The Problem with the "Pregnancy is Work" Argument For Abortion

Over at The Atlantic, Ta-Nehisi Coates reprints a post that he wrote two years ago which he considers to be a strong argument for the unrestricted "right to choose" abortion. This argument is basically that pregnancy is hard and sometimes dangerous work, and that women should thus not be forced to do it if they don't choose to.

Like most people, I have deep problems with the termination of life -- and that is what I believe abortion to be. Still a decade ago, I learned that those problems were abstract, and could not stand against something as tangible and imposing as death.

My embrace of a pro-choice stance is not built on analogizing Rick Santorum with Hitler. It is not built on what the pro-life movement is "like." It's built on set of disturbing and ineluctable truths: My son is the joy of my life. But the work of ushering him into this world nearly killed his mother. The literalism of that last point can not be escaped.

Every day women choose to do the hard labor of a difficult pregnancy. It's courageous work, which inspires in me a degree of admiration exceeded only by my horror at the notion of the state turning that courage, that hard labor, into a mandate. Women die performing that labor in smaller numbers as we advance, but they die all the same. Men do not. That is a privilege.

He says that since writing this, his feelings have only become more one sided on this issue:

I no longer have "deep problems" with the termination of fetal life. I don't think it's my place. I don't think I have much right to any qualms. I will never be pregnant. I will never be subject to the many biological functions that precede pregnancy and the ones that follow. I cannot know what it is to subject my body to such a process for the benefit of another. I don't believe everyone's opinion should be weighed equally. Some people carry more than others.

The thinking here seems to be that the work of being pregnant is so great that only those who have experienced it (or could) can really have an understanding of what it means. Now my first thought was: If one sees pregnancy as the big dividing line here, are women who have been pregnant more or less likely to support the "right to choose"? I consulted the General Social Survey to see if I could find out. Sure enough, all the data one needs is in there. I focused in on the question ABANY: "Please tell me whether or not you think it should be possible for a pregnant woman to obtain a legal abortion if: g. The woman wants it for any reason?" This is part of a series of questions in the survey which ask whether abortion should be legal for any reason (this question) and if it should be legal in certain specific situations (not able to afford another child, doesn't want more children, serious health problem for the mother, etc.) I filtered my data to look at women only and then I broke the data out by the number of children the woman had. The results are interesting, and basically what I expected:

Bold numbers are percentages, regular text represents absolute numbers.

Women who do not have any children (I'm not able to filter on whether they may have experienced miscarriages or abortions, but in general this should be the group of those with the least experience of pregnancy) are the most likely to support abortion on demand. Women who have experienced pregnancy (and the new life which it represents) are less likely to support abortion on demand. I tried separating the data out for married women and never-married women, but the views are almost exactly the same.

But what about the most extreme "hard case" situations? I pulled similar data for two questions in the survey dealing with pregnancy in cases of rape and pregnancies that severely threaten the health of the mother. As in the population as a whole many more women support abortion being legal in these situations. This table shows support for abortion being legal in cases of rape:

This one shows responses to the following question: "206. Please tell me whether or not you think it should be possible for a pregnant woman to obtaina legal abortion if: The woman's own health is seriously endangered by the pregnancy?"

This last is somewhat different from the others in that support for legal abortion in cases of serious health risk to the mother is virtually the same among women who have 0, 1 or 2 children, but then falls off progressively among women with three or more children. I tried splitting this out by how often she attends religious services, but while women who attend religious services weekly or more than once a week are much less likely to support abortion in cases of serious health risk than women who seldom or never attend religious services, the shape of the pattern is similar with women with 0, 1 or 2 children having fairly similar opinions and then increasing opposition to abortion as the number of children goes up from three.

While this doesn't mean that pregnancy isn't a unique and difficult experience, it seems to show that experiencing pregnancy does not make women more likely to support the "right" to "terminate a pregnancy". Indeed, it appears that pregnancy generally makes women less likely to support abortion. If, as Coates suggests, we left the question up to the veterans of pregnancy, abortion would be restricted more than it currently is.

Will Money Make Everyone Virtuous?

One of the many divides among modern Catholics is between what we might call the "moralizers" and the "justice seekers". "Moralizers" are those who emphasize the importance of teaching people moral laws and urging them to abide by them. "Justice seekers" seek to mitigate various social evils (poverty, lack of access to health care, joblessness, etc.) and believe that if only these social evils are reduced, this will encourage people to behave better.

Moralizers tend to criticize the justice seekers by pointing out that following moral laws is apt to alleviate a lot of the social evils that worry the justice seekers, arguing, for example, that if one finishes high school, holds a job and gets married before having children, one is far less likely to be poor than if one violates these norms.

Justice seekers reply that the moralizers are not taking into account all the pressures there work upon the poor and disadvantaged, and argue that it's much more effective to better people's condition than to moralize at them (or try to pass laws to restrict their actions) because if only social forces weren't forcing people to make bad choices, they of course wouldn't do so.

(I'm more of a moralizer myself, but I think that we moralizers still need to take the justice seeker critique into account in understanding where people are coming from and what they're capable of.)

One area in which the justice seeker approach seems to come into particular prominence is the discussion of abortion. We often hear politically progressive Catholics argue that the best way to reduce abortions is not to attempt to ban or restrict them, but rather to reduce poverty and make sure that everyone has access to health care. There's an oft quoted sound bite from Cardinal Basil Hume (Archbishop of Westminster) to this effect:

“If that frightened, unemployed 19-year-old knows that she and her child will have access to medical care whenever it’s needed, she’s more likely to carry the baby to term. Isn’t it obvious?”

You'd think that it was obvious, but I'm suspicious of the idea that having more money or resources makes us better or less selfish people (an idea which strikes me as smacking of a certain spiritual Rousseauian quality that doesn't take fallen human nature into account) so I thought it would be interesting to see if there's any data on this.

I was not able to find data on the relationship of abortion to health insurance, but I was able to find data on the relation of abortion to poverty, and it turns out that the Cardinal, and conventional wisdom, are wrong.

It's often pointed out that a disproportionate number of abortions are procured by women living below 200% of the poverty line (that's about $22,000/yr for a single person). This causes people to conclude that poor women are more likely to abort because they can't afford a child. As it turns out, however, poor women are less likely to abortion an unwanted pregnancy than non-poor women.

The numbers I'm looking at are from this study by the Guttmacher Institute (the research arm of Planned Parenthood -- hardly an anti-abortion source) which looks at pregnancies and abortions for unmarried women aged 20-29 from 2001 to 2008.

The study looks at unmarried women in three economic groups: Those living below the poverty line (around $11,000 per year), those living between the poverty line and 200% of the poverty line ($11,000 to $22,000), and those making more than 200% of the poverty line. For convenience, I'm going to look at the two most extreme groups, those living below the poverty line and those who make more than 200% of the poverty line. The middle group falls pretty much in the middle on all statistics.

The first thing you see is that poor women get pregnant a lot more than better off women. The pregnancy rate for unmarried women living below the poverty line was 277 pregnancies per 1000 women in 2008. For unmarried women making more than 2x the poverty line, that rate was 56 per 1000 women. So poor women are five times more likely to get pregnant.

Now, the first thing that most people would guess is: Poor women must have a lot more unintended pregnancies. They can't afford birth control, or they hadn't had good sex education, or for some other social reason they're not able to control their pregnancies.

Well, it turns out that for unmarried women between 20 and 29 a majority of pregnancies are unintended, but poor unmarried women have a lower percentage of unintended pregnancies than better off unmarried women. 67% of pregnancies of 20-29 year old unmarried women living below the poverty line were unintended in 2008 while 73% of pregnancies of unmarried women making more than 200% of the poverty line were unintended.

Even so, surely a woman with more means is going to be more able to support an unplanned child than a truly poor women, right? Well, she may be more able, but that's not, on average, what she chooses to do. Unmarried women living below the poverty line aborted 48% of their unintended pregnancies in 2008. Unmarried women making more than 200% of the poverty line aborted 62% of their unintended pregnancies in 2008. So an unmarried woman living at more than 2x the poverty line is 30% more likely to decide to abort an unplanned pregnancy than an unmarried woman living below the poverty line.

Unmarried women are far more likely to abort unintended pregnancies (51% aborted) than married women (17% aborted), but unfortunately the Guttmacher report only provides income breakdowns of unmarried women, not married women. However, that does at least mean that the data we're looking at is not thrown off by the fact that a much greater proportion of poor women are unmarried than better off women.

So it turns out that the conventional wisdom is wrong on all fronts. A smaller percentage of pregnancies are unplanned for poor women than for better off women. And a smaller percentage of poor women who have unplanned pregnancies abortion than better off women. The only reason why a disproportionate number of abortions are obtained by poor women is that they get pregnant far more frequently than better off women.

What this underlines is something that should be fairly obvious to anyone with a Christian understanding of fallen human nature: Having more money and resources does not make us better people. Those who are better off are just as capable of doing wrong than those who are less well off. Indeed, in this case, it appears that people who are better off are more likely to do wrong than those who are less well off.

