Between a Sonogram and a Hard Place

You might be feeling anxious. You might wonder if I am on your side about abortion. I know the feeling; it can be a gut punch to learn that someone you trusted disagrees with you.

To spare you from sweating through this whole piece, I’ll show you my hand at the beginning. I consider myself pro-life. Generally speaking, I believe abortion is wrong because it ends a vulnerable human life without that person’s consent. However, the wide variety of good-faith answers to the question of when personhood begins makes it difficult for me to be dogmatic about mine.

Additionally, I think much anti-abortion activism is reprehensible because it tramples women’s rights, health, and safety and ignores the larger societal factors contributing to abortion.

My views come firstly from my personal experience as a mother. I have four kids, ages four to fourteen. My mom friends and I talk about sex, pregnancy, our bodies, men, babies, kids, jobs, money—all the things that factor into this conversation. Additionally, I’ve gotten a close-up view of the margins of our society through volunteering with a Christian organization that supports pregnant and parenting teens.

As you may have observed over the past decade, moral outrage has become a cheap commodity. Abortion is one of the topics everyone is mad about. But what if our anger isn’t helping us achieve the justice we seek?

Anger never exists in isolation. It’s always a response to an underlying emotion such as hurt, fear, or guilt. For example, if you yell at your child for running away from you in the store, what likely happened first is that you were afraid your child would get lost. But fear is so uncomfortable, we’ve become experts at translating it into anger without even noticing.

Collective moral outrage, like individual anger, is often deployed as a self-defense mechanism to shield us from an uncomfortable underlying feeling: guilt.

In a study published in 2017, researchers found that the more personal guilt a person felt about a large societal problem like corporate labor exploitation, the more likely they were to express outrage at a third party for contributing to the problem. What’s more, the study showed that when people had an outlet to express their moral outrage at the third party, doing so actually assuaged their personal guilt.

This finding begs the question: why on earth would Republicans feel guilty about abortion when they actively work against it? Why would Democrats feel guilty about abortion when they don’t believe it’s wrong?

I think it’s because there are internal contradictions within each party’s position. Abortion is a natural byproduct of free-market capitalism, which is a contradiction on the Republican side. Abortion oppresses a marginalized group, which is a contradiction on the Democratic side. So both sides do what comes naturally—turn their unacknowledged guilt into anger and direct it outward.

You have the Internet. You know how this goes.

Moral outrage. Attack. Counter-attack. More moral outrage. And, just as happens in our interpersonal relationships, this cycle spirals deeper and deeper. We protect our ego but avoid digging below the anger to explore the causes of our guilt.

Anger is not bad. It has been used to spark movements against feudalism, slavery, religious oppression, poverty, drunk driving, and of course, taxation without representation. Quite frankly, though, sparking action is where its usefulness ends. As Harry Beltik tells Beth Harmon in The Queen’s Gambit, “Anger is a potent spice. A pinch wakes you up. Too much dulls your senses.” Historically, where anger remains the primary driving force, many people die and the survivors end up in a new iteration of the same old problems.

That’s what happened with abortion in the United States. Many people voted for Donald Trump in 2016 in large part because he presented himself as the pro-life candidate. However, after abortion rates had been declining steadily during Barack Obama’s presidency, they went up during Donald Trump’s presidency. Although Trump appointed conservative Supreme Court justices who overturned Roe v. Wade in 2022, that ruling has not had the effect many pro-life activists hoped; abortion in 2023 was at its highest nationwide rate in over a decade.

People who want abortions are finding ways to get them. They are just traveling farther, spending more money, and experiencing more pain and suffering to do so. Meanwhile, maternal mortality is climbing and fewer women and children have access to basic medical care.

When we are angry, we don’t think as clearly. Anger helps us make decisions quickly by reducing our options. Abortion, enmeshed as it is with human rights, biology, health and safety, economics, legislation, and politics is one issue on which we need more options, not fewer. We desperately need to think clearly. We need a long-term, sober-minded, fully informed plan, and that cannot be accomplished as long as we are functioning from a place of moral outrage.

Here I must confess that I do not have a long-term, sober-minded, fully informed plan. Coming up with such a plan will take more than one person, I’m pretty sure. Wouldn’t that be strange if I had solved abortion all by myself on my laptop?

