The Moral Dilemma of Repeat Abortion

Gurgle.com is a UK-based website that bills itself as "the web's friendliest community for first time parents." Until Tuesday, I had never heard of it, but that all changed when one of its stories was picked up by Yahoo! News. The headline read: "Single women using abortion as another form of contraceptive," and the lead paragraph included the following revelation:

According to recent statistics, 5 out of 6 abortions in England and Wales were repeat abortions.

If true, that would be almost twice the repeat abortion rate of the United States, where an estimated 47% of all abortions are performed on women with at least one prior abortion. As it turns out, the percentage reported by gurgle is not true. In a Sunday story from the Daily Mail, covering the same NHS data, they report that "only" a third of all abortions in England and Wales are repeat abortions. This discrepancy led me to the NHS website itself, where they state that in 2010, 34% of all abortions were repeats, up from 30% in 2000.

Returning to the Mail article, they report that unmarried women account for "five out of every six repeat terminations." This is almost certainly where gurgle's erroneous, 5 out of 6 claim originated from–reminding us again to be careful about what we read online. But despite publishing a significantly botched statistic, the central premise of the article still stands, namely that repeat abortion is costing the UK roughly £1million a week. This, in fact, is the headline of the Daily Mail article: "NHS spends £1m a week on repeat abortions: Single women using terminations 'as another form of contraceptive'"

The concern in both articles is that women in the UK are routinely (and casually) using abortion as birth control. And because the UK publicly funds all abortions, tax-payers are footing the bill. Daniel Martin, the author of the Mail piece, marvels that "it is not unknown for some women to have seven, eight or even nine terminations in their lifetime." A female reader from Liverpool added the following comment to the story:

Words fail me… abortion is a choice and preference for some people in varying situations but for people who clearly haven't learned time after time there needs to be something in place where abortion is not used as a contraception!! It should be no more than 2...

The biggest flaw with statements like this is the implication that though there is nothing wrong with having one or two abortions, there is something wrong with having eight or nine. This makes no sense. If there is nothing wrong with one, how can there be anything wrong with nine? I read a USA Today story on Wednesday about the mother in Florida who shot and killed her four children. Nowhere in the article did anyone assert that the mother's behavior would have been more reasonable if she'd limited herself to just shooting one or two of her children. Imagine someone saying, "I can understand a mother making a mistake and killing one child, but to kill four… that's outrageous!" What an absurdity such thinking would be, and yet this is exactly the ideology that is all too common in the context of abortion. This was particularly clear in a Daily Mail commentary published on Monday. Bel Mooney, who identifies herself as a longtime abortion-rights advocate, writes the following:

Like so many of my peers back in the late Sixties and early Seventies, I passionately argued the case for [legal] abortion… [but] when I read that the NHS is spending just under £1 million per week on repeat abortions, I found myself plunged into another sort of depression at the sheer carelessness of my own sex. Yes, some of those terminations will have been carried out for sound reasons.

I should know — I had an abortion just over 30 years ago for medical reasons. And, frankly, I’ve no wish to see babies born to schoolgirls. But too many abortions are clearly happening because grown-up women are just too sloppy to take proper control of their own bodies.

When my generation marched with placards asking for ‘Abortion on Demand’, we were not suggesting abortion should be seen as  merely another variety of contraception — although that view was held  on the wilder shores of the  women’s movement.

But, shockingly, today that seems to be how many young women treat a medical procedure which, let us not forget, terminates a life.

Give Mooney credit for admitting that abortion ends a human life, but isn't it puzzling that this concession doesn't influence her thinking further? She believes abortion is appropriate for schoolgirls, but not for grown women who should know better. Are we to believe then that the lives terminated by schoolgirls are less human than the lives terminated by adults? Are children born to teenaged parents less valuable or less deserving of protection than children born to women in their 20's or 30's? The difficulty society has in reconciling the widespread, casual use of abortion is strong evidence that there is something intrinsically wrong with abortion itself. Try as we might, we can't have it both ways. If abortion is an amoral medical procedure, who cares how many times a woman has one? But if abortion is a fatal assault against a helpless human being, how is one abortion any more justified than nine?

