Episode 40

Roe v. Wade, Part 2

Published on: 13th July, 2021

Welcome to Breaking Down Patriarchy! I’m Amy McPhie Allebest. Today is Part 2 of our discussion on the 1973 Supreme Court case Roe vs. Wade. Last time we introduced this landmark document, and we covered about half of the points of the case. And today we will share our thoughts on some of the key points from the second half of the text. And again I’m joined by my reading partner, Lindsay McPhie Hickok. Hi, Lindsay!

Lindsay: Hi, Amy!

Amy: We ended our previous episode with the story of Mehnaz in Pakistan. And after we recorded that episode I was thinking that I would like to share another story, this time about someone I know. This is a story of a very, very dear friend of mine, so I won’t say her name to protect the anonymity of her family. But Lindsay you remember her. 

Lindsay: Yes I do

When I was a new mom with just Baby Lindsay, I had a neighbor who had a baby just Lindsay’s age, and we became friends. We took turns watching each other’s babies so we could exercise and then we would eat lunch together, we kept our own food at each other’s houses because we were together so often. We served in church together, spending hours and hours outside of church in planning meetings and doing service for a congregation that had a lot of needs. We got pregnant with our second babies at the exact same time, so we went through the pregnancies together and then had our babies within a week of each other. We shared a lot of really deep conversations - she had a masters degree in social work and we both loved learning about psychology - she was a really curious person and a deep thinker, and she was also really fun. She was one of the best friends I’ve ever had in my life. Eventually she and her husband moved to a different state so that he could go to law school, and I was devastated that she moved, but we talked on the phone sometimes. We weren’t great about keeping in touch - that was before texting and neither of us were really phone talkers… but she did reach out and said “Hey, I just want you to know I just got diagnosed with melanoma. I’m near one of the best cancer hospitals in the country, but it’s complicated because I’m pregnant so they can’t treat it aggressively.” So she and her husband had to make the choice of what to do. She chose to keep the pregnancy and do a very complicated and difficult balancing act of doing what they could to treat the cancer without hurting the baby. She carried the baby as long as she could, and then when the doctors decided the baby was healthy enough, they delivered the baby by C-section. The plan had been to battle the cancer as soon as the baby was out, but it was too late, and Erin died 6 days after her baby was born, leaving her husband with their two little boys and a newborn in the NICU.


Obviously this is really hard for me to talk about - it’s been almost 14 years and I still can’t say her name without crying - but what I want to say is that my friend was a smart person. My friend was a courageous person. My friend was a moral person and a wise person, and she happened to be a spiritual person too. When I think of her being in that agonizing, excruciating situation, I have two really strong urges: the first is that I want to hug her and tell her she is good and brave and that I love her. And the second very strong urge I have is that I want to clear the room to protect her from anybody who thinks they know what is best for her, and just tell them to go home and keep their opinions to themselves. I know that in this moment of anguish my friend brought in her husband and her family and a team of doctors, and she was a person of faith, so I know she prayed every second of that time while she made the decision… and I don’t think it’s anybody’s right to judge her or tell her what was right for HER LIFE and HER FAMILY. That was nobody’s right but hers. 


And as I’ve read more and more stories of girls and women - and you can go on the website if you want to read some - I have that same urge. I want to hug them and say “you are brave. You are smart. You are wise.” And then ask them “who do you trust to support you while  you make this choice?” And then clear the room of EVERYONE ELSE so that she can think clearly and have every option that she and her doctor think is best.


Lindsay: I think you are brave for sharing that story. I know her death was heartbreaking for you. And that is a really complicated situation that she was in! Weighing maternal against fetal health feels nearly impossible sometimes. My heart aches for the women who have to make these difficult choices.


Me too. And I also want to say that making abortion safe and legal for all women, in all the different complex circumstances they find themselves in, does not mean that a woman ever has to have an abortion. If a woman feels for any reason - religious or otherwise - that she doesn’t want to end her pregnancy, she never has to. That will never be imposed on her. But it also makes sure that her private beliefs won’t be imposed on anyone else either.


