist could expect to bring about a reduction in the number of abortions. Quite simply, if it is made more difficult to get an abortion, there will be fewer of them. The first step towards this end, if desired, is of course to reverse the Supreme Court’s decisions and return the problem to the State Legislatures from whence it came. This will only come about if more judges who are “strict constructionists” of the Constitution are appointed to replace those who retire or die and if somehow a relevant legal case is brought to reverse Roe v Wade and the other decisions that extended it. I do not need to go into the enormous difficulties facing those who would have to try to bring this about.

The rise in abortion is in fact only one more feature of what has happened to what might be roughly called Western Civilization during the last forty years, put in lapidary form by Louis Roussel, head of the French National Institute for Demographic Studies and quoted here:

It is exceedingly rare in the history of populations that sudden changes appear across the entire set of demographic indicators. Yet in barely 15 years, starting in 1965, the birth rate and the marriage rate in all the industrialised countried tumbled, while divorces and births outside marriage increased rapidly. All those changes were substantial, with increases or decreases of more than 50 percent.