The fact that there is so much widespread, moral outrage over repeat abortion is strong indication that whether society admits it or not, we know on what side of the abortion debate we should be falling.

Transvaginal Ultrasound and the Fallacy of Control

When the brouhaha over mandated, pre-abortion ultrasound emerged earlier this year, I hadn't yet read the National Abortion Federation's (NAF) teaching text on abortion, Management of Unintended and Abnormal Pregnancy. After hearing pundits across the land describe the sonogram law in Texas and a similar proposal in Virginia as "state-sanctioned rape," you can imagine my surprise when I read that transvaginal ultrasound is standard protocol for early abortions. Quoting from the NAF text:

Nearly all US members of the National Abortion Federation have ultrasound machines on-site, and 91% perform dating ultrasounds routinely before first-trimester aspiration abortion. (138)

Ultrasound plays a major role in pregnancy diagnoses... The milestones described in this section will consistently be imaged earlier with a vaginal, rather than abdominal, transducer. (68)

A 5- to 10-MHz vaginal probe improves visualization of earlier pregnancies. (143)

Advances in pregnancy testing, ultrasonography, and medical and surgical abortion techniques have accelerated the trend toward earlier abortion care. (135)

Remarkably, the NAF gives no indication that transvaginal ultrasounds are akin to rape. They simply state that such procedures allow abortions to take place earlier in pregnancy than would otherwise be advisable. That's a far cry from the impression one gets from the mocking satire of Doonesbury or this week's video offering from Kate Beckinsale, Judy Greer, and Andrea Savage – a parody in which they pose as imbecilic Republican women begging the government to "Get in My Vagina."  

The real question is, are the 91% of abortionists who are already performing pre-abortion ultrasounds "raping" those women whom they image transvaginally? No. And why not? Because by consenting to an abortion, a woman consents to all of the intrinsically intimate, unnatural and invasive procedures that are part of that abortion. Prominent late-term abortionist, Warren Hern, writes in Abortion Practice that "it is paradoxical to have a woman complain about the idea of an intrauterine device on the grounds that it requires the placement of an unnatural object in one of her body cavities, while she willingly submits to an abortion, requiring the placement of several unnatural objects into her body cavities." (89)

Despite all the rhetoric about "vaginal probes" and "shaming wands," the real issue has far less to do with the procedure itself than it does with the results of that procedure. Nine times out of ten, diagnostic ultrasound is going to take place anyway. What the laws in Texas and Virginia propose is that the real-time imagery from those ultrasounds be showed to the mother. Why are abortion-advocates so afraid of this? Because of that tiny little heart, beating rapidly there on the screen. Blobs of cells do not have beating hearts. Simply put, ultrasound imaging makes it much harder to maintain the illusion that abortion is anything less than the intentional destruction of the most helpless members of the human community.

The "Get in My Vagina" video trots out the tired old assertion that those who oppose abortion only care about controlling women's bodies. This absurdity is easily exposed by the fact that you never see people praying and counseling outside a dental office, begging women to not get a tooth pulled. Nor will you find such people outside a beauty salon, urging women to leave their hair and nails as they are. There is no such presence outside of the offices of plastic surgeons or at tattoo parlors, nor is there a campaign to get women to stop smoking or drinking (unless you count the Ad Council amongst Republican conspirators). Finally, I've never seen anyone with signs outside of McDonalds or Baskin Robbins, trying to dissuade women from going in.