Does this mean that we shouldn't work to alleviate poverty or to make sure people are able to get the medical attention they need? Of course not. But this conventional wisdom that people only do wrong things because they're not well off is simply not the case.

UPDATE: Okay, I'm realizing that due to some odd formatting on the Guttmacher study, I hadn't realized that their data is split into two halves. First they provide overall rates of pregnancy, unintended pregnancy and abortion for all women 20-29 and break that data down into married and unmarried women. However, all of the demographic breakdowns which are provided in the lower section of each table are for unmarried women only. So the percentage of pregnancies which are unintended and the percentage of unintended pregnancies that end in abortion which I quote in the article are for unmarried women only. I've edited the article appropriately, but am leaving this update separately to make the changes clear.

Did RomneyCare Reduce Abortion?

There's a claim being made that Obama's Affordable Care Act will significantly reduce abortions, despite the concerns voiced by the US Catholic Bishops about the ACA funding abortions, on the theory that providing people with a guarantee of contraception and pre-natal care will reduce the "need for abortion."  The original basis for this claim is, so far as I can tell, a 2010 article by Patrick Whelan, the president of the Catholic Democrats, published in the New England Journal of Medicine. This article states:

The number of abortions in Massachusetts in 2006, the year before the new law was implemented, was 24,245, including 4024 among teenagers. I obtained data from the Massachusetts Department of Public Health for each of the two subsequent years.... In 2007, the first year of Commonwealth Care, the number of abortions fell to 24,128, and in 2008, it fell to 23,883 — a decline of 1.5% from the 2006 level. The number of abortions among teenagers in 2008 fell to 3726, a 7.4% decline from 2006. These decreases occurred during a period of rising birth rates, from 55.6 per 1000 women 15 to 44 years of age to 56.9 per 1000 in 2006 and 57.2 per 1000 in 2007 (the latest year for which data are available from the Massachusetts Department of Public Health), and an increase in overall population (in 2008, the Massachusetts population surpassed 6.5 million for the first time, and it was nearly 6.6 million in 2009, according to the Census Bureau). The abortion rate thus declined from 3.8 per 1000 population in 2006 to 3.6 per 1000 in 2008. Overall, since 2000, the number of abortions in Massachusetts has dropped by 12% (from 27,180 to 23,883) and by nearly 36% since 1991.

Now, as you can see from the quote, the claim here is already a little dubious. Dr. Whelan would like to attribute the last couple years drop in abortions to RomneyCare, but he of course has to admit that abortion had fallen much more in the years before, without the benefit of universal health care.

A couple days ago, Brian Fung of the Atlantic published a piece in which he appears to have updated Dr. Whelan's data using the same rough estimation methodology: getting the raw number of abortions per year from the Massachusetts Department of Public Health and dividing it by the total Massachusetts population (men and woman of all ages). Based on this update, he reports that the raw abortion rate (number of abortions divided by total population) has further reduced to 3.14 in 2011, giving a total reduction in the raw abortion rate of 17%.

Commonweal reported on the Atlantic piece writing:

Writing for The Atlantic, Brian Fung reports, “As the number of insured has gone up in Massachusetts, new state data show a corresponding decline in the number of abortions performed there since 2006.” Since passage of “Romneycare”, Massachusetts’ abortion rate has dropped 17%.

Then Vox Nova writer Mornings Minion piles on, citing the Commonweal piece and writing:

With this in mind, I thought I would share the results of two interesting new studies.

The first shows that abortion rates in Massachusetts dropped by 17 percent after the introduction of Romney’s healthcare reform. Given that the Affordable Care Act is almost identical to the Romney plan, and has some explicit pro-life measures and protections that the Romney plan did not have, we might expect the same outcome at the national level in the years ahead.

The second study tries to estimate the impact on abortion rates from overturning Roe v. Wade. It finds that the most likely outcome is that 31 states ban abortion, and that the overall abortion rate falls by 15 percent. If only 17 states banned abortion, the rate would only fall by 6 percent. In the most optimistic scenario – all but four states banned abortion – the rate would still only fall by 29 percent. That’s basically the best we can hope for.

Is this claim remotely believable?

The obvious question is: Is the decline in abortions in Massachusetts sufficiently unique to suggest that it is Massachusetts's universal health care system which is responsible for the recent decline. Determining this is made difficult by the fact that rigorously calculated data on abortion rates is not available from reputable sources like the Center for Disease Control or the Guttmacher Institute for years past 2008. However, I took a look at the change in abortion rates for a number of states from 2005 to 2008 according to the Census Bureau (2006 was not reported). The results I got showed that Massachusetts had declined in real abortion rate (the number of abortions per 1000 women aged 15 to 44) by 7.24% between 2005 and 2008. This was more than the US average, which was up by 0.86%. However, it was similar to the decreases in a number of other states:
-8.85% in Alaska
-8.96% in Mississippi
-7.15% in Maryland
-10.71% in Nebraska
-7.25% in North Carolina

Other states saw large increases:
+37.06% in Delaware
+15.37% in Kentucky
+36.59% in Louisiana
+22.22% in Pennsylvania

I picked one of the states that had performed similarly to Massachusetts from 2005 to 2008 that I was able to find data online from (Nebraska) and compared their change in raw abortion rate to that in Massachusetts. The result is very similar: Nebraska (not known for its universal health care coverage) saw a 22% reduction in its raw abortion rate from 2006 to 2011, and a 19% reduction in total abortions over those same years. The raw rate dropped from 1.66 per 1000 in population in 2006 to 1.29 in 2011.

Although each article in the above cited sequence offered stronger claims that 'researchers think' there's a link between Massachusetts's health care law and the reduction in abortions in that state, that belief seems to be based on no more than wishful thinking and interviews with low income Massachusetts residents who say they're "delighted" to have access to subsidized contraception. There certainly appears to be no evidence from the data cited to suggest that RomneyCare has reduced abortion in Massachusetts, nor is Massachusetts unique in its declining abortion rates. The claim that ObamaCare will somehow reduce abortion more than overturning Roe is, obviously, hard to prove one way or the other, since any model of what a post-Roe US would look like would be highly speculative. But at the very least, we can say that there is no real foundation for the belief.

Akin's Idiocy

You'd have to try moderately hard to come up with a dumber and more insensitive comment than Rep. Todd Akin, the Republican Senate nominee from Missouri, made the other day. Asked why he opposed abortion even in cases or rape, he responded:

It seems to me, from what I understand from doctors, that’s really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down. But let’s assume that maybe that didn’t work or something: I think there should be some punishment, but the punishment ought to be of the rapist, and not attacking the child.

As best as one can guess from Akin's statements (which he has apologized for since the firestorm they kicked up) his beliefs about the issue may have been inspired by studies showing that extreme emotional or physical stress can cause delayed ovulation. Thus a woman who was raped when she was otherwise about to ovulate might not ovulate on time, and thus not conceive.

The first big problem in Akin's thinking appears to have been the result of wishful thinking that is depressingly common. Having read that conception might be less likely after a sexual assault than after normal sexual intercourse, he seems to have wishfully extended this out to be virtually always the case. Akin, like other serious pro-lifers, opposes abortion even in cases of rape. However he seemingly does not want to deal with the fact that opposing one clear evil (killing an unborn child) may leave a woman who has already had her body assaulted by a rapist also unwillingly pregnant. Rather than dealing with the fact that doing the right thing often does not make us happy, he apparently wishes the problem away.

In the process, he adds insult to injury, since his words distinguish "legitimate rape" (from which he believes pregnancy virtually never results) from... Well, he doesn't say what, but the implication is clearly that he's distinguishing between a "real rape" and some sort of rape that the victim didn't actually mind all that much. Since he has magically turned less likely to almost never, the implication (one hopes unintentional) is that if a woman gets pregnant as a result of a rape, she probably didn't really mind being raped -- in other words, it wasn't really a rape.

It doesn't take any imagination to figure out why this is a very offensive implication.

When someone says something this dumb and offensive, its easy to pile on, but difficult to say anything constructive. Rebecca Kiessling provides some fairly calm and thoughtful analysis over at LifeNews. In addition tackling Akin's comments, she deals with some of the other misguidedly sunny attempts pro-lifers have made to address the issue:

The pro-life attorney says pro-life candidates need to be coached on how to answer the media’s inevitable question.

“Senator Rick Santorum, during his presidential campaign, said that he thinks that a child conceived in rape is “a gift from God,” and he was made fun of for that. Just Google images for “Santorum rape” and you’ll see all of the posters where he is mocked for this statement. While I believe it’s true that every child is a gift from God, including children conceived in rape, I don’t believe this was the best response for the interview,” she explained. “If it had been my birthmother sharing that she believes that I’m a blessing and a gift from God, she would not be mocked and ridiculed in the same way he was. And then Sharron Angle, during her Senate race in Nevada, said it’s a “lemonade situation,” which did not come across well at all. The problem is not with these candidates’ values. The problem is how they express them.”

