The doctors weren’t sure whether Sophie’s defects were a result of random bad luck or something hereditary. Her DNA looked normal, but it was clear there was a programming error at some point early in the gestation. “The human genome is massive,” the geneticist explained to us in fall 2008, soon after the crushing initial diagnosis. Many syndromes — particularly the very rare ones — simply haven’t been mapped yet, he’d said to us. And even when they have, we can’t always attribute a cause. Many mutations are random. “We just don’t know.” As a quantitative social scientist, I could easily wrap my head around this. But as a woman who craved both a family and certainty, the implications were daunting. The only way to find out if we’d have more children with the same condition was through a fetal cardiac echo somewhere between 18 and 20 weeks’ gestation.
Sophie has two younger sisters. They have beautifully boring four-chambered hearts with all the connections in the right places. Neither would exist if abortion were not safe and legal. The reason is simple: Although I desperately wanted at least a second child, I knew without hesitation that it would have been inhumane to bring another into the world who would possibly endure the same fate. I also wasn’t sure I had the wherewithal to wage the battle again. Knowing that the baby kicking inside you might not survive makes pregnancy a daily mix of hope and despair. (The medical term from eight weeks until birth is fetus, but I have used the term baby simply because that was my perception of my pregnancies; I’d never foist that terminology on others, however.) And although Sophie had a number of good days, the impossibility of protecting her and making it “all better” on the bad days was very hard. Terminating a pregnancy I very much wanted would have been difficult. But I would have done it.
Policymakers in Alabama and other states seeking to restrict or even outlaw abortion often tell us that they care about family values. So do I. The family I now have would not exist if abortion were not an option. It’s as simple as that.
Having witnessed the suffering of other children in hospitals across the country, I doubt that I’m unique. But women terminate pregnancies for a variety of reasons. Financial concerns and the ability to provide for a child are No. 1. Three-quarters of American women seeking abortions are low-income, with 50 percent living below the federal poverty level. Women who terminate pregnancies are also predominantly young (especially in their early 20s), and often they are in college or pursuing further education. These women resoundingly say they’re delaying motherhood because they want to better position themselves educationally and economically before having children.
Maternal health and fetal anomalies also figure into the reasons for seeking abortions, but they’re not at the top of the list. Given that many diagnoses, including Sophie’s, aren’t possible until well into the second trimester, this means that 20-week bans are especially problematic for women like me: These bans may condemn babies to awful fates, including certain death by suffocation in the days after birth, or a life spent in a permanent semi-vegetative state with no ability to communicate. But women like me aren’t the only ones who might need access to second-trimester abortions. Women who seek later abortions often have healthy fetuses but are among the most economically and socially vulnerable: many took months rather than weeks to figure out they were pregnant; didn’t know about resources to help pay for the abortion; and reported being in denial about the pregnancy.
Some people believe that it should be legal to terminate a pregnancy if and only if there are severe abnormalities. There are at least two problems with this model of policymaking. First, it would be virtually impossible to figure out how much potential suffering would be sufficient to “justify” an abortion. Is the suffering of a child whose sternum is repeatedly sawed open in order to access the heart any worse than the suffering of a child who is hungry because her parents don’t have the resources to feed her, neglected because her parents are ill-prepared to care for her, and inadequately loved because her parents are still children themselves? I don’t know the answer to that question. Ideally, we’d ask the fetus. For obvious reasons, we can’t. Surely the prospective parents are better-placed to decide than are legislators, who may or may not have encountered real struggle themselves.
It’s rarely clear in-utero precisely how a fetus with congenital abnormalities will fare once he or she enters the world as a baby. Much hinges on third-trimester development, the quality of health care, and luck. For many birth defects, it would be virtually impossible to develop a criterion for determining whether the problem is sufficiently likely to be awful and therefore “eligible” for termination. This was certainly the case for Sophie. Some children with her condition are alive and well. Others are alive and not well. And others are deceased. Even with the best doctors and the best health care in the country, my daughter did not make it. No one could tell me with any certainty that this would be the case in fall 2008.
It’s hard to know how many children like my second and third daughters exist today. On some level, it’s easier for women like me to speak up, since I’ve never terminated a pregnancy (and so don’t have to worry about abusive responses, except from those who have told me God has a plan, even for suffering children). For understandable reasons, it’s more daunting for women to say “my two healthy, happy, well-supported kids are only here today because I was able terminate two unwanted pregnancies earlier in my life, putting off childbearing to a time when I knew I’d be able to give my kids everything they needed.” The social taboo is strong, but it’s changing. Women are sharing their stories. Given that 1 in 4 women in the United States terminates a pregnancy, I have no doubt that those cases are more common than mine.
And I see those women’s reasons for terminating as no less valid than mine, had I had to make that difficult decision. My reasoning is both ideological (I think governments should be able to compel people to do things to their bodies only in extreme circumstances, which pregnancy is not) and practical (forcing children upon women who are unable to care for them does not benefit those children, or society as a whole). I accept that others don’t see it my way. But those who would like to see more restrictions need to understand that it would be impossible to develop a fair and just mechanism for assessing “eligibility” for abortion. And those who want abortion to become completely illegal need to consider the consequences for life and for families. If they don’t, there will be more lives that involve suffering, and fewer happy and healthy children in the world.