But I hope that one or two things you read here will crack open some calcified beliefs you might be holding onto because you’re afraid of betraying babies or women. You won’t. Updated information won’t betray anyone. It’s a new world post-Dobbs. Our old conversations about abortion are as useful as Apple’s second-most-recent chargers. 

Human Rights: “A person’s a person, no matter how small”

It’s chilling to look back at the arguments the defenders of slavery used and compare them to the arguments reproductive rights advocates use today.

What about the rights of slave owners? What about the certain financial ruin that would befall them if slavery were to be criminalized? What about the strain on society if hundreds of thousands of uneducated slaves were released into it?

Slave owners did not want to feel guilty about owning slaves, so they sanitized the way slavery was depicted to make it more palatable to the general public. Preachers and politicians were instrumental in this effort.

In the same vein, supporters of abortion rights sanitize the way abortion is depicted to make it more palatable to the general public. It’s extremely difficult to find graphic information about abortion online. The first three pages of search results for “what happens during an abortion” detail what medications are used, what happens with a woman’s cervix, and how long a woman can expect to take off work or school for recovery. The physical description of the actual killing of the baby is limited to “removes the contents of the uterus.”

The only places these sterilized descriptions are not used are shoddily made, radical anti-abortion sites with expired links. Yet, if you dig enough, you can find the grisly details: photo after photo of dismembered fetuses; tiny hands smaller than a dime; lifeless pink blobs, unmistakably human, resting on the fingertip of a latex gloved-hand.

There is a scene in Amazing Grace, the story of British abolitionist William Wilberforce, where a cadre of abolitionists comes to Wilberforce’s home to persuade him to take up their cause in the British House of Commons. Right after introductions, former slave and abolitionist Olaudah Equiano unbuttons his shirt to reveal his many gruesome scars from being whipped, chained, and branded.

It was one thing to understand on a conceptual level why slavery was wrong. It was another thing to see firsthand evidence of physical violence perpetrated against slaves. Exposure to that evidence was critical in compelling Wilberforce to work tirelessly toward ending the slave trade in Europe. When we refuse to allow the disturbing physical evidence of the violence of abortion to be made known to the general public, we are complicit in the violence against unborn children.

If it’s not acceptable--and it’s not--for a grown woman to be slapped across the face, forced into sex, held captive in her own home by financial bullying, or threatened at knife point, it’s not acceptable for that same woman’s life to be extinguished before it even starts.

Just because abortion is understandable--and it is--that does not make it acceptable.

I wish the conversation could be that simple. The problem is, in no other human rights case is there such a conundrum of two fates tied up in one. [1] If we aren’t feeling very rock-and-a-hard-place when we think about abortion, we aren’t being honest with ourselves. Pregnant women’s bodies are both their own and inextricably linked to the bodies of their babies.

Our conversations about abortion need to be as complex as this reality. The good news about abortion is that both women and unborn babies have people advocating tirelessly for them. Not every oppressed group can say the same. The bad news is that we’ve pitted women and babies against each other and forced everyone to take a stand on whose rights are more important.

The pro-choice side considers themselves defenders of human rights when it comes to abortion because by “human rights” they mean women’s rights.

The perennial appeal of the Democratic platform is that it cares for the underdog. But as I inch toward the left side of the political spectrum on many issues, I find my views on abortion unwelcome there. The left does not seem to account for the rights of unborn babies. It is an inherent contradiction: they are fighting for one underdog while completely ignoring another.

Unborn babies share defining characteristics with oppressed groups throughout history—women, the handicapped, the queer, the poor, the sick, the very old, the very young, and myriad racial and ethnic groups. Like those groups, the well-being of the unborn often only matters when it affects someone else. Their voices are silent and silenced. They cannot advocate for themselves. They cannot form interest groups, organize rallies, raise funds, send newsletters, lobby in Congress, or go on strike.

This type of person—the extremely vulnerable—is precisely whom social safety nets should target. Instead, those advocating for expanding social safety nets are the same ones advocating for expanding women’s abortion rights.

If there were a hierarchy of power in the procreation triad, men would be at the top, unborn babies would be at the bottom, and women would be in the middle—often oppressed by the men at the top and faced with the impossible decision of whether to alleviate some of their own oppression by passing it on to the unborn babies, or to absorb it, sparing the babies. In my opinion, no matter how difficult carrying, birthing, and raising the child will be for the mother, the baby does not deserve to die.

