"Stab yourself in the Eye with a Pencil!!!"

Rarely is political satire so perfect.

Maybe these religionists should go back to to the Socratic notion, adopted by Aquinas, of ensoulment, thereby allowing the woman an option in the first trimester while also giving conservative politicians religious cover. Odd that the only solution to the Gordian Knot crafted by these troglodytic lawmakers is to go back to the Middle Ages.

(h/t Bob Cesca and Jay)

Rape, Abortion, and the Violinist

Analogies are not always appropriate but I’ll present Judith Jarvis Thomson’s Defense of Abortion from 1971 that framed the Roe v. Wade debate at the time. The essay is quite a bit longer and presents other arguments in favor of abortion rights, but here is one part:

You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist's circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, "Look, we're sorry the Society of Music Lovers did this to you--we would never have permitted it if we had known. But still, they did it, and the violinist is now plugged into you. To unplug you would be to kill him. But never mind, it's only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you." Is it morally incumbent on you to accede to this situation? No doubt it would be very nice of you if you did, a great kindness. But do you have to accede to it? What if it were not nine months, but nine years? Or longer still? What if the director of the hospital says. "Tough luck. I agree. but now you've got to stay in bed, with the violinist plugged into you, for the rest of your life. Because remember this. All persons have a right to life, and violinists are persons. Granted you have a right to decide what happens in and to your body, but a person's right to life outweighs your right to decide what happens in and to your body. So you cannot ever be unplugged from him."

The strength of this analogy is that Thomson is not denying that a human life is involved, or even that of a legal “person”, she is asking whether the lives of all persons should be protected, and to what extent that protection should be mandated by law. Does the individual have any determination as to how their body should be used. We can try to convince the life-giving donor to acquiesce to a certain moral code, but is it right, or even possible, to mandate it?  

What is your moral responsibility to the violinist, and what is the government’s role in protecting the life of the violinist at your expense? Can personal morality be legislated to this degree? Certain moral codes, such as that of the Roman Catholic Church, are very clear on the sanctity of human life, no matter the “method of conception”, even if it is rape.

Mitt Romney has said that he will protect the woman’s right to abortion is cases of rape-- this week anyway--but that could change by January since he seems to waver on this and every other issue. Alternatively, Paul Ryan, who could very well be the President in the event of Romney’s death, is very adamant about his views. He says that human life is so precious that abortion should be disallowed in all instances except where the mother’s life is in danger.  Ryan says that rape is merely a “method of conception”, and the method of conception doesn’t matter.



Personally, I find this clip chilling. But in Ryan's defense, this is exactly the stance of the Republic Party platform.

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Thomson continues later in her 1971 essay:

My argument will be found unsatisfactory on two counts by many of those who want to regard abortion as morally permissible. First, while I do argue that abortion is not impermissible, I do not argue that it is always permissible. There may well be cases in which carrying the child to term requires only Minimally Decent Samaritanism of the mother, and this is a standard we must not fall below. I am inclined to think it a merit of my account precisely that it does not give a general yes or a general no. It allows for and supports our sense that, for example, a sick and desperately frightened fourteen-year-old schoolgirl, pregnant due to rape, may of course choose abortion, and that any law which rules this out is an insane law.

A Modest Proposal to End Abortion

Finally, a practical solution that would work...and leave it to an ob/gyn to devise it.

Make men responsible every time they impregnate a woman. Dr Evan Evans' brief 3-page is summarized: 

Restrict elective abortion to the first 16 weeks.

Require DNA testing to determine paternity of all out-of-wedlock children, even aborted.

Require the father to establish a $50,000 trust fund to care for any out-of-wedlock child, even if adopted. If the child is aborted, the fund is used for sex education.

If the father can’t pay, he joins the military and uses his enlistment bonus and salary to pay.

No man can avoid paternity claiming “she seduced me,” or that she claimed she was on the pill, had her tubes tied, whatever.

Man under 18? His parents are responsible.

Send it to every legislator who feels compelled to limit women's reproductive rights.

From the Utah Standard -Examiner:

Evans, a retired Ogden OB/GYN, came by his disgust for abortion in a horrendous three-month stint in the pathology/obstetrics ward at Cook County Hospital in Chicago in the 1950s when he did his residency.

Abortion was illegal but very common.

Rich women went to Europe, or Mexico, or had a friendly doctor take care of them.Poor women had to seek local “help,” and many, bleeding from a botched or self-administered abortion, would show up at Cook County, “nearly dead. I’d give them a shot of morphine and complete the abortion, then transfuse them.”

In that three months, “I completed a lot of back-door abortions.”

More than 500, which works out to six a day, give or take. And he was just one doctor, in one hospital, and those were the survivors.

When abortion was illegal, more than 100,000 women a year died from botched abortions.They will again if Roe v. Wade is overturned. That’s a hard fact abortion opponents, who claim they are saving lives, choose to ignore.

Lose the fetus, or lose the mother? Evans says he once asked Utah’s Catholic bishop, “Which is the proper Christian murder?”

You say neither? Funny thing, so does Evans.

However unlikely this proposal has of ever becoming law, it absolutely is on the right track, and anyone who says they want to restrict abortion by any other means is just playing politics (IOW, they're full of shit.)

He continues:

“No boy would dare have sex without wearing three condoms,” he said, because one might break, and two can still leak.

His law, he proudly says, would completely shut down abortion clinics.

All pro-choice and pro-life forces need to do, he said, is “join forces and preach contraception and hold the boy responsible.

We’d put them out of business because they’d have no business.”

It's the hypocrisy, Mr. Romney

Presidential candidate Mitt Romney says life begins at conception and women should not have a right to interfere in any way, yet: 

...[Romney] seems to have no problem charging supporters $50,000 a plate at a fundraiser at the house of Dr. Phil Frost. Frost's company, Teva Pharmaceuticals, isn't exactly evasive about their relationship with Plan B, either. Think Progress points out that on the company's website, the logos for Plan B and other contraceptive products are displayed prominently (including ParaGard, an IUD, which also causes abortions in the eyes of the Personhood movement). Hypocritical? Yes. Surprising? No. 

Granted, being full of shit is de rigeur for most politicians, but being hypocritical and abridging others' rights about such fundamental personal issues is another thing altogether.  

Governor Brewer Practices (Bad) Medicine

We have Big Invasive Government here in the wild west. Arizona Governor Jan Brewer took time from wagging her finger at black men to sign the nation's most restrictive anti-abortion legislation last week. The bill contains the boilerplate provisions present in other states' recent legislation, such as 24-hour required ultrasounds, counseling, showing pictures of developing embryos, etc, but the Arizona bill goes further. 


1. The most remarkable thing is that Arizona's bill prohibits all abortion after 20 weeks gestation even in cases of lethal fetal anomalies, unless the mother's health is imperiled by a "medical emergency". The woman is required by law to carry the pregnancy until...when? Presumably until natural labor starts or in utero death occurs.  Brewer's rationale is that:


“Knowing that abortions become riskier the later they are performed in pregnancy, it only makes sense to prohibit these procedures past twenty weeks."


She's practicing medicine, plain and simple... and it's substandard medicine at that.  The question is not whether abortion is safer at 11 weeks versus 20 weeks gestation-- there is no question that earlier terminations are safer and more cost-effective-- rather, the question is whether carrying a lethally anomalous fetus to term or until fetal death is safer than termination at 20 or 22 weeks: the answer is almost universally that early termination is safer.  


Lethal fetal anomalies are rarely diagnosed before 18 weeks and sometimes much later; this bill will certainly increase the use of 16-17 week ultrasound to look for gross anomalies (anencephaly and renal agenesis) in order to plan possible termination before the 20 week legal deadline. And since such early fetal anatomy is not adequately developed to see more subtle structures such as heart valves, etc, a subsequent ultrasound will be likely recommended in most pregnancies. Brewer's bill will cost more money for everyone since the current practice is to get one screening ultrasound around 20 weeks which can visualize major and minor anomalies.

There will be further increase in the cost for health care and maternal risk when anomalies are found after 20 weeks since the pregnancy will need to be carried to fetal death or natural onset of labor, with greater occurrence of morbidity, pain, c-section, gestational diabetes, pre-eclampsia, etc, etc, as the gestational age increases.


These patient-doctor decisions are always gut-wrenching; the presence of the Arizona legislature and Governor Brewer in this discussion is unnecessary and intrusive and will not decrease the number of abortions.


2. But there's even more crappy medical reasoning in the bill.  It also limits medical abortion before 9 weeks which is noninvasive and safe and quickly becoming the standard of care for 1st trimester termination.  This is when most abortions take place...and when Doctor Governor Brewer says they are safer.  The Arizona prohibition is inexplicably limited to medical abortion (ie, not suction) prescribed more than 30 miles from a hospital with the implied intention of patient safety.  In practice, however, this rule serves as an unnecessary (and dangerous) barrier to abortion services.  Failed medical abortion occurs at a statistically low rate and these failures are easily diagnosed with office ultrasound and completed with office suction; a hospital is not necessary.


The likely consequence of both of these measures within the bill is that pregnancy care in both instances will become more expensive, with greater opportunity for mismanagement and greater health risk to women. 


My Comment 1:  I get it. Conservatives don't like abortion. Newsflash: nobody does. Arizona is ignoring evidence-based medicine, requiring reckless practices, subverting the doctor-patient relationship, increasing bureaucratic hassle and putting women at risk.  This bill only serves to increase barriers to safe and effective pregnancy care and will likely not reduce abortion rates at all. The implicit rationale in the bill is to badger women and the result will be to require medical personnel to practice substandard medicine.  Is this really where we want to go as a state?


A better approach might be to define the purpose of the legislation and then look to other locales that have succeeded in this purpose.  If the desired goal is to reduce abortion, then look to other states and other nations with low abortion rates to see how they have done it.  Western Europe and the Northeast United States have the lowest abortion rates in the world and they've achieved this without draconian invasion into the doctor-patient relationship but rather increased access to contraception and education.


If the desired purpose is to eliminate all abortion, then Governor Brewer and the Arizona legislature should run for election in Fantasyland and and preside over a mythical population.


My Comment 2: Make no mistake, the Arizona bill is invasive.  It extends authority of the state into the most intimate decisions a woman can make.  Small-government conservatives should be bothered by this authoritarianism since Governor Brewer can glibly mischaracterize 'safe medicine'  while signing a bill that severely restricts medical decision-making and eschews science.  And Republican state legislator Kimberly Yee says: 

“The state has a compelling interest to protect women from the serious health and safety risks of abortion."


If the State of Arizona is in the business of deciding the absolute and relative safety of medical and surgical interventions then why not outlaw breast augmentation, botox, Viagra, and just about every aesthetic procedure... which all surely carry more risk than non-intervention?  

This belies the real purpose of Arizona's abortion bill: to hassle women into making a decision pre-ordained by the state.  Implicit in this bill is the opinion that Governor Brewer and the Arizona legislature know better than you or your doctor the optimal management of your pregnancy.

My Comment 3: Elections matter and the passage of this bill is the result of the election of conservative lawmakers who apparently reflect the will of the people, and the trend seems to be toward even more social conservatism and intrusion into people's private lives.  The unintended consequences of this approach are legion.   Instead of decreasing abortion these measures will merely increase risk-taking and unsafe practices.

My challenge to lawmakers:  If the people of Arizona truly believe that personhood begins at conception, and you truly want to legally protect all embryos then pass a law that states as much. This is the intellectually honest approach to outlawing abortion: if the fetus is a person then make that law, otherwise shut up.  For the Governor to engage in mental masturbation about what is "safe medicine" and to pass inane requirements prohibiting the standard of medical care do nothing to reduce abortion or advance the discussion. 

"I never really thought about it..."

There are answers to these questions, but it is amazing that anyone could be so active in such a movement and never have even thought about it. WTF. Or perhaps they have thought about, and have an opinion as to what the punishment should be, but simply don't want to discuss it on camera. That argument does not compute; you would think that they would take the opportunity to expound on how they are going to solve this dilemma once and for all.

How can we prevent abortion?

I've been having a discussion on another blog about abortion and reproductive rights. While we disagree on most aspects of these loaded topics, we agreed to try to find consensus. We agreed that reducing the number of abortions was a beneficial goal, and to wit Leila has been gracious enough to present her 3 (really 4) suggestions. My discussion follows. At some later date, I'll present my 2 or 3 suggestions as well. She says:

How can we prevent abortions?

1) Make it illegal. We are a civilized society, and barbarism should not ever be enshrined in law, especially when it targets the most vulnerable and voiceless among us.

2) Teach virtue. Sex is sacred. It has purpose. Sex leads to babies and teens (and adults) must be retaught this. We have bought the lie that only "unprotected sex" leads to babies, which is a whole other post. So, virtue. Chastity. Do not have sex till you can accept the baby that will come with it.

3) Promote intact, two-parent families. The single mothers, the fewer men who take responsibility, the more poverty, the more abortions. Two parent, intact families.

Teach those three things and mean it, and you will have DRASTICALLY reduced the abortion rate.

Oh, and one more thing: Teach science and biology. Make sure we all see lots and lots of ultrasound photos of the unborn, and make sure we all understand that (as you know), science has long ago determined that human life begins when the sperm meets the egg to form a new individual human being.

Yep, that ought to do it! Agreed?

The short answer is yes. We agree! (on some issues). The long answer is, alas, more complicated.

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Defining the issues

Like many movements, the abortion rights movement was based on compassion. Women were being injured by illegal abortions, and organizers wanted to make it safe by taking it out of the alleys. I know this is nothing new and I know that the anti-choice community thinks this is misguided compassion. The only reason I bring this up is to point out the positive intention of the pro-choice movement, which is important.

Ok, so chastity, virtue and two-parent families. Yes, yes and yes (most of the time, assuming no spousal abuse.) Nothing in the abortion rights movement prevents the promotion of these beneficial attributes to personal and social hygiene. I think the case has been made, and continues to be made. To live a virtuous life is uncomplicated and affirming regardless of your belief system.

I suppose we can draw a correlation to Roe v Wade as the beginning of the breakdown of these virtues: If not for Roe, many assume we'd have no abortion, or surely less abortion. But is that what the empiric evidence shows? Was Roe the cause of the breakdown of virtue/chastity? Or was it an effect?

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Making Abortion Legal

Roe was a response to unwanted pregnancy which has always been present, and increasing; women were attempting abortion at a greater rate which was leading to morbidity, pain and cost when those abortions were done wrong. Accurate demographics of botched abortions at the time are nonexistent, but anecdotal accounts are gruesome:

Desperate women used a number of dangerous means to terminate pregnancies. Some sought abortions from back-alley abortionists, with usually humiliating and sometimes deadly results.

Other women tried to induce abortions with homemade means--such as a bleach douche, or inserting sharp instruments into her cervix. This is why the now almost forgotten image of the wire coat hanger became the symbol of the abortion rights movement.

"In Chicago, at Cook Country Hospital, there were about 5,000 women a year coming in with injuries bleeding resulting to illegal abortions, mostly self-induced abortions," Leslie Reagan, the author of When Abortion Was a Crime, said in an interview. "They had an entire ward dedicated to taking care of people in that situation. Those wards pretty much closed up around the country once abortion was legalized."

The goal of the abortion rights movement in the 60's and 70's was to reduce the preventable morbidity associated with abortion. But preventing such morbidity certainly has increased the number of fetuses being aborted, right? We are merely exchanging one pathology for another, no? Well, that's a good question that may not have a clear intuitive answer. Statistics about abortion pre-Roe are difficult to decipher since we cannot know exactly how many abortions were being done surreptitiously, but we can try.

From Guttmacher:

Estimates of the number of illegal abortions in the 1950s and 1960s ranged from 200,000 to 1.2 million per year. One analysis, extrapolating from data from North Carolina, concluded that an estimated 829,000 illegal or self-induced abortions occurred in 1967.

One stark indication of the prevalence of illegal abortion was the death toll. In 1930, abortion was listed as the official cause of death for almost 2,700 women—nearly one-fifth (18%) of maternal deaths recorded in that year. The death toll had declined to just under 1,700 by 1940, and to just over 300 by 1950 (most likely because of the introduction of antibiotics in the 1940s, which permitted more effective treatment of the infections that frequently developed after illegal abortion). By 1965, the number of deaths due to illegal abortion had fallen to just under 200, but illegal abortion still accounted for 17% of all deaths attributed to pregnancy and childbirth that year. And these are just the number that were officially reported; the actual number was likely much higher.

Simple arithmetic: The 829,000 illegal abortions in 1967 before Roe, added to the 2061 legal abortions performed in 1967, would give an abortion ratio (abortions per 1000 live births) of 23.6, compared to an abortion ratio of 23.3 in 1977, four years after Roe. This is in the ballpark of the current rate of abortion, assuming the population growth of the United States. So did Roe cause an increase in abortions? My conclusion, based on this admittedly incomplete data set, is no.

Legalizing abortion has reduced morbidity and mortality in women with unwanted pregnancy, but apparently has not increased the abortion ratio. Cook County Hospital no longer has a ward dedicated to managing complications from abortions gone awry. The abortion ratio peaked at 30 in 1980 and fluctuated in the teens an twenties over the subsequent decades. In the 2000's the ratio has been consistently in the teens; that low rate may be due to incomplete reporting, such as with the increasing use of medical terminations, or better and more available birth control, or social, religious and cultural factors (see below) .

Of course, we can argue that while physical morbidity may have decreased, we have done nothing for the emotional anguish of women aborting fetuses. Even the most strident pro-choice advocate would admit that abortion is not an optimal intervention. Even when done as safely as possible, medical complications can occur. Even when medical complications do not occur, emotional and psychological sequelae, often unquantifiable and unpredictable, may ensue.

At some later date, I can walk through the consequences of making abortion illegal again. Unsurprisingly, mMy conclusion is that most prohibitions probably would not have a material effect on abortion rates, but could increase morbidity in the pregnant woman.

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The Chastity Argument

The concept of chastity has been around for a long time and, as Leila says, it has merit. But if that were the universal understanding, if it's such a great idea, then why doesn't everyone remain chaste? Yeah, this usually brings up the argument about Hollywood, television, the media, absent parents, and the loss of faith in God. If only we could correct these horrors, the First Amendment be damned, we'd have a Renaissance of virginal children growing up into monogamous spouses who stay married forever and have sex only for procreation, and the desire for abortion would be eliminated... just like it was in the good ol' days. I doubt that the good ol' days ever existed, at least for any sustained period of time, and it certainly is not what we see today. Or, alternatively, maybe today is as close we get to the good ol' days?

My grandfather would say to me, "Be good, and if you can't be good, be careful; and if you can't be careful, then name it after me." Then he'd smile, draw on his fat cigar and go back to his crossword puzzle. Message received: our actions have consequences, and as much as I loved my grandfather I did not want to change diapers on his namesake.

With such compelling reasons to avoid unwanted pregnancy, the emotional issues of promiscuity, the potential for disease, why hasn't the whole chastity thing caught on? I don't have one answer, but it likely has to do with a combination of our limbic system, or maybe the lack of fear of the negative consequences, or the endemic disbelief that some omniscient supernatural being is judging our bad behaviors. Even my sainted grandfather, who never missed Sunday Mass, did not appeal to the alleged omniscient Father in heaven to affect my behavior. Or, maybe it has caught on and this is about as chaste as our society will ever be.

No discussion of chastity would be complete without discussing abstinence-only education. Studies (1, 2, 3) have disputed the efficacy of such an approach. And while one recent study has indicated a marginal benefit, the study was flawed since it did expose the participants to non-comprehensive information about contraception, and the benefit was short-lived with 1/3 of abstinence-only participants engaging in sexual activity at the 2-year mark. Abstinence-only is a quantum event: either you do it all the time, or it fails.

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Other issues

I'm blogged out for now,and have other things to do, but certainly Leila's desires for the "promoting two-parent households" (however we could do it?) and science education (including comprehensive sex education?) are valid. Those discussions will need to wait for now. Certainly there are ways to decrease the numbers of abortions, and we should continue to look for consensus on effective ways to reduce the numbers of abortion. What do we do right? What do other nations do right? What works and what doesn't?

Stephen Baldwin brings the stupid

"When you're dealing with serious pro-lifers, there's no grey matter here..."  Okay, I know what he meant, but it's hilarious from a freudian standpoint.  

And speaking of no grey matter... Steve Doocey doesn't disappoint either. Doocey misrepresents the latest Gallup poll on abortion, saying that "There are more that say 'abortion bad' than the alternative."  According to the poll: while the the number who identify as "pro-life" has increased from 44% to 51%, there are still 76% who feel that abortion should be allowed in certain circumstances.  Seventy-six percent !!  

Using moron language like "abortion bad" fits the show.  Yes, abortion is a sub-optimal outcome--nobody would disagree-- but let's be careful about the interpretation of the data.

The video is great:

Abortion: What's the Goal?

A previous president once said that abortion should be safe, legal and rare. While the first two may not be universal goals, the third can be considered the holy grail of both sides of the abortion debate. The goal should be to reduce the numbers of abortions.

Halifax (name withheld on the internet) has opined that Bush will be forgiven by pro-lifers on his “nonchalance” regarding gay marriage and abortion because he has passed the partial birth abortion (PBA) ban and the Unborn Victims of Crime Law. Granted, pro-lifers most likely view these two items as significant, but I will argue contrarily. And I will not argue because I want more third trimester abortions, nor because I feel that crime against pregnant women should go unpunished. I will argue that these two items are poor legislation because they will not reduce the number of abortions, nor will they reduce the crime against pregnant women. The goals are lost amidst emotional rancor that panders to the socially conservative base, and the women and children will be the losers. Solutions are found in a pragmatic, multifaceted approach that would improve quality of life for the most vulnerable members of our society with education and access to health care.

First, a few truisms. Number one, abortion is here is here to stay. Since time immemorial women have attempted to terminate their pregnancies and this trend will continue regardless of any legislation humans might pass. Especially with the advent of pharmacologic agents that have made abortion more private, more safe and more accessible. If outlawed, abortifacient agents—RU486, methotrexate and cytotec-- would still be available on the gray and black markets. The desire for some women to terminate their pregnancy is strong enough that the demand will be met by supply regardless of any attempt to limit it. Even if every other state would outlaw abortion, right or wrong, the surreptitious leakage of these medications across state borders would surely commence.

Number two, fetuses are not children, and under the law, fetuses do not have personhood rights. I am not a lawyer, and this may seem like a technicality, but it’s true nonetheless. In the McCorvey opinion of a few years ago offered by Halifax , the judge refers to a fetus as a "child", which is at best a sloppy use of the legal language of the time, and at worst, an emotional plea that belies her prejudice under the law. The Unborn Victims Law of 2004 attempts to give more value to the fetus, and even calls fetuses "children", the legality of which will most likely be argued in the courts in due time before anybody serves time for “murdering” a fetus. Regardless, such legislation as written will not prevent one abortion, nor will it likely reduce violence against women, which to my knowledge is already illegal. (In 2002, the Bush administration attempted to give personhood rights under executive regulation for the State Children’s Health Program (SCHIP), but of course, overstepped reason by not only trying to define “childhood” as beginning with conception, but did so without legislative support.) Call me cynical, but that’s the way I see it. I’m pretty sure you could see strong support for giving, say, 32 week fetuses certain (albeit very restricted) rights under the law that no legislator would or could oppose, but even then, the impact on protection of fetal life would be negligible since terminations at such an age are exceedingly rare and universally for good reason.

Number three, the partial birth abortion ban is a sham. The term itself is not found in the medical literature. The law as written only prohibits one very specific form of the procedure that is described as delivering a live fetus in breech position and then opening and collapsing the skull for delivery. Apparently, a similar procedure would be legal as long as the fetus is rendered lifeless beforehand by some other means, say, umbilical artery potassium injection (or conceivably, electric shock or purposeful blunt trauma.) This law is just plain stupid, and acts to limit the woman’s and physician’s choices while not materially changing the outcome for the better. The majority of third trimester abortions are for severe fetal anomalies, severe maternal medical disease, or both. Of the 1.3 million abortions in the US every year, those after 21 weeks make up less than 1% . Forcing these women to undergo an invasive umbilical artery catheterization prior to the termination may increase her risk; therefore, those exact women who would most benefit from a late trimester abortion are thus put at greater risk because they cannot undergo the very safest procedure. The federal government, under President Bush, has now attempted to enter the medical decision-making field. (Mr. Bush’s decisions regarding pre-emptively invading countries is bad enough, let’s leave him out of the doctor’s office.) As had been predicted by Clinton, the PBA ban has been found unconstitutional because of the lack of provision for the well-being of the mother. (Stenberg v. Carhart, 2000) So, Halifax, what good is a law if it is innately flawed and found unconstitutional, other than to stir up the pro-lifers in time for election?

Number four, abstinence-only programs are educational malpractice. In a perfect world, all sexual intercourse would occur between consenting adults with adequate social and family support. Such support would necessarily include health insurance, access to prenatal care and contraception, with a lack of threats to one’s personal well-being. Unwanted pregnancies would be avoided by the proper instruction in the use of birth control. Unfortunately, the perfect world doesn’t exist. Teen-agers have sex. They have sex with for a myriad of reasons, under a plethora of circumstances, with an uncountable number of partners. Statistically, the majority of US teens will engage in premarital sexual activity by age 20. Haranguing about celibacy does not change this statistic—90% of those “choosing” abstinence-only will eventually fall to the siren of illicit sex; only now they do so without knowledge of contraception and STD prevention, thus leaving them more vulnerable. According to Planned Parenthood (with multiple supporting references): “When they do become sexually active, though, they often fail to use condoms or other contraceptives. Meanwhile, students in comprehensive sexuality education classes do not engage in sexual activity more often or earlier, but do use contraception and practice safer sex more consistently when they become sexually active.” Without birth control, 85% of sexually active women will become pregnant within a year. Therefore, the public health dictates that sex education and birth control should be available to all people who require it (which is ALL women and men BEFORE they become sexually active.) As long as we as a society deny this fact, we will live in a world of unwanted pregnancy and preventable abortion. Addressing this most vulnerable segment of the population, we can work on the highest proportion of young women who choose abortion, thereby getting the greatest benefit. Not only do we avoid the loss of an unwanted fetus, we save the young woman the anguish of having to face such a heartbreaking decision, which the real lesson of McCorvey has shown can lead to lifelong distress.

The solution: If the goal is to decrease the number of abortions, then common sense would dictate that we should address social factors associated with abortion. According to Alan Guttmacher Institute, of the 1.3 million abortions, almost 90% occur in the first trimester, almost all of which are unwanted pregnancies (see “agi-usa” reference above.) Over half are in young women (under 25 years old) with the largest proportion among 18-19 years old (19%). Regrettably, the US has the highest abortion rate in the developed, western world. As Huf would remind me, causality for any phenomenon, especially abortion, is hard to generalize, but we do see strong associations worldwide; and more importantly, negative associations.

For example, some of the highest rates are in countries where abortion is illegal, namely Latin America, thus showing us that simple prohibitions are not satisfactory; and the lowest rates are in countries with very liberal laws, namely Northern and Western Europe. The strongest associations are that abortion rates are lowest in nations where women are empowered financially, health insurance is guaranteed and government-run quality sex education is either mandatory or strongly recommended in the early teen years.

Even in that minority of instances where women are married prior to first sexual experience, quality sex education and access to healthcare would still be empowering. By linking health insurance to employment or spousal support, women are left vulnerable to the whims of their husband or their employer. This arrangement has the potential effect of decreasing their access to birth control or prenatal care, thus increasing the likelihood that abortion would become a choice for that woman or couple. Furthermore, pro-life groups fight access to morning-after pill which has been implicated in decreasing the number of abortions by tens of thousands per year in the US (see “womanissues” reference above.)

Planned Parenthood has been much maligned by many pro-life activists because they are the largest single provider of pregnancy terminations in the US. The fact that is lost is that PP is also the number one single entity working to prevent abortion—with education and affordable and accessible birth control. In effect, PP is performing the function that public health departments and secondary schools perform in other civilized nations. As a society, we should be ashamed at the abysmal state of our national health that we must rely on a philanthropic organization to be the primary purveyor of such an important and necessary function.

While the Bush administration and pro-life groups dance around the periphery of the abortion debate, and try to appeal to the lowest emotional level, we continue in our national health nightmare. Our president accepts kudos by his misguided political base because he supports worthless laws, such as PBA ban, and ridiculous policies, like abstinence-only education and “life begins at conception.” Meanwhile, American children live in ignorance and deprivation and get pregnant prematurely. Ironically, many of these same adults who gush about the virtues of the PBA ban and abstinence-only education also protest the very things that would likely lead to fewer abortions because of some ideological aversion to big government, or national health, or federal deficits, or whatever. We argue endlessly about allocating a few hundred million dollars to reduce abortion—a yearly budget that would be equal to a couple weeks’ expenditure for our Iraqi occupation. I maintain that for a president, and other leaders, to stoke the flames of controversy with talk of abstinence-only and partial-birth abortion, etc. is to act immorally, and with forethought. Mr. Bush should know better. A true leader would use his Ivy League education to interpret the data, and present the cold hard facts to his loyal constituency. Until he does that, the blood of every preventable abortion is on his hands.