Who in their right mind is anti-life? The way the abortion debate is currently framed, you might think there are valiant forces of heaven-sent armies who favor life, pitched in epic battle against dark, evil forces who are opposed to life. Like so many contentious issues in today’s world—think “my body my choice” anti-vaxxers, for example—how we frame our debates ends up driving how we debate and what we debate about. It’s the old loaded question trick that politicians and pundits have used since forever to put their opponents on the defensive instead of debating the pros and cons of issues. In the case of abortion rights, the more honest and accurate approach—although this suggestion is about 50 years too late—should be for the pro-choice side to reject this framing and instead insist on pro-choice versus anti-choice.
Why choice instead of life? There are two reasons.
The first is that science and society don’t have a hard and fast definition of “life.” The process of life begins at conception. The key word in this sentence is “process,” not “conception.” For humans, this process begins with the joining of sperm and egg, and ends with the birth of a fully developed being, with myriad in-between steps that mark various stages of human development.
Which leads us to the second reason: We can’t argue that governments have a compelling interest in protecting all life (through the entire process) all the time. If so, then every miscarriage or egg that fails to implant in the wall of the uterus would be protected and parents would be subject to manslaughter charges; every loss of human “potential” would be actionable (my parents didn’t sing to me in the womb, which harmed my chances of becoming a musician, and therefore I’ve been injured); and every induced abortion would be murder, even in cases where the mother would die if she carried her baby to term.
Science doesn’t have an answer to all this, nor does religion. Science keeps improving our knowledge about fetal development, and our ability to fertilize eggs outside the womb and grow babies in incubators keeps improving year by year. But there is no hard and fast science that says a fetus is less than fully human at week x and then fully human by week y. And despite what you might think given the decades of protest on this issue, religion doesn’t know the answer either. Different religions have different opinions, and there are different opinions within each religion.
There are cultural differences as well, based on observations and traditions of when pregnancy becomes more about a baby than a pregnancy. The “quickening” has been the milepost used by many cultures throughout history—the time at around four months into a pregnancy when the fetus begins moving in the womb.
What we do know is that worldwide, according to the World Health Organization and other reliable medical sources, there are currently about 213 million pregnancies every year. About half of these pregnancies are planned, and the other half are unplanned. Six out of ten the unplanned pregnancies end with an induced abortion, as do three out of ten planned pregnancies, totaling about 73 million induced abortions every year. The rate of unplanned pregnancies has been declining in higher income countries due to better access to contraception and family planning services. Globally, the abortion rate has decreased in countries where it is legal, but not decreased in countries where it is illegal (due to higher rates of unplanned pregnancies; the same countries that restrict abortion also restrict family planning). In these settings, women must take legal and physical risks to seek abortion care. In countries where safe abortions aren’t available, more women die from unsafe abortion procedures, to the extent that unsafe abortions are the third leading cause of maternal mortality. It is important to note as well that globally, unintended pregnancy and abortion are experiences shared by women across regions, incomes, ethnicities and legal status.
In the US, the most recent survey data available through the Center for Disease Control shows that about 630,000 legal induced abortions were reported in 2019, at a rate of about 195 abortions per 1,000 live births (or 19.5%, compared globally to 73 million abortions per 140 million live births, or about 52%). This rate has generally been dropping over time, consistent with global patterns. About 93% of abortions in the US take place prior to 13 weeks, 6% from 14-20 weeks, and fewer than 1% at 21-weeks plus (due to fetal complications or maternal health risks).
In the US, the leading reason (40%) for why women seek abortions is a lack of financial preparedness. Around 36% seek an abortion because their pregnancy was unplanned (not the right time), followed by 31% who have partner-related reasons (their partner is abusive, relationship is bad, etc.), 29% who need to focus on their other children, 20% who worry that another child will interfere with their future opportunities, 19% who feel emotionally unprepared, 12% who have health-related reasons, and 12% who want a better life for their baby than they can provide. There are other reasons as well, and many women have multiple reasons. Although the percentage of women who seek a legal abortion due to rape and incest are low in terms of annual reported totals (and reported is a key word here), almost three million women in the US have experienced a rape related pregnancy in their lifetime. Barriers to getting an immediate abortion include not knowing about the pregnancy (40%), trouble deciding what to do (33%), not having the money (31%), and not knowing where to go for help (18%).
So to recap, science doesn’t have a definitive answer for when “life” begins. Religion doesn’t either. And regardless, abortion is a safe (where legal) and common procedure that all women everywhere will continue to access regardless of the legality or convenience of this procedure, and for a wide variety of personal reasons.
Why is it such a political issue then? Because a small and vocal group of individuals have decided that life begins at conception and that we should all submit to their reasoning?
To their credit, anti-choicers do have a point. This point just isn’t being expressed correctly. Science and religion don’t support their position, but they are correct that we shouldn’t be cavalier about abortion (if we were before), and it’s good that they’ve raised this issue and promoted it. This kind of activism is how we evolve and improve as a society, raising awareness and developing solutions.