It’s crucial to add here that many women choose abortion specifically because they believe it’s the kindest thing to do for their unborn baby and/or their existing children. When I say “alleviate some of their own oppression,” I certainly do not mean “live an indulgent, carefree lifestyle.” I mean that abortion sometimes offers women basic safety and freedom they wouldn’t have if they continued the pregnancy.

Even if someone is born into a desperate situation, that person’s life is still meaningful. Of the 109 billion people who have ever lived, the vast majority have been extremely poor; social class is not a good barrier to entry into this world.

Many people in the rooms of Alcoholics Anonymous are in desperate situations. They might be unable to hold a job or maintain positive relationships when they first start coming. One of the promises in Al-Anon, a similar 12-step group, says, “Our lives, no matter how battered and degraded, will yield hope to share with others.” Let’s not assume that being poor, or disabled, or having unhealthy parents, or any other serious problem means your life is not worth living.

As mentioned above, I have four kids. If I were to draw a pie chart of where my energy goes, the largest section by far would be My Kids. In fact, if I were to make an actual pie, the largest section would go to my kids. If I had chosen abortion, I would have been responsible for killing my kids. For me, it will always come back to this. I cannot imagine explaining to my children that I chose to end the life of their baby brother or sister. I don’t think there is any amount of poverty, hardship, or lack of freedom that would have made abortion the right choice for me.

But I say this more quietly than I used to. I am not so arrogant as to believe that there is no amount of poverty, hardship, or lack of freedom—not to mention physical danger—that might make abortion the right choice for someone else. Life is so much more hostile than I used to realize.

Biology: “I decided then and there I would have sex with as many women as I could”

I was ten years old, riding with my friend Kelsey in the backseat of her mom’s car. Her mom and her mom’s boyfriend were arguing, and I heard him say something I have never forgotten: “I decided then and there I would have sex with as many women as I could for the rest of my life.”

Sociobiologists have observed that all animals, including humans, are inherently motivated to engage in behaviors that help them pass on copies of their genes to the next generation.

It sounds coarse, but it makes good biological sense for a man to have sex with as many women as possible and for a woman to be choosier, having sex only with those men who appear to have healthy genes and to be most likely to care for her and her offspring. Considering that females have a limited number of eggs (about 400 in their lifetime) and males have virtually unlimited sperm, “it pays males to be aggressive, hasty, fickle and undiscriminating.” Biologist Edward O. Wilson wrote that in his 1978 book On Human Nature and it made a lot of people mad.

But it might partly explain why, 6000+ years into human history, we still have so many men who seek out female partners primarily for sex. Sometimes they want offspring too, but preferably offspring they only have to engage with in small blocks of time at their own convenience. Many men like the idea of having children—that is, they want genetic copies of themselves running around in the world—but are not interested in feeding, clothing, cleaning up after, supervising, entertaining, educating, or disciplining their children.

Brian Fisher, co-founder of the Human Coalition, a non-profit organization committed to ending abortion in the United States, argues that men are primarily responsible for the existence of abortion. He says abortion “frees male sexual aggression” and is “the ultimate get-out-of-jail-free card for men with non-committal sex lives.” In other words, abortion allows for sex without the inconvenience of babies. I have seen this play out in real life; I know men who have pressured their sexual partners into abortion to avoid a lifelong consequence of their behavior.

What Fisher overlooks is that men continue to engage in sex without the inconvenience of babies regardless of abortion—because women care for the babies. From King David to David Beckham, it’s a well-documented phenomenon that men are more likely to initiate sex and to have more sexual partners than women, yet are less likely to be the primary caregivers for the offspring resulting from that sex.

Here let me stop and acknowledge the millions of men in this country who happily care for their children or who perhaps are caring for children who aren’t even their responsibility. I am one of six kids. When I ask my mom if it was hard having so many kids, she always shrugs and says 1) it was a simpler time and 2) Dad never minded changing diapers. As best I can tell, although my mom had plenty on her plate, she did not feel alone with the burden of our family.

Some good news: recent research indicates that perhaps the disparate sexual behaviors between men and women can be explained more by societal and cultural factors than biological factors.

Even though many men rise above the deadbeat dad stereotype, many American women still find themselves pregnant by a man they cannot count on to provide for them or share the burden of child-rearing. In a best-case scenario, these women have the resources to provide for themselves and family and friends to support them as they raise their children. Real life is not always best case, though.