Kiessling provides some somewhat better talking points for politicians to use, though they remain very much what they are: talking points.

My own thought is that we as Americans find these kinds of moral issues very difficult because we have no tragic sense: we labor under the illusion that doing the right thing means that bad things won't happen to you, or that if misfortune comes, doing the right thing will necessarily lessen our suffering right away. Often it doesn't.

In Honor of the March for Life: The Annunciation and the Passion

I have never been on the March for Life, but I'm praying today for those who are walking in DC today.
Last night I came across a John Donne poem that seemed appropriate for a day on which we remember the death of millions of the very youngest humans, written in 1608 on the occasion of Good Friday falling on the feast of the Annunciation (March 25).

THE ANNUNCIATION AND PASSION.
by John Donne

TAMELY, frail body, abstain to-day ; to-day
My soul eats twice, Christ hither and away. 
She sees Him man, so like God made in this,
That of them both a circle emblem is,
Whose first and last concur ; this doubtful day
Of feast or fast, Christ came, and went away ; 
She sees Him nothing, twice at once, who's all ;
She sees a cedar plant itself, and fall ;
Her Maker put to making, and the head
Of life at once not yet alive, yet dead ; 
She sees at once the Virgin Mother stay
Reclused at home, public at Golgotha ;
Sad and rejoiced she's seen at once, and seen
At almost fifty, and at scarce fifteen ; 
At once a son is promised her, and gone ;
Gabriell gives Christ to her, He her to John ;
Not fully a mother, she's in orbity ;
At once receiver and the legacy. 
All this, and all between, this day hath shown,
Th' abridgement of Christ's story, which makes one—
As in plain maps, the furthest west is east—
Of th' angels Ave, and Consummatum est. 
How well the Church, God's Court of Faculties,
Deals, in sometimes, and seldom joining these. 
As by the self-fix'd Pole we never do
Direct our course, but the next star thereto,
Which shows where th'other is, and which we say
—Because it strays not far—doth never stray,
So God by His Church, nearest to him, we know,
And stand firm, if we by her motion go.
His Spirit, as His fiery pillar, doth
Lead, and His Church, as cloud ; to one end both. 
This Church by letting those days join, hath shown
Death and conception in mankind is one ;
Or 'twas in Him the same humility,
That He would be a man, and leave to be ;
Or as creation He hath made, as God,
With the last judgment but one period,
His imitating spouse would join in one
Manhood's extremes ; He shall come, He is gone ;
Or as though one blood drop, which thence did fall,
Accepted, would have served, He yet shed all,
So though the least of His pains, deeds, or words,
Would busy a life, she all this day affords.
This treasure then, in gross, my soul, uplay,
And in my life retail it every day. 

How We See The Other Side

Kyle links to a "pro-lifers are mean" comment by pro-choice advocate Amanda Marcotte and counters that while the behavior she describes is bad, it is not typical of what he has experienced among pro-lifers, that pro-lifers tend to be focused not on disdaining women (as Marcotte seems to think) but on protecting unborn human life.

Part of the problem, I think, in each side estimating the extent of unloving attitude present in the other is that people remember slights against their side far more viscerally than slights against the other.

I went to clinic prayer vigils exactly twice in my life -- protest is not something that my intellectual and emotional makeup makes me good at, regardless of the topic, and after spending those two occasions (as a college freshman at Steubenville curious about what it was all about) standing tensely over to one side with the police officers, watching what was going on but unable to really focus on praying at all, I figured it pretty clearly wasn't the place for me.

On both occasions I noted with chagrin that some of the non-University protesters were doing things I considered counterproductive: holding pictures of aborted babies, shouting "stop killing babies" at the clinic staff as they went in in the morning.

At the same time, what I remember so viscerally that I can feel my blood rising in an instant just thinking about it is the behavior of the "pro-choice escorts" who were there to make sure that sidewalk counselors didn't dissuade anyone from getting an abortion. They wore bright yellow t-shirts over their clothes (it was winter, so we were all bundled up) saying "Pro-Choice Escort" and their basic tactic whenever a sidewalk counselor got near someone was for one to throw herself between the counselor and the woman approaching the clinic, put her arms out in basketball blocking stance, and scream as loud as possible (so that the counselor couldn't get a word in) a stream of, "She doesn't want to talk to you! Get back! If you tough me it's an assault! Get back! Officer, he's touching me! [this almost invariably a lie which the police ignored] Get back! She doesn't want to talk to you, you pervert!" etc.

The sidewalk counselors were trained to take this with equanimity, but just watching it tended to wind me up. What I really remember, however, is a a middle aged pro-choice escort with close cropped grey hair who seemed to have appointed herself the protester taunter. She zeroed in on a student who showed voice and body language signs of being retarded and imitated him all morning, as he prayed or sang hymns with a guitar. She'd prance around singing back at him in a "retard voice" and every so often pause and say, "Your mother wishes she'd come here."

I imagine that if Marcotte had been at the same protest, she would have remembered the misbehaviors of some of the pro-life protesters much better than I do, and this woman she would remember not at all, or as a minor misbehavior in a trying situation. But to me, the pro-choice movement will always be that gray haired woman taunting an apparently disabled young man that his mother must wish that she had killed him.

Information and Metaphysical Conclusions

I was struck by Kyle's post on Friday "Abortion, Rational Decision-Making, and Informed Consent", but it took me a while thinking it over to come to an explanation of exactly what I find wrong about it. Kyle is addressing the issue of "informed consent" laws which require a woman seeking an abortion to view an ultrasound of her baby or read an explanation of fetal development at the stage of pregnancy her child is at. He is concerned, however, that such laws miss the real moral point:

Catarina Dutilh Novaes explains her worry about some new laws requiring physicians to show a woman an ultrasound of the fetus and describe its status, organs and present activity before performing an abortion. She writes: “It does not take a lot of brain power to realize that what is construed here as ‘informed decision’ is in fact yet another maneuver to prevent abortions from taking place by ‘anthropomorphizing’ the fetus” and “it is of striking cruelty to submit a woman to this additional layer of emotional charge at such a difficult moment.” She’s right, I suspect, about the underlying motivation behind the laws and the suffering their practice would impose. If the legislators and activists pushing these laws recognize the suffering they may inflict, they clearly see it as justified, weighing, as they do, the vital status of the nascent life as greater than the emotional status of the expectant mother.
...
There’s something to this. The information the physician is legally required to communicate by these new laws informs in a very limited way: it doesn’t provide evidence of personhood or a right to life or any such metaphysical or moral reality. The sight and description of the fetus may give the appearance of a human life worthy of respect, but, as pro-lifers note, appearance is not indicative of moral worth. An embryo doesn’t look like a human being, but that appearance doesn’t signify anything moral or metaphysical about it.

The woman, for having this information, is not in any better position to make a rational, ethical decision. It may cause her to “see” the nascent life as human, but it doesn’t offer her a rational basis for such a perception. Her consent is no more informed after seeing and hearing the physical status of the life within her, and so these new “informed consent” laws don’t achieve what they are supposedly designed to do.

There are places conducive to informing people about the nascent life’s stages of development and about what exactly, scientifically speaking, abortion does to that life. A high school health class, for example. There, the scientific information about the unborn life and abortion can be more thoroughly considered, and once fully understood, serve in other settings as a reference point for metaphysical and moral considerations. Consent to abortion should be informed, but the information these new laws require to be communicated does not on its own result in informed consent or provide an additional basis for a rational, ethical decision. Why? Because, by itself, appearance is not ethically relevant and can also be misleading.

Now on the basic point, I agree with Kyle: appearance is not moral worth. A person is not worthy of human dignity simply because someone looks at him or her and sees similarity. To say that would be to suggest the converse: that when someone looks at another and sees simply "other" he is justified in not treating that person with human dignity. For instance, one could imagine (though I think it is the far less likely option) a situation in which a woman is leaning against abortion because she thinks that the child inside her will look "just like a baby", she sees a fuzzy ultrasound of something that still looks like a tadpole on an umbilical cord, and she thinks, "Oh, that's all? It must not be a baby yet. I'll abort."  Clearly, in this case, the information would have led to the wrong conclusion.  An appearance of similarity or dissimilarity does not a person make.

At the same time, the suggestion that informed consent laws are a bad idea just rubs me the wrong way, not just from a pragmatic point of view but from a moral one, and when I have this kind of conflict between instinct and reason, I tend to poke at the issue until I come up with a reason why it is that the apparently reasonable explanation seems wrong to me.

Having gone through this poking exercise, I realized that the issue is that Kyle's argument seems to imply that there are two sets of information -- information which relates to personhood, and information which relates to other qualities (appearance, sound, texture, etc.) -- and that informed consent laws are problematic because they require that people be provided with the latter type of information (information about appearance) when the relevant question is one of personhood, and thus only information relating to whether the being in question is a person would be applicable to the decision being made.

This seems reasonable for a moment until you try to think what information is actually in the first set, the set of information which relates to personhood. And here lies the paradox: there is none.