No, the only arena in which we're trying to "control" women (if you want to call it that) is that of abortion, and the reason is simple. Abortion is an act of violence that kills an innocent human being. In the United states, it kills more than half a million women each year, and globally, the problem is even worse. It is no stretch to say that abortion represents the single greatest threat to women in all the world – which may be why 67% of Abort73's Facebook fans are female, as compared to 54% of Facebook users in general. Opposing abortion has nothing to do with controlling women; it has to do with protecting the weak and vulnerable from being wrongfully destroyed. And guess what. Around the world, the overwhelming majority of the weak and helpless who are destroyed by abortion happen to be female.

The Blind Leading the Blind: America’s Awkward Entry Into Chinese Abortion Policy

What's a pro-abortion president to do when global sentiment compels him to aid an anti-abortion activist? Such is the plight of President Obama in regard to Chen Guangcheng. Abortion, of course, is only the back-story to this growing, diplomatic crisis, but it's at the heart of Chen Guangcheng's activism. There would be no crisis if he'd simply minded his own business. Instead, the now globally-recognized, "barefoot lawyer" formally challenged the town of Linyi's forced abortion policy. His courage and conviction netted him six years of imprisonment and abuse–until he escaped from his captors last week and fled to the US Embassy in Beijing. His getaway has been called "a real Chinese version of The Shawshank Redemption"–though it remains to be seen whether Chen will enjoy a Hollywood ending. Yesterday, the US Embassy released him back to Chinese authorities, assuring the world that a favorable agreement had been reached. Subsequent reports make their assertion less certain.

Returning to the issue of abortion, I find it ironic that so many of the news stories I reviewed this week refer to Chen as a women's rights advocate. Strictly speaking, the moniker fits, but it's a bit misleading. On the American political scene, women's rights has become a euphemism for abortion rights, and many of the stories didn't even bother pointing out that Chen is working to protect women from abortion. Nor does his profile on Human Rights Watch make any mention of abortion, instead declaring him to be an opponent of "family planning abuses." Not surprisingly, Human Rights Watch is a global proponent of abortion–putting them in the awkward position of championing the cause of an abortion opponent. This, in fact, is the same tension facing President Obama and Secretary of State Clinton, who are both passionately committed to protecting abortion rights. But this is not the most significant tension they face as the U.S. tries to steer China towards the more humane treatment of their people.

The obvious problem is one of economics. Because China owns more than a quarter of our national debt, the U.S. is losing leverage and influence at an alarming rate. This is the same problem TIME magazine noted back in 2006, after Chen was first imprisoned on trumped-up charges:

In previous years, a plea from the U.S. State Department could help get a Chinese political prisoner released, typically as a goodwill gesture before important international summits. But in recent months, foreign pressure appears to have done little… After all, what leverage does the international community now hold? China is the world's factory. It holds bountiful foreign-currency reserves… The balance has shifted from China feeling like it needs the world to the world needing China.

Because America is in China's pocket, so to speak, it has become increasingly difficult for the United States to make any kind of credible threat against China's continued human rights abuses. As reported this week by the Los Angeles Times, though President Obama claims to "emphasize the issue of human rights at every meeting with China," this kind of "familiar diplomatic language [is] unlikely to limit the administration's maneuvering room." In other words, President Obama knows what he can and can't say. If he has a reputation for "being too soft on China," it's because his hands are tied. He doesn't want to step on the toes of America's primary creditor. But I would suggest that there is something more than mere economics at play, and I say that because of America's complicity in the monumental human rights atrocity that is abortion.

I have already called President Obama a pro-abortion president. Many will take issue with that label and remind me that he is a pro-choice president. Likewise, I have called Chen Guangcheng an anti-abortion activist. Here again, many will argue that it's more accurate to call him a pro-choice activist, since his lawsuit only applies to forced abortion. To the first complaint, I would submit that the difference between pro-abortion and pro-choice is a distinction without meaning. A president who is pro-choice on abortion is the moral equivalent of a president who is pro-choice on slavery. When someone today calls themselves "pro-choice," abortion is the only choice they have in view. If you doubt this, consider the outrage that's arisen in recent months over whether or not employers, religious or otherwise, should have the choice to not pay for their employees' birth control. Most of those who are firmly pro-choice when it comes to abortion are decidedly anti-choice when it comes to giving employers the right to choose whether or not to fund contraceptives.