More darkly, about one in twenty American women will become pregnant as a result of rape or sexual coercion in her lifetime. Sometimes these women are also victims of reproductive coercion: their partner actively prevented them from using birth control or refused to use a condom as a means of exerting further control over them. Most of these men (77.3%) were current or former intimate partners. Home continues to be the most dangerous place for women—a place where all forms of abuse, including sexual abuse, can thrive without outside interference.

Women are right to feel angry that men get them pregnant, sometimes against their will, yet often slink into the shadows when it comes time to care for the resulting children. Conservatives and liberals agree that, to see the end of abortion in the United States, men need to either a) stop getting women pregnant so often and/or b) show up to take full responsibility for their children.

The question is, until we find an effective way to hold men accountable for their “aggressive, hasty, fickle, and undiscriminating” sexual tactics, what do we do with all the pregnant women in the meantime?

Health and Safety: “I’m standing in front of doctors who know exactly what to do and they’re refusing to do it”

Until recently, I thought that pregnancy rarely endangered a woman’s life. I’ve been lucky enough to have four healthy, full-term pregnancies. I have had one miscarriage, which was dreadful, but my life and health were never in jeopardy. As I have a bad habit of doing, I projected my experience onto everyone else.

I assumed that all women pretty much know as soon as they become pregnant. I assumed that all women have plenty of time to make pregnancy-related medical decisions. Self-righteously, I assumed that the only real question to ask was, “Are you a good enough person to keep a baby with Down Syndrome?”

I’ve since learned that I was wrong. Pregnancy can be very dangerous for women. Worldwide in 2020, almost 800 women died every day from preventable complications related to pregnancy and childbirth. Although many factors affect maternal mortality, access to quality reproductive care is an important piece of the puzzle. In states where abortion is severely restricted, 62 percent more women die before, during, and shortly after childbirth than in states where abortion is less restricted. Instances where abortion is the most medically sound option for a woman are not unicorn-like exceptions; they are common.

About 82,000 pregnancies a year are ectopic, meaning the fertilized egg implants outside the uterus or in abnormal tissue like scar tissue. An ectopic pregnancy is unsustainable; the baby will eventually die. For this reason, doctors advise terminating the pregnancy as soon as possible either by methotrexate injection or laparoscopic surgery. If this intervention is not done, not only will the baby die, the woman will likely develop sepsis or experience severe bleeding, two leading causes of maternal death.

Doctors have worked hard to develop reliable procedures for diagnosing and treating ectopic pregnancy, as well as every other pregnancy-related complication. Other conditions in which the life or health of a pregnant woman may be at risk are severe preeclampsia, cancer that needs immediate treatment, and placental abruption, to name a few. Thank God doctors have years of experience and shared databases of research they can draw from to provide accurate, timely, and empathetic care to their patients. There is no one-size-fits-all approach. That’s why we have doctors.

Pregnancy-related health issues can be extremely complex. Not only can they threaten a woman’s life, but even when her life is spared, they can render her unable to bear future children or leave her with other lifelong health problems. Many women choose abortion for a wanted pregnancy because the danger to them, the unborn baby, or the unborn baby’s twin, triplet, or future sibling is so serious.

In 1988, the United Nations established the Committee against Torture (CAT). The CAT “has acknowledged that abortion laws and denial of abortion can result in “physical and mental suffering so severe in pain and intensity as to amount to torture.’” They are not making it up. Nobody is trying to use the life and health of the woman as an excuse to “get away with” abortion. The life and health of the woman are the actual concerns. [2]

Severe abortion restrictions have had an additional negative effect on women’s health: doctors are leaving states with severe restrictions because they are terrified they’ll be imprisoned or lose their license. Because these strict laws only allow for abortion “to prevent the death of the pregnant woman,” providers are forced to watch their patients’ conditions worsen until they’re “bad enough” to perform a legal abortion. 

Understandably, doctors don’t feel morally right about practicing medicine where it’s illegal to offer the best care to their patients. This exodus is creating care deserts where women and children cannot access basic medical services. It’s happening most frequently in rural states where there already weren’t enough doctors.

It’s not just about pregnant women seeking abortions. It’s also about families that cannot access the basic services they need—something that, unfortunately, America is becoming notorious for among developed nations.