As beings who are both physical and rational, we understand the metaphysical concept of "person", but the inputs which we can receive from the outside world (things which we might be informed of as "facts" via "informed consent") are all sensory inputs. We reach the conclusion metaphysical, "This other being is a person, just as I am a person," based on sensory information, not metaphysical information.

Famously, in the movie Juno the main character is persuaded not to have an abortion when her pro-life classmate tells her that her baby has fingernails. This detail is what humanizes the baby in Juno's mind and causes her to decide not to abort the baby. Responding to this example, Kyle says:

The scene in Juno shows the effectiveness of giving a description of the fetus in order to humanize it, and it’s good that she chose to keep the baby, but she didn’t exactly make an informed ethical decision. Whether or not her baby had fingernails is irrelevant to the morality of abortion. It doesn’t follow that because the baby had fingernails that it was a human being with a right to life that the law should protect, but acting as though this information about fingernails led to “informed consent” implies that it does.

At the literal level, of course, the attribute "having fingernails" is not something that makes a being a person. We would not say, "Man is an animal with fingernails." Nor, if a human being through some genetic deformity was born without fingernails would be conclude that that member of our species was not a "person" because he lacked fingernails.

And yet, it is invariably through these surface level details that information comes into our minds and allows us, eventually, to form enough of an understanding of something that we are able to form metaphysical conclusions about it.

Picture, if you will, that at this moment I were to head down to the local coffee shop, and there I found Kyle sitting at a table with a banana.

"Darwin," Kyle informs me. "This banana is actually a person. It's an intelligent space alien."

My first reaction, after ordering a triple espresso, would doubtless to be respond, "It doesn't look like an alien. It looks like a banana."

My statement would have been about appearance, and yet, it would be completely normal for me to form the metaphysical conclusion that the banana was not a person based on this appearance combined with my experience of other similarly looking fruits. If a moment later, the thing-that-looked-like-a-banana were to rise in the air and trace in glowing letters a refutation of Derrida's claim that apartheid in South Africa was a consequence of phonetic writing which, "by isolating and hypostasizing being, ... corrupts it into a quasi-ontological segregation" -- I would rapidly revise my conclusions since this would be behavior far more in keeping with my experience of persons than with my experience of bananas.

The fact is that we will invariably reach the metaphysical conclusion "this is a person" based on a grouping of non-metaphysical sensory inputs. A materialist approach would to be say that this means that metaphysical conclusions never follow from "the data" and thus should be abandoned. Since there is no specific, observable characteristic which I can say "this is what makes something a person", this approach would reject personhood as a useful concept.

I would argue, instead, that it is precisely because we are beings able to perceive metaphysical realities through our sense of reason that we are able to take in a number of pieces of sensory "information" about something outside of ourselves and use those pieces of information to reach a metaphysical conclusion. In the case of deciding whether the unborn child is a "person" in the moral sense, pieces of information which might be key would be: member of our species (human), has unique DNA different from mother than father, heart is beating, eyes have formed, moves spontaneously, etc. None of these pieces of information is metaphysical in import, and yet, from the combination of them all, many people would form the conclusion that the creature in question is "a human being".

Further, there is simply a visceral reaction to seeing someone. Recall the New York Times piece on "twin reduction" that was going around a few weeks ago:

One of Stone’s patients, a New York woman, was certain that she wanted to reduce from twins to a singleton. Her husband yielded because she would be the one carrying the pregnancy and would stay at home to raise them. They came up with a compromise. “I asked not to see any of the ultrasounds,” he said. “I didn’t want to have that image, the image of two. I didn’t want to torture myself. And I didn’t go in for the procedure either, because less is more for me.” His wife was relieved that her husband remained in the waiting room; she, too, didn’t want to deal with his feelings.

Kyle's is right in saying that appearance itself is not evidence of personhood, but he is wrong in saying that this means that an ultrasound would not form a piece of "information" which would lead to a more "informed consent" in regards to abortion. In the end, no piece of information is in and of itself evidence of personhood. And yet, it is through these incomplete clues, these pieces of information which do not themselves indicate personhood, that we know that anyone at all is a person -- indeed, that anyone at all exists.

The Shallow Pretensions of Evil

The New York Times reports on the phenomenon of women who've conceived via IVF "reducing" their twins to singletons. The quotes speak for themselves.

“Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure,” she said later. “If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

...

One of Stone’s patients, a New York woman, was certain that she wanted to reduce from twins to a singleton. Her husband yielded because she would be the one carrying the pregnancy and would stay at home to raise them. They came up with a compromise. “I asked not to see any of the ultrasounds,” he said. “I didn’t want to have that image, the image of two. I didn’t want to torture myself. And I didn’t go in for the procedure either, because less is more for me.” His wife was relieved that her husband remained in the waiting room; she, too, didn’t want to deal with his feelings.

...

A. and her partner were sick, physically and emotionally. Because A. had already miscarried once, her doctor worried she might not carry two to term; if she reduced, the doctor said, she had a better chance of taking a baby home. The women were tempted to reduce both pregnancies, so each woman would carry one, in part to ensure that even if one miscarried, they would have at least one baby. “But we discovered that the reality of having two pregnant moms when you have a 14-month-old is insane. We’ve both been very ill from the pregnancies, and it’s been hard to give him what he needs. At 14 months, they’re inquisitive and energetic, and it was becoming harder and harder to chase him and get him up and down the slide. There were days I’d be in the bathroom throwing up, she’d be on all fours with him, and then we’d switch. We all think we can conquer the world, but then reality hits you, and you realize you have limitations.”

For the sake of the boy they already had, they decided to reduce A.’s pregnancy to one, and right after that A.’s partner lost her whole pregnancy. “I don’t wish this on anyone,” A. says. “I’m very grateful that we had this option at our disposal, that it can be done safely and in a legal way, but it was very difficult for both of us. I still wonder, Did we choose the right one? — even though I wasn’t the one who chose. That idea, that one’s gone and one’s here, it’s almost like playing God. I mean, who are we to choose? Even as it was happening, I wondered what the future would have been if the doctor had put the needle into the other one.”

I mean, who are we to choose?



I really do believe that the people uttering these chilling words believe that they are brave, that they are enlightened, for being so honest about their motivations. But it makes one more culpable, not less, to put a name to the venal motivations for committing an evil act. And to kill a child because he or she can be equated with unwanted merchandise is evil.



In a Facebook discussion about this article, a wise friend who specializes in the bitter history of Eastern Europe, especially the region brutalized "between Hitler and Stalin", said to me:

I wonder if we are missing something when we speak of understanding? Perhaps here it is the problem that evil itself is elusive - that we cannot understand it in the same way we understand goodness because the thing itself is actually opposed to meaning? Real mysteries, holy things contain hidden depths - but it could very well be in the nature of evil to appear to be deep and complex but to be as simple?



...I wonder if we face the kind of difficulties that made it so hard for people to face the atrocities they were committing decades ago? That dehumanization which is the precursor to personal violence actually requires us to shut down the connections between what at some level we know to be true and what is being done. For example - if we were aware that a few blocks from us there was a place where people were bringing in toddlers to be butchered, what really would deter us from gathering a posse of our friends and going there immediately to at a minimum protect any children near it - and if possible to destroy such a place? Yet we are compelled by all sorts of deeply powerful social forces and institutions to live by such institutions day in and day out, knowing that the difference between my hypothetical toddler butchery center and an abortion clinic is not that great. Yet we really are powerless and any effort to change by force our own society's violence would rebound on us and harm the unborn.



But to take it a step further - those who are murdering are successful in forcing their concepts upon us and upon the state - we face a language in which some people literally feel it is a matter of life and death to keep as muddy as the SS men and Nazi administrators worked to convince themselves and those around them that Jews really were subhuman. Again, the differences are real, but the similarities are also quite compelling when you think about it - the sustained effort to subvert, contain or delegitimize the protests of those who had a radically different way of seeing requires a great deal of commitment on the part of those who are "pro-choice."

...

I think some of it is that in my neck of the historiographical woods people tie themselves up in knots about how we can't understand the Holocaust or other deep evils. In the back of my mind there is the description in C.S. Lewis of the demon in Perelandra which "employs reason the way a soldier learns to use the bayonet" but also rather despises reason and on its free time just likes to torture animals for "fun". I also think there is that Augustinian tendency in me to think that we have gone far too far in our fascination with evil, and we forget that we are not Manichaeans - that evil is not simply the opposite of good, Satan is not God's kid brother - that evil is the movement toward non-being/nothing.



It could be there is a steep fall-off from any and all meaning when we get to the kinds of things about which you write are incomprehensible - that there really is NO meaning or content in such things - that a person "feeling two children inside of you, seeing them, and saying "kill this one, love that one." - is someone who has lost something key - and all that is there is fear and even perhaps the demonic - a force that delights in murder for the sake of murder, and is able to enter the empty place where should beat the heart of a mother and takes possession to pursue its own agendas (and needless to say, as N. points out that emptiness is enabled by the missing love of the man who should be there to both comfort the soon-to-be-mother and protect his child).



