Is Abortion Ever Medically Justifiable?
Today is the 43rd anniversary of the Supreme Court’s landmark decision legalizing abortion. One of the front runners in this year’s Presidential election has taken a stand against abortion, regardless of the reason. Many people believe we must allow abortion in cases of rape, incest or where the life of the mother is at risk. I won’t discuss cases of rape or incest in this post, but I would like to examine the idea that abortion should be reserved for cases where the mother’s life may be at risk. First we need to bring a little clarity to the terms used in this discussion.
As they pertain to abortion, the “life” of the mother is completely different issue from the “health” of the mother. Whether an abortion is necessary to save the life of a pregnant woman is easy to determine. If an abortion is the only (or most reasonable) option known to medical experts to save the life of a pregnant woman with a certain medical condition, it is medically justifiable. The health of a pregnant woman is a completely different issue.
The Supreme Court’s 1973 abortion ruling intended to allow abortion during the first two trimesters, but not during the third—unless the pregnancy posed a threat to the health of the mother. So far, so good. But the Court defined the word “health” so broadly that it can be applied to almost anything. The Court defined “health” to include “physical, emotional, psychological, (or) familial” trauma. These qualifiers allow for an almost unlimited number of possibilities.
If for example, a pregnant woman suffers shame or guilt because of how her family perceives her pregnancy, this would constitute a valid reason for an abortion, because it negatively impacts her metal health. If a mother believes her health may suffer in any way—regardless of which health factor she identifies—she can legally have an abortion at any time during her pregnancy. The point here is that making an exception for the health of the mother is not the same as making an exception to save her life.
There are a number of medical conditions that must be considered when looking at what procedures might be needed to save the life of a pregnant woman. We’ll look at them one at a time, but first a few basic facts about pregnancy:
A full term pregnancy is considered to be 40 weeks in duration. Not surprisingly, full term babies have a very high survival rate. But what about babies delivered before full term?
Due mostly to advances in technology, a baby that is delivered today at 25 weeks gestation has between a 50-80% chance of survival to discharge from the hospital. At 24 weeks the odds are ten percent less. At 23 weeks it has a 10-30% chance of survival. At 22 weeks the chance of survival drops to less than 10%. There are no known cases of a baby surviving birth at 21 week gestation. (source) A baby delivered after 23 weeks (whether by vaginal birth or by c-section) has a decent chance of survival to discharge from the hospital.
Now let’s look at specific medical conditions that could be a threat to a pregnant woman. You might imagine there are dozens of different medical conditions that could potentially threaten the life of a pregnant woman, but in fact—there are only a few. Eclampsia is one of them.
Eclampsia is a condition marked by hypertension, protein in the urine and in serious cases—seizures. In rare cases, eclampsia can be fatal, due to prolonged and uncontrolled seizures. But eclampsia is a late-term condition. Ninety percent of cases occur after the 34th week of gestation. Although the symptoms of eclampsia can be treated with medications, the best treatment is delivering the fetus—either by inducing labor or by c-section.
Preeclampsia is a related condition that has the same symptoms as eclampsia, but without seizures. Preeclampsia can begin around the 20th week, but it is not a threat to the mother’s life. It is only when preeclamspia becomes eclampsia that it threatens the mother’s life, and that happens late enough in pregnancy for the fetus to survive delivery. Since eclampsia is only a threat late in pregnancy and since it can always be treated by delivering the fetus, there is no medical necessity for an abortion to save the mother’s life.
There are a couple of other conditions that pose a threat to the lives of a pregnant woman and fetus during late stage pregnancy. Abruptio placenta is when the placenta detaches from the lining of the uterus and the blood supply to the fetus is compromised. This condition sometimes results in fetal death, but in the majority of cases, a viable baby can be delivered either vaginally or by c-section, if detected early enough. Placenta previa occurs when the placenta blocks the cervical opening. Once diagnosed, most cases are treated with delivery by c-section. Abortion is never necessary to treat either of these conditions.
Some have argued that medical conditions such liver failure, heart failure and kidney failure may require treatment during pregnancy (including the possibility of organ transplant) and such cases may require a pregnancy to be aborted. While it’s true that some mothers who are pregnant may have these conditions, the conditions themselves are not caused by pregnancy and ending the pregnancy won’t provide any therapeutic effect to the mother. Whether the pregnancy is ended or not, the mother will still have the condition, thus there is no medically justifiable reason to terminate a pregnancy for such conditions.
Some have argued that cancer treatments such as chemotherapy and radiation cannot be safely done during pregnancy and since these treatments may save the life of the mother, they are a valid medical reason for abortion. Pregnancy doesn’t interfere with these treatments. All standard treatments that may be necessary for a cancer patient can be done on a pregnant woman just as easily on one who is not pregnant. The effects of such treatments on a fetus cannot be reliably predicted. While it’s true that these treatments may have an adverse effect on the fetus, it’s equally possible that a fetus will suffer no harmful effects. This exhausts the list of medical conditions that pose a threat to a woman’s life in late-term pregnancy.
