As the laws supporting abortion continue to be challenged, a common objection is raised that abortion ought to be legal when the life of the mother is at risk. So common is this objection that the President, who has been arguably the most pro-life executive ever, says that it is a necessary exception. Like all the other “reasons” for abortion this one too depends upon propaganda and ignorance. Therefore, we need to have a reasoned response ready to refute this seeming “no-brainer.”
Notice first that I said it depends upon propaganda. This is because it is an attempt to circumvent the “exception proves the rule” principle. If this really is an exception, then you must be willing to concede the rule that abortion is otherwise always wrong. The problem is that even if we were willing to make a concession in this situation, abortion supporters really want abortion on demand. It is an attempt to play on compassion while creating a smokescreen that makes abortion legal and right in all cases.
That being said, it is also not an exception to the rule, a point that otherwise preys upon general ignorance. Abortion, that is the direct killing of a pre-born infant, as either a means or an end, is always wrong and admits of no exceptions. This does not mean that in true cases where a mother’s life is in jeopardy that she must simply suck it up and put her affairs in order. Instead, in every case in which a mother’s life might be in jeopardy, there are moral solutions that do not involve an abortion.
This brings up a point that merits further examination before we dive into the specifics. It is certainly common sense but unfortunately is often overlooked, especially in the name of medical expedience. There is always a moral solution to a problem of health. This is not to say that it won’t involve additional suffering, but that these “damned if you do and damned if you don’t” situations always have solutions that are good for the whole person. I say this not to be callous but as a reminder that we should never think we have to do something wrong. It is also meant to be direct challenge to the medical community that they only offer and investigate what would ultimately be moral solutions. If doctors and medical researchers really care about the health of the person then they will care not just about the body, but the soul as well. The first question for medicine should never be “can we” but “should we”?
Early Pregnancy
Looking then more closely at the specific situations in which a mother’s life is truly in jeopardy will underscore all that has been said so far. These threats come most often at the beginning of pregnancy with what are commonly called ectopic pregnancies. As the etymology of the term suggests, ectopic pregnancies occur when the developing person is “out of place” and implants somewhere other than the uterus. This can occur in the abdomen or cervix, but the overwhelming majority of cases occur within the fallopian tube. These pregnancies pose a serious risk to the mother’s life because of hemorrhaging. As an aside, these types of pregnancies are occurring at much greater rates than in the past thanks to scarring from an increase in the incidence of sexual transmitted diseases (most especially PID), IUDs, tubal sterilization and contraceptive pills.
We should mention both that the child will never achieve viability. There have been a few, though very few, cases of successful transfer of the child to the uterus but this is still an important area of research we should be devoting energies (and prayers) towards. Also of note is the fact that up to 2/3 of ectopic pregnancies resolve themselves, requiring no medical intervention. In the remaining cases there are three treatment options.
The first is a chemical solution that uses methotrexate (MTX). MTX directly attacks the outer layer of cells produced by the developing baby that serves as connective tissue to the mother. The child detaches and then is washed out of the tube. Note this has appeal because of it is the least invasive, but also has the most serious side effects. It also does not treat the underlying cause of the ectopic pregnancy, increasing the likelihood that it will happen again.
Although the Church has not spoken definitively upon this issue, most moralists would categorize this as an abortion because it involves the direct killing of the child as a means to saving the mother’s life. An unborn child may die as a result of treatment, but the treatment itself cannot be the killing of the child. The death must be an unintended, although it could be foreseen, side effect of the treatment. That is why one of the surgical options called a salpingostomy is not a moral option either. The doctor makes a small incision in the fallopian tube and removes the child in the hopes of preserving the mother’s fertility. This also amounts to an abortion because it is the direct removal of the child that “saves” the mother.
A third treatment is called salpingectomy. This has been the preferred method of dealing with ectopic pregnancies by faithful Catholic for years. It involves removing the portion of the tube that is at risk of rupturing. Unfortunately, it is the same section that also contains the embryonic human being. Although the baby dies, it is a double effect and not something directly willed. This moral solution probably represents the best physical health option as well because it removes the damaged portion of the fallopian tube. Depending on the amount that is removed (if it is ruptured then a total salpingectomy might be necessary), it does put the mother’s fertility at risk. Therefore, it is not always preferred even though, by removing the problematic portion of the tube, it makes it far less likely that the problem would ever occur again.
This can seem like a very legalistic approach to things considering that the end result—the termination of the pregnancy—is the same in all three of the approaches. But, like all moral decisions, the means we use to achieve the end matter just as much as the end itself. The means we use to do anything must also be good. The mother, even though she has not seen her baby, is still his mother. Knowing that, despite the difficult circumstances, she did right by her child can bring her great solace. But either way, the demand for abortion because of ectopic pregnancy is a red herring.
Later Pregnancy
What about later in the pregnancy? A moment’s reflection also shows that abortion is not needed. If the child is viable, then the mother can be induced or an emergency c-section can be performed. There is absolutely no medical reason why a later-term abortion is necessary. Even when the child is not viable, inducing labor for the sake of saving the mother’s life can be justified even though the child might not survive. Obviously, this requires clinical judgment, but the situations where it happens that the woman’s life is in danger because she is pregnant, and the child is not near viability, are very rare (and some say non-existent). Nevertheless, there is still no need for abortion in these cases either.
Upon closer scrutiny then this so called “hard case” really is not so hard. I say that not because it is an emotionally and psychologically challenging time, but because it offers a clear moral path. The need for abortion when the mother’s life is in jeopardy is not a real need and we need to present the facts as such.