When Protecting Scruples Comes Before Women’s Health

Pregnancies that threaten the life of the mother can pose a bit of a problem problem for pro-lifers. Some, such as Live Action’s Lila Rose (who by the way grew up in the same conservative Christian homeschool environment I did), solve this problem by simply denying that pregnancy ever threatens a woman’s life (“Abortions are never medically necessary. Some doctors prescribe abortion as if it’s a treatment for a disease or a problem, but that’s not a solution a truly compassionate and just society should turn to.”). The maternal mortality rate would beg to differ with Lila Rose. In contrast, many pro-lifers accept that life-threatening pregnancy conditions do exist and justify abortions in these cases on the grounds self-defense. Others, however, admit that pregnancies can be life-threatening but argue that abortion is not okay even then because it is never okay to take an innocent life (i.e., that of the embryo or fetus), even in self defense. In this post we’re focusing on that last group.

Beatriz is a 22-year-old El Salvadoran woman with a life threatening pregnancy who was denied an abortion last month even though her fetus was anencephalic and therefore doomed anyway. Abortion is banned in El Salvador, even in the case of the life of the mother. El Salvadoran pro-life groups praised the decision deny Beatriz an abortion: “Once again, Salvadorans have given an example to the entire world that we defend the right to life of all human beings however small, poor, vulnerable or defenceless.” As you may have heard, Beatriz ultimately survived. How? Like this:

Doctors in El Salvador got around the law by waiting until the 26th week of pregnancy and then performing a Cesarean section—a procedure everyone knew would result in the death of the fetus (which it did) but which can be construed as a “birth” instead of an abortion, even though the end result is the same.

With this solution, Beatriz lived and El Salvadoran politicians could live with sound consciences. To me, this is a bit bizarre. The result was the same and everyone knew the result would be the same, but apparently calling it a “birth” rather than an “abortion” made it suddenly okay. Did I mention that this work-around involved gambling with a pregnant woman’s life, and making decisions for her that weren’t in her medical best interests?

Of course, a C-section is significantly more dangerous than an abortion (and especially more dangerous than an earlier abortion, which Beatriz could have had two months ago if she didn’t live in a “pro-life” nation). C-sections are invasive surgical procedures, which are significantly more complicated than early abortions, and pose much higher risks of infection or complication, especially when performed on someone whose health is already compromised by lupus and potential organ failure. They take longer to recover from, and they’re more expensive. Beatriz, thankfully, seems to be doing fine. But she was still legally compelled to undergo a more dangerous, invasive and complicated procedure — and forced to have her body suffer through declining health — so that ideologues could feel better about the intent of a more dangerous procedure that everyone knew would have the exact same outcome as an earlier, safer one.

And now I want to turn to a second example. Up to 1 in every 50 pregnancies is ectopic, meaning that the embryo implants outside of the uterus, usually in one of the Fallopian tubes. This condition is life-threatening to the woman, and the chances of the embryo or fetus surviving are nil. While some ectopic pregnancies may resolve on their own, a significant number will rupture if action is not taken, and rupture can lead to shock and death. If an ectopic pregnancy is discovered early enough, treatment involves taking a drug to stop the production of pregnancy hormones and induce a miscarriage. If it is caught when the pregnancy is more than a few weeks along, surgery will be necessary to remove the pregnancy and part or all of the Fallopian tube. If the ectopic pregnancy ruptures, emergency surgery is needed.

And here is where it gets interesting. The Catholic church does not permit women with ectopic pregnancies to take drugs to end their pregnancies, but it does allow  surgery—if the entire Fallopian tube is removed, rather than just the pregnancy.  This is the same logic that made extremely premature birth, but not abortion, acceptable in Beatriz’ case, even though everyone knew that both would have the same result. Homeschool leader and biblical patriarchy supporter Doug Phillips takes a slightly different line: He is against the drugs and against surgery to remove the pregnancy whether or not the entire tube is removed. His argument is that women should just wait it out and see what happens—in half of all cases it would resolve without a problem, and in the other half the ectopic pregnancy would rupture. Emergency surgery after rupture is fine with Phillips, because the life of the embryo or fetus has already ended and the surgery simply removes its deceased form.

Phillips’ justification, besides the argument that it’s never okay for a mother to kill her child, is that very few women actually die from ruptured ectopic pregnancies today. Further, he argues that there is actually some chance that an ectopic pregnancy can come to term, arguing that there are rare cases of this happening. (In actual fact, while there are a few cases of ectopic pregnancies coming to term, none of these cases involve ectopic pregnancies where the embryo implanted in the Fallopian tubes, which count for 98% of all ectopic pregnancies.) Even if you accept that (in the United States) most women whose ectopic pregnancies rupture survive, think about what’s going on here: Phillips thinks women should have to face a medical situation that is extremely dangerous to their health rather than take the pregnancy-ending drugs or have a surgery to prevent possible rupture, even though the end result for the embryo or fetus is the same.

The feeling I get here is that protecting scruples is more important than protecting women’s health (remember that in all of these cases the pregnancy is doomed anyway, so this isn’t about saving lives). Vision Forum, by the way, is associated with Samaritan Ministries, which serves as a third-party health insurance sharing program for thousands of evangelicals and has officially endorsed Doug Phillips’ position on ectopic pregnancies. Hmm.