Late-Term Abortion

Neverfox
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Late-Term Abortion

(Note: Yes, this is long. But since you can see that, you can choose not to read it if that bothers you. For the rest of you, thanks for taking the time.)

I found myself in unexpected and uncharted waters a couple of days ago. I found out that my wife and I had different conclusions concerning the issue of late-term (~3rd trimester) abortion. The reason this was unexpected is primarily because we are both pro-choice (though this issue points out that that term doesn't have one definition) and both adamantly don't want children. There is no question, as we have discussed like any mature adults, that if she became pregnant despite birth control that an abortion would be a no-brainer. We both believe that the mass of cells in her womb are not a person. There would be no reason we can think of why we would ever find ourselves in a 3rd trimester pregnancy so the topic has just never come up for that or any other reason.

So how did it come up finally? Two reasons really. One, I had been participating in some on-line debates with pro-life fundamentalists on another forum and had related my experiences to her. She, on the other hand, has been reading quite a bit about the election and expressing her frustration over troubling aspects of Obama's record on reproductive rights. So the issue began to enter our conversations from a more theoretical, whole-issue perspective than before. She mentioned to me that she was frightened of the prospect of Obama supporting the removal of exceptions for late-term abortions for mental health. I then looked at her kind of funny because I took it for granted that she would be opposed to late-term abortions for the same reason I can come to that conclusion: the fetus at about 20 weeks completes the connection of the neocortical fibers of the brain (essentially fully turning on the nervous system) and is, in addition, proven viable outside the womb and begins releasing pain hormones in response to stimuli. I had taken the Lockean view of person-hood and I saw the ~20-24 week mark as the point at which Lockean person-hood could be achieved for the first time (though admittedly it is a hedged bet since there is no test for it). I had held this position in debates about when abortion should be allowed (before ~20 weeks) and I thought my position was fairly obvious and scientifically and rationally sound. I even patted myself on the back for thinking what a good feminist I was for fighting the good fight for a woman's choice. But she called me out on it when she heard it. See, my wife, it turns out is truly pro-choice...period.

I will attempt now to sum up her stance without getting it wrong. She isn't here to write this herself. To her, the woman's choice trumps everything until the moment the umbilical cord is cut. "Separate" is the final key delineating factor in determining who has rights. She doesn't believe it has anything to do with person-hood in the Lockean sense alone but also requires separation. I came across this website that seems to express her view well. Please look over the FAQ so that I won't need to waste too much space describing it. An interesting note is that I would describe our general political views as leaning towards socialism and this is described by this site as a "capitalist" view of abortion but I'm not sure how they get into mixing an economic philosophy with abortion. That's a topic for another day.

So it was needless to say a bit scary to find that we disagree on an issue that is so volatile. I've seen people get really worked up over abortion or politics in general. But after the initial high blood pressure exploration of the topic with each other (mainly we argued about the meta aspects such as who was thinking more rationally), I've decided to try and explore the various aspects of the topic and see what I can learn or if the facts can change or reinforce my stance. My goal is to get at the truth. As my sig line says, when the facts change, I change my mind. I'm looking for input from others who have thought about this. What I'm not looking for is a discussion of when life begins or the ethics of early term abortions. I know people disagree on these topics too but my wife and I are past that and don't need to rehash it.

I've identified several arguments that play a role in most discussions of late-term abortion:

  1. Viability
  2. Separateness
  3. Permission
  4. Person-hood
  5. Relative value

If you can think of any others that are worth discussing, please bring them up. I'd love to hear them. Notice I didn't mention life. We don't disagree that the fetus is alive. That's not the issue. The issue is does it have a right to live at any definable point prior to birth in the late-term.