To the second complaint, I must concede that I don't know Chen's position on non-forced abortion. But I'm optimistic. I have now read dozens of stories on Chen Guancheng, and not a single one has inferred that he supports elective abortion. Because so much of the mainstream media bends over backwards to support elective abortions, if Chen supported them too, I'm fairly certain that news would be shouted from the proverbial rooftops. The second reason I'm hopeful is because Chen is blind. He overcame incredible odds in a country where people with disabilities aren't even allowed to attend college to become a self-taught lawyer. Surely, he knows what elective abortion does to unborn children diagnosed with disabilities. It kills them. Finally, I'm hopeful because of Chen's close relationship with Pastor Bob Fu, who fled China with his wife to spare their first child from abortion. Fu wrote in op-ed piece for the Washington Post this week that, "This is a pivotal moment for U.S. human rights diplomacy. The United States must stand firmly with this broadly popular individual or risk losing credibility as a defender of freedom and the rule of law."

It is precisely this, the United States credibility as a defender of freedom and the rule of law, that has been so compromised by our headlong embrace of abortion. Something that stood out to me in both of the medical textbooks I just read on abortion is this. All of the early innovations in abortion technique came out of Russia and China. The first aspiration abortion was performed in Russia in 1927. Thirty years later, the technique was "perfected" in China, where abortion was legalized in 1957. Warren Hern reports in Abortion Practice that "important innovations in abortion technology began to flow from China and Eastern Europe several years before legal changes occurred in the the United States." (277) If you follow abortion's trajectory, it's not hard to see that America is simply following China's lead, where more than 13 million abortions occur each year. This of course raises an important question. In light of China's horrific record on human rights, what should we conclude about the ethics of abortion? Is China really the country we want to follow when it comes to how we treat the most vulnerable human beings?

We may criticize China today for forcing women to have abortion, but don't lose sight of the fact that they're simply further along the abortion timeline than we are. When China legalized abortion in 1957, Americans in the know decried their barbarity. Twenty-six years later, we legalized it ourselves. When China introduced their one-child policy in 1978, the international community was outraged. Thirty-three years later, Vice President Biden told a Chinese audience that he fully understands and does not second guess their one-child doctrine. Is this too where America is headed? Is this where all the claims that population growth is unsustainable will ultimately lead us?

I want to close with an excerpt from the most compelling of the stories I read about the lawsuit that first put Chen Guangcheng on the global map. This comes from TIME magazine and describes what forced abortion looks like in practice:

The men with the poison-filled syringe arrived two days before Li Juan's due date. They pinned her down on a bed in a local clinic, she says, and drove the needle into her abdomen until it entered the 9-month-old fetus. "At first, I could feel my child kicking a lot," says the 23-year-old. "Then, after a while, I couldn't feel her moving anymore." Ten hours later, Li delivered the girl she had intended to name Shuang (Bright). The baby was dead. To be absolutely sure, says Li, the officials--from the Linyi region, where she lives, in China's eastern Shandong province--dunked the infant's body for several minutes in a bucket of water beside the bed. All she could think about on that day last spring, recalls Li, was how she would hire a gang of thugs to take revenge on the people who killed her baby because the birth, they said, would have violated China's family-planning scheme.

We must not lose sight of the fact that the end result of forced abortion, and the end result of elective abortion are exactly the same for the child in the womb. We read the account above and cringe at such cruelty. But is the practice any less cruel when it happens in accordance with the mother's will? It is not. Instead of taking the moral high ground, the United States has followed Chinese utilitarianism down a dark and terrible path–one that is willing to trample upon individual human lives for the good of the regime. We may not be as far down the path, but it's the same trail nonetheless. The question is, what are we willing to do to get off it? Chen Guangcheng was willing to invoke the ire of his government and to endure imprisonment and abuse. He fell as many as 200 times during his escape through the countryside before arriving at his destination muddy and bloody. “He was a very wounded man, except in spirit," says Bob Fu. And though his wife continues to share in Chen's danger, she remains unwavering in her conviction that "the outside world must know what is going on… so it can help change things for the better."

May we follow her courageous lead as she herself follows a blind man with incredible vision.

The Tangled Web of IVF and Birth Control

When I first read John Ensor's book, Innocent Blood, last December, I was particularly struck by one of his assertions. He says, "Abortion is the defining experience of this generation." As I read that, I had to ask myself whether he was overstating the case, whether it was fair to elevate abortion to a place of that much cultural significance. Though I'm as sympathetic to his line of reasoning as anyone, I wondered if those not vocationally tied to abortion, or those on the other side of the debate would scoff at such an assertion. Their platform, after all, is largely built on the idea that abortion is no big deal. It's a medical procedure of no moral consequence to be had and forgotten about. And then I read this on page 22 of the National Abortion Federation's (NAF) Management of Unintended and Abnormal Pregnancy:

Induced abortion is arguably the most important human rights and equity issue of our time. (22)

Add that to the NAF statement I referenced earlier, about abortion being as integral to modern life as cars and computers, and you begin to realize that John Ensor did not overstate his case. Those devoted to promoting and protecting legal abortion have elevated its importance over and above all other justice issues. Their assertion is a staggering one if you really think about it. After all, what are the human rights and equity issues getting the most attention today? Sex-trafficking. Slavery. Child soldiery. AIDS. Famine. Unclean water. Is the NAF really suggesting that it is more important for a woman to have access to abortion than it is for her to have access to food or water? Is easy access to abortion really a more pressing need than freedom from sex-trafficking, slavery and disease? According to the NAF it is.

By my thinking, abortion is only comparable to these other human rights abuses if you understand abortion as something people must be protected from, not as something to be protected itself. From the vantage point of those most victimized by abortion, namely unborn children, its threat is even more serious than the threat of sex-trafficking, slavery, soldiery, AIDS, famine or unclean water. It threatens death, and it almost always delivers. The results are irrevocable. But even if you're only looking at things from the vantage point of the woman, how absurd it is to argue that the right to abortion is more important than the right to freedom from slavery, famine or disease. And yet this is what the NAF seems to be advocating.

In this, my final set of observations from Management of Unintended and Abnormal Pregnancy, I want to focus on two abortion-related issues that received significant coverage in the NAF textbook and are plenty controversial in their own right. The first is birth control. The second is in-vitro fertilization (IVF), also known as Assisted Reproductive Technologies (ARTs). In relation to each other, most forms of birth control attempt to artificially prevent conception (or implantation) while IVF attempts to artificially produce conception. In relation to abortion, birth control is touted as the best solution for reducing the number of abortions, and abortion (or fetal reduction procedures) is touted as the best solution for reducing the number of human beings conceived through IVF. Let's begin with birth control by looking at one of the NAF statements on demographics and abortion that I did not include in yesterday's analysis. Speculating as to why women who have aborted in the past are more likely to abort in the future, the NAF writes, "After abortion, women remain at elevated risk of having another abortion because they are sexually active, willing to terminate an unintended pregnancy by abortion, (and) have difficulty using contraceptive methods effectively…" (27) The universal solution to abortion, according to almost all abortion-rights advocates is contraception. You hear it over and over. The NAF pounded away at this idea throughout the book. But how effective are birth control methods really are at reliably preventing pregnancy and abortion? Consider the following statements, all from the pages of the NAF teaching text on abortion:

• In close to half of those women experiencing an unintended pregnancy, the woman or her partner regularly used a contraceptive method… (x)
• Oral contraceptives, the most widely used reversible method of contraception, carry failure rates of 6 to 8% in actual practice. (x)
• (Over) the past decade... little progress has been made in reducing rates of unintended pregnancy. (xv)
• Globally, WHO estimates that some 19 to 20 million unsafe abortions occurred each year between 1993 and 2003. This figure has remained relatively constant despite an increase in contraceptive prevalence during the same period. (13)
• Each year an estimated 27 million unintended pregnancies occur as a result of method failure or ineffective use; of these, about 6 million occur although the contraceptive method has been used correctly and consistently… Contraceptive use alone was not sufficient to meet the growing demand for fertility regulation and, therefore, recourse to induced abortion increased. (18)
• South-East Asia has a 49% prevalence of modern family planning methods, almost exclusively of reversible methods (42%). It appears though, that abortion is used to keep fertility low. (18)
• Failure of contraception results in abortion and unwanted births, and these outcomes occur more frequently in the USA than in most other Western developed countries. (24)
• According to NSFG data, (only) 11% of sexually active US women who were not seeking pregnancy were using no method (of birth control) in 2002, up from 7% in 1995. (26)
• Only 12% of non-(birth-control-)users were because of cost or access. (27)
• Of pill users having abortions, only 13% said they used the method correctly. (26)
• In a recent study of 373 teen mothers involved in a comprehensive pregnancy-prevention program, the only determinant of pregnancy prevention in the first 2 postpartum years was initiation of the contraceptive implant. Currently, only a small percentage of female contractors in the USA use implants and IUDs. (212)
• In the USA… only 2% of women contractors currently use IUDs. (214)
• Condom use confers protection against STIs, but it does not provide top-tier protection from pregnancy because of breakage, slippage, inconsistent use, and low continuation rates. (217)

What's the take away from all this? No matter what your ideologic opinion of birth control, from a purely pragmatic standpoint, contraceptives have proved remarkably ineffective at reducing our global reliance on abortion. Notice a few things from the statements above. The practical failure rate of the birth control pill is 6-8%. Borrowing some of the data from Abort73's page on birth control, there are an estimated 21,131 sexually active girls at the University of Minnesota (according to a 2007 state survey on college sexuality). Even if all of them were on the pill (which is generally regarded as the most reliable of the non-implanted, non-permanent forms of birth control) that would still result in up to 1,690 unplanned pregnancies a year–on a single college campus. Of course, many people will claim that birth control would be more generally effective if more people had affordable access to it. But notice that only 12% of sexually-active, non-users cite access or cost as the reason for not using birth control. And further notice that only 11% of sexually-active women who don't desire pregnancy are not using birth control. What is 12% of 11%? 1.32 per cent. Where do condoms fit in all this? According to the NAF, condoms do "not provide top-tier protection from pregnancy."

On the very first page of the NAF textbook, no doubt in an attempt to normalize abortion historically, they say that "individuals in past societies vigorously sought to regulate their fertility [through] abortion and contraception." They then concede that those same societies also regulated fertility through "child abandonment and infanticide." Two things strike me about this statement. First, how does placing abortion alongside its historic bedfellows, child abandonment and infanticide, increase its moral legitimacy? The fact that abortion was perfectly normal in societies that also abandoned and executed their newborns is not a point in abortion's favor. Second, if contraception was actually effective at eliminating unwanted pregnancies, and if these societies practiced it "vigorously," then why did they have to resort to abortion, child abandonment and infanticide in the first place?!

