Let’s get something straight, shall we?

In the wake of Dr. George Tiller’s murder in Kansas, I’ve been in some conversations, read other blogs without joining in, and was apprised of conversations other people had had, that discussed the nature of the abortions he performed. One man said that “6,000 women will die every year” because Tiller won’t be able to perform “life-saving abortions” on them. Many other people apparently think that most if not all of post-viability and/or third-trimester abortions Tiller performed were to save the life of the mother. This is not true.

Here is the link to the Kansas Department of Health and Environment’s abortion reports, from 1998-2008. I’ve only looked at a few of them, and as far as I know they don’t mention Tiller by name, but I believe he was the only person in Kansas who regularly performed abortions after fetal viability. The Data Summaries appear to be pretty standard, and starting around page 10 have tables showing abortions performed at 22 weeks or more — where the women were from (Kansas or another state), before or after fetal viability, the reason for the abortion, etc. I looked at the 2001 document (just picked that one at random) and was surprised at several things, which may be of interest to you, regardless of where you fall on the pro-choice/pro-life spectrum.

Let me insert here, that it is a “spectrum”, as polarizing as this debate can get. Few people who call themselves “pro-choice” will literally agree that women should have the right to have an abortion at 39 weeks 6 days for any reason; and few people who call themselves “pro-life” believe that there should be no abortion ever, not even to save the life of the mother in the case of a pre-viable fetus. (I have read a few comments or seen a few polls that way, which is either not consistent with a pro-life stance [sacrificing two lives when one could be saved], or they define “abortion” in such a way that they don’t consider that removing a tubal pregnancy is an actual abortion, because the purpose of the surgery is not to kill the baby, but rather to save the mother’s life, and the death of the baby is an unfortunate and unavoidable end result of saving the mother’s life, since the baby is pre-viable.) Most people are in-between, with lots of shades of variation.

So, there is a wide spectrum, but the abortions I think of when I think of Dr. Tiller are the post-viability and/or third-trimester abortions.  “Viability” is the point after which the fetus could live outside the mother’s womb, and this varies depending on the technology of the country and the particular hospital. In America, it’s generally agreed to be about 24 weeks, which is when 50% of all babies survive, albeit with many babies suffering from defects (including things like cerebral palsy, blindness, mental retardation, etc.) due to being born too soon. [Those of you who work with L&D or the NICU or know first-hand statistics can fill in some of the gaps, or correct any mistakes.] The rate of survival goes up and the risk of defects goes down the longer the baby stays in, so delaying birth if possible is always a good thing from that standpoint; and by the beginning of the third trimester, the baby has a good hope of survival with much lower risk of long-term negative side effects. Obviously, the likelihood the baby will survive if born prior to 24 weeks is low, but the youngest surviving baby I’ve heard of is Amillia Taylor, who was born at 21 weeks 6 days of gestation; she turned two last fall, and is starting to walk and talk. Considering that she had less than half the typical womb-time of most babies, this is miraculous; and adding in the nearly 5 months she ought to have gotten before being born, she would be about 18-19 months old, so not even totally off the developmental charts for a baby born at a normal gestational age.

So, back to the 2001 report, dealing with abortions at 22 weeks or greater (on the edge of viability, or beyond) — 1) 585 abortions were performed on out-of-state women, with only 50 done on Kansas women. 2) 385 post-viability women were from out of state. This makes me wonder just how dangerous the woman’s condition was that she could go off to another state for health care, rather than going to her nearest hospital. To those of you who work L&D and particularly antepartum, trying to keep pregnant women safe and alive who are suffering certain health complications — does it sound even remotely safe for you to pack up these women and transport them from all over the country to Kansas for an out-patient procedure, under the “medical care” of the woman’s family or friends? I’ve read numerous blog posts from you, in which you detail working with patients on magnesium drips — how you have to watch them carefully, taking reflexes every hour, among other things, to make sure that they are being treated properly. Does it sound right to you to send off sick women for an out-patient procedure without medical care? Or does it give you the heebie-jeebies? 3) There were no abortions performed to save the woman’s life; all post-viability abortions were done to “prevent substantial and irreversible impairment of a major bodily function” should the pregnancy continue. In fact, I just looked at all the data summaries, and not one case was done to save the woman’s life. But in many cases, these babies are viable, meaning they have a reasonable chance of living outside the womb, if they were allowed to be born alive by induction or C-section, if the pregnancy did indeed need to be terminated for maternal health reasons. (Since there is no break-down of abortion data, we can’t say from here how many abortions were down at 24 weeks, and how many were done at 30 weeks [when there is at least a 90% viability rate, with a low rate of long-term complications due to prematurity] or beyond. 4) There were no “emergency” abortions — which is a good thing, because the abortion procedure Tiller employed took 3 days to complete, usually starting with an injection of digoxin into the baby’s heart to stop it from beating and thus kill him or her, and inserting laminaria into the woman’s cervix to slowly dilate it, before administering some drug (perhaps Cytotec) to induce labor and the woman would give birth to the dead baby. This blog goes more in depth into the data summaries, adding up all the reasons of all the years.

