The Difficult Cloudy Middle of Abortion

By Dan Summers

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I enjoyed Chris’s recent post about Obama’s commencement speech at Notre Dame.  With his indulgence, I will take his metaphor about side roads and interstates, and modify it for my own purposes.  Traveling through his post, I was distracted by the following exit sign, and from it I turned to the road down which I find myself presently wandering.  To quote:

“In the controversy around abortion, it is not hard for Obama to look fair-minded.  Obama is helped in this by useful idiots from his left flank who write not particularly bright commentaries on his speech concerning abortion like this one on the front page of the HuffingtonPost.”

Useful idiocy is an intriguing concept, so I couldn’t help but follow the above link.  (Being no great fan of HuffPo’s intellectual bona fides probably contributed to my curiosity.)  It led to a not particularly bright commentary by Martha Burk, of the Center for Advancement of Public Policy.

What sticks in my mind, and has bothered me enough to write this post is the following passage:

“A few minutes before President Obama’s commencement speech at Notre Dame, the CNN anchor was intoning that he supports stem cell research and he supports abortion rights, and that he would not shrink from his positions on either. In fact, she said, he was going to use an email he had gotten on the subject of abortion as part of his remarks.

Good, I thought. It will be from the parent of the mentally retarded high school student who was gang raped, the doctor of an 11 year old incest victim, or possibly a woman with four kids already whose husband has just lost his job and medical benefits along with it.
Boy, was I wrong.”

The above desired examples of women (or girls) seeking abortion are precisely the kind of examples that do nothing whatsoever to further the purpose of honest debate about abortion in this country.  Women (or girls) in such circumstances are chosen as examples because theirs are the stories most likely to evoke sympathy from most people (even if they do not sway the edicts of the Holy See).  That Ms. Burk would cherry-pick them is not surprising, but nor does it speak to her desire to see abortion honestly discussed.

My trouble with her examples stems from my own experience as a doctor in New York City.  For a few years, I worked in a clinic that provided free care to adolescents and young adults.  I saw many, many young women who had become pregnant unintentionally.  Many of them went on to deliver and parent their babies.  Many opted to abort.  (Before moving forward, I should clarify that our clinic did not provide abortions, but did serve as a point of referral.)

It would be so very much tidier to assert that the decisions were invariably hard for the young women in question.  Indeed, both President Obama in his speech and Ms. Burk in her response describe abortion as a “heart-wrenching decision.”  It would make things much easier to accept if abortion were not used by some as a form of contraception.  If all women evinced signs of struggle or sorrow over the profundity of their decision, I would have had little cause to write at all.

And if wishes were horses, beggars would ride.

The facts of abortion occupy a muddy moral space.  Do the examples Ms. Burk mentions exist in reality?  Of course they do.  But they do not tell anything like the entire story.  The strident pro-choice left would have it that no women choose abortion blithely, and that all weigh it carefully.  They would have us focus on the cases at the edges, where the circumstances are most extreme and least likely to cause dissent.  They would have us ignore the difficult truth that for some, abortion is not a heart-wrenching decision.

Much of my experience would make for a harder rhetorical fight for the pro-choice side.  Many of my patients, all of whom (by nature of being in the clinic in the first place) had access to free contraception, made the decision to abort with no apparent hesitation at all.  The option was exercised by some several times.  Adoption planning was chosen so infrequently as to have been all but eliminated from the conversation.  While I would not like to create the impression that I would wish the young women in question to have been tormented by their decision, I was genuinely disheartened by how blithely it was made by many.

Did my experience harden me to the arguments for legalized abortion?  No.  I remain pro-choice, if ambivalently.  The young women I saw, profoundly unready to be parents, are the ones most likely to die of illegal abortions if they are no longer sanctioned and safe.  I cannot countenance that possibility.  (Yes, it would be best if the pregnancies had been avoided in the first place.  I also wish my asthmatic patients wouldn’t smoke.  With freedom comes the disappointing fact of poor decision-making.)  If I have to choose between legal abortion and back-alley abortion, I will choose the former with a heavy heart.

I am not so foolhardy as to maintain that my experiences as a medical provider adequately describe the experiences of all (or even most) women who choose to terminate their pregnancies.  However, neither will I see them conveniently and quietly elided from the conversation.  Abortion is an immensely complicated issue, and one for which both sides have arguments of merit.  But, by all means, if we are going to discuss an issue as thorny as abortion in the first place, let us do so honestly.  Let us leave aside the easy cases at the margins, and discuss the difficult, cloudy middle.  Though I am not arrogant or stupid enough to believe there is an easy answer, neither do I believe we will move any closer if we refuse to ask the hardest questions.