Turning my attention now to IVF, I must be careful how I proceed. In-vitro fertilization is a delicate subject, and I don't want to give the impression that IVF is intrinsically immoral. What I do want to point out is that most IVF protocols are inextricably linked with abortion, and anyone who uses such technologies must tread with extreme caution. The NAF reports that (as of 2009), "more than 2 million babies have resulted from assisted reproductive technologies (ARTs)… [and] multifetal gestation remains a serious concern." (312) "Although fertility therapies hold important benefits for women and couples," the NAF says, "they also increase the risk of multifetal pregnancy with its attendant maternal complications." (316) The problem with IVF? Generally speaking, more children are being conceived than can realistically be born. What happens to all the extras? ART technicians, Mark I. Evans and David W. Britt, report that 75% of their patients "have combined CVS (chorionic villus sampling) and fetal reduction procedures" to solve this problem. (314) Chorionic villus sampling is a form of prenatal testing. Multifetal pregnancy reduction (MFPR) is the process of aborting the "extra" babies that were conceived through IVF. How do they selectively abort one baby without harming another? This is how it's described in the book:

For the first 10 to 15 years, the approach we used was to perform the reduction first at approximately 10.5 weeks' gestation, reducing down to twins or triplets… for patients reducing to a singleton pregnancy… we performed a CVS before reduction, usually on one fetus more than the intended desired number… Techniques to achieve fetal reduction have evolved over time. In the mid-1980's, needles were inserted through the abdomen and maneuvered into the fetal thorax for injection of potassium chloride… Some centers used transvaginal mechanical disruption (like D&E), but data suggested a significantly greater loss rate (of the other fetuses) than with the transabdominal route. Today, virtually all experienced operators perform the procedure by inserting needles through the maternal abdomen under ultrasound guidance. For first-trimester fetal reduction placement of the needle within the chest cavity suffices for success. (314)

A 1993 study placed the MFPR pregnancy loss rate at 16%, meaning that 16% of the time, the fetuses who were not targeted to be killed still ended up dying in the process. A 2001 study places the loss rate at 9.6%. In reality, of course, the loss rate is 100% for the fetuses who were intentionally aborted through MFPR. And as if that weren't enough, the NAF reports that since "reduction of twins to a singleton improves the outcome of the remaining fetus… we expect that requests for reduction from twins to singleton will increase in the years ahead." In other words, since killing one twin frees up more resources for the other twin, they have no moral objection to doing just that–not realizing perhaps that the exact same argument could be applied to born twins as well. Here's what the NAF authors do say about the moral implications of MFPR:

Although MFPR reduction has been integrated into infertility therapies, it will remain controversial because of widely divergent religious and ethical positions… Most proponents see it in terms of the principle of proportionality, [as a] therapy to achieve the most good for the least harm. (316)

For my part, I would urge couples struggling through infertility to consider adoption first. I realize that, as someone with biological children of my own, I'm not in the best position for giving advice. But in light of the dubious morality of most IVF providers and the abundance of needy orphans around the world, adoption makes for an extremely worthy alternative.

Who is Most at Risk to Have an Abortion?

This is now my third post in response to the National Abortion Federation's (NAF) teaching textbook on abortion, Management of Unintended and Abnormal Pregnancy, which I finished reading last week. The first post looked at the factors most responsible for improving the relative safety record of abortion, at least as it relates to the mother (abortion is never safe for the baby). The second post examined the strange and rather arbitrary ban on partial-birth abortion. Today, I'd look to focus on how to identify those who are most at risk for having an abortion. I do this for two reasons.

First, as someone who has devoted my vocational life to persuading women (and men) not to have abortions, it's fairly important that I have a sense of who is the most demographically vulnerable to abortion. One of the great challenges for those who want to intervene on behalf of abortion-vulnerable children is the fact that you can't see them. They truly are invisible children, and the window for intervention is incredibly short. Walking down the street, there's no way to tell which women are vulnerable to abortion and which women aren't. That's where some of the statistical data from the NAF comes in handy. For anyone interested in combatting abortion, it helps us identify whether our programs and resources are being the most strategically deployed, amongst those who are the most vulnerable to abortion. This information has already shaped some of the markers Abort73 uses to advertise on Facebook.

