Is Abortion Ever Necessary to Save a Woman’s Life?
In 2012, in response to efforts to legalize abortions in their country, Irish doctors launched the Dublin Declaration, which declares that abortion is not necessary to save women’s lives. To date, more than a thousand medical professionals have now signed the Declaration, which states:
As experienced practitioners and researchers in obstetrics and gynaecology, we affirm that direct abortion – the purposeful destruction of the unborn child – is not medically necessary to save the life of a woman.
We uphold that there is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child.
We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.
In 2013, Dr. Anthony Levatino, an ob-gyn who formerly performed abortions and has treated women with high-risk pregnancies, testified before a Congressional subcommittee that abortion is not a viable treatment option when a mother’s life is at risk:
Before I close, I want to make a comment on the necessity and usefulness of utilizing second and third trimester abortion to save women’s lives. I often hear the argument that we must keep abortion legal in order to save women’s lives in cases of life-threatening conditions that can and do arise in pregnancy.
Albany Medical Center, where I worked for over seven years, is a tertiary referral center that accepts patients with life threatening conditions related to or caused by pregnancy. I personally treated hundreds of women with such conditions in my tenure there. There are several conditions that can arise or worsen typically during the late second or third trimester of pregnancy that require immediate care. In many of those cases, ending or “terminating” the pregnancy, if you prefer, can be life saving. But is abortion a viable treatment option in this setting? I maintain that it usually, if not always, is not.
Before a suction D & E procedure can be performed, the cervix must first be sufficiently dilated. In my practice, this was accomplished with serial placement of laminaria. Laminaria is a type of sterilized seaweed that absorbs water over several hours and swells to several times its original diameter. Multiple placements of several laminaria at a time are absolutely required prior to attempting a suction D & E.
In the mid second trimester, this requires approximately 36 hours to accomplish. When utilizing the D & X abortion procedure, popularly known as Partial-Birth Abortion, this process requires three days as explained by Dr. Martin Haskell in his 1992 paper that first described this type of abortion.
In cases where a mother’s life is seriously threatened by her pregnancy, a doctor more often than not doesn’t have 36 hours, much less 72 hours, to resolve the problem. Let me illustrate with a real -life case that I managed while at the Albany Medical Center. A patient arrived one night at 28 weeks gestation with severe pre-eclampsia or toxemia.
Her blood pressure on admission was 220/160. As you are probably aware, a normal blood pressure is approximately 120/80. This patient’s pregnancy was a threat to her life and the life of her unborn child. She could very well be minutes or hours away from a major stroke. This case was managed successfully by rapidly stabilizing the patient’s blood pressure and “terminating” her pregnancy by Cesarean section. She and her baby did well. This is a typical case in the world of high-risk obstetrics. In most such cases, any attempt to perform an abortion “to save the mother’s life” would entail undue and dangerous delay in providing appropriate, truly life-saving care.
During my time at Albany Medical Center I managed hundreds of such cases by “terminating” pregnancies to save mother’s lives. In all those hundreds of cases, the number of unborn children that I had to deliberately kill was zero.
Abortionist Don Sloan has also refuted the claim that late-term abortions are necessary to save women’s lives:
If a woman with a serious illness — heart disease, say, or diabetes — gets pregnant, the abortion procedure may be as dangerous for her as going through pregnancy … with diseases like lupus, multiple sclerosis, even breast cancer, the chance that pregnancy will make the disease worse is no greater that the chance that the disease will either stay the same or improve. And medical technology has advanced to a point where even women with diabetes and kidney disease can be seen through a pregnancy safely by a doctor who knows what he’s doing. We’ve come a long way since my mother’s time. … The idea of abortion to save the mothers’ life is something that people cling to because it sounds noble and pure — but medically speaking, it probably doesn’t exist. It’s a real stretch of our thinking.
Risks of Late-Term Abortions
Late term abortion itself carries its own risks, as Levatino noted in 2014:
Second trimester abortion procedures are neither simple nor safe …
It is particularly easy to cause a uterine perforation as the uterine walls are thin, soft and very vascular. Once while performing a suction D & E at, coincidentally 18 weeks, I was unaware that I had perforated the uterus until I pulled my patient’s intestines out through her cervix and vagina. That was a life-threatening injury. It turned out well because she was in a hospital operating room with proper anesthesia and we could respond immediately to the crisis. I shudder to think what would have happened to my patient if she had been in a freestanding clinic. …
… If a serious complication occurs, the woman will be dumped into a local emergency room and a physician with admitting privileges will be forced to care for her. Whole Women’s Health website promises a “fabulous abortion experience.” Is being abandoned by your abortionist when a serious complication occurs fabulous?
Further, as Dr. Mary L. Davenport noted in a 2010 article entitled “Is Late-Term Abortion Ever Necessary?”:
T. Murphy Goodwin, M.D., a distinguished professor of maternal-fetal medicine at the University of Southern California, has written an eloquent article describing how women are told they need abortions for their own health, when this is patently untrue. A major reason for unnecessary abortion referrals is ignorance, to put it bluntly, especially on the part of physicians in medical specialties inexperienced in treating women with high-risk pregnancies. According to Goodwin, there are only three very rare conditions that result in a maternal mortality greater than 20 percent in the setting of late pregnancy.[2] Even in these three situations there is room for latitude in waiting for fetal viability if the mother chooses to accept that risk. …
Late-term abortions result in more hemorrhage, lacerations and uterine perforations than early abortions,[3] as well as risk of maternal death approaching that of carrying the baby to term.[4] Subsequent pregnancies are at greater risk for loss or premature delivery due to trauma from late-term abortions.[5] The psychological damage of aborting a late-term pregnancy, particularly one that is desired, can be profound and long lasting.
In conclusion, although serious threats to health can occur, there is always a life-affirming way to care for mother and baby, no matter how bleak the prognosis. The elimination of late-term abortion would not create a void in medical care, but would instead result in a more humane world in which vulnerable humans would be treated with the dignity and respect that they deserve.
From a psychological perspective, a 2010 study of women who had abortions found that women undergoing later abortions face increased psychological risks, are more likely to be ambivalent about having an abortion and are more likely to need counseling and support.
The study also found high rates of post-traumatic stress disorder (PTSD) symptoms for women having both early and late abortions, with 52 percent of of the early abortion group and 67 percent of the late term abortion group meeting the American Psychological Association’s criteria for post-traumatic stress disorder symptoms (PTSD).
When it came to differences between the late and early abortion groups, women having later abortions were more likely to report having disturbing dreams, reliving the abortion, having trouble sleeping and experiencing intrusion, a PTSD symptom that involves having recurring memories, flashbacks or hyperactivity when confronted with reminders of the trauma.
Providing Real Help and Hope, Not Abortion
In 1979, Dr. Sandra Mahkorn carried out the first published study (and even today, one of the few) of the experiences of women who became pregnant as a result of rape. [6] She found that most of the women she surveyed stated that their primary problem was the need to confront and deal with “feelings or issues related to the rape experience,” although a significant minority (19 percent) placed primary emphasis on the need to confront and explore feelings about the pregnancy, including feelings of “resentment,” “hostility toward the child,” and “denial of the . . . pregnancy.”
When asked what conditions or situations made it most difficult for them to continue the pregnancy, most women responded that it was social pressure—the opinions, attitudes, and beliefs of others about the rape and pregnancy. Reasons included “family pressure [to abort],” “attitudes of boyfriends,” and the belief that “people will not believe that she was raped or that it could have been prevented.”
Though some women initially felt angry with the unborn child because of the attack, Mahkorn found that these women consistently had more positive attitudes as the pregnancy progressed. The overwhelming majority of the women had a better self-image and a positive view of the child by the time of delivery. None of the women displayed more negative attitudes, a fact which prompted Dr. Mahkorn to write:
The belief that pregnancy following rape will emotionally and psychologically devastate the victim reflects the common misconception that women are helpless creatures who must be protected from the harsh realities of the world . . . [This study illustrates] that pregnancy need not impede the victim’s resolution of the trauma; rather, with loving support, nonjudgmental attitudes, and empathic communication, healthy emotional and psychological responses are possible despite the added burden of pregnancy.
She went on to note:
Perhaps as a result of their own biases and an unwillingness to deal with the more emotionally difficult complications of a pregnant rape victim, many physicians suggest abortion in this case as one would prescribe aspirin for a tension headache . . . While on the surface this “suggestion” may appear acceptable and even “humane” to many, the victim is dealt another disservice. Such condescending [“quick-fix”] attitudes on the part of physicians, friends and family can only serve to reaffirm the sense of helplessness and vulnerability that was so violently conveyed in the act of sexual assault itself. At a time when she is struggling to regain her sense of self-esteem, such a “take charge” attitude can be especially damaging. Often the offer of such “quick and easy” solutions as abortion only serves those who are uncomfortable or unwilling to deal with the special problems and needs that such complications as pregnancy might present.
. . . [The] attitudes projected by others and not the pregnancy itself pose the central problem for the pregnant victim.
By no means am I attempting to conclude that pregnancy as a result of rape is a simple matter. Such a conclusion would indeed be naive. This study does seem to suggest, however, that even though emotionally and psychologically difficult, these burdens can be lessened with proper support.
Mahkorn’s conclusions were echoed more recently by Dr. Ingrid Skop, a fellow with the American College of Obstetrics and Gynecology, who had this to say about a case involving a 10-year-old girl who became pregnant as a result of incest:
As the mother of an 11-year-old daughter, I was saddened to hear of the 10-year-old girl in Paraguay who is pregnant as a result of incest. It is natural when one hears of such a tragic situation to want to reverse the clock and return her to her childhood innocence. But that is not possible. So the question should become, what should be done now?
As an obstetrician, I realize that pregnancy in such a young girl carries increased risk. Statistics tell us young teenagers are more likely to give birth prematurely, have a lower birth-weight baby, suffer from anemia, poor nutrition, and substance abuse, and are at higher risk for cesarean delivery.
Yet, the proposed alternative of terminating her pregnancy late in the second trimester (she is reportedly 22 weeks pregnant), also carries substantial risks. Abortion complications increase in number and severity as the pregnancy advances. Physical risks include infection, hemorrhage, perforation of the uterus leading to infertility, damage to the cervix leading to increased risk of subsequent premature delivery, and in rare cases, death.
Mental risks are difficult to quantify, and a young girl who is the victim of incest is likely to suffer from depression and post-traumatic stress regardless of the pregnancy outcome. While she may not be fully aware of the long-term implications of carrying a pregnancy to term, she undoubtedly understands that it is a baby she carries inside her body. By the mid second-trimester she can feel its kicks. Young girls usually love babies, and to forcibly terminate the baby growing inside her body is likely to cause severe emotional trauma. Conversely, to allow her to carry the baby to term is likely to provide some comfort, because some good has come out of her difficult situation.
Too often on the abortion issue we are given false choices. The choice in this situation is not solely between an abortion or a dangerous delivery. Since she has come to international attention, I am sure that there would be those willing to provide care and comfort to this young girl if she wants to continue her pregnancy. With social support, good nutrition, and prenatal care, the odds are great that she will remain healthy as she delivers a healthy baby. An open adoption might allow the girl to maintain a relationship with the child, who is also a victim of the crime of incest.
The sexual abuse of women and girls is a worldwide problem. Sadly, when a victim of rape or incest becomes pregnant, instead of receiving real help with the goal of helping her heal from the trauma, she is often encouraged or even forced to abort — often to cover up and continue the abuse. Abortion advocates and some “human rights” groups have used the cases of pregnant victims to demand that countries overturn their abortion laws. But abortion will do nothing to help the already traumatized victims, and can only cause additional harm.
In the book Victims and Victors, one of the survivors, Jackie, wrote:
I soon discovered that the aftermath of my abortion continued a long time after the memory of my rape had faded. I felt empty and horrible. Nobody told me about the pain I would feel deep within causing nightmares and deep depressions. They had all told me that after the abortion I could continue my life as if nothing had happened.
Wiping out the pregnancy is a way of hiding what happened, a “quick and easy” way to avoid dealing with the survivor’s true emotional, social and financial needs. As Kathleen wrote:
I, having lived through rape, and also having raised a child “conceived in rape,” feel personally assaulted and insulted every time I hear that abortion should be legal because of rape and incest. I feel that we’re being used by pro-abortionists to further the abortion issue, even though we’ve not been asked to tell our side of the story.