Unfortunately, we don’t hear or see nearly as much parallel action in this movement about how we can help more women avoid unwanted pregnancies (by improving family planning funding, for instance, which usually gets cut by the same movement), improve adoption options, and make sure young women have strong networks to support them through pregnancy and beyond. The anti-choice point seems to begin and end with insisting that the union of egg and sperm results in a “life” or “potential life” that is instantly of interest to the state. And unfortunately, this position simply isn’t legally sustainable—again, think in terms of police reports and prosecutions for early term miscarriages.
What about the argument that the state should have an interest in life once it starts developing recognizable physical attributes? This approach is also problematic, mired in guesswork and motivated reasoning. Take the current fetal heartbeat standard being used by several states. In fact, the human fetus at eight weeks doesn’t have a heart at all, but simply a collection of cells that emit radio signals detectable on an ultrasound. The human heart is fully developed by 16 to 18 weeks, not eight. Many other similar standards have been debated—fingernails, face, brain waves, and so on.
What isn’t guesswork is that every decade, the age of fetal viability—the ability of a child to survive outside the womb—decreases by one week. This age was 28 weeks in the 1970s and is 23-24 weeks today (even though the 22 week mark may be on the horizon, babies delivered at this age are at high risk for a lifetime of complications). This 23-24 week mark, then, is the age at which most governments that permit abortion begin expressing a legal interest in protecting life. In the US, legal abortions performed after this date need to be due to fetal complications or to save the life of the mother. And this is consistent with the data we see. Less than 1% of US abortions are performed after 21 weeks, and less than 0.02% after 26 weeks (320 cases in total), with no abortions performed close to birth.
Which brings us back to the “my body my choice” framing used by anti-vaxxers. If this framing makes sense for vaccines, why not for abortions as well? (It actually makes no sense for vaccines, but all the sense in the world for abortions.) Ultimately, there are so many personal factors, interpretations and decisions involved. Why should the state be able to decide for all women everywhere how they will handle their pregnancy? What right do they have to do this? How is this approach better than letting women make these decisions in consultation with their families, friends, faith and physicians, as they do today?
And importantly, what positive outcome is expected by removing the right of women to make this decision themselves? More live births? If history and statistics are a guide, this won’t happen. What will happen instead is that more women will seek unsafe or illegal ways to obtain an abortion, and that legal providers will continue to disappear to the point where safe abortions will become increasingly unobtainable, particularly for younger women and women of lesser financial means. The legal and societal nightmare will be on full display as well as states incarcerate rape victims who take a morning after pill, arrest women who visit the ER due to complications from an illegal and unsafe abortion, and do nothing to help 15 year old girls navigate a lifetime of struggle after they drop out of high school to care for an unplanned pregnancy (while at the same time expecting nothing of the boy involved).
This is a course of action driven entirely by the emotion of how this debate has been framed over the years—pro-life versus anti-life. Everyone wants to be pro-life; pro-choice sounds utterly selfish and immoral by comparison. When we frame this debate as pro-choice versus anti-choice, however, we take some of the knee-jerk “pro-life” reaction out of the equation and have an easier time seeing where common ground might exist between these two positions.
Of course, framing isn’t everything. Even if we put the debate on more equal footing, there’s still the small matter of legal opinions, and here, for now, both sides are batting zero. The Supreme Court still hasn’t described a scientifically sound reason for why any state or federal government should have a compelling interest in a protecting the rights of a fertilized egg—a life form with only the potential for full human life—and at the same time the Court is poised to strike down Roe on the basis that the right to an abortion is not specifically mentioned in the Constitution. Of course it isn’t. The right of Black Americans to be free from slavery isn’t described in the Constitution either. Nor is the right of women to vote or own property. Or the right of children to get an education. Or the right of people with disabilities to avoid state sponsored discrimination.
Our founding fathers were brilliant, but they didn’t foresee everything. Many of the rights and liberties we depend on today were read into the Constitution and built up over years and decades of legal rulings as our society has matured and evolved. If a bench suddenly filled with originalists is going to start dismantling the protections upon which our modern society has been built, and instead punt these protections to elected officials who might enact these protections one year and retract them the next like some sort of civil rights whack-a-mole game, the next generation will live in a society defined by chaos and polarization, experiencing a constant battle between those who think the world should be recast in their image, and those who realize instead that the world is a complex place better governed by understanding and compromise than by what often comes across as ignorance and intolerance.
Regardless of what the Supreme Court decides next month, abortions in the US will continue to occur, and abortions around the world will continue to occur. This isn’t a moral or ethical yay or nay either way—just a statement of fact. And in policy matters like this that are at the intersection of science and society, it serves us better to focus on facts than on the vaguely aspirational and unknowable. In this case, the facts are that abortion is commonplace, personal, and safe, and doesn’t involve terminating a life that the state could have any realistic interest in protecting. The aspirational and unknowable is that abortion terminates potential life and that, of course, abortion should be eliminated altogether, but both of these positions are bridges too far in the policy world.
This doesn’t mean stalemate. Instead, both sides can and should work together to reduce the incidence of unwanted pregnancies and improve the financial and decision support for women experiencing pregnancy—these two moves alone could make a significant reduction in abortion. If we focus on this end of the issue instead of on the question of when life begins, we are much more likely to find common ground and create better outcomes for all involved.