When abortion was legalized in January 1973, the “facts of life” seemed to change. Over the next 49 years, more than 63 million lives have been lost, with almost quadruple that now deprived of life from the multi-generational effect of the decision. While our society fights over whose lives matters more, Christians should desire to affirm that ALL life matters to God, especially those that can’t speak for themselves. Life in all stages matters, is perfectly and wonderfully made, and is planned according to His good purpose.
If we are to sufficiently prepare ourselves for defending truth, we must first, we must agree on what we truth we are debating. Abortions rights advocates cite three primary reasons to bolster their argument: 1) the embryo or fetus is a “clump of cells” and not a life, therefore making the abortion decision a private medical matter in line with other medical disorders and not considered a murder; 2) abortion is needed to save the mother’s life, and 3) having a child will somehow permanently alter the life of the mother in such a profound way as to make abortion justifiable. While there are other arguments in the debate, understanding the truth surrounding these arguments is critical to our ability to give loving answers for the hope we have (1 Peter 3:15).
When Roe was passed, its primary legal power was in the determination of viability. Before Roe, several other landmark cases decided that the viable fetus had rights and was protected from harm. The Roe decision established that abortion was legal until viability– defined as the limit below which a medical professional would not be able to safely assume a delivered infant would survive, with or without life support. Our current advances allow for survivability as early as 23 weeks gestation. Many states have passed new laws that allow abortion beyond viability, while others have prohibited abortion earlier than viability. Mississippi is one of those states, passing a law banning abortion after 15 weeks gestation. This Mississippi law is what was brought before the Supreme Court in January of this year and is the basis for the current controversy.
What is clear is that courts are not good at deciding when a baby is alive. In fact, medical organizations have been woefully silent on this topic over the years. Therefore, the question of life must be addressed. Simply stated, life is any state of organic matter that has the capacity for growth, reproduction, and response to stimuli. No scientist can argue with this definition. As we consider life in the womb, let’s ascertain a few other facts. A baby is called an embryo until the 8th week of life. Confusingly, this corresponds to the 10th week of pregnancy, because conception generally occurs two weeks after a menstrual cycle begins, and pregnancies are most often dated according to the last cycle. At 8 weeks of life, all organs are already present and the rest of the gestation is spent in growth. At this point, an embryo becomes a fetus.
What begins as one fertilized cell becomes 16 after 3 days. Thereafter, doubling of cellular division and growth occurs every 24 hours, to over a billion cells by five weeks. At 5 weeks and 5 days, the heart begins to beat. By 8 weeks, nearly all fetuses can move, all organs (even reproductive tract) are present, and by 10-11 weeks most will already respond to stimuli. At the latest, by 11 weeks of life, every fetus can grow, has the capacity for reproduction, and has the capacity to respond to external stimulation. But all the information for all of that to occur is already encoded in the single fertilized egg, so by definition, a fertilized egg has the capacity for growth, reproduction, and response to stimuli, and therefore, has life!
Some in the pro-choice crowd will claim, even if the above is accepted, a fetus at 20, 25 or even 30 weeks cannot exist on his or her own, and that the requirement for intensive life support is grounds to claim absence of life. An easy response to this argument is to counter that a healthy 40 week baby at one hour of life cannot exist on his or her own, but we surely wouldn’t assert that the healthy baby is not alive. An adult in a coma cannot live on his or her own, but would we state he or she is already dead? What would we say about a 90-year-old grandmother in the nursing home, who requires at least daily assistance to function?
In addition to the life debate, we must also attack the idea that abortion is sometimes needed to save life. In the medical literature, only four real diagnoses exist that are truly life saving emergencies for the mother. Three of them are exceedingly rare, the fourth is not considered normal pregnancy. The only reason to perform an emergent abortion or previable delivery is for acute prevention/treatment for cardiovascular collapse. Only three disorders meet this criteria: amniotic fluid embolism, acute heart failure from stroke or heart attack, and previable severe preeclampsia. None of these disorders occur more often than 1:25,000 live births, none of them occur in the first trimester, and none have been reported spontaneously prior to viability except severe preeclampsia (earliest reported case at 17 weeks). The only one that can occur in the first trimester is ectopic pregnancy, and, as previously stated, is not considered normal viable pregnancy. While there have been case reports of survival of babies in ectopic pregnancies to viability, the vast majority sadly have to be removed in order to prevent maternal bleeding complications. However, the risk of death in ectopic pregnancy is 0.5 per 1000 live births, coincidentally the same as abortion.
The take home points here are several. First, there are NO recognized medical reasons for first and early second trimester abortion. The only window for a medically justifiable reason prior to viability is between 17 and 23 weeks, and this is with severe preeclampsia, a rare diagnosis that only occurs once every 25,000 pregnancies in that gestational age range.
Second, abortion advocates state that abortion fatality is substantially lower than pregnancy. While this assertion is backed with statistics showing a 0.05% death rate from abortion versus a 0.17% death rate from pregnancy, the argument is misleading. Ninety seven percent of all abortions are in the first trimester. As we just learned, there are no recognizable diagnoses that increase death risk in the first trimester. Those who appeal to this “fact” are comparing abortions during the first 13 weeks of life to 40 weeks of pregnancy. It is not a true comparison. Remember, the only disorder that increases death risk in the first trimester is ectopic pregnancy. The simple, inconvenient truth is that the death rate in the first trimester of normal pregnancy is actually lower than abortion in the first trimester of normal pregnancy. Beyond the first trimester, abortion-minded mothers have the same gestational age-related risks as those mothers intent on carrying pregnancy.
The last primary argument made by the pro-choice crowd is that the decision saves the mother from a life of poverty as a result of a carried pregnancy, and avoids dooming the baby to a potential worse outcome. While the facts surrounding this argument are certainly more nuanced and philosophical, I think we can easily see through the smokescreen. I propose we simply look at history. For every mother who commits an abortion, studies say there are 5 or 6 who consider it. Let’s think about the decisions those mothers made to keep their babies. To formulate the argument as fact, we would have to see that most single mothers who keep their baby live in poverty thereafter. The facts do not support this and neither does human nature. While children are expensive, and a large minority of single mothers do live below the poverty line (23%) this is certainly not the majority, and it likely not because they had a child. The reasons are multifactorial, but the vast majority of single mothers in poverty are multigenerational. The data, however, do suggest the majority have success overcoming poverty. Interestingly, when asked if they would have rather had an abortion than have a 10-year-old son or daughter, nearly 100% will say they do not regret their decision. In fact, in my practice, every single mother that I ever asked was glad of their decision to keep their baby. Conversely, of the women who’ve had abortions, every single woman I’ve ever asked admitted to regret.
The abortion debate will continue long after the Supreme Court releases its upcoming decision. However, that does not mean we should be apathetic to fight for life, or hesitant to actively engage. The bible tells us to be ready to defend our faith, that the Holy Spirit will teach us what to say in defense (Luke 12:11,12) and to preach good news, proclaim liberty, heal the sick, release the oppressed, and proclaim the year of the Lord’s favor (Luke 4:18,19)
My hope is that love wins. We may know from reading our bible to the end that persecution is only going to worsen. Love can still win. As we love life and the sanctity of life, let us also love those who don’t share our views. As we show grace and mercy in our words and present truth in genuine, peaceful, and comforting ways, love will always win.
Michael Carozza, MD