A Polish colleague is doing some good work on the demonic that proposes a good deal of our practical atheism comes not from the effort to deny God but from our denial of the devil (no, they are not equal, but in denying the possibility of radical evil I think we miss key facts about the world that blind us to other, more primary and important realities - it is the people who have never felt deeply the sting of their own sin and betrayals who I think tend to natter on and on the most about the brutality of the crucifixion - i.e. they cannot contemplate how little and great evils form links in a chain).

Choice and Gendercide

Last weekend's Wall Street Journal featured an interesting review of Mara Hvistendahl's new book Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men. The topic is one that pro-lifers are all to familiar with -- the use of sex selective abortion throughout the world which has resulted in the death of 163 million unborn girls being aborted over the last 40 years, specifically because their parents wanted a boy instead. (In other words, over and above all of the abortions going on for other reasons.) The sheer number of "missing girls" is staggering -- imagine a number of women equal to the current total populations of France and the UK combined.

Mara Hvistendahl is worried about girls. Not in any political, moral or cultural sense but as an existential matter. She is right to be. In China, India and numerous other countries (both developing and developed), there are many more men than women, the result of systematic campaigns against baby girls. In "Unnatural Selection," Ms. Hvistendahl reports on this gender imbalance: what it is, how it came to be and what it means for the future.

In nature, 105 boys are born for every 100 girls. This ratio is biologically ironclad. Between 104 and 106 is the normal range, and that's as far as the natural window goes. Any other number is the result of unnatural events.

Yet today in India there are 112 boys born for every 100 girls. In China, the number is 121—though plenty of Chinese towns are over the 150 mark. China's and India's populations are mammoth enough that their outlying sex ratios have skewed the global average to a biologically impossible 107. But the imbalance is not only in Asia. Azerbaijan stands at 115, Georgia at 118 and Armenia at 120.
...
But oddly enough, Ms. Hvistendahl notes, it is usually a country's rich, not its poor, who lead the way in choosing against girls. "Sex selection typically starts with the urban, well-educated stratum of society," she writes. "Elites are the first to gain access to a new technology, whether MRI scanners, smart phones—or ultrasound machines." The behavior of elites then filters down until it becomes part of the broader culture. Even more unexpectedly, the decision to abort baby girls is usually made by women—either by the mother or, sometimes, the mother-in-law.

If you peer hard enough at the data, you can actually see parents demanding boys. Take South Korea. In 1989, the sex ratio for first births there was 104 boys for every 100 girls—perfectly normal. But couples who had a girl became increasingly desperate to acquire a boy. For second births, the male number climbed to 113; for third, to 185. Among fourth-born children, it was a mind-boggling 209. ...

Ms. Hvistendahl argues that such imbalances are portents of Very Bad Things to come. "Historically, societies in which men substantially outnumber women are not nice places to live," she writes. "Often they are unstable. Sometimes they are violent." As examples she notes that high sex ratios were at play as far back as the fourth century B.C. in Athens—a particularly bloody time in Greek history—and during China's Taiping Rebellion in the mid-19th century. (Both eras featured widespread female infanticide.) She also notes that the dearth of women along the frontier in the American West probably had a lot to do with its being wild. In 1870, for instance, the sex ratio west of the Mississippi was 125 to 100. In California it was 166 to 100. In Nevada it was 320. In western Kansas, it was 768.

What's at the same time interesting and dissonant is that Ms. Hvistendahl comes from entirely outside the pro-life movement, nor does her horror at the idea of people aborting girls for being girls carry through to opposition to abortion itself.

There is so much to recommend in "Unnatural Selection" that it's sad to report that Ms. Hvistendahl often displays an unbecoming political provincialism. She begins the book with an approving quote about gender equality from Mao Zedong and carries right along from there. Her desire to fault the West is so ingrained that she criticizes the British Empire's efforts to stamp out the practice of killing newborn girls in India because "they did so paternalistically, as tyrannical fathers." She says that the reason surplus men in the American West didn't take Native American women as brides was that "their particular Anglo-Saxon breed of racism precluded intermixing." (Through most of human history distinct racial and ethnic groups have only reluctantly intermarried; that she attributes this reluctance to a specific breed of "racism" says less about the American past than about her own biases.) When she writes that a certain idea dates "all the way back to the West's predominant creation myth," she means the Bible.

Ms. Hvistendahl is particularly worried that the "right wing" or the "Christian right"—as she labels those whose politics differ from her own—will use sex-selective abortion as part of a wider war on abortion itself. She believes that something must be done about the purposeful aborting of female babies or it could lead to "feminists' worst nightmare: a ban on all abortions."

It is telling that Ms. Hvistendahl identifies a ban on abortion—and not the killing of tens of millions of unborn girls—as the "worst nightmare" of feminism. Even though 163 million girls have been denied life solely because of their gender, she can't help seeing the problem through the lens of an American political issue. Yet, while she is not willing to say that something has gone terribly wrong with the pro-abortion movement, she does recognize that two ideas are coming into conflict: "After decades of fighting for a woman's right to choose the outcome of her own pregnancy, it is difficult to turn around and point out that women are abusing that right."

Late in "Unnatural Selection," Ms. Hvistendahl makes some suggestions as to how such "abuse" might be curbed without infringing on a woman's right to have an abortion. In attempting to serve these two diametrically opposed ideas, she proposes banning the common practice of revealing the sex of a baby to parents during ultrasound testing. And not just ban it, but have rigorous government enforcement, which would include nationwide sting operations designed to send doctors and ultrasound techs and nurses who reveal the sex of babies to jail. Beyond the police surveillance of obstetrics facilities, doctors would be required to "investigate women carrying female fetuses more thoroughly" when they request abortions, in order to ensure that their motives are not illegal.

Such a regime borders on the absurd. It is neither feasible nor tolerable—nor efficacious: Sex determination has been against the law in both China and India for years, to no effect. I suspect that Ms. Hvistendahl's counter-argument would be that China and India do not enforce their laws rigorously enough.

These struck me, in particular, because this odd police regime she recommends sounds very much like what pro-choice advocates often accuse pro-lifers of wanting to institute. Obviously, it takes a much more invasive regime to allow abortion but only for reasons that you approve of than simply to ban it as a legitimate medical procedure. Once again, there is a police state supporter in the room, and it's not the person standing on the right.

That said, like the reviewer, I hope that Ms. Hvistendahl's work will, contrary to her wishes, call attention through the wider culture to the shocking nature of abortion, and not leave them thinking, "It's horrible to abort a baby just because she's a girl, but on the other hand, if you want to abort her because you don't want to have to shop at Costco, well, go right ahead!" Perhaps it can even do a better job of that since it comes from the "safe" source of a pro-choice feminist.

Does Giving Women a Year's Supply of The Pill Reduce Abortions?

A reader asked me to take a look at this study (abstract here) and see if it reaches a valid set of conclusions. The study was conducted in California among ~80,000 women who receive birth control pills paid for by the state as part of a program for low income women. Previously, women in the program have received a 1 or 3 months supply of birth control at a time, and then have to go in to the clinic in order to receive a refill. In the study, a portion of these women were given a full year's supply instead of one or three months, and state medical records were then used to see if this resulted in a change in the rate of unplanned pregnancy and abortion among the women who received a full year supply of birth control.

Researchers observed a 30 percent reduction in the odds of pregnancy and a 46 percent decrease in the odds of an abortion in women given a one-year supply of birth control pills at a clinic versus women who received the standard prescriptions for one – or three-month supplies.

The researchers speculate that a larger supply of oral contraceptive pills may allow more consistent use, since women need to make fewer visits to a clinic or pharmacy for their next supply.

"Women need to have contraceptives on hand so that their use is as automatic as using safety devices in cars, " said Diana Greene Foster, PhD, lead author and associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences. "Providing one cycle of oral contraceptives at a time is similar to asking people to visit a clinic or pharmacy to renew their seatbelts each month."
...
Oral contraceptive pills are the most commonly used method of reversible contraception in the United States, the team states. While highly effective when used correctly (three pregnancies per 1,000 women in the first year of use), approximately half of women regularly miss one or more pills per cycle, a practice associated with a much higher pregnancy rate (80 pregnancies per 1,000 women in the first year of use), according to the team. [source]

The details of that decrease are as follows:

Women who received a 1-year supply were less likely to have a pregnancy (1.2% compared with 3.3% of women getting three cycles of pills and 2.9% of women getting one cycle of pills). Dispensing a 1-year supply is associated with a 30% reduction in the odds of conceiving an unplanned pregnancy compared with dispensing just one or three packs (confidence interval [CI] 0.57–0.87) and a 46% reduction in the odds of an abortion (95% CI 0.32–0.93), controlling for age, race or ethnicity, and previous pill use.[source]

So, what should a Catholic pro-lifer make of this?

