A Case for Reframing the Issue of Abortion

We have long been given the advice that we should avoid talking about two things; politics and religion. I find this advice to be well-intentioned but very detrimental to the development of our society and our ability to have civil conversation with folks who think or feel differently than we do. We should not be avoiding talking about these things, we should be learning how to talk about them. Very frequently these conversations can turn into passionate discussions where people fall into the trap of being quick to speak and slow to listen. The issue of abortion conveniently (or inconveniently) fits into both of these categories and our society has framed this issue in a way that encourages binary thinking. If any conversation is had on this issue the first question is usually one person asking another if they are “pro-life” or “pro-choice”. In asking this question it is assumed the answer will tell you everything you need to know about the other person’s values and whether or not you agree with them. But I have not found that question to be very useful.

First, we have to acknowledge the disagreements among those who label themselves the same way. There are differing degrees of people who are pro-life and differing degrees of people who are pro-choice. Essentially people who label themselves in the same way might actually draw the line in a different spot than those who they “agree with”. For example, I have spoken to many people who label themselves pro-life, but when they are asked if they would support amending the Constitution to make abortion illegal in all circumstances, with no exceptions they are not so quick to say yes. I usually get a “well in some circumstances it’s okay, like if the life of the mother is at risk”. At that point we have introduced a grey area and now we begin down the line of the profound complexities of this very divisive issue.

So I would like to make a case for reframing this conversation and steer it away from binary thinking, away from demonization, away from name calling, away from the dialogue that has bogged us down in actually helping the people involved; namely women and unborn children. I believe there is a common goal that we can all be working toward regardless of whether we label ourselves pro-life or pro-choice. I don’t make that claim with empty optimism, I make it because when we break down what each side actually wants, they are not as far apart as we would like to believe. We believe they are far apart because the people who speak frequently about this issue like to gravitate to the most extreme cases which distorts our perception of what is really happening. For example, we have Presidential debates where politicians use rhetoric like “they are ripping babies from the mother’s womb in the 9th month” or “This is a decision between a woman and her doctor”. Both of these quotes are the talking points of the pro-life and pro-choice perspectives but quite frankly, they are both not useful.

Women are not carrying children through to term and at the last minute deciding to abort. In fact, only about .01% of abortions even occur after the 28th week, let alone the 40th week. Also the other talking point about it being between a woman and her doctor doesn’t paint a clear picture either because over 90% of abortions occur before a patient-doctor relationship is even established. So if we are to actually solve this issue and find common ground we need to be talking about the reality, not just the convenient political rhetoric that breeds the binary thinking I pointed to before.

So let’s get to some baseline facts that need to be acknowledged before I propose our way forward. First, there seems to be a perception that abortion is becoming more frequent in the United States, however that is not the case. From 1973–1990 we saw abortion numbers increase with 1990 being the peak with 1.4 million legal abortions in that year. For the last 30 years we have seen the numbers decline. According to the CDC most recent numbers put us at about half the amount we saw in 1990. Pro-life folks will point to the fact that there are still hundreds of thousands of abortions each year and not take refuge in the fact that the numbers are going down. As someone who is pro-choice, I agree with them. Those numbers are still too high. So the questions become; how do we continue the downward trend without trampling over women’s medical decisions in extreme cases? And how do we tackle the main reason women get abortions in the first place?

The second part of that question I would like to address now. But first we need to get the who, when, where and why of abortion. So let’s start with the who. Many people have this idea that the vast majority of women who get abortions are young ladies who are being irresponsible with their relationship choices. However, there are more women ages 35–40 (13.4%) who get abortions than 15–19 (9.7%). Also 60% of women who get abortions already have at least one child. Knowing that pregnancies in the higher age range carry with them many health risks is relevant to illustrate the higher incidence in that age group in comparison to the younger one. The vast majority of abortions are done between the 20–34 age range.

As for the when…According to the Guttmacher Institute 88.8% of abortions happen in the first 13 weeks of pregnancy, 10% happen between 13–20 weeks, 1.1 % happen between 20–23 weeks, 0.09% happen between 24–27 weeks, and 0.01% after 28 weeks. The where is as follows: 4% in hospitals, 1% in physician’s offices, and 95% in freestanding family planning clinics (which also help to prevent unwanted pregnancies, and other female medical needs).

Looking at the who, when and where of abortion I hope you can see why the political talking points are not useful. The majority of our political discussion is focused on the minority of the incidents. We talk about late term abortion when less than 1/10th of 1 percent are considered late term, without even looking at why those particular instances take place. Also saying that “this is a decision between a woman and her doctor” is also based off only 5% of the abortions that are performed. So if we are going to attack this issue and help women and the unborn we need to look at the bulk of the instances. I think we need to look at the most important aspect of this issue and the most important piece in my opinion, is why.

According to surveys given to women, the reasons are overwhelmingly economic. 74% of women said that work, education, or care for other children was their reason for terminating a pregnancy which most likely occurred in the first 13 weeks. Again, remember that 60% of women already have children they are taking care of. So looking at this, I think it would be wise to try to cure the ills that drive women to make these economic decisions that are not only about the cost of a child, but the cost of a pregnancy.

A good place to start is that 75% of women who have abortions are considered poor or low income, with 50% being below the poverty line. With these statistics we can make some general assumptions that might not always be the case but would apply to the vast majority of these women. Number one, they work in a job that doesn’t pay much or they don’t have a job at all. Number two, they are most likely uninsured or like 70 million Americans who are underinsured. Number three, they most likely work for a job which doesn’t provide any type of paid maternity leave, as 60% of employers in the United States do not.

So the scenario could be something like this…A woman that is already a mother of one or two kids is working a job that doesn’t pay much, it does not offer insurance, and also doesn’t have paid maternity leave. That paid leave would provide the window of time when this mother would be able to take off to have a baby and not lose money in the process. Meanwhile she is still worrying about how she is going to provide for the children she already has and the short term loss of income she is facing. She is faced with the reality that having another child could very easily put the children she already has in a very difficult situation. So in this scenario whether you would judge this woman or not, you have to acknowledge that this person is not living in a reality that empowers women to feel they can carry a pregnancy to term if their economic situation is similar to the one I described. Another part of this that people also need to acknowledge is the all too frequent occurrence of men not taking responsibility for the part they played in making a child.

Another big chunk of why women terminate a pregnancy is because of the career aspirations that woman might have in order to not fall into the scenario I just described above. But for the sake of expediency I will not dive into that one. The overall point is this… To my pro-life friends, if you are really concerned with saving the unborn and continuing to lower the incidence of abortion then I ask you unshackle yourself from only the moral argument you have been making. If making it illegal is your only solution, I think you are not only wasting your time, but you are not actually achieving the goal you have. Start supporting solutions to the health insurance problem in this country, start supporting paid maternity leave, start supporting family planning and insurance paying for contraception, and start trying to remedy the conditions that too often corner women into feeling there is no other way. To my pro-choice friends, start acknowledging that this isn’t just a medical issue. It is an economic issue. This is not just about a woman’s right to choose, this is about a woman’s right to thrive, this is about a woman’s right to equal pay, this is about a woman’s right to have avenues to be a successful mother and a successful career. Most of all this is about a woman’s right to not feel alone or alienated during an experience that only a woman can have.

In closing, here are my proposals. First, lets as a country set this goal: To make abortion rare and to continue contributing to its decline, not because we are shutting down clinics that provide medical care for women, or because we are making criminals out of women, or out of doctors. But because we are attacking the conditions that are contributing to that choice being made. Most people believe there are circumstances in which an abortion is acceptable, even pro-life people make these admissions. In cases where the woman’s life is in danger, in cases of rape, in cases of treatment to other medical conditions unrelated to the pregnancy etc. Here are a couple of rare but real scenarios. If a young teenage girl is raped and becomes pregnant, do you really think it is the place for all of us or the government to force that girl to carry to term? If a woman has cancer and becomes pregnant and the doctor tells her she can either continue with chemo by terminating the pregnancy or carry the child…do we or the government have any place in making that heart wrenching decision for her?. It is my view that trying to legislate the abortion issue by making it illegal would make it difficult to insure that women caught in these types of scenarios would be protected to be able to make their decision. But making it illegal is not our only avenue for alleviating this problem.

Even if I haven’t done anything to persuade folks who believe it should be illegal. I would just ask you to not only focus on that avenue as a solution. In the meantime, we can do so much to help women, help the unborn, and help the already born. If we would only channel the energy we use to fight with each other into the same cause we can achieve extraordinary things. We should be pushing for policies that incentivize strong family units, and improved economic well being. I think we should give even more tax incentive for marriage, including same-sex and traditional. Because that could help facilitate families that can support children both through procreation, and adoption. I support paid paternity leave and maternity leave to make sure families can start off on the right foot after bringing their bundles of joy into this world. I think we should be pushing for better health insurance whether it be government solution or private sector solution, to make sure the medical cost of a birth doesn’t ravage the financial well-being of a couple. I support a requirement that health insurances must cover contraception, because preventing an unwanted pregnancy is a huge piece on how to lower abortion rates. I support a bigger child tax credit that can be used to help families pay for child care if both parents work. If we want to promote strong families, we want to protect women medically, and we want to protect the unborn we have to look at these avenues that are much more complex than the pro-life vs. pro-choice shouting matches we are currently having. I believe we can make abortion rare, through strengthening the foundations of our society, empowering women, and making creative solutions that aren’t dictated by demonizing those who have a different opinion. We can do better.