  1. Viability - The earliest known healthy, surviving birth is 17 weeks. I've never been one to base my argument purely on viability because it only represents potential and potential is never a good argument in my opinion for reasons that any discussion about early-term abortion or contraception will prove. It does however get interesting when you mix it with a discussion about separateness. Because unlike the potential of sperm or eggs or zygotes, a viable fetus means a fetus that can potentially be separated (see next)
  2. Separateness - This is my wife's primary measure (along with relative value). "Snip it" and then and only then does it have rights that other people have. I admit that this is no different in style from my picking the neocortical connection point as the moment in time that person-hood begins. It always seems a bit absurd to take any one point in time as "the" moment when it is likely a subtle continuum but it is all we really can do without rendering ourselves helpless. Immediately though, I can see puzzles that arise from this criterion. First, if viability can be achieved at 17-20 weeks, why couldn't induced labor be the alternative to abortion at this phase. It achieves separateness without violating one of the other principles here. My wife brought up some reasonable objections to this. One, it requires the woman to submit to a medical procedure that could cause her harm. I think this is a good point but it does beg the question that the harm to the woman is paramount and exceeds to rights (if any) of the fetus, which is part of the debate itself and would need to be demonstrated. Also, if separateness is the only measure then what do you do about the fact that some abortions involve separating the fetus from the mother? This argument would then imply that the separate being now has rights which would prevent you from letting it die (which defeats the purpose). I realize however that you can kill the fetus first before separating it but that seems to be a technicality. Can this issue  rest on the order in which we perform a procedure? Another example that comes to mind is that of Siamese twins. If you base an argument on "no person has the right to live attached to another person's body" then you can see the issue here. This example does have the added aspect that both twins may be conscious and thus able to express their shared conflict of rights that would cancel out. That brings us to person-hood questions below.
  3. Permission - Related to separateness but subtly different. This says that the woman is letting the pregnancy happen by giving permission to use her body. If she chooses to retract it, then so be it. The problem I see with this is that when we have someone who trespasses, is it the obvious conclusion that you kill them? Some might think so if it is self-defense and I think some argument can be made for self-defense in the case of the health of the mother but can it be made for any reason? I should note here that when I bring up the issue of "reasons" my wife can get very sensitive because she thinks it ridiculous that the debate always goes towards the woman who would "change her mind" late-term. She thinks this is sexist and ignores the real problems that a woman might face in the late months. I agree but I also think that you have to assume all things might happen in some cases, no matter how infrequent, and so you need to cover all the bases.
  4. Person-hood (also consciousness/self-awareness etc.) - This is a fuzzy area but is where I've spent most of my time. My conclusion, perhaps not complete, was that whatever our laws for defining right to life in separate beings should be applied even in the womb. I rejected separateness/dependence as a criteria because a 1-year old child is also dependent (though separate) and because separation can be achieved if it's necessary. To me, the issue is about the brain. Is it at a level that allows it to function in a way that would full the Lockean definition of a person. In my first round of research, I arrived at 20-24 weeks at the point where it seems likely a consciousness is possible and thus it would be risky to abort without potentially violating a person. I've moved this to 28-32 weeks since I've learned more about fetal brain development. Even thought the neocortex is connected, the Melina sheaths are not sufficient for "human" thought until then. So as you can see, I've moved the window to about 7-8 months based on my original argument. But that still leaves room for an issue. The problem with pre-birth person-hood is that is conflicts with the very real issue of the woman's rights. Are her rights more or less important or are they in an intractable deadlock?
  5. Relative value - Another one of my wife's angles is that even if you assume person-hood or reject separateness or permission, the woman's rights take precedence based on relative value. This is based on the idea that the woman has a mental life that not only includes cognition but emotion, imagination and creativity. The woman is not only alive but living in the real world whereas the fetus (which wouldn't be there without her anyway) doesn't know what it is missing. I guess one could argue then how this differs from the life after birth. Arguably a 1-day old (which I assume isn't in debate here) isn't different from a minus-1-day old in this regard. This is where "separate" comes back in to play.

OK, now you have the issues all laid out. Solve it for me Eye-wink Just kidding. I would however love to get some different perspectives on this. I want to be rational and base my conclusion on a logically consistent foundation. I also don't want to be just another white male jerk who can't see it from the woman's perspective. I'd like to think that if men could get pregant I'd could still reach the same conclusion. All in all it's not an easy one to sort out.

 

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"...what we always meant by socialism wasn't something you forced on people, it was people organizing themselves as they pleased...And if socialism really is better...then it can bloody well compete with capitalism. So we decided, forget all the statist shit and the violence: the best place for socialism is the closest to a free market you can get!" - Ken MacLeod's The Star Fraction


kellym78
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Kavis wrote: Human

Kavis wrote:
 

Human pregnancy is one of the most difficult and dangerous flavors of reproduction on the planet, with childbirth being especially dangerous.  Even with modern medicine, it's not guaranteed a woman will emerge from labor with her body, life, or child intact.

Nor is it guaranteed after an abortion--particularly a late-term abortion, which has a higher morbidity and mortality rate than childbirth.

Quote:
Cesarean sections are particularly traumatic to the woman's body, and involve partially removing the woman's uterus from her abdominal cavity.  Not that "natural" childbirth in a hospital is much better: many hospitals assume the woman's vagina will tear during delivery, and make an incision along her vaginal wall to control the tear as a matter of course.  Nevermind that the odds there will be tearing are increased by the presence of the incision.

Yeah--I know. I had a c-section with my first, an unmedicated, episiotomy-less birth with my second, and a homebirth with my third. Hey--I'm still here! Educated women don't allow their obstetricians to make decisions for them.

Quote:
Given the dangers and complications inherent in human pregnancy, I think the organ donation comparison is apt.

Pregnancy does not invariably result in the loss of an organ or any significant trauma. Is there a risk--sure. But as I stated before, there is a risk to abortion as well, and late-term abortions are much more dangerous than pregnancy and birth.

 

Quote:
Edit: I finished this post without the following, because I couldn't find numbers from reputable sources. I have since been able to pin down the numbers from a World Health Organization report for 2005, a National Centers for Health Statistics report, and Wikipedia.

It's estimated that, worldwide, about 529,000 women die as a result of pregnancy each year, according to reports by the World Health Organization¹ and the United Nations. While the risk of death for the mother is relatively low in the United States, it is still ridiculously high in developing nations.  In the US, about 13 of every 100,000 live births result in the mother's death.  In Pakistan, it's 1,900 of every 100,000 live births.

Pregnancy is a much riskier prospect for the child: "The mean stillbirth rate in the United States is approximately 1 in 115 births."² ³ However, this doesn't seem to be terribly relevant to the current discussion, except to note that stillbirths can add complications to an already risky biological process.  

You are aware that the WHO considers a death within one year of childbirth to be a complication of pregnancy, right? Are you also aware that iatrogenic (physician-caused) complications account for a portion of these deaths? For example, epidurals cause 15-20 deaths a year in the US alone. Women who died during childbirth not because of the process, but because the drugs they were given by the doctors. Stillbirths include any miscarriage from the 5th month up--not necessarily all full-term.

There are many factors to be considered in an issue this complex, but you cannot reasonably assert that late-term abortion is safer than childbirth. It just isn't. Ask any abortion provider.


Kavis
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I wasn't arguing that

I wasn't arguing that late-term abortion is less traumatic than childbirth.  I was arguing that given the risks and medical ramifications of bringing a child to term, pregnancy (and especially labor and birth) is comparable to other medical interventions - including major surgeries and organ donation.   In the United States, no one can be forced to receive medical treatment they don't want.  No one can be forced to donate organs.  Abortion resides in the same sphere as other medical interventions in this way: a woman cannot be forced to make a medical decision that can potentially kill her or leave her sterile for the sake of another person. 

 

If a woman chooses to bring a child to term, that's wonderful.  If she chooses to abort the pregnancy, I believe her decision should have the same kind of social stigma as choosing surgery over chemotherapy: it's nobody else's business. It's "My body, my choice" with attitude.

Religion is a virus.
Fight the infection.