Economics: “None of this works if you have small children in the house”

Between the responsibilities of their jobs and families, most American parents feel overwhelmed. Several years ago, I saw an influencer on Instagram share their System™ for running an organized household. Someone wryly commented, “Of course, none of this works if you have small children in the house.”

That’s the truth, isn’t it? The COVID-19 pandemic shined a light on a truth that women have long known: you can’t do anything else well when you’re taking care of little kids. Running a household, taking care of children, and working a paid job are each full-time jobs in their own right. Yet many women doing all three are only getting paid for one.

Before the industrial revolution, it was different. “Work” and “home” were not separate. A household produced what it needed to function and everyone contributed: dads, moms, children, and extended family. This arrangement avoided many of our modern problems but had plenty of its own. Children often died by falling into wells or similar accidents. Life was harder for everyone. Disease and infection killed so many people that the average life expectancy in the United States in 1860 was 39-40 years old.

Fewer infants and children are dying these days, which is great! Most people are living well into their 70s or 80s—also great! But all those very young and very old people need caregivers. When we separated work and home, we decided women would do home (for free) so men could do work (for pay). Poor women and women of color were affected differently; many of them worked outside the home from necessity, while their children either accompanied them to work, took care of themselves, or were cared for by others in their communities.

Then second-wave feminism happened and more women started doing work and home, while men pretty much continued just doing work. (Disparities in race and class are still present today.)

This arrangement hasn’t been going well. Even as technology has made home tasks easier, demands on women have increased. American women are living in a constant state of burnout that researchers recognize is untenable. Many factors contribute to this burnout, such as isolation of the nuclear family, constant digital input, and pressure to be thin and beautiful.

But there is a basic economic impasse underneath it all: there is not enough childcare to go around. When evaluating their finances, families try every combination of stealing from Peter to give to Paul. For many families, the math never adds up.

If I’m working, I can’t take care of my kids. I don’t make enough money to pay someone to take care of my kids. If I stay home to take care of my kids, I don’t have enough money to live.

It’s not that women aren’t willing to do the work of caregiving. Many women consider it a great honor. But they simply can’t do it all. I’ve spoken with grandmothers at the park who care for their grandchildren full-time. I can see in their weary eyes the tension between how much they love their family and how exhausted they are from constantly meeting the demands of aging parents, a helpless spouse, busy children, and energetic grandchildren. And those are the lucky families! Many families don’t have a Nana who can take care of the kids, so Mom ends up reducing her hours or quitting her paid job entirely.

This is a market failure. There is a high demand for a service but an insufficient supply. Why? Because people performing that service are not sufficiently compensated.

Although women and children bear the brunt of this failure, they are not the only ones affected. As Melinda French Gates, a powerful philanthropist with loads of empirical data on health and poverty, says, “When we invest in women and girls, we are investing in the people who invest in everyone else.” The opposite is also true. When women are not supported, everyone suffers.

A 2021 report by the Bipartisan Policy Center found that “the country’s lack of access to formal child care…costs the United States an estimated $142 billion to $217 billion in economic productivity.” It’s not just about an adult being present with children during the workday, although that is a huge component. For many families, the squeeze also comes from substandard childcare, the logistical feat of stringing babysitters together, and the mental load of being the one person responsible for someone else’s well-being.

Babies don’t get born and then magically melt into society. Someone has to be attuned to their whereabouts and well-being for almost every second of their first five years of life. It doesn’t get much easier after that, either. Jean Kerr, author of Please Don’t Eat the Daisies, famously quipped, “Now the thing about having a baby - and I can't be the first person to have noticed this - is that thereafter you have it.” She would know; she had six kids.

In our post-industrial society where we’ve decided not to make small kids do dangerous manual labor, babies and children are purely an economic liability (no offense, babies and children). At the very bottom of this market contribution food chain are unborn babies. Not only do they contribute nothing, they also inhibit their parents—especially their mothers—from contributing to their maximum capacity.

You know another economic system with a high demand for a service but insufficient compensation for it? American chattel slavery. (Slavery just keeps coming up, doesn’t it?) Lin-Manuel Miranda highlighted this economic disconnect for us in an argument between Alexander Hamilton and Thomas Jefferson in Hamilton:

Jefferson: “Don’t tax the South ‘cause we got it made in the shade. In Virginia, we plant seeds in the ground, we create. You just wanna move our money around.”