Well, there may or may not have been methodological issues with this study. I read several science news stories about it, but I can't get access to the full text, so I don't know for sure how they dealt with sample bias, etc. However, I have to admit, that from what I've read it makes sense to me that the study results are valid as far as they go. But they also give us a window into the contraceptive mentality which is at play in feeding into abortion in this culture.

The women in the study are receiving birth control so that they can have sex at will while not getting pregnant. Nevertheless, some percentage of them are getting pregnant (around 1% of those getting the year supply, around 3% of the rest) during any given year. The good news is that they are like the rest of California women in that in 80% of these cases, they are carrying these unexpected children to term. The bad news is that 20% of the time they choose an abortion instead.

But part of what's feeding this problem is not the quantity of birth control that's being given out at a time, but the sense in which people's actions are (for whatever reason) not fitting with their desires. One article on the study includes this telling quote:

“It's a cost-savings thing, but it's also a quality-of-care issue — and it's the right thing to do,” she says. “People don't stop having sex when their pills run out.”

So people are taking birth control pills in order to have sex while not getting pregnant, but if they run out of pills -- they don't stop having sex.

The study's proposed solution to this is "let's just make sure they always have lots of birth control on hand" and I suppose in the context of them taking birth control, I really don't have any strong feelings about whether they get a month's supply or a years supply at a time. But it seems to me that we're looking at the root of a much deeper issue when we hear someone conducting a study on this topic saying that people do not appear to stop having sex when they run out of birth control -- even if they know it's only the birth control that's keeping them from getting pregnant as a result of having sex.

All other things staying constant, if it's true (as the study appears to indicate) that some women on birth control are late in refilling their prescriptions and thus gap out for a few days, yet continue having sex as normal (or abstain during the couple days they don't have pills, but then go back to having sex as normal as soon as they start taking the pills again without realizing that the unexpected fertility might well come a week or two after the gap, not during it) then it's pretty logical that reducing the frequency with which women have the potential to experience that gap would reduce the number of unplanned pregnancies. And if we assume that the same percentage of unplanned pregnancies will always result in abortions, then necessarily reducing the number of unplanned pregnancies will reduce the number of abortions.

I think this does suggest that for those people who are in the business of dispensing birth control pills, it would be an obvious thing for them to dispense large prescriptions, and perhaps to look into some sort of automatic reminder or shipment in order to help women avoid these gaps. Women who are coming to them for birth control obviously don't want to get pregnant, and they will do a better job of fulfilling those women's wishes if they help them avoid those gaps.

I don't think we pro-lifers who have moral objections to birth control need to go out and become cheerleaders for the idea of handing out larger prescriptions of The Pill -- though in light of this study I think we shouldn't actively try to keep birth control dispensers from dispensing larger amounts at a time. The moral content of taking birth control is the same regardless of how much you pick up at a time and the larger prescription amounts seem to have, on the whole, positive results from everyone's point of view.

I think the role for us as pro-lifers is two fold:

First, either way, we believe that everyone will be better off if abortion is simply not on the table. (For those birth control enthusiasts, this might even result in some more conscientious pill taking.) This clearly makes no different in our fight to remove abortion from the set of legal medical options.

Second, our society is clearly both confused and dysfunctional when it comes to sex, if we have a lot of people who are taking birth control in order to avoid getting pregnant yet don't stop having sex if they run out of birth control. The birth control advocates who are the sources of this study are going to be no help in solving these problems, because their whole worldview is built around the idea that sex should be totally separate from reproduction. It is up to us to build the cultural understanding that sex results in new human life, and that even "protected" sex does some percentage of the time. If you are having sex, you had better be sure that it is with a person whom you are willing to have a child with -- even if you're taking measure to reduce the likelihood of that happening in any given year down to around 1%. One person out of a hundred is still a pretty significant group of people, and a number of years your chances of ending up with a child at some point only go up.

The Transmission of Human Life

The transmission of human life is a most serious role in which married people collaborate freely and responsibly with God the Creator. It has always been a source of great joy to them, even though it sometimes entails many difficulties and hardships.

The fulfillment of this duty has always posed problems to the conscience of married people, but the recent course of human society and the concomitant changes have provoked new questions. The Church cannot ignore these questions, for they concern matters intimately connected with the life and happiness of human beings. --Humanae Vitae 1

She urges man not to betray his personal responsibilities by putting all his faith in technical expedients. -- HV 18

In a hospital room on the Greek island of Crete with views of a sapphire sea lapping at ancient fortress walls, a Bulgarian woman plans to deliver a baby whose biological mother is an anonymous European egg donor, whose father is Italian, and whose birth is being orchestrated from Los Angeles.

She won't be keeping the child. The parents-to-be—an infertile Italian woman and her husband (who provided the sperm)—will take custody of the baby this summer, on the day of birth.

The Wall Street Journal's article "Assembling the Global Baby" is about the new business of surrogacy. I use the term "business" advisedly: there is a product that can be customized to the demands of the consumer, which is being outsourced because foreign workers will do the job for less than their first-world counterparts. And the excessive inventory is liquidated if the buyer doesn't want to purchase it.

Some of his own clients have faced the abortion decision, Mr. Rupak says. "Sometimes they find the money" to pay for more children than they expected, he says. After all, they went to such lengths. And if they decide otherwise, Mr. Rupak says, "We don't judge."

From this it follows that they are not free to act as they choose in the service of transmitting life, as if it were wholly up to them to decide what is the right course to follow. -- HV 10

PlanetHospital's most affordable package, the "India bundle," buys an egg donor, four embryo transfers into four separate surrogate mothers, room and board for the surrogate, and a car and driver for the parents-to-be when they travel to India to pick up the baby.

...Mr. Rupak says he is vigilant about the risks inherent in a lightly regulated business. He says he stopped using egg donors from Georgia in Eastern Europe, for instance, because a black market for eggs has sprung up in the region. This fall, Greek authorities busted a group of Romanian and Bulgarian men for allegedly forcing poor immigrant women to undergo egg extractions.

No statement of the problem and no solution to it is acceptable which does violence to man's essential dignity; those who propose such solutions base them on an utterly materialistic conception of man himself and his life. The only possible solution to this question is one which envisages the social and economic progress both of individuals and of the whole of human society, and which respects and promotes true human values. -- HV 23, quoting Mater et Magistra

...The couple planned on having two children. But their two surrogate mothers in India each became pregnant with twins.

At 12 weeks into the pregnancies, Mr. Aki and his husband decided to abort two of the fetuses, one from each woman. It was a very painful call to make, Mr. Aki says. "You start thinking to yourself, 'Oh, my god, am I killing this child?'"

Consequently, unless we are willing that the responsibility of procreating life should be left to the arbitrary decision of men, we must accept that there are certain limits, beyond which it is wrong to go, to the power of man over his own body and its natural functions—limits, let it be said, which no one, whether as a private individual or as a public authority, can lawfully exceed. These limits are expressly imposed because of the reverence due to the whole human organism and its natural functions... -- HV 17

Choice and Information

One of the persistant worries of pro-abortion advocates is that pro-life crisis pregnancy centers may maliciously trick women into not having abortions. How, after all, could one be so wicked as to call oneself a "pregnancy center" without offering the where-with-all to end a pregnancy?

Pentimento has a thoughtful and moving post up, spurred by an NY Times article reporting on CPCs versus Planned Parenthood vacilities in light of an upcoming New York City Council vote on whether or not to require pregnancy centers to disclose on all advertising what services they do (and do not) offer:

The bill was triggered by a recent study undertaken by NARAL, which aims to show that the pregnancy centers use deceptive advertising to lure young women in crisis and . . . not give them abortions. Chris Slattery, a member of my old parish in the Bronx and the director of Expectant Mother Care, which runs pregnancy centers in some of New York's poorest neighborhoods, believes that this proposed legislation is an attack on the work that the centers do, because, while technically it doesn't seem like a bad idea to require businesses to be specific about what they do and don't offer, in the case of the emergency pregnancy centers, this forced disclosure could very likely lead to loss of life. If an abortion-minded woman in a crisis pregnancy goes to an EMC center without knowing that abortion is not on the menu, it's easier for the staff to persuade her to change her mind. This, NARAL says, is a very bad thing indeed. The fact that a woman may be talked out of having an abortion apparently does grievous harm to her freedom of choice.

I was fascinated today to read this article in the New York Times, in which a pregnant newspaper reporter took herself on an investigative-journalistic tour of two crisis pregnancy centers and one Planned Parenthood clinic. She went first to one of Chris Slattery's centers, and was overwhelmed by what she freely calls the love with which she was welcomed. She also admits that Planned Parenthood was the only one of the three places that had "a financial stake" in the choice she made vis-à-vis her (in real life, non-crisis) pregnancy.

But most salient for me in this story were the reader comments -- or, I should say, one of the reader comments, which twisted my heart (most of the other comments were just what you might expect): [continue reading]

Red vs. Blue Families

It's fairly common for advocates of more liberal social policies to point out that "red states" tend to have higher rates of divorce, teen pregnancy, etc than "blue states". This is taken to suggest that, however much conservatives may go on about "family values", it is actually more liberal social values which are best for families. Ross Douthat does a good job of addressing this mentality in his column from last Sunday, in which he takes a closer look at some of these "family values" statistics.