All pregnancies are terminated at some point. The majority of them end somewhere between 37-42 weeks with the birth of a live baby, either by C-section or vaginal birth. There is no doubt that some pregnancies should be terminated early, but whether this ends in the birth of a dead or live baby is where the point of contention lies. What is the reason to ensure that the baby will not be born alive (which is the point of a post-viability abortion, and the only difference between an abortion and a preterm induction)? Except for having limited medical attention over the course of the dilation, and giving the baby a lethal injection prior to birth, Tiller’s procedure is basically an induction — the mother gives birth vaginally to the baby at whatever stage of gestation she is, whether 22, 24, 27, 30, or 36 weeks. If she can give birth vaginally to the baby at that stage (which she obviously can without damaging her “health” or “major bodily function”… since that is exactly what she did), why kill it first?

I will also take another side-track to define “health” and “major bodily function” the way either the United States or the Kansas Supreme Courts do, and that is to include “mental health” as a “major bodily function” and “finances” as an aspect of her “health.” Of course, most people who use the terms “major bodily function” and “health” do not think that finances are an aspect of health, nor that “mental health” is a “major bodily function.” I have to tread lightly here, because I don’t want to seem like a jerk about mental health. I’m not; but I have a major problem with the way the courts have defined it, and more importantly with the way elective abortions have been shoehorned through that loophole. If you want an actual psychiatrist’s take on Tiller’s “diagnoses” of these women, click here to watch an interview with Dr. McHugh, who reviewed the redacted medical records and noted a paucity of actual clinical diagnostic information, and said, “he had mostly social reasons for thinking that the late term abortions were suitable. That the children … would not thrive. That the woman would have her future re-directed. That they wouldn’t get a good education after they had a child. That they would be always guilty in some way about having that child. That they had been abused already and that this — to have the baby would be another form of abuse. These … are not psychiatric ideas… These were social ideas. …. There was nothing to back these things up in a substantial way.”

In response to one hard-headed abortion advocate I was discussing this issue with, I emailed a group of pro-life Maternal-Fetal Medicine specialists with the following letter:

I’m currently in the middle of a debate on a pro-life blog with an abortion proponent who is insisting that the sort of late-term abortions the late Dr. Tiller did were medically justifiable, although he can come up with no such medical reason, and a L&D nurse I know said she could think of none — saying if the mother’s life or health is in danger, they induce or C-section the mom, thus saving both. I’ve asked if he could give evidence of any OB doing what Tiller did (i.e., kill a baby who could be born alive, particularly leave a woman who supposedly needed an abortion to preserve her life or health in a hotel for 3 days with her friends), rather than at least keep the mom in a hospital. He claims that Tiller’s way must be okay since, “you can’t point to even a single case of his way being condemned by any authority.” So, I guess I’m asking for authoritative voices who have condemned Tiller’s method of terminating the pregnancy in such a way as to kill the baby, rather than preserve his or her life. If you could particularly point me towards sources that authoritatively declare that the proper way to end a pregnancy if a woman’s life or health is on the line does not include out-patient procedures, nor injecting digoxin into the fetal heart, but in trying to preserve both mother and baby.

To which they responded:

Kathy,

1)       Dr. George Tiller was a family practice doctor. He had NO training in high risk pregnancies, fetal or maternal problems.

2)       There is no need after 23-24 weeks to ever perform an abortion in the way that Dr. Tiller did, to save or protect maternal life or health in any way. If life or health is threatened all trained obstetricians and maternal-fetal medicine physicians can and would simply deliver the baby and place the baby in a neonatal intensive care unit. It happens every day, many times, all over the United States .

3)       Sometimes before 23-24 weeks (rarely) a pregnancy has to be delivered because the mother’s life is clearly in danger. In this case, the labor can be induced, the baby delivered and the baby will not survive because of the early gestational age, but this can be done without intent of killing the baby.

4)       The only reason abortions were done by Dr. Tiller was because the mother did not want a LIVING baby born. He induced their labor and delivered the baby, almost always killing the baby first, before inducing the labor, to achieve the real purpose for which woman came to him: they did not want to deliver a living baby.