Hamilton: “A civics lesson from a slaver, hey neighbor, your debts are paid ‘cause you don’t pay for labor. ‘We plant seeds in the South, we create.’ Yeah, keep ranting, we know who’s really doing the planting.”

It’s relatively easy to make money if your costs are artificially suppressed, like when my kids earn $60 in thirty minutes selling lemonade in cups I paid for. If I require them to pay me back for supplies, they earn about $12 in thirty minutes. That’s less exciting than $60 but more sustainable as a business model.

When slavery was abolished (in other words, Mom stopped paying for the cups), the American South had to totally revamp its economy. Those who had benefited from slavery were extremely resistant to this and found ways to continue exploiting Black and poor Americans for profit until, well, the present day. But overall the system eventually changed; most labor in the American South is now paid labor. Except caregiving.

Unpaid caregiving is not a sustainable business model. If we want a country where vulnerable people like children, the elderly, and those with disabilities (who all were unborn babies at one point) are cared for, we need to make major substantive changes to our economic system. Care work must be compensated. Families must feel confident that they will have the resources to welcome another child into their lives.

Transforming our economy into one that’s decidedly pro-life will be a long road, no doubt. But many ideas are already on the table. Some of these aren’t scary, even for economic conservatives, like a modest expansion of the child tax credit and minimum family leave time. Patrick T. Brown is a fellow at the conservative think tank Ethics and Public Policy Center. Brown warns that if Republicans refuse to implement key pro-family policies, they “leave unprotected the very people the movement to end Roe has sought to help: pregnant women and their unborn children.”

Legislation: “It feels sketchy because it is”

Whatever your opinion about the overturning of Roe vs. Wade, the result is that each state now has much more control over its abortion laws. Whether you have access to safe, legal abortion depends on where in the country you live. [3] Doctors and patients nationwide are knocked off balance, unsure of their state’s latest laws. Because abortion access depends on where you live, it also depends on what resources you have. Wealthier women can more easily travel out of state for a legal abortion or obtain a safe illegal abortion from home than poor women.

In my home state of Texas, abortion is illegal except in certain cases when the pregnant woman is “at risk of death or ‘substantial impairment of a major bodily function.’” There are no exceptions in Texas for rape, incest, or very young girls. [4] It’s not illegal for a woman to get an abortion; it’s illegal for someone else to perform one. Providers who violate this law commit a first-degree felony and are subject to a minimum $100,000 fine and losing their medical license.

Not only can the person performing the abortion be penalized, but so can anyone who “intends to engage” or “knowingly engages in conduct that aids or abets the performance or inducement of an abortion, including paying for or reimbursing the costs of an abortion through insurance or otherwise…regardless of whether the person knew or should have known that the abortion would be performed.” You could be sued for researching mifepristone online or driving your daughter to another state to get an abortion.

What’s more, private citizens are the ones tasked with enforcing this law (rather than, say, the police). They do not have to abide by the same pesky search and seizure protocols that officers of the law do. A private citizen stands to win $10,000 or more in each successful lawsuit against someone who provides, aids, or abets an abortion.

The law was written this way very intentionally. It cannot be challenged preemptively because no governing body enforces it. “The idea behind [Texas law] is that if no state officials are enforcing the law, then there’s no one to sue for violating your rights.” Literally every person in Texas except a pregnant woman, her doctor, and her court-appointed attorney has more control over her decision to get an abortion than she does.

Texas Health Code 171.202 (adapted from the 2021 “Heartbeat Bill”) says, perhaps oblivious to the irony, “To make an informed choice about whether to continue her pregnancy, the pregnant woman has a compelling interest in knowing the likelihood of her unborn child surviving to full-term birth based on the presence of cardiac activity.”

This phrasing is deceptively simple. The American College of Obstetricians and Gynecologists cautions lawmakers against using the language of viability in legislation. In one sense, “viability” simply means a normally developing pregnancy as opposed to early miscarriage.

The second meaning of viability is whether a baby is likely to survive outside the womb—a critical question for parents planning their families and one that “a normally developing pregnancy” does not answer. Healthcare providers consider many factors to inform patients about the likelihood their baby will survive outside the womb and have a bearable quality of life.

Removal of nonviable pregnancies is in the same medical boat as fertility treatment, D&Cs after spontaneous miscarriage, and selective abortion. The law cannot adequately parse out every element of reproductive healthcare.