In any pregnancy where a medical condition threatens the life of the mother, if the pregnancy needs to be terminated, and is past the 23rd week, the baby can simply be delivered either by inducing labor or by c-section, without harming either the baby or the mother. Stated in another way—there is no medically justifiable reason for abortion after about the 23rd week of gestation. This is true regardless of the medical condition in question. Which brings us to conditions that threaten the life of a woman early in pregnancy.
What conditions pose a legitimate threat to the mother’s life in an early-term pregnancy?
There is only one: ectopic pregnancy.
Ectopic pregnancy occurs when the embryo implants outside the uterus—typically in the Fallopian tubes, but rarely in the ovary, abdomen, or cervix. In almost all cases, ectopic pregnancy does not result in a live birth, although there have been documented cases of successful live births:
- In September 1999 an English woman, Jane Ingram gave birth to triplets. Two of the fetuses developed in the uterus, while the third developed outside the uterus. All three survived.
- In July 1999, Lori Dalton gave birth by c-section in Ogden Utah, to a healthy baby girl who had developed outside of the uterus.
- In 1999, a healthy baby boy was delivered in London after having implanted in his mother’s fallopian tube.
- In 2000, a healthy baby girl was delivered in Nottingham (UK) despite the fact that the placenta attached to the lining of her mother’s bowels.
- In 2005, a woman in the UK gave birth to a healthy baby girl who spent the entire pregnancy in her mother’s abdomen.
- In 2008, a woman in Australia delivered a healthy baby girl from an ovarian pregnancy.
The odds of a fetus surviving ectopic pregnancy are extremely slim, but it does happen. Ectopic pregnancy can, in rare cases, be fatal to the mother. What kind of threat does it pose?
A report on ectopic pregnancy published by the American Academy of Family Physicians (AAFP) reveals that ectopic pregnancy occurs at a rate of about 19.7 cases per 1,000 pregnancies in North America. To date, 14 studies have documented that between 68 and 77 percent of ectopic pregnancies resolve without intervention. Most cases are never treated. The embryo usually miscarries without medical intervention and the pregnancy ends.
Next let’s calculate the risk of death to the mother:
The CDC reports that between 2003–2007, there were 0.5 maternal deaths related to ectopic pregnancy for every 100,000 live births. Death is usually due to hemorrhage after the Fallopian tube ruptures. Although the likelihood of death for a mother with ectopic pregnancy is extremely small, the risk of continuing the pregnancy is real, and the baby’s chance of survival is almost zero.
When the life of the mother is threatened by continued pregnancy, sound ethics tell us that everything possible should be done to save the lives of both the mother and the child. After the 23rd week, the pregnancy can be terminated by inducing labor or performing a c-section. But when pregnancy endangers the life of the mother during the first half of pregnancy, the most ethical course of action is harder to determine. The reason abortion is condemned by so many people is because it kills an innocent human being. What do you do when the existence of one human being, through no fault of their own, threatens the life of another human being? Do you end the life of the child, to save the life of the mother?
The problem can be viewed this way:
A) If the pregnancy is allowed to continue, the mother will die, and if the mother dies, the child will die.
B) If the pregnancy is ended through abortion, the child will die, but the mother will live.
The question is usually put in these terms: If there is no way to save the child, but there is a way to save the mother, it is ethical to save the mother’s life by ending the child’s life? Isn’t it better to save one life, than to lose two?
Those in favor of abortion tend to view the outcomes of such pregnancies as guaranteed: “My doctor said that if I had not had the abortion, I would have died.” Although this reasoning may appear to be sound, in reality, the outcome can never be known with certainty. Although we can say with certainty that if a mother dies, the child will die—we can never say with certainty that if the pregnancy were to continue the mother would die. Unless you are omniscient, it’s impossible to say what would happen to a mother if a procedure had not been done. The best we can do is guess. And if we want to be truthful, we must admit that we can never know with certainty whether a mother will live or die if she does not have an abortion. Therefore, we must modify statement A above. The first part would need to read:
A) If the pregnancy is allowed to continue, the mother might die…
There is a world of difference between “will die” and “might die,” and this is where things get sticky. Like any other medical condition, pregnancy always carries a small risk of death, and an ectopic pregnancy increases that risk slightly. But does that small risk justify an abortion?