5)       If a mother’s life or health was really at risk from her pregnancy it would at least border on malpractice, if not be frank malpractice, for a family practice doctor without any special training in high risk obstetrics to induce the labor in such a woman in the outpatient setting. This alone should make it clear to anyone familiar with medical practice that none of the abortions he did were MEDICALLY necessary, at least not with the need to kill the baby before delivery.

You won’t find any “authoritative” voice that will say exactly what you are looking for. It would be like looking for an authoritative source that says if you jump out of an airplane and want to survive you need a parachute. In other words, it is so obvious, and there is no other way it is normally done, that you don’t need an authoritative source to state this in so many words. Any one in medicine who works in obstetrics would have to admit this.

On the other hand, every single text book on obstetrics or maternal-fetal medicine can be scoured and you will not find any description stating that killing a fetus before delivery is necessary to save the life or health of the mother, in any circumstance. This should be evidence enough. . …

Nathan Hoeldtke, MD for the Pro-Life Maternal-Fetal Medicine Group.

For those of you who may still have reservations, thinking there must be some reason for late abortions to be necessary sometimes to save a woman’s life or health, or that ACOG would have some position statement either endorsing or censuring it, let me direct your attention to something. The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) wrote a brief one-paragraph statement about how ACOG arrived at its stance on partial-birth abortion (which is not precisely what was under consideration in the majority of this post — PBA was outlawed in Kansas at some time during Tiller’s career, so he switched from that to digoxin-induction as his method of abortion; but I think it has bearing on the topic). Basically, a select panel met to formulate a policy statement, came to the conclusion that there were no circumstances in which PBA was necessary to save the life or health of the woman… and then the ACOG board unilaterally added the statement that it “may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman. . .” The AAPLOG response to the actual ACOG position statement is here, in which they blast the leadership for issuing such a position without any evidence, saying it “lacks scientific credibility.” If you’re surprised that ACOG would take such a position without evidence… remember their stance on elective C-sections, as well as on home birth.

So if you’re in a conversation about late-term abortion and somebody says that they’re necessary to save a woman’s life or health, or that Dr. Tiller in particular saved women’s lives by performing late-term abortions nobody else would do, ask them, “Where’s the evidence for that?”

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14 Responses

  1. Thank you so much for this information. It is very helpful.

  2. Hi Kathy
    There has been quite a bit written lately about the condition of babies that would lead their mothers to want to spare them the pain of living. These are the women who are sent to Dr Tiller.
    This resonated with me “To those of you who work L&D and particularly antepartum, trying to keep pregnant women safe and alive who are suffering certain health complications — does it sound even remotely safe for you to pack up these women and transport them from all over the country to Kansas for an out-patient procedure, under the “medical care” of the woman’s family or friends?”

  3. I’ve been reading your blog because I’m pregnant and interested in natural birth, and have ignored a few sidebars into prolife territory. We’re all entitled to our opinions.

    But this post means that I’m going to unsubscribe your blog from my reader.

    I hope that you’ll click on the link below and read someone’s first-person memories of Dr. Tiller: he and his wife had a pregnancy terminated at 21 weeks because their fetus had a life-incompatible defect, and they weren’t able to obtain a legal abortion in their home state. This couple had to spend hours in a car to end a pregnancy that had no other outcome but giving birth to a dying baby.

    http://www.metafilter.com/82070/Pro-Life-does-not-mean-what-you-think-it-does#2585686

    You need to educate yourself more on why people might seek to terminate a much-desired pregnancy. A dear friend of mine recently terminated a longed-for pregnancy at 24 weeks for medical reasons that, like the couple above, boiled down to the fact that she could either terminate or give birth to a baby who would die horribly within hours of birth.

    Who are you to condemn the choices of these loving parents and niggle over what “health of the mother” means?

    Maybe you never faced these choices. Lucky you. But luck isn’t the same as being better or more morally upstanding. It’s just luck. I, too, hope to be lucky. I hope never to face these choices. But I’m not going to sit in judgment on the poor folks who aren’t quite so fortunate.

    • Valerie,

      I’m glad you enjoyed my blog and am sorry you no longer wish to read. The thrust of the blog post was on disproving the notion that the abortions Dr. Tiller performed saved the lives of any woman. I understand that there are reasons why some women think they must or ought to have an abortion — I have read numerous stories such as you linked to, of women who have been faced with a poor or difficult prenatal diagnosis and chosen an abortion. Sometimes they felt like they had no choice; sometimes they made the choice because they thought it was best for the child; sometimes they made the choice because they felt like they couldn’t bear to be pregnant any longer, just waiting for the baby to be stillborn or live only a short time. That is a different discussion.