Today, couples with college and (especially) graduate degrees tend to cohabit early and marry late, delaying childbirth and raising smaller families than their parents, while enjoying low divorce rates and bearing relatively few children out of wedlock.

For the rest of the country, this comfortable equilibrium remains out of reach. In the underclass (black, white and Hispanic alike), intact families are now an endangered species. For middle America, the ideal of the two-parent family endures, but the reality is much more chaotic: early marriages coexist with frequent divorces, and the out-of-wedlock birth rate keeps inching upward.

When it comes to drawing lessons from this story, though, the agreement between liberals and conservatives ends. The right tends to emphasize what’s been lost, arguing that most Americans — especially the poor and working-class — would benefit from a stronger link between sex, marriage and procreation. The left argues that the revolution just hasn’t been completed yet: it’s the right-wing backlash against abortion, contraception and sex education that’s preventing downscale Americans from attaining the new upper-middle-class stability, and reaping its social and economic benefits.
...
Conservative states may have more teen births and more divorces, but liberal states have many more abortions.

Liberals sometimes argue that their preferred approach to family life reduces the need for abortion. In reality, it may depend on abortion to succeed. The teen pregnancy rate in blue Connecticut, for instance, is roughly identical to the teen pregnancy rate in red Montana. But in Connecticut, those pregnancies are half as likely to be carried to term. Over all, the abortion rate is twice as high in New York as in Texas and three times as high in Massachusetts as in Utah.

So it isn’t just contraception that delays childbearing in liberal states, and it isn’t just a foolish devotion to abstinence education that leads to teen births and hasty marriages in conservative America. It’s also a matter of how plausible an option abortion seems, both morally and practically, depending on who and where you are.

Whether it’s attainable for most Americans or not, the “blue family” model clearly works: it leads to marital success and material prosperity, and it’s well suited to our mobile, globalized society.

By comparison, the “red family” model can look dysfunctional — an uneasy mix of rigor and permissiveness, whose ideals don’t always match up with the facts of contemporary life.

But it reflects something else as well: an attempt, however compromised, to navigate post-sexual revolution America without relying on abortion.

On additional point which Douthat does not draw out is that the high divorce rates in red states are closely related to the fact that marriage continues to be fairly common in these states. For instance, the Massachusetts divorce rate has hovered around a low 2.2 from 1990 through 2007, while Alabama had a divorce rate of 6.1 in 1990 which was still 4.6 (more than twice MA's rate) in 2007. However the marriage rate in Massachusetts was 7.9 in 1990 and declined to 5.9 by 2007, while Alabama's marriage rate only declined from 10.6 to 9.0 during the same time period. Obviously, if yo never get married int he first place, you can't get divorced. The fact that increasing numbers of Massachussets residents are simply not getting married does not necessarily speak to the strength of the "blue state" approach to marriage. [source data]

A Matter of Choice

Some time back there was a fellow in the news named Matt Dubay, a man who was claiming that Michigan's paternity law is unconstitutional because it didn't give him any 'choice' in whether to become a father.

The interesting thing about this suit is that it points out the inherent contradiction's in the current legal understanding of sex in the United States. On the one hand, a woman must be given a 'choice' as to whether or not to be pregnant after she has already conceived, and so abortion is legally mandated. On the other hand, a man is considered to have already made himself financially liable for any children conceived from the moment that he has sex. Thus, in the man's case, US law recognizes a traditional understanding of what sex is (an act that can naturally be assumed to be fertile) while in the woman's case sex is merely considered an act which may bring on a transitional condition in which a woman has conceived yet has not yet decided whether or not she wants to actually be pregnant.

Clearly, being pregnant (and caring for a child) is a far, far greater burden for a woman than for a man, so one can see how (thinking with its heart rather than its head) our country got itself into this position. But it's still a pretty untenable position to be in. Clearly, one must say either than sex is an act which has the inherent potential to create another human person, or it is not. One of these positions, of course, has the benefit of being true, while the other might be convenient for some, but is quite provably false.

However, while I do believe that the law should protect a newly conceived human being from her mother's second thoughts just as thoroughly as it does from her father's, it does seem to be that there is a hierarchy of claims to parenthood of the child in situations where a man and woman conceive outside of wedlock. Currently (at least from what female coworkers who have dealt with these situations tell me) if a man can prove that he is the father of your child, he has (unless this is somehow considered dangerous) both financial duties to you and visitation rights to the child.

This seems to me a little off. If a woman is willing to claim a certain man as the father of her child (and if there is any question about it, if tests prove her right) then it seems fair to me that he be both required to take some financial responsibility for the child and also allowed to have visitation rights or shared custody. However, if the couple have never been married and the woman wishes to refuse to acknowledge the man as the father of her child (even if biologically speaking he is) it seems to me to be reasonable to allow him to exclude him from the child's life, assuming she also does not try to seek money from him.

This may not be 'fair' in the sense that many use the term (as in, treating everyone equally regardless of whether that makes any sense) but it does seem to me to make a certain degree of sense.

Though on the devil's advocate side (or the libertarian side -- in this case they are one and the same) there is a certain sense in which allowing any demand for child support from a man to which one has never been married weakens the importance of marriage as an institution. If a woman need not be married to a man in order to be assured that she can hold him financially responsible for any offspring she may have with him, than being married before having sex is at least somewhat less urgent.

In the words of The Hitchhikers' Guide to the Galaxy: "To summarize the summary, people are a problem."

Abortion, Clean and Dirty

Via Matthew Lickona, this essay by Caitlin Flanagan in The Atlantic, a book review of The Choices We Made, in which women tell their stories of back-alley abortions before legalization:

In the middle of a hot New York summer 60 years ago, my mother and her two roommates were invited to spend a weekend at Fire Island. The three girls, recent nursing-school graduates, worked together at Bellevue and were sharing the rent on their first apartment. When a fourth young nurse of their acquaintance overheard them talking about the trip, she asked if she and her young man, a resident at the hospital, could borrow the apartment while they were away. In those days, lovers had to seize on those kinds of opportunities to be alone together. The apartment key was given to the friend, no big deal, and my mother and her roommates left for the beach.

They returned late Sunday evening, in a commotion of kicked-off shoes and set-down carryalls and switched-on lights. One of them pulled the string on the kitchen bulb, and her cry brought the other two. At first they thought a crime had taken place. Strictly speaking, one had: The boyfriend, a kid with a year or two of medical training under his belt, had performed an abortion on his girlfriend. Literally, a kitchen-table abortion. There was blood on the table and the floor, and there were wadded-up bloody towels in the sink.

Or, consider this:

The quality of the criminal abortion that a woman received depended largely on where she lived and how wealthy she was. Reports a woman who got pregnant while a student at Barnard in the 1930s: “The actual abortion was comfortable, clean, the absolute tops.” On the other hand, here’s a description of an abortion the actress Margot Kidder had as an 18-year-old in the mid-1960s. Her boyfriend, John, made the arrangements, “all done with great secrecy and a great sense of evil and sordidness”; the couple were told to check in to a certain hotel room where the abortionist, a woman, would meet them. After gaining their assurance that they would never go to a hospital if something went wrong, she began the procedure.

I was told to undress and lie in the bathtub, which I did. John was in the other room. There was no anesthetic, of course. She jammed something through my cervix. It was incredibly painful. I was screaming and crying; I had no idea what was happening to me. Then she used what looked like a douche to shoot some sort of solution up through my cervix.

The woman had filled Kidder’s uterus with Lysol.

The horror of both these stories is compounded by the fact that in each case the woman's boyfriend, the father, was present. What did John think, what did he do, when he heard his girlfriend screaming in pain and fear? Did the young nurse continue to see the boyfriend who performed an abortion on her and left the bloody mess for her friends to find?

The raw squalor of these stories stand in stark contrast to the carefully sanitized tone of this piece from The Atlantic dating back to 1965, in which "Mrs. X" writes in chillingly clinical, impersonal language about her decision to obtain an illegal abortion.

I set out recently to find an abortionist in the large Eastern city where I live. My husband and I are in our mid-forties and have three children. When I discovered that I was pregnant for the fourth time, my husband and I considered the situation as honestly as we could. We both admitted that we lacked the physical resources to face 2 A.M. feedings, diapers, and the seemingly endless cycle of measles, mumps, and concussions of another child. Years of keeping a wary eye on expenditures (a new suit for my husband every two years and one for me every five) had allowed us to set up a fund which we felt would enable the children to attend reasonably good colleges away from home if some financial assistance in the form of grants or scholarships could be obtained. Since my husband's income has reached its zenith, it was plain that one of the four would have to forgo all or part of a chance at higher education. The part-time secretarial work which I had been doing for some years to augment our income would have to stop since the revenue it produces would not cover baby-sitting fees. We have no rich uncles likely to make our children their beneficiaries. We have also had sufficient experience living to acknowledge that while the Lord will sometimes provide, He may be busy looking after somebody else when you need Him most.