Amy: Ok, well let’s start back into Roe vs. Wade. Last time we highlighted some parts of the historical timeline, and we’ll continue that now by talking about the tradition of American law in the 19th Century.

5. Amy

First, the document explains how English common law was adopted by different states differently. He goes into a lot of detail, but the main point is:

It is… apparent that at common law, at the time of the adoption of our Constitution, and throughout the major portion of the 19th century, abortion was viewed with less disfavor than under most American statutes currently in effect. Phrasing it another way, a woman enjoyed a substantially broader right to terminate a pregnancy than she does in most States today. At least with respect to the early stage of pregnancy, and very possibly without such a limitation, the opportunity to make this choice was present in this country well into the 19th century. 

This changed in 1857, when the American Medical Association Committee on Criminal Abortion was formed and they began a campaign against abortion rights. 

Roe vs. Wade cites this campaign as a huge turning point in American attitudes. Here’s a quote:

“In 1871 a long and vivid report was submitted by the Committee on Criminal Abortion. It recommended... among other things, that it "be unlawful and unprofessional for any physician to induce abortion or premature labor, without the concurrent opinion of at least one respectable consulting physician, and then always with a view to the safety of the child— if that be possible," and calling "the attention of the clergy of all denominations to the perverted views of morality entertained by a large class of females—aye, and men also, on this important question."

Several things stand out to me from that quote: First, again I have to point out that the American Medical Association was comprised of all men. And they were marshalling the forces of doctors (who of course were all men at the time) and the clergy (again - 100% men) to make the decision on a matter that takes place 100% inside of women. And then further, they describe the women’s views as “perverted views of morality.” 

And the other two things that I see as being problematic are the phrases: “always with a view to the safety of the child” - not the mother; and

that it "be unlawful and unprofessional for any physician to induce abortion or premature labor!” 

What do you think of those things, Lindsay??

Okay. First off, that statement makes me crazy because it says that a large class of females are perverted. I feel to say “how dare they.” How dare they judge women in this way.

I do want to give a bit of background though. During the time at which that statement was given, doctors practiced what is called medical paternalism. It was believed that only a doctor could properly understand symptoms and draw useful conclusions. During this period, the prevailing consensus was that disease was nothing more than symptoms. This meant that the individual history of the patient didn't matter in providing care, so the patient him or herself was irrelevant in the medical encounter.

This was how all medicine was practiced. So if you cast that light on obstetrics, the woman is rather irrelevant and all that matters is just delivering a baby. It’s all about the safety of the baby. 

I am so glad we know and do better now. Medical paternalism fell out of favor towards the end of the 20th century and doctors now consider the views and experiences of their patients as critical information when they are creating a care plan.

That is so interesting, and reminds me of our episode on “The Yellow Wallpaper.” That story was about a new mother with postpartum depression at the end of the 19th century, and she was not taken seriously at all by her doctor, and that explanation of medical paternalism makes a lot of sense when I remember that story.

 

And speaking of medical paternalism - the word itself of course comes from “pater,” which is latin for “father” and has the same root as “patriarchy,” the American Medical Association Committee on Criminal Abortion, nearly 100 years later in 1967, still thought that they should make the rules. Although maybe some of these rules seem better - Lindsay what do you think? It says there should be no abortion...

“except when there is "documented medical evidence" of a threat to the health or life of the mother, or that the child "may be born with incapacitating physical deformity or mental deficiency," or that a pregnancy "resulting from legally established statutory or forcible rape or incest may constitute a threat to the mental or physical health of the patient," two other physicians "chosen because of their recognized professional competence have examined the patient and have concurred in writing," and the procedure "is performed in a hospital accredited by the Joint Commission on Accreditation of Hospitals." 


Lindsay:  Yes! Good! We are making progress right? Now we are talking about the health and the life of the mother! Though I will say we still have a long way to go, because as you said, in the 1960s, they said that abortion would be allowed if a pregnancy was from legally established rape or incest.  Ugh. Legally establishing rape or incest is nearly impossible. It is estimated that less than 25% of rape is reported and it is less than 10% for incest. Rape kits in many areas are backlogged, victims don't often get medical help (and, thus, evidence) right away, and most don't ever even seek legal help. Allowing women the option of abortion, but then making it hinge on the legal system, is ridiculous. It gives the appearance of options, but in the real world, this doesn't help.


Lindsay

Putting that condition aside, there were many good developments happening in the 1960s and 1970s. With the decline of paternalism, the American Public Health Association adopted rather helpful standards for abortion services - the national recommendations included safe, clean environments, highly trained professionals and counseling for patients. Please note, we are now entering the era of Roe v Wade. So the American Public Health Association was making strides in recognizing that abortions do occur and that women seeking them needed assistance, but this is happening in a national body. State by state, things still varied greatly. Like in Texas, where Roe challenged Wade - abortion was still criminalized.

Amy:

In the next part, the document lists three reasons why laws criminalizing abortion were advanced in the 19th Century. We’ll cover them quickly, but I do want to cover them because they bring up some important issues. 

  1. “It has been argued occasionally that these laws were the product of a Victorian social concern to discourage illicit sexual conduct.”


That can’t still be the case, because the law in Texas didn’t discriminate between unwed and married women. However, I have heard that argument a lot! That if abortion is legal, then people will have sex all the time and it will encourage premarital sex. 

Lindsay: “Yeah, people are not going into a sexual encounter thinking “yes, we’re going conceive, but no biggie - we’ll just get an abortion. People who are going to have sex are going to have sex either way.

Right. There are lots of ways that people are foolish and irresponsible in their sexual lives, like not using birth control, but they’re more likely to think “I’m not going to get pregnant.” Not “I am going to get pregnant and have an abortion.” 

 

  1. A second reason is concerned with abortion as a medical procedure. When most criminal abortion laws were first enacted, the procedure was a hazardous one for the woman.This was particularly true prior to the development of antisepsis. Abortion mortality was high. Even after 1900, and perhaps until as late as the development of antibiotics in the 1940's, standard modern techniques such as dilation and curettage were not nearly so safe as they are today. Thus, it has been argued that a State's real concern in enacting a criminal abortion law was to protect the pregnant woman, that is, to restrain her from submitting to a procedure that placed her life in serious jeopardy.


First of all, I appreciate their concern, but it’s patronizing - as you described Lindsay it’s evidence of that attitude of “medical paternalism” for the all-male “state” to override a woman’s wishes in the supposed notion that they want to protect her. It’s like a parent-child relationship where men are saying to women “we know what is best for you, so this is against the rules,” and she is saying “actually I  am an adult and I know what is best for me, and I’m going to do it anyway. 

The statistics show that throughout time, women have gotten abortions whether or not they are legal.

Back to the document: 

Modern medical techniques have altered this situation. … although not without its risk, [abortion] is now relatively safe. Mortality rates for women undergoing early abortions, where the procedure is legal, appear to be as low as or lower than the rates for normal childbirth. Consequently, any interest of the State in protecting the woman from an inherently hazardous procedure ...has largely disappeared. 

So that means obviously that that paternal reason of protecting women from unsafe abortions by making them illegal was no longer relevant. 

So what we have now is a situation where, because hospitals have antibiotics and trained professionals and sterile equipment, abortion is extremely safe in a medical environment. But it’s extremely unsafe in an unregulated environment. So if the state really wants to protect women’s lives, then it needs to keep abortion legal. 

 Because making abortion illegal does not prevent women from getting abortions, it just endangers the lives of the women. In my research project I read about women in such desperate situations that they performed their own abortions with whatever they could find - poison or sticks and bicycle spokes. Or we have all heard of “back-alley abortions,” performed by local practitioners who have no medical training on sanitation or even anatomy. These practitioners are sometimes called “butchers” - although sometimes they are seeking to help these women in desperate situations, they are sometimes just seeking the profit. And because these procedures take place secretly and illegally, there is no oversight to make sure they are performed in a clean, sterile environment. So many, many women throughout history have died from these procedures.

In fact in parts of the world where abortion is illegal, botched abortions still cause about 8 to 11 percent of all maternal deaths, or about 30,000 each year.  

 

(https://www.theatlantic.com/health/archive/2018/10/how-many-women-die-illegal-abortions/572638/)


 

So here we see that the Supreme Court in 1973 acknowledged that fact. Justice Blackmun writes:

“The State has a legitimate interest in seeing to it that abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient. This interest obviously extends at least to the performing physician and his staff, to the facilities involved, to the availability of after-care, and to adequate provision for any complication or emergency that might arise. The prevalence of high mortality rates at illegal "abortion mills" strengthens, rather than weakens, the State's interest in regulating the conditions under which abortions are performed. 

Yes. I think this is one of the most important facts that I learned during my research project, so I’ll read it again:The prevalence of high mortality rates at illegal "abortion mills" strengthens, rather than weakens, the State's interest in regulating the conditions under which abortions are performed. 

Women will get abortions either way. They always have. All throughout history. Keeping them legal and safe protects women’s lives.

 

So next Roe v. Wade keeps talking about women’s safety, and specifically about the fact that abortion is safest when it’s performed early. It says:

Moreover, the risk to the woman increases as her pregnancy continues. Thus, the State retains a definite interest in protecting the woman's own health and safety when an abortion is proposed at a late stage of pregnancy.

Yes. The risk to a woman definitely increases as pregnancy continues. So let’s talk about late-stage abortions. They are extremely rare, and can usually be avoided if early abortions are legal and easy to procure, and don’t have a ton of hoops to jump through. The more barriers and requirements for permission and waiting periods, the later the abortion takes place.

However there are cases where late stage abortion is needed. There are so many situations women can find themselves in that we can’t anticipate, and I was extremely impacted by a Facebook post that our cousin shared about a year ago. A young woman named Destiny Young posted pictures of herself and her husband doing a big “gender reveal” with a pink puff of smoke to announce that they were having a girl - they looked ecstatic… next to a picture of her husband and her curled up together in a hospital bed. She wrote:

“If you’re mad about the new abortion law in New York please take a minute to read this. You’re probably picturing the horrible women who decide last minute that they in fact don’t want to be mothers and decide to kill their baby instead. I understand why that image makes you angry so please look at these ones instead.

After having 2 miscarriages, I almost died giving birth to my stillborn daughter. She had a genetic problem that was not compatible with life outside of the womb. WE had no idea until she died at 32 weeks. Recovery was hard, I had an emergency c section and lost more than half my blood. We stayed in the hospital for a week, until my levels were okay enough to spend the next 6 weeks at home on bed rest, grieving my daughter.

I’m 15 weeks pregnant now and if we find out that this baby has the same genetic isues as our last then we will be faced with the difficult decision of terminating the pregnancy or again possibly almost dying giving birth to a stillborn baby.

So I just wanted to show you who this law is for. It only allows for late term abortions of babies that are going to die anyway or for pregnancies that might kill the mother.

This law is for the women who have been struggling for years to have a healthy baby, only to find out at the end of their pregnancy that their baby won’t survive, or that if they continue the pregnancy they will probably die. This law will give women a little bit of control of something so horrible happening to them. This law will save lives of women like me.”

This is so powerful, and it strikes me in the same way as the story of my friend. I just want to hug that woman and tell her that’s one of the hardest things I can even imagine. And then I just want everyone to get out of her way while she and her husband cry together and grieve and consult with doctors, and make the decision that they need to make. I just think about that picture of Trump and Pence making decisions and declarations, or the picture of the men in the Vatican… and I just think “what are you even thinking?? Why would you think you have any right to even weigh in on something so personal? You don’t know that woman, and you’re not a doctor. So get out of the way.”

Lindsay:

Yes. We need to support and trust these women. They are the ones dealing with these impossible and personal situations. They know what is going on so much better than any of us watching from the outside.

Backing up, we mentioned two reasons why abortion was criminalized and the third reason is the duty the state has to protect life or potential life.  Obviously the state wants to protect the mother’s life but at what stage are we going to protect POTENTIAL life? Does the state have a vested interest in the potential life of a 7 week fetus? Because it can grow into a life? 

I think it’s a legitimate question to ask, and I think it’s fine for people to ponder it and have their own opinions and beliefs about it, but I find people’s claims of absolute knowledge on this matter, and especially their imposition of law based on their religious beliefs,  to be completely inappropriate in a democracy where we espouse separation of church and state. Again, if your religious belief says you should never have an abortion, then that is absolutely fine. You don’t ever have to have one. But I do have to say when I hear some people who get just incensed about the government getting in their personal business, fully support taking away someone else’s rights about the absolute most personal thing there is, it just doesn’t make sense to me.


---------


Amy:


So the next part talks about the constitution.

[Read this whole next part]

The Constitution does not explicitly mention any right of privacy. In a line of decisions, however, going back perhaps as far as Union Pacific R. Co. v. Botsford, 141 U. S. 250, 251 (1891), the Court has recognized that a right of personal privacy, or a guarantee of certain areas or zones of privacy, does exist under the Constitution. [This understanding of “right to privacy” also influenced the legalization of interracial marriage in Loving vs. Virginia and the use of contraception in Eisenstadt vs. Baird.]


Lindsay: I’m starting to love the Right to Privacy!! I didn’t know it had been the deciding factor in other cases that are so important and wonderful!


I hadn’t known that either! Ok, here is one point where Justice Blackmun says that some arguments for abortion rights do go too far. He says that some dissenting opinions...

... argue that the woman's right is absolute and that she is entitled to terminate her pregnancy at whatever time, in whatever way, and for whatever reason she alone chooses. With this we do not agree. We, therefore, conclude that the right of personal privacy includes the abortion decision, but that this right is not unqualified and must be considered against important state interests in regulation.

I do agree that you can’t make the argument that a person can do with their own body whatever they choose, without regulation. Just like Lucy pointed out in her episode on the UN Declaration of Human Rights, you can do whatever you want with your body as long as it doesn’t hurt someone else. And it is true that abortion does involve another human life, or at least a potential human life. So it’s not a good-faith argument to pretend that that’s not true. Like on the Planned Parenthood website it says that abortion removes “pregnancy tissue.” And I think that’s disingenuous. It’s important to deal with this issue as it actually is, which is a complicated moral and philosophical question.

Lindsay

QUOTE: We need not resolve the difficult question of when life begins. When those trained in the respective disciplines of medicine, philosophy, and theology are unable to arrive at any consensus, the judiciary, at this point in the development of man's knowledge, is not in a position to speculate as to the answer.

 It should be sufficient to note briefly the wide divergence of thinking on this most sensitive and difficult question. There has always been strong support for the view that life does not begin until live birth. This was the belief of the Stoics. It appears to be the predominant, though not the unanimous, attitude of the Jewish faith. 

Yes, this really grabbed my attention! So I did some additional reading and it turns out that The Hebrew Bible does not mention abortion (the New Testament doesn’t either, incidentally), and The Talmud - which is another sacred Jewish text that includes the original oral version of the Torah and then a compendium of Rabbis’ teachings - describes a human being as a “soul” when its head emerges from the mother.

I found an article in US Today that describes  the frustration that some Jewish people feel when Christians refer to the Bible - the sacred book they share - as prohibiting abortion. 

“It makes me apoplectic,” says Danya Ruttenberg, a Chicago-based rabbi who has written about Jews' interpretation of abortion. “Most of the proof texts that they’re bringing in for this are ridiculous. They’re using my sacred text to justify taking away my rights.”

While some Orthodox rabbis have denounced abortion, within Jewish communities there’s considerable support for keeping it legal. Studies from the Pew Research Center show that Jews overwhelmingly (83%) support abortion rights

Debbie Wasserman Schultz is a Jewish Congresswoman from Florida. She says “I have always served and looked at policy through a distinctly Jewish lens. And so for me, when I’m thinking about a woman’s right to make her own reproductive choices, the Jewish tradition that I’ve always been taught holds that existing life should take precedence over potential life, and a woman’s life and her pain should take precedence over a fetus.” 

For Wasserman Schultz, abortion access should be unrestricted, regardless of faith. “I’m not going to tell you that you’re interpreting Scripture incorrectly,” she says. “But don’t prescribe rules for me and my decisions based on your interpretation of your scripture.” 

 

Lindsay: Viability

So powerful. No one wants to be ruled by someone else’s moral compass. I thought it was interesting to hear that idea from the Talmud that life begins when the head emerges from the mother. We have discussed quickening as a possible time when life begins. However, doctors usually focus more on the time at which the child becomes “viable” or able to live outside the mother, albeit with assistance.

Is viability an appropriate cut-off date? It seems logical to me, but the point of viability is getting earlier and earlier. Others propose making the cut-off date the point that a fetus can feel pain. That also makes sense to me and reminds me how sad this whole issue is, and how important it is that girls and women have access to safe, legal abortion so that they can take care of it as early as possible. :( 

Inherent in this whole discussion of abortion and pregnancy, we are looking for a “cut-off date.” Right? A place where we draw a line in the sand and say ok at this point the mother’s life is more important. Or at this point the baby’s potential life is too compelling to allow abortion. I will quote Roe v Wade.

QUOTE: Each [meaning the health concerns of the mother and the health concerns of the fetus] grows in substantiality as the woman approaches term and, at a point during pregnancy, each becomes "compelling."

With respect to the State's important and legitimate interest in the health of the mother, the "compelling" point, in the light of present medical knowledge, is at approximately the end of the first trimester. This is so because of the now-established medical fact... that until the end of the first trimester mortality in abortion may be less than mortality in normal childbirth. It follows that, from and after this point, a State may regulate the abortion procedure to the extent that the regulation reasonably relates to the preservation and protection of maternal health. 

That is preferable. However, to return to the situation of Destiny Young, sometimes women don’t know there are fetal genetic problems until well into the second trimester. 

In areas other than criminal abortion, the law has been reluctant to endorse any theory that life, as we recognize it, begins before live birth or to accord legal rights to the unborn except in narrowly defined situations and except when the rights are contingent upon live birth. ...In a recent development, generally opposed by the commentators, some States permit the parents of a stillborn child to maintain an action for wrongful death because of prenatal injuries. ...In short, the unborn have never been recognized in the law as persons in the whole sense. [In other words, considering fetuses as “people” easily goes too far. I have read cases of states pressing charges against mothers who miscarry because they consider the fetus a person]

(NYT “When PRosecutors jail a mother for miscarriage)

Woah. I see where that comes from ...the idea that if we are saying that a fetus is a person, and purposefully ending its life in an abortion is murder, than it would perhaps follow that accidentally ending its life would be manslaughter.  BUT THIS IS HORRIBLE

I have had many experiences caring for mothers who have lost their babies in utero. I think every single time, the patient has asked me if there is something they did wrong. I will never forget one particular patient. She came to the hospital because she couldn’t feel her baby moving. We did an ultrasound and confirmed that her baby had, in fact, died. One of her first questions was “what did I do wrong? Her eyes widened as she said “oh no! Could it have been that the movie I went to last night was too loud? I knew I should have left.”  I tried to assure her that a loud movie would not cause a heart to stop beating. But she wanted answers - a reason why this had happened. Patients experiencing fetal loss already feel an incredible degree of self doubt and misplaced guilt. The worst thing in the world would be to make them feel like they had committed a crime.

I am so glad that, in Roe vs Wade, the justices determined that the state did not have the right to override maternal rights and that they must attend to protecting the woman as well as the unborn. So placing the unborn child’s life above the mother’s is not appropriate.

Amy:

One last quote before we wrap up is demonstrated by this quote:

“the attending physician, in consultation with his patient, is free to determine, without regulation by the State, that, in his medical judgment, the patient's pregnancy should be terminated. If that decision is reached, the judgment may be effectuated by an abortion free of interference by the State.”

Here I have to point out that all the possessive pronouns are male. The doctors are assumed to be male - and in the 1970’s they mostly were. And keep that in mind as I read this next quote too, which is part of the Roe vs. Wade decision:

The abortion decision in all its aspects is inherently, and primarily, a medical decision, and basic responsibility for it must rest with the physician. 

I think that the abortion decision should be supported by physicians and that abortions should be performed in medical facilities under the care of physicians, but in my view, the abortion decision in all its aspects is inherently, and primarily, a pregnant woman’s decision, and basic responsibility for it must rest with the woman.

 

Amy: So that wraps up our discussion today. We usually end by sharing a takeaway or two, and so if it’s ok I’ll share one of my thoughts and then ask you to share a key point or two.

One of the most surprising features of Roe vs. Wade for me was the tone of gravity and of sensitivity, and the acknowledgement that any time there is a woman saying “I need an abortion,” it is because of a very sad circumstance in her life. As I said at the beginning of our last episode, both men nor women, on every part of the political spectrum agree that abortion is not a happy thing for anyone, so what can we do to decrease the number of abortions?

As I mentioned, I did extensive research on abortion data, and here are the facts, as cited by the Guttmacher Institute:

  •  Abortion is sought and needed even in settings where it is restricted—that is, in countries where it is prohibited altogether or is allowed only to save the women’s life.
  • Unintended pregnancy rates are highest in countries that restrict abortion access and lowest in countries where abortion is broadly legal.
  • As a result, abortion rates are similar in countries where abortion is restricted and those where the procedure is broadly legal 
  • In analyses that exclude China and India, whose large populations skew the data, the abortion rate is actually higher in countries that restrict abortion access than in those that do not.
  • In countries that restrict abortion, the percentage of unintended pregnancies ending in abortion has increased during the past 30 years, from 36% in 1990–1994 to 50% in 2015–2019.

So in summary, abortion rates are lower in countries where it is legal, and higher in countries where it is illegal. This is of course correlated also with an overall approach to reproduction: The Netherlands, for example, enjoys one of the lowest rates of unwanted pregnancy in the world, and one of the lowest abortion rates in the world. And in The Netherlands they teach their children about sex in preschool, and they have displays on sex in their children’s museums, they talk about sex openly, and their population has access to cheap, effective birth control, which both men and women use, because men feel equally responsible in the process. And there are all kinds of positive outcomes associated with that comprehensive approach: In a 2018 article in the Atlantic called “How the Dutch Do Sex Ed,” author Bonnie Rough reports:

On average, Dutch and American teenagers have sex for the first time around the same age—between 17 and 18—but with dramatically different results. ...American teenagers still give birth at five times the rate of their Dutch peers, who also have fewer abortions. In the United States, people under 25 make up half of all new STI cases each year, while young people in the Netherlands account for 10 percent of new cases in the country. Socially, sex is different, too: Sexually active young people in Holland sleep around less, communicate more often with their partners about their likes and dislikes, and report higher rates of sexual satisfaction.” 

And if you’ve read Peggy Orensein’s book Girls and Sex, you know that that communication and sexual satisfaction is a whole other huge problem for American girls.

https://www.guttmacher.org/report/abortion-worldwide-2017

https://www.theatlantic.com/family/archive/2018/08/the-benefits-of-starting-sex-ed-at-age-4/568225/

So my takeaway is: reducing unwanted pregnancy is a goal that everyone can get behind. We know how to do it, so I think we should look at the data and do what works. And that means education, contraception, and access to safe, legal abortion.

Lindsay, what would you say is a main takeaway for you, or something you want to leave our listeners with?

Lindsay: Well, I agree with what you’ve stated. If we can increase sex education, preventative health care, and access to contraception, we can decrease the number of unwanted pregnancies. However, if a woman finds herself pregnant and she feels the need to terminate that pregancy, the best thing we can do is to offer compassion and support and trust.

I say trust, because I believe women are capable of making wise and courageous decisions. I know a women who had an abortion because she was a teenager and she knew she did not have the strength or wisdom to raise a child. Her abortion was driven by a desire to provide children with capable, prepared parents. 

I know a woman who was raped and chose not to have an abortion. She continued the pregnancy, but could not relate to the fetus as a human child. For her own mental health, she chose to treat the fetus as a growth - a tumor to be excised after 40 weeks. When delivery time came, we treated her like a surgical patient only. That was what she needed and it was a brave and wise choice. She had four other children and she knew what was best for her and her family.


I have helped countless women deliver babies that have passed away in utero. I can’t even begin to explain the grief that I have witnessed in these women. But I have seen the most inspiring strength and wisdom in them as well. Whether pregnancies end accidentally or whether a woman has to choose to end it purposefully, the loss is acute and the pain is immense. We need to have compassion and we need to trust these wonderful, brave women.


I guess my main take away from all of this, is that there are as many circumstances in pregnancy  as there are women in this world. And there is absolutely no way we or any other governing body can know what is best for them. But you know who can know what is best? Each woman individually.  If we allow each woman to choose, and we trust that woman is making her choice based on her values and experience and wisdom and heart, we will be putting power back in the hands of the ones who know best.


Lindsay, thank you so, so, very much for reading with me, and for your incredibly insightful comments and for sharing the wisdom that comes from your personal experiences. Thank you so much!


Lindsay: This is such an important and tender topic. I learned so much reading and discussing this with you.  Thank you so much for having me!



Amy: On our next episode of Breaking Down Patriarchy, we will discuss the book, This Bridge Called My Back: Writings By Radical Women of Color, by Cherrie Moraga and Gloria Anzaldua. This is an anthology of women’s work that was published in 1981, and it centers on the experiences of women of color, emphasizing the points of what we now call intersectionality within women’s multiple identities. This book made a huge impact on the field of women’s studies when it came out, and it’s required reading in many Women’s Studies curricula. As I’ve said before, one of my goals in doing this project is to bring these texts and these ideas out of academia and get them circulating more widely among men and women who are never going to have a chance to take a Women’s studies course. I personally found my mind and my heart to be hugely expanded by reading it - it was a gift for me to be able to get inside the thoughts and hopes and worries of so many women who were different from me. So I highly, highly recommend it, especially for listeners who want to expand their understanding and their empathy. So join us for a very enriching discussion of This Bridge Called My Back: Writings By Radical Women of Color, next time on Breaking Down Patriarchy.


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About the Podcast

Breaking Down Patriarchy
An Essential Texts Book Club
Breaking Down Patriarchy is a podcast for everyone! Learn about the creation of patriarchy and those who have challenged it as you listen to bookclub-style discussions of essential historical texts. Gain life-changing epiphanies and practical takeaways through these smart, relatable conversations.

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Amy Allebest

I grew up in Colorado as the oldest of 5 children, reading, writing, drawing, singing, and practicing the piano and violin. I attended Brigham Young University, where I met Erik Allebest during my first week of freshman year, studied abroad in Israel, lived in Chile for a year and a half as a missionary, and married Erik all before graduating with a degree in English. Erik and I moved around - to Colorado, Southern California, Utah, Spain, and Northern California - while Erik started and ran chess businesses for a living (primarily chess.com) and I stayed home to raise our four children. Those four kids have become brilliant, hilarious people and are our very best friends. I am a long-time trail runner, a recent CrossFitter, a lifelong reader and writer, and an almost-graduate of Stanford University's Master's of Liberal Arts program.