Here’s What We’re Not Addressing in the “Late Term Abortion” Debate

I’ve spent the past week trying to educate myself about the context for and content of recent bills regarding what some call “late term abortion.” I’ve been reading articles, listening to testimonies, and engaging with medical professionals on Twitter. I’m still not ready to address this issue directly, especially given the kind of vitriol that tends to be directed at anyone who attempts to approach life ethics with nuance.

I am, however, prepared to talk about something no one seems to be addressing, which is relevant for this debate no matter where on the spectrum of perspectives you fall.

And that is: how will you pay for it?

“It” in this case could refer to any number of things. I read one account of a couple who opted for the procedure sometimes called late-term abortion after they realized that their child would be born into a life of intense suffering. They had to fly halfway across the country and pay 20,000 dollars in order to have the procedure done.

In a Twitter conversation, progressive Christian writer Rachel Held Evans asked:

“If you know exactly what you would do if a scan revealed your baby was missing his kidneys & much of his brain & doctors said terminating would spare him prolonged suffering in the few hours of life he might get after birth, congratulations. Because I don’t.

Bioethicist Charlie Camosy retweeted with the response:

“First, I’d get a doctor who knows about perinatal hospice and failure rates in prenatal diagnosis. Second, I’d get a spiritual advisor who understood a Christian aversion to violence and the unequivocal equality and important of every human life, no matter how brief or disabled.”

I think both of these writers are coming from a place of respect for the dignity of life, though Evans emphasizes the value of alleviating suffering, while Camosy tends to put more stress on prohibitions against taking life. Both of these are important.

But for many women even in this powerful and wealthy nation, neither option is possible. What would I do if I found myself in a situation like that? In order to get to any kind of specialist, I’d need to have the insurance to cover it. Many doctors will not even take patients who are not covered in some way. I might call around. I might start a GoFundMe.

But there’s a pretty good chance that I would not be able to access needed care, and that both I and my unborn child would be added to the annual infant and maternal mortality statistics – which are higher in the US than in any other developed nation in the world. That would mean leaving my husband without a wife, my children without a mother, and a whole lot of nasty funeral costs.

I would like to stress also that both prenatal and postnatal care for a threatened pregnancy and a severely disabled infant are absolutely guaranteed to be far more expensive even than the astronomic 20,000 (plus plane ticket) for the pregnancy termination.

And because of the way our medical system works, and because medical outcomes reside so much in the realm of the unknown, parents in a dire situation would not even be able to work out, in advance, whether and how to afford treatment – if they even had the opportunity to consult with a specialist, in the first place, which for many would be unlikely.

Given the above factors, much of the debate that is happening takes place in a realm of of privilege that has little bearing on the actual reality women and their families face. And people seem simply not to be aware of this. One individual on Twitter informed me that any woman in a difficult pregnancy could just “go get Medicaid.” Which, even if one qualifies, can take months to process. And many do not qualify.

If we want women to opt for life even in difficult and threatening circumstances, they need to be reassured that the care that they need will be available. Until we’ve done something about the complete inaccessibility of medical care for many women in challenging pregnancies, conversations about the ideal ethical choice in cases where women and their babies’ lives are threatened tend to have little relevance outside ethics classes.