...The operation was successfully concluded as scheduled. Forty-five minutes after I entered the doctor's office for the second time, I walked out, flagged a passing cab, and went home. Admirably relaxed for the first time in two weeks, I dozed over dinner, left the children to wash the dishes, and dove into bed to sleep for twelve hours. The operation and its aftereffects were exactly as described by the physician. For some five minutes I suffered "discomfort" closely approximating the contractions of advanced labor. Within ten minutes this pain subsided, and returned in the next four or five days only as the sort of mild twinge which sometimes accompanies a normal menstrual period. Bleeding was minimal.

Did Mrs. X ever regret her decision? Did she ever lay awake at 2 AM and cry, since baby wasn't there to do it for her? Did her children ever discover the true cost of their college education, and would they have thought it worth the sacrifice? And here once again, the father of the child is involved and is complicit in the abortion.

Mrs. X waxes as eloquent as she gets about the marvels of medical technology which moves abortion from a sordid, back-alley business to a efficient, sterile procedure:

My operation at least was performed with what seemed to me incredible proficiency, speed, and deftness, with sterile instruments designed for the purpose for which they were used.

But Caitlin Flanagan finds herself struck by another, newer kind of technology, one that puts a human face on the matter:

But my sympathy for the beliefs of people who oppose abortion is enormous, and it grows almost by the day. An ultrasound image taken surprisingly early in pregnancy can stop me in my tracks. In it is much more than I want to know about the tiny creature whose destruction we have legalized: a beating heart, a human face, functioning kidneys, two waving hands that seem not too far away from being able to grasp and shake a rattle. One of the newest types of prenatal imaging, the three-dimensional sonogram—which is so fully realized that happily pregnant women spend a hundred dollars to have their babies’ first “photograph” taken—is frankly terrifying when examined in the context of the abortion debate.

This "human face", this "beating heart", these "waving hands" were on the business end of that syringe of Lysol, or the gleaming scalpel. We must never lose sight of this fact. Clean or dirty, abortion has the same outcome: a woman is bleeding and a child is dead.

The Abortion Issue as Pressure Without an Outlet

I have an reflexive admiration for writers who writers who actively think through questions and come to conclusions which are not necessarily indicated by their initial commitments -- even though this effect is usually achieved by the writer disagreeing with me on at least some basic elements of worldview. Megal McArdle, who blogs for The Atlantic, is often one such, and she has a very interesting set of posts dealing with the murder of abortionist George Tiller.

The War on The War on Abortion

A Really Long Post About Abortion and Reasoning By Historical Analogy That is Going to Make Virtually All of My Readers Very Angry At Me

One More Post on Abortion

There are a couple more as well, but these struck me as the most fascinating. McArdle is basically pro-choice, and an economic libertarian, though in most ways was more an Obama supporter than a McCain one. But her take on this is event is a characteristically interesting one:

if you actually think late-term abortion is murder, then the murder of Dr. Tiller makes total sense. Putting up touching anecdotes about people he's helped find adoptions, etc, doesn't change the fact that if you think late-term abortions are murder, the man was systematically butchering hundreds of human beings a year--indeed, not merely butchering them, but vivisecting them without anaesthetic. I'm sure many mass murderers have done any number of kind things over the course of their lives, to which the correct response, if you're trying to stop the murders, is "so?"

Imagine a future in which the moral consensus has changed, and our grandchildren regard abortion the way we regard slavery. Who will the hero of history be: Tiller, or his murderer? At the very least, they'll be conflicted, the way we are about John Brown.

McArdle is the kind of writer who thinks historical analogies through, and she she sees she doesn't like:

But in this case, I think the analogy to slavery is important, for two reasons. First of all, it was the last time we had an extended, society-wide debate about personhood. And second of all, as now, there were structural political reasons that it was much harder--nearly impossible--to change slavery through the existing political process.

Listening to the debates about abortion, it seems to me that really broad swathes of the pro-choice movement seem to genuinely not understand that this is a debate about personhood, which is why you get moronic statements like "If you think abortions are wrong, don't have one!" If you think a fetus is a person, it is not useful to be told that you, personally, are not required to commit murder, as long as you leave the neighbors alone while they do it.

Conversely, if Africans are not people, then slavery is not wrong. Or at least it's arguably not wrong--if Africans occupy some intermediate status between persons and animals**, then there is at least a legitimate argument for treating them like animals, rather than people.

The difference between our reaction to the two is that now we know Africans are people. It seems ridiculous to think that anyone ever thought they might not be people. They meet all the relevant criteria for personhood in twenty-first century America.

But of course, those criteria are socially constructed. The definition of personhood (and, related, of citizenship) changes over time. It generally expands--as we get richer, we can, or at least do, grant full personhood to wider categories. Except in the case of fetuses. We expanded "persons" to include fetuses in the 19th century, as we learned more about gestation. Then in the late 1960s, for the first time I can think of, western civilization started to contract the group "persons" in order to exclude fetuses.

But that conception was not universally shared. And rather than leave it to the political process, the Supreme Court essentially put it beyond that process. Congress, the President, the justices themselves, have been fighting a thirty-five year guerilla war over court seats. Presidents try to appoint candidates who will support their theory of Roe, Congress strategically blocks change, and the justices refuse to retire until they know they will be replaced by someone who supports their side. To change the outcome, a pro-life political coalition would have to gain a supermajority in Congress for twenty years--long enough for a few liberal justices to die in office.

It is theoretically possible that this could happen, just as it was theoretically possible to come to some political accomodation over slavery. But a combination of supreme court rulings and the peculiar federalist structure of American meant that the only way for either side to gain decisive results was violence. At every turn, the pro-slavery forces no doubt slyly congratulated themselves on their political acumen, while also solemnly and sincerely believing that they preserved an important right. But they made war inevitable.

If you interpret this murder as a political act, rather than that of a lone whacko, than this should be a troubling sign that the political system has failed. So why do so many people think that the obvious answer is simply to more firmly entrench laws that are rightly intolerable to someone who thinks that a late term fetus is a person?

And yet the reaction she sees among many fellow urban elite pro-choicers seems to run counter to this historical indication:

Still, I am shocked to see so many liberals today saying that the correct response is, essentially, doubling down. Make the law more friendly to abortion! Show the fundies who's boss! You know what fixes terrorism? Bitch slap those bastards until they understand that we'll never compromise!

Well, it sure worked in Iraq. I think Afghanistan's going pretty well, too, right?

Using the political system to stomp on radicalized fringes does not seem to be very effective in getting them to eschew violence. In fact, it seems to be a very good way of getting more violence. Possibly because those fringes have often turned to violence precisely because they feel that the political process has been closed off to them.

We do not punish murderers by changing large sections of American law. We certainly don't punish them by, in essence, shouting "nya, nya, nya, we're killing more babies!!!!"* We punish murderers by sending them to jail, where they belong. If any of these changes to current law are justified, they're justified on their own merits, not because they'll piss off Tiller's nemesis.

* I understand that those advocating such changes do not perceive themselves to be saying this. But if you're trying to punish the gunman, and deter others, it's their perception that matters. And what bothers them is that they think you're killing more babies.

I think that McArdle rightly identifies why abortion has remained such a toxic issue for so long -- Roe used judicial fiat to create an abortion regime significantly more liberal than that of any country in Western Europe, and did so in such a way as to put the issue effectively beyond the democratic process. In doing so, it closed the pressure valve that democratic action usually provides to out polity. If you feel passionately about a topic, you can campaign to have the law changed. Except that around abortion, our ability to do that is signficantly reduced because we either need to flip the Supreme Court majority (and even so get only a potentially temporary victory) or pass a constitutional ammendment, which requires a massive super-majority of national support. This removes the ability to compromise, and when the ability to compromise is taken away, it necessarily empowers the extremists. As pro-lifers, we may not like the anology, but I don't think her comparison to the Middle East is entirely misplaced:

My argument is that abortion, like slavery, is becoming in this country an issue upon which people have no reasonable political recourse. I'll go further, and say that the process by which 7 judges enforced their consciences on the American public was itself borderline illegitimate; it was first, not in their proper job description, and second, a bad way to run a government.

Yes, in theory pro-lifers could pass an amendment. And in theory, the Palestinians have access to the political process too, as right wing blogs often point out--all they need to do is elect a coherent government that Israel is willing to negotiate with. Most Obsidian Wings posters and commenters don't have much trouble discerning that a sufficiently remote possibility of political access is not political access, and that the individual Israeli actions which might be justified in a democratic government acting on an enfranchised population, are problematic when Israel does them to the Palestinians. After all, we bulldoze peoples' homes, too--we just call it eminent domain.

Historical analogies can only take one so far, but I think that the comparison that McArdle is making in regards to slavery and abortion is good enough that it ought to be in the interests of all Americans to get the issue back into the democratic process and allow it to be fought out with ballots rather than bullets.