Healthcare providers must be able to trust each other and do what is best for their patients on a case-by-case basis. The chaos, fear, and confusion caused by Texas law completely derail best medical practice. You can’t perform an eleventh-hour emergency surgery if you’re afraid the hospital aide who’s wheeling the patient in might charge you with a felony because, in their opinion, the patient wasn’t that close to dying.

Lawmakers are, first and foremost, motivated to satisfy their voter base. The validity of a law comes second. Texas Health Code 171 has a lengthy “severability” clause which explains that, even if portions of the law are found to be invalid or unconstitutional, the rest of it still applies. It seems the bill’s authors know it’s a bad law but they’re hoping it will be too much trouble to sort it all out in the courts. After an attorney friend helped me understand the implications of the severability clause, I remarked that it seemed sketchy. He said, “It is indeed.”

Texas abortion law is written, not to preserve the life and health of women and babies, but to gain apparent moral high ground by paralyzing all abortion-adjacent activity. It takes a good premise—protecting the unborn—and applies it irresponsibly to a delicate web of human life.

It’s like a law that says, “WAR IS BAD. NO MORE WAR.” I agree with that premise. War is bad. But such a law ignores many situations in which war might save lives. I believe private citizens can and should hold our government accountable for ethical war practices. Nonetheless, can you imagine if private citizens were encouraged to sue soldiers for doing anything that might be considered war-adjacent, like owning a weapon or doing 6 a.m. fitness drills? That would be madness.

Abortion laws in Texas are outsourcing Texas’s demand for abortion to other states while increasing maternal mortality, alienating much-needed healthcare professionals, and setting up perverse incentives for citizens to prosecute each other. (Check out your state’s laws here.) We need representatives at the state level who are not under the thumb of anti-abortion activists but instead responsive to what most Texans want: for abortion rates to go down and for women and children to get the health care they need.

What to Do + A Story About My Friend

As I said at the beginning, it’s demonstrably false that Donald Trump is “the most pro-life president this country has ever seen.” Abortion rates went up under his presidency after having gone down under Obama’s. Even his great pro-life victory—appointing the justices who overturned Roe—has not resulted in a lower nationwide abortion rate. The numbers we have from 2022-2024 indicate that, although the number of abortions performed in states like Texas has gone down dramatically, it doesn’t mean abortions are happening less. They’re just happening in states with fewer restrictions.

If there is any cause-effect relationship between the president and the rate of abortions in the United States, it’s that Republican presidents result in more abortions. However, with the 2022 Dobbs decision, the president will have less to do with abortion numbers than ever before. To me, this is a good thing. The chokehold the Republican party has had since the mid-1980s on pro-life voters has dissolved. You can vote for the person you think will do the best job as president without feeling guilty that you’re sending millions of innocent babies to their graves.

As you vote at the local, state, and federal level (you’re planning to vote, right??), I hope you’ll take a wide lens. Please research each candidate’s position on pro-family policies. Please look up what’s on the ballot before you get to the polls; the language they use for those propositions is so manipulative. It will say, “Do you hate puppy dogs or think they’re cute?” so of course you’ll select “I think puppy dogs are cute” and then later you’ll find out you supported something horrific.

I have to be honest with you here. I wanted to end by suggesting some precious action items, like volunteering at Casa de Amigos or bringing a meal to someone who just had a baby. And I do recommend those things! Our local Casa de Amigos desperately needs volunteers. (Apply here!) But the state of affairs is being worsened by a critical mass of people who believe, mistakenly in my opinion, that piecemeal private charity can cure broad public ills.

I know a woman who desperately needed respite care for her two children, ages two and three. She was in the middle of a very traumatic childhood when she became a mother herself. Although she had family and friends, none of them were in a position to provide permanent, stable help. It was logistically impossible for her to both work and care for her kids. Her mental and physical health had seriously declined.

When she became pregnant for a third time, it was the final straw. The father of the baby was not interested in fathering a baby. The pregnancy had already begun causing her severe back pain, abdominal pain, nausea, and fatigue. As challenging as things were, she had been able to work by stringing together hodge-podge childcare—but none of those people would take on a baby along with two toddlers. West Texas Opportunity provides heavily subsidized childcare for people like my friend, but they told her the waitlist was very long because Texas had run out of funding for the program.