      In one of the links I provided, to a video of the psychiatrist who was called in to judge the records, he said, “There was no clear work of — in those records that would be construed of capable of giving you a full picture of the mental condition of these women. They highlighted certain kinds of things that …. were sometimes of a most trivial sort, from saying that ‘I won’t be able to go to concerts’ or ‘I won’t be able to take part in sports'” … This is not a — None of them represented a full psychiatric history.” These are not women getting abortions because they feel like they cannot bear to have their child be born to suffer, nor bear to continue the pregnancy only to have it end in stillbirth. Nor do I think them the only type of late-term abortions Tiller performed; but I highlighted those because well-meaning people might say, “Ok, so these abortions weren’t done to save the mother’s life, but they preserved her health…” and that’s not exactly the case. Perhaps some women may have fallen into the category of feeling like they would do better or be better if they had an abortion and “got over with the inevitable” if their child was told s/he would have anencephaly or some other fatal anomaly, but Tiller estimated that only 8% of the abortions he performed were due to fetal defect (which also might range from lethal diagnoses to mild or moderate defects of some sort, such as cleft lip), so they were still the minority, even if it could be shown that abortion for fetal defects were a valid reason for an abortion.

      So, I do not directly condemn women in the post for choosing an abortion for fetal abnormality, because from what I’ve read, these were not the typical post-viability abortions Tiller performed, and they certainly were not those that were under consideration in the medical records the psychiatrist reviewed. Also, for the most part, the Kansas abortion records show a paucity of fetal reasons given for the abortion — out of 5000+ mid- or late-term abortions, only 15 had an actual fetal diagnosis given as a reason that the baby wasn’t viable, although 37% just had a generic “doctor’s professional judgment” that the baby wasn’t viable.

      Onto a more general discussion of abortion for fetal defects… This BMJ study noted that 1/200 fetuses aborted due to information gotten from an ultrasound were found to be normal or had much milder defects than the u/s appeared to show; and in this study4 out of 343 aborted fetuses were found not to have the pre-abortion diagnosis. The possibility of aborting a healthy baby bothers me, even if abortion for fetal abnormality is considered preferable.

      There are numerous studies which demonstrate that termination of pregnancy due to fetal abnormality has higher rates of negative outcomes for the parents than does carrying to term, even if it results in stillbirth or neonatal death. “it is possible that termination of pregnancy is more psychopathogenic than other forms of fetal loss“; “The counselor responsible for helping the family through its grieving stage, found that the mother was managing well and was more emotionally stable than the majority of women who underwent termination on genetic grounds“; “We saw him. If I had had a termination we would have had nothing to remember. And I would always have wondered if the scans were wrong. I would have had that termination on my conscience for the rest of my life” (case 4). “I’d 99.9% accepted that the baby wasn’t going to live. I was always holding out a little hope. But if the pregnancy had been terminated I would have had guilt. Now I feel no guilt or remorse” (case 5)”; “The parents in this case emphasised that they did not have objections in principle to termination and supported others’ right to choose that path. For them, it was a question of giving their baby a chance of surviving, however slim, and of being able to live with themselves in the years to come. They have not regretted their decision to go ahead” (be sure to read the Rapid Responses for this case as well); The results indicate that termination of pregnancy is to be seen as an emotionally traumatic major life event which leads to severe posttraumatic stress response and intense grief reactions that are still detectable some years later”; “Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP”; and, “Although there has been increased recognition in the research literature of the profound grief reaction following pregnancy termination due to fetal anomaly, many medical caregivers continue to assume mistakenly that responses are much milder, akin to elective abortion.”

  4. Very interesting. I thought Dr. Tiller was an OB. I don’t see how a family practice Doc could do these proceedures. I always thought you would have to be surgically trained.

  5. Kathy, you are amazing – thanks for creating posts like these. You are a brave woman! I hope to emulate your courage.🙂

  6. I have read the families stories on the website. They are all very sad stories. I am not going to comment on whether I feel Dr Tiller and his patients were in the right or wrong on terminating their pregnancies.

    I have to comment, however, on the induction method: injection of the fetal heart to cause death, followed by several days worth of induction agents – on an OUTPATIENT basis. That is downright scary. Some induction agents (cytotec) can cause violent, tetanic contractions, and the women definitely need much closer observation then just induce and sent to a hotel. Or return to a “clinic” to labor and deliver. The women need to be in a hospital — where there are life-saving abilities at hand, should she have complications where the labor/birth can endanger her life. Like: placenta doesn’t detach (common in mid trimester births), hemