The “Single Issue Disqualifier”

Don’t worry! This post is not about Covid-19!

It’s about abortion.

I’m technically on “vacation” this week, which is a load of crap. Vacation, as it exists in my mind (on a beach sans children) is no longer a thing. And calling a week off from work “vacation” just rubs salt in my wounds, as the new reality of “vacation” is that of me being precepted by my dear husband in the ways of stay-at-home-parenting in the era of Covid and remote learning and school-issued ipads and webex meetings and electronic homework and class reminder alerts ringing incessantly through our house…..etcetera, etcetera. This is why I’m hiding in my office blogging about abortion. Makes sense, right?

I didn’t wake up intending to think about abortion today, let alone blog about it. But this morning as I was scrolling through my facebook feed (which I do every morning because the algorithm has my reward pathways figured out), I came across an article about how Christians should vote. It was a seemingly reasonable article, but then it threw in this little gem:

“Single-issue disqualifiers. Christians should care about a variety of issues that impact our local communities, states, nations, and world. However, in weighing those issues, some carry far more weight than others. For example, if a candidate ever advocated for a return to slavery or wanted to initiate another Holocaust, that would be so egregious as to disqualify them, regardless of what their stances were on other issues. Although we are not aware of any candidates today who want to make slavery legal, there are politicians who openly favor expanding abortion and forcing all taxpayers to help pay for it. Considering the massive number of children already killed each year through abortion, we similarly consider that to be a single-issue disqualifier.”

Deep breathing. Okay, I’m going to give everyone the benefit of the doubt and assume we all agree that slavery and the Holocaust were bad…right? We should also (AND THIS IS IMPORTANT) recognize that a candidate would never publicly promote his plans to “initiate another Holocaust” or “make slavery legal.” Though he might strongly align with white supremacists and even call them to arms. But I digress…

Okay…back to the original topic. Let’s dive into this idea of abortion being a “single-issue disqualifier.” This notion assumes that because someone is “pro-choice” they are also “pro-abortion” and enjoy the idea of dead babies. When I was much younger and incredibly naive, I thought that the pro-choice crowd were a bunch of horrible, murderous villains, lurking in dark corners, waiting to pounce on unsuspecting pregnant women, salivating at the thought of killing an unborn baby. I’m embarrassed that I was so ignorant, but that’s the imagery I was fed. It’s terrifying, and it is false. I honestly don’t know anyone, republican, democrat, liberal, conservative, black, white, brown, teacher, doctor, nurse, attorney, barista, real housewife or B list celebrity who wants women to have abortions. I don’t know anyone who wants a fetus terminated. I don’t know anyone who finds joy or pleasure in any of this. What I have discovered about the pro-choice crowd is that they are actually pretty anti-abortion.

Woah! Hold on to your iced coffee! Yes…you can be “pro-choice” and “anti-abortion.” I’ll give you a minute to take some deep breaths.

Here’s how that works. Some people think that to reduce or prevent abortions, they need to be illegal. Okay…fair enough…on the surface that might make sense. Others, however, have looked at this issue more objectively and recognized that a more effective way to reduce abortions is to eliminate the root cause. If most abortions are performed because of unwanted pregnancies, how do we reduce the number of unwanted pregnancies? 1) Accurate sexual education. 2) Access to healthcare. 3) Access to free contraception (ideally long-acting reversible contraceptives). Studies have actually shown that when these three things are available, the number of unintended pregnancies falls, as does the demand for abortions. Oh, and because rape and incest also lead to unwanted pregnancies, I’m going to suggest that men be held accountable for raping women. Just a thought.

So in reality, advocating for affordable health care, quality education and effective contraception is the very definition of “pro-life.” Throw in paid maternity and paternity leave as well as financial resources to help poor families who might not otherwise be able to support a baby, and we’re talking next-level pro-life here!

Okay, so that’s all good and well, but why should people still be able to get abortions, from actual doctors, covered by insurance if we are all working toward minimizing them?

Because shit happens. Damnit! I wasn’t going to cuss in this blog.

As a palliative care doctor, I’ve discovered that there are situations that one could never possibly plan for and it is important to both understand one’s options as well as to have access to necessary resources if faced with such a scenario. For example: An oncologist friend of mine was seeing a young woman with a new diagnosis of cancer. The patient found out that she was pregnant (with a wanted pregnancy) shortly after receiving this diagnosis. Her cancer was curable, but unfortunately the chemotherapy that she needed would cause significant birth defects or kill her unborn baby because she was early in her first trimester. At that point, her options were to 1) forgo treatment which would likely result in her death as well as the death of her baby, 2) initiate chemotherapy to save her life, understanding that it would profoundly affect or kill her baby, or 3) seek an abortion to prevent her baby from suffering the affects of treatment and to allow her to proceed with aggressive cancer care. This is clearly an impossible situation that we could never fathom ourselves landing in. But it happens. And a woman needs to be able to have a conversation with her doctor to explore the options and how those options impact herself and her family. And if she does come to the difficult decision that abortion is what makes the most sense, she needs to have quick and affordable access to this option.

Consider another scenario: A couple has been trying for years to get pregnant and are elated that they are finally going to have a baby. The 20 week ultrasound shows the devastating diagnosis of anencephaly, a condition where a baby does not develop critical parts of the brain and skull, typically resulting in death shortly after birth. While some parents chose to carry such a pregnancy to term and provide comfort care to the infant immediately after birth, the thought of this might be too emotionally distressing for other parents in a similar situation. I personally can’t fathom carrying a baby who could die at any moment and have perfect strangers approach me, congratulate me and ask me what color the nursery is. There are clearly no good options in such a scenario, however if a mother chooses to end this pregnancy due to emotional distress or fear that her baby will suffer during the birth process, she should have that option. She should not have to go to another state to find a reputable abortion physician, and she should not be forced to endure propaganda trying to deter her from her decision. This is the typical scenario in what politicians like to refer to as a “late term abortion.” You have probably seen such ads.

Lets consider one last implication of outlawing safe and affordable abortions. This maneuver would do just that…outlaw safe abortions. We would be kidding ourselves if we believed that it would prevent them. Maybe, while we’re at it, we should try outlawing teenage sex. Before abortions were legal, women were forced to seek out other means of pregnancy termination including ingestion of toxic chemicals and methods akin to self-mutilation which frequently resulted in bleeding, infections, infertility and sometimes death. You can read about the horrors of the Septic Abortion Ward here.

Clearly abortion is an incredibly complex and nuanced issue which is impacted by a multitude of factors that cannot be immediately legislated away. Quality education, access to health care, racial and socioeconomic equality have to be part of the conversation. As much as I would love to see an end to the perceived need for abortions, that’s just not practical. So instead of drawing one-sided conclusions based on half-truths and using abortion as a tool for religious manipulation, I would encourage all of us to evaluate the data surrounding this issue. We need to have open and honest conversations about the best, most compassionate and most effective ways to prevent unwanted pregnancies. And we should also be more open to the notion of lending financial support and resources to families where an unexpected pregnancy will cause an insurmountable financial burden.

And so, if nothing else, I hope this clarifies why abortion is not a “single-issue disqualifier” but quite the opposite. If anyone tries to fear-monger you into voting a certain way based on this notion, please call them out.

Links below for further information:

• New Clarity for the U.S. Abortion Debate: A Steep Drop in Unintended Pregnancy Is Driving Recent Abortion Declines – Guttmacher Institute – “The abortion decline between 2008 and 2011 was driven by a steep drop in unintended pregnancy, which in turn is most plausibly explained by more and better contraceptive use.”

• Planned Parenthood: Record-Low Abortion Rates in U.S. Highlight Impact of Access to Birth Control – “This report confirms what we’ve long known to be true — that increasing people’s access to affordable and effective methods of birth control leads to fewer abortions. The report also shows that restrictive state laws are not responsible for a reduction in abortion.” Dr. Gillian Dean

• Who are the 1 in 4 American women who choose abortion? – “Barriers to contraception play a major role. Among women with unintended pregnancies, 54 percent were using no birth control. Another 41 percent were inconsistently using birth control at the time of conception.”