She became so desperate that she reached out to a local organization that seemed like the perfect solution. This organization works alongside government agencies and other charitable organizations to empower local communities to care for at-risk kids and families.

This woman, having struggled daily for four years as a single mother and finally run out of cards, explicitly asked this organization to pair her with a family to care for her kids (essentially, to foster them without all the red tape) for three to six months. This reprieve would allow her to attend counseling, see doctors for her multiple untreated health conditions, finish her GED, wade through all the paperwork of activating government aid, get car insurance, and save up money. She would also need someone to spend several hours a week helping her with these tasks.

The organization said they would work on her case. I asked my friends if they knew any families willing to care for two small kids for a few months. They asked their friends. We asked church groups.

What happened next? Nothing. One family showed interest, but ultimately decided it wasn’t the right time for them. Not a single other family came forward. I didn’t come forward.

This is a good time to hop on a soapbox about the hypocrisy of pro-life people who are against abortion but unwilling to care for those babies after they are born. That hypocrisy exists and is part of the problem. But I think the problem is bigger. I think it’s simply too big of an ask. Most families are barely keeping their heads above water. I felt guilty about not stepping up to take in her kids, but I simply couldn’t. I was in over my head with my own family’s demands.

The father of my friend’s baby strongly encouraged her to get an abortion. Although she felt guilty about it, ultimately she decided it was the right thing to do by him and by her existing children. She was also concerned about her ability to have a baby with a potential future husband, as she had already had two C-sections. Since abortion is illegal in Texas, she had to save up money to make the trip to a different state where it is legal. That took about six weeks. During that time, she experienced more and more severe pain.

At the clinic, the provider did a sonogram that revealed a) my friend was much further along than she had thought and b) the pregnancy was ectopic. You’ll know all about ectopic pregnancies from my little primer above. If she had waited even another week or two, she could have died.

She got the abortion and drove straight home to her babies so she didn’t have to pay for another night in a hotel. Nothing much has changed, except now she has less money and is no longer in imminent danger of dying from sepsis.

My point is not to criticize the organization that said they would help my friend. They are a good organization doing good work. My point is that goodwill is not sufficient to seal up the cracks in our country that so many people fall through. If private solutions were going to work anywhere, they would work here, in this very wealthy, very Christian, very family-oriented town.

I’m hesitant to share this story because I’m afraid someone will pick it up with a clumsy hand and squeeze the humanity out of it. But that’s exactly why I have to share it. None of this is abstraction. It’s all real. There are a million places in my friend’s story where any of us could have—and still can—intervene.

I recognize that everyone can’t care about everything. You probably get calls to action every day on your social media feeds. If you come away from this piece with a little more humility in your stance on abortion, that’s a big win! If you gain a little more courage to push back when one of your friends repeats wrong information, I will sleep better tonight.

Remember the good news about abortion? Both oppressed people groups in this American story have fierce advocates. Let’s metabolize our anger to create a safer, more just society for babies and for women.

Footnotes

[1] The only other case with a similar tension might be conjoined twins.

[2] We aren’t just talking about the health of women, either. A study by Suzanne Bell of the Johns Hopkins Bloomberg School of Public Health showed that infant mortality in Texas spiked after the state passed S.B. 8 (the “Heartbeat Bill”), a law prohibiting abortion if a fetal heartbeat is detected. The biggest reason for this increase was that babies with fatal anomalies were being born and dying shortly afterward. These were pregnancies that many parents would have chosen to terminate to avoid additional pain and suffering for themselves and the baby, had that been a legal option.

[3] Obviously abortion is never safe for the fetus who dies. When I say “safe,” I mean abortions that are done according to best medical practice to protect the life and health of the mother, as well as end the pregnancy with as little pain as possible for the fetus.

[4] I have little confidence in the enforceability of exceptions for rape anyway. The one thing a rapist cannot tolerate is being called a rapist; he believes his victim OWES him sex. It’s extremely dangerous for women in abusive relationships to reveal that they think they are being abused, let alone to legally prove in court that the sex that got them pregnant was, in fact, rape. The odds of the victim winning that case are slim, and while it’s going on, the baby is growing by the second, making it more and more dangerous and heartbreaking to get an abortion. Incest is slightly easier to prove because of DNA testing, but carries all the same problems of danger for the victim in revealing her abuser.