The second reason I think this information is important is because it can help make women themselves more aware of their own relative vulnerability to abortion. Lots of the testimonies on the Abort73 website are from those who always considered themselves pro-life until they suddenly found themselves in a crisis pregnancy. I've heard abortion-rights advocates cynically suggest that most women are pro-life, except when it comes to their own abortion. The NAF textbook even includes advice on how to manipulate women who are ideologically opposed to abortion. They suggest reminding "religious" women of God's forgiveness and asking them, "Do you believe in a merciful God who understands what's in our hearts?" (55)  For women who have "always been against abortion," they suggest pointing out that "If she has made exceptions for rape or life endangerment, then she can see herself as having kept an open mind on abortion for certain circumstances, and is now expanding her acceptance of other circumstances (to include her own)." It's easy to think, abortion could never happen to me, but without vigilance and forethought, it can! 

To those ends, these are some of the demographic markers related to abortion, all taken directly from the pages of the NAF text:

• The demographic characteristic most associated with the decision to terminate an unintended pregnancy is marital status (in 2007, 84% of all abortions were performed on unmarried women). (28)
• Women living with a partner to whom they are not married account for 25% of abortions but only about 10% of women in the population. (29)
• The highest abortion rate, 40 abortions per 1,000 women in the age-group, occurred among women aged 20 to 24 years. (28)
• The percentage of teenagers' unintended pregnancies terminated by abortion (about 40%) was lower than that among US women generally (48%). (26)
• The (abortion) rate among Black women is more than four times as high (as White women). (29)
• (The abortion rate) of Hispanic women lies between that of Black and White women. (29)
• The abortion rate of women with Medicaid coverage is three times as high as that of other women. (30)
• The abortion rate of non-metropolitan women is about half that of women who live in metropolitan counties. (32)
• More than 23% of US abortions occur in California (roughly 12% of the US population lives in California). (136)
• Women seeking abortion are generally young and healthy. (252)
• Most women choose abortion for reasons other than threat to maternal health. (78)
• One per cent (of aborting women) reported that they were the survivors of rape. (28)
• In 2004, 47% of US women obtaining abortions had had a prior induced abortion. (27)
• Women who terminate a pregnancy differ from those who do not in ways that affect reproductive health. For example, they are more likely to smoke and (more likely) to be exposed to sexually transmitted infections [because they've had a] greater number of sexual partners, (and an) earlier age at first sex… (253)

To summarize, if you're having sex with someone you're not married to, if you're 20-24 years old, if you're a minority or on Medicaid, if you live in a metropolitan area or in California, if you consider yourself young and healthy or you're a smoker, if you've had multiple sexual partners or started having sex at a young age, if you've already had an abortion in the past, then statistically speaking, you have an elevated vulnerability for future abortion. Be aware of that. I realize that some of the listed risk-factors cannot be modified, and I'm not suggesting that changing cities or states is a way to escape the reach of abortion. What I am suggesting is for each of us to take a long, hard look at the behavior decisions that so often lead to abortion, and make any changes that are necessary.

I want to finish this post by looking at an one more, admittedly-perplexing NAF statement relating to demographics and abortion. It comes from page 224 of the NAF textbook:

Women of races other than White are more than twice as likely to die from induced abortion (in the US). About one-fifth of the excess mortality risk among minority-race women is because of their later gestational age at the time of abortion.

This statement seems totally unaccountable to me. Why do minority women die from induced abortion at twice the rate of Whites? The NAF attributes a small portion of this imbalance to the fact that minority women are more likely to abort later in pregnancy, which makes the procedure more dangerous to the mother. But what accounts for the other 80%? The NAF offers no explanation and probably hopes nobody will ask. But in light of the American abortion-industries' long and sordid relationship to eugenic principles, is it possible that more minority women die by abortion simply because they're not considered as valuable as their White counterparts? No doubt economics plays a role in maternal mortality as well, but abortion's historic, disproportionate targeting of minorities may be evidence that something much more sinister is also in play.