By the time an ectopic pregnancy is discovered (typically by 7 to 8 weeks gestation) the embryo has usually died. When an ectopic pregnancy is discovered and the embryo is still alive, one of two procedures is performed. If the mother has a healthy, normal ovary and Fallopian tube on the opposite side of the ectopic pregnancy, the Fallopian tube and embryo are surgically removed. If she does not have healthy organs on the opposite side, an incision is made in the Fallopian tube and the embryo is removed. (Everything possible is done to assure the mother has at least one healthy Fallopian tube and ovary.)
This procedure is always fatal to the embryo. And although it bears some similarity to an elective abortion, it is generally viewed differently—even by religious organizations that oppose abortion. The death of the embryo or fetus is the sole purpose of an elective abortion, but it is the undesired and unavoidable consequence of surgically treating a life-threatening ectopic pregnancy. This seems to be the one situation in which ending a pregnancy is medically justifiable.
Thanks for bearing with me. I hope this article has helped you see this issue a little more clearly.
We had an ectopic pregnancy and were given no choice about treatment by the doctors – my wife was rushed to surgery. We prayed that God would take the baby before the surgeons did. And He was gracious. Baby Rachel had died when the tube had burst. It was heartbreaking.
But even in the darkness God was there. We called on friends to pray and had a peace that genuinely did pass all understanding given the circumstances we where in. And then after the operation we had, what can only be called, an angelic visit. A doctor sat down and talked to my wife the following day and said he was watching the operation through the uplink and asked if she would like to see pictures of her baby. It brought such comfort to my wife to see what was left of Rachel and to know that she had died before the operation and this was the only reason we knew what had happened as no other doctor told us what had happened – it was just a “procedure” to them. However, when we asked to see this doctor again, no-one had ever heard of him. When we asked if we could again see the pictures that this doctor had shown us the surgeon said that no photos were taken during the operation and so they wouldn’t be able to….
I thank Father for the maturity and clarity with which you tread into what many might view as volatile ground. I wish more people would offer such rational discussion(s).
Really well done, PM.
You know, I don’t know that I’ve ever heard medical vocabulary and clinical descriptions ever express as much love as I have heard today.
You enrich the people of God, in heart and soul, so very well. I’m thankful for you!
Around 3 years ago at about the 8th week of my pregnancy I found myself in the emergency in severe pain. We had gone through a lot to get pregnant and were terrified we were loosing our baby. The ER doctor had warned me that the ultra sound technician would not give me any information about my baby. They were wrong. She first showed me that our baby was ok and we saw that beautiful beating heart. Then we saw I was bleeding internally as well as I had a blood clot on my ovary. We found the bleeding was coming from my ruptured tube where another tiny beating heart was. We had no idea we were pregnant with twins. At that moment I heard God’s voice say to me “This one is coming with me.” The doctors said I did not have much time and that we had no choice. I wanted with all of my heart to save that baby and they said there was no possible way. I heard a song in my heart, “I lean not on my own understanding, my life is in the hands of the maker of Heaven.”
Our daughter is 2 years old now and I think of her twin so often. I know I will be with my child in Heaven, and until then, I know God is taking care of him or her. I can never imagine ending the life of a healthy baby or even an unhealthy baby. I am so thankful for the grace God gave me through it all, I never felt responsible, not for a moment.
I appreciate this article. Thanks for reading my story, it feels good to share it.
Just after I was born of the Holy Ghost in 1978, I was diagnosed with a Tubular Pregnancy, (it never occurred to me to have it removed that it would be an Abortion, nor have I read that before this post). The Doctor said he needed to remove it and set up a date for surgery.
I had just heard Jesus heals us, so I prayed and asked Father God to heal me… while in prayer Father made a request of me. I agreed to it … immediately the excruciating pain I was in left.
When I went in for surgery there was no longer a baby in my Fallopian Tubes. The Doctor had no explanation other than it must be an answer to my prayer. He said there was a sudden pattern of a lot of women were being healed, so who was he to say it was not an answer to our prayers.
I am glad I did not have to make that decision, for later in life had I discovered naively I had an abortion, I would have been very, very upset and would have had a hard time forgiving myself and receiving God’s forgiveness.
Here is another form of Abortion, many are not aware of:
I conceived my twins with an IUD in place. The Doctors said if they removed the IUD it would cause a spontaneous Abortion. A Doctor told me later, that is what an IUD does, it aborts the fertilized egg before it can be planted. Had I known this I would have never gotten one.
I carried my twin sons 6 months before the IUD punctured my water and they were still born. This pregnancy was before I was born of the Holy Spirit. Even so Father gave me a Prophetic Dream before I conceived them. I did not recognize this was from Him for sure until after I was born again. I did not know God still speaks to us through Dreams and Visions in our current age.
I grieved for 5 years. The Holy Spirit brought this dream to mind 5 years later when I asked to be healed of the Grief. I could not rejoice with my best friend who was having twin sons. The remembrance of this Prophetic Dream brought me comfort. I was able to stop blaming myself for their death, with the If Only’s… Should Have’s and the like.
