The Natural Consequences of Banning Abortion

The Natural Consequences of Banning Abortion April 5, 2016

Poland’s controversial proposed new abortion ban hit the news this weekend:

Thousands protested on Sunday against the Polish government after the ruling party’s powerful leader and the country’s prime minister said they backed a complete ban on abortion advocated by the Catholic Church.

Abortion is already highly restricted in Poland. What would the new bill do?

The proposed move would end a status quo reached in the 1990s under which abortion is allowed in three cases — when the pregnancy is the result of a crime like rape or incest, when it puts the health of the mother at risk, and when the fetus is terminally ill or has a severe disability.

As I read about Poland’s bill, I was struck by how familiar much of it felt. Here in the U.S. we are already saddled with some of the consequences that of necessity accompany such blanket bans on abortion—consequences abortion opponents are rarely fully honest about. I am speaking specifically about a willingness to play fast and loose with a pregnant woman’s health, prioritizing a fetal heartbeat over her very survival, and about the practice of investigating miscarriages.

Neither of these things are in the best interest of any woman, regardless of her views on abortion, but both are the inevitable consequences of fetal personhood, and neither is talked about often enough.

Here in the U.S. abortion is technically legal (with some restrictions, depending on the state) if a pregnancy endangers a mother’s life, but the Catholic Church’s investment in our hospital system means that this is not always true in practice. There are hospitals in the U.S. today that will let a pregnant woman bleed out rather than complete a miscarriage while a fetus’s heart is still beating. Just because performing an abortion to save a woman’s life is legal doesn’t mean hospitals controlled by the Catholic Church are going to do it.

The woman inside the ambulance was miscarrying. That was clear from the foul-smelling fluid leaving her body. As the vehicle wailed toward the hospital, a doctor waiting for her arrival phoned a specialist, who was unequivocal: the baby would die. The woman might follow. Induce labor immediately.

But staff at the Mercy Health Partners hospital in Muskegon, Michigan would not induce labor for another 10 hours. Instead, they followed a set of directives written by the United States Conference of Catholic Bishops that forbid terminating a pregnancy unless the mother is in grave condition. Doctors decided they would delay until the woman showed signs of sepsis – a life-threatening response to an advanced infection – or the fetal heart stopped on its own.

In the end, it was sepsis.

Have we forgotten Savita Halappanavar of Ireland?

The husband of a pregnant woman who died in an Irish hospital has said he has no doubt she would be alive if she had been allowed an abortion.

Savita Halappanavar’s family said she asked several times for her pregnancy to be terminated because she had severe back pain and was miscarrying.

Her husband told the BBC that it was refused because there was a foetal heartbeat.

Remember that the Catholic Church sainted a woman who refused to have an abortion even as her pregnancy killed her, ultimately leaving her husband a widower with four young children. Remember too that only a few years ago the Catholic Church excommunicated a nun in Arizona for approving a life-saving abortion on a woman who was 11 weeks pregnant with her fifth child. What I want to emphasize is that this isn’t just something that happens in Ireland, or Poland, or countries in South America which have blanket bans on abortion. It’s something that happens in the U.S. today.

Whatever people say about abortions performed for other reasons, when it comes to a pregnancy that threatens a woman’s life, we ought to be able to reach some level of agreement. We don’t prosecute people who refuse to go back into burning buildings after people who are trapped—in fact, firefighters tell people not to do that—and we especially would not prosecute them for not doing so if a risk-assessment suggested that no one would be saved and the would-be rescuer would have died in the blaze along with the others. Neither of the two women referenced above had reached the point in pregnancy when a fetus can survive outside the womb, meaning that the question was not whether to save the mother or the fetus but rather whether or not to let the mother die along with her fetus.

Restrictions on abortion when the life of the mother is at risk are incredibly dangerous. Pregnancy comes with health risks. That’s how it works. Women have to be able to terminate the process if the risk to their health and very life becomes to much. Some women have health issues such that a pregnancy is guaranteed to endanger and very likely end their lives. For these women, absent legal abortion, becoming pregnant is like signing a death warrant. Prioritizing the life of the fetus over the life of the mother puts women’s health in danger. There’s no way around this.

Can we talk about the fact that in some countries, miscarriages are investigated?

If this new legislation in Poland becomes law, doctors could be investigated if women under their care miscarry. After all, harming a fetus in any way, even to save a mother’s life, would be a crime meriting jail time. In order to enforce the law, hospitals would have to ensure that doctors did not do anything to complete a miscarriage already in progress or induce a miscarriage in women with other life-threatening conditions. And that means treating miscarriages as suspect.

Here in the U.S., where women in many states are already prosecuted for self-induced abortions, the idea that miscarriages might be investigated is not a stretch.

Can we talk about what such investigations might look like?

When Carmen Guadalupe Vasquez was rushed to hospital after giving birth to a stillborn baby boy, the doctors first treated her life-threatening bleeding and then called the police who handcuffed her to the bed.

In El Salvador, where all abortion is illegal and emergency wards are turned into crime scenes, the confused, weak and desperately ill 18-year-old maid was placed under investigation for terminating her pregnancy and driven away in a police van.

After prosecutors declared that the foetus could have lived, they upgraded the charges to aggravated homicide. Despite Miss Vazquez’s insistence that she had done nothing to harm her unborn child, she was sentenced to 30 years in prison after a cursory prosecution case was laid out.

Before anyone suggests that couldn’t happen here, please note that it already has.

El Salvador’s abortion regime has consequences.

Suicide was the most common cause of death in 2011 among 10-to-19-year-old girls, half of whom were pregnant, according to Health Ministry figures.

It was also the third most common cause of maternal mortality.

All of this may seem extreme, but in some sense it is only the natural consequence of banning abortion. In a world where abortion is illegal, miscarriages are automatically suspect. In fact, in a world where fetuses are considered legal persons, every miscarriage of necessity has to be investigated, just as every death is, to determine whether it was natural or whether foul play was involved. Because abortions are simply induced miscarriages, telling the difference between a spontaneous and induced miscarriage is not always be easy.

On some level, I understand why so many people identify as pro-life. I get it. I grew up in a pro-life home and only changed my position on the issue halfway through college. The idea that we need to save unborn babies from being murdered can seem compelling. But we need to be clear about where laws banning abortion and granting fetal personhood will take us. Republicans reacted with faux shock last week when Donald Trump suggested that women who have abortions should be punished, but the unvarnished truth is that there is no way to ban abortion without creating negative consequences that affect every individual with a uterus.

Discussions of the unintended consequences of banning abortion often center on back alley abortions, but the problems go further. A total ban on abortion would mean investigating miscarriages looking for foul play, and letting hemorrhaging women die on the operating table because a fetal heartbeat is still detectible. The system created by the sort of restrictions Poland is talking about passing is a danger even to women with wanted pregnancies. We don’t talk about this nearly often enough.

And in too many areas and hospitals, this problem is already with us.

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