Plus, about that time Father told me that they were alive and with Him (in my mind as one not born of the Holy Ghost I thought since they were stillborn they had no life to go on, I am amazed that I believed that, in hindsight … we do truly walk in darkness on so many levels until we are born of His Spirit and given eyes to see and ears to hear). He said they were growing up and someday we would meet, they were eagerly awaiting that moment. Father also said He had a plan for them in Eternity, but not on earth, that He needed my body to conceive them and for me to be at peace.
Peace came over me and never left … then I remembered my Tubular Pregnancy and sensed I have a daughter awaiting me too. The Spirit of our Lord told me sharing this Testimony would comfort those who had lost their babies during childbirth, even those who repented from aborting them; for Father’s Forgiveness covers all sins and He works everything out for the good in the end. I have found this to be true… and am moved often to comfort with the comfort I have been given and to offer wisdom and understanding I have received with Testimonies of His Goodness and Faithfulness and dealings in my life, as well.
What about in the case of trauma to the mother and although you may not be aborting the baby intentionally, the mother’s life is critical and tx of the baby may be put off??
It is too easy for a man to judge and choose his side, since it is never HIM who has to suffer that pain and bleeding, and it is never HIS life at risk. If bearing and having children were up to men, reproduction would be a completely different story, I’m afraid… As a man, if your life was imminently threatened by a bleeding that would not stop by itself while you were in so much pain you could not think any more, what would you do? Not even think twice about rushing to the doctors and doing everything to stop it, i bet.
A child surviving outside of the womb is a miracle by itself. But one surviving the rupture of a fallopian tube? Only if God himself takes that bundle of cells and with his own hand re-implants it into the uterus, for the blood supply is completely cut off during that process – usually the child would be dead before the docs could even get to the spot.
Also keep in mind: with internal bleedings, the clock is ticking – you have only limited time to safe the mother.
I had the agony of suffering 3 ectopic pregnancies. This being considered an abortion never crossed my mind as I didn’t choose to rid myself of an unwanted child. I also had a miscarriage. With every pregnancy, I wanted that child more than ever. It is a horrific emotional experience.
It’s also a physically painful recovery from surgery.
My 1st ectopic blew my left tube apart. I did not know I was even pregnant. The pain was so intense, I knew something was very wrong. I will never forget that pain or that day. I blacked out 4 of the 7 days I spent in the hospital. My doctor said I had hemmoraged so much, I nearly died. My abdomen literally had so many staples it looked like a zipper.
My 2nd ectopic I was whisked straight away to surgery as I was already considered “High Risk”. Surgery involved 3 small holes & no staples. I was sent home the same day.
My 3rd ectopic experience, my doctor had to schedule me for 1st thing the next morning. That night before surgery, I watched on the news where a few young children including a baby had been left alone in an apartment for a few days by their mothers so they could go out & party. It was winter time in Chicago. I cried so much my heart went cold with bitterness. Why did I have to give up all my babies when fortunate mothers abused theirs? I asked my doctor before surgery if he would just take my remaining tube to forego anymore ectopics. He refused. I had same procedure as #2 and I was sent home to recover.
I had a miscarriage & my last 2 ectopic all within 2yrs.
Then I got pregnant again. The ultrasound showed no fetus in the womb. I was absolutely panicked because they couldn’t get me in to a doctor for a whole week. This was around Thanksgiving 1998. I was already 2 months pregnant & my baby was in the tube again. I cried out not to God but to friends. I was still angry at God at this time. Unknowst to me at that time, one of my friends girlfriend notified her church & they had a special prayer service for me & my unborn child. (Thank You Central Christian Church in Mesa Az). God moved his hand!
When I finally seen my new doctor, he found my baby right where he should be. This was definitely a miracle pregnancy. During the next few months I recovered my lost sense of smell I lost when my nose was cauterized at 7 yrs old. I had a severe head-on car accident the year before & had been nursing back pain for over a year, but now there was no more pain! The best part is I got to experience the full length of my pregnancy & I gave birth to the most Beautiful & healthy boy in the world. He will turn 17 this June. He makes me happy & grateful every single day. I know God has a purpose for his life as it was God & God only who could have made this happen.
I think of all the babies I’ve lost time & time again. It isn’t something I can forget & I still grieve they didn’t make it but I am so ever grateful for the one I have.
I wasn’t a praying woman back then but I sure am now. I nearly lost my son one other time to a domestic kidnapping. After 3 hopeless days, I got down on my knees face to the floor praying with all I had in me & within an hour, they found him & returned him back to me.
God is very real and He is very Powerful. Make Him apart of your life & He will bless yours.
Thank you for writing a clear article about this issue. Truth gets so distorted by the mainstream media that it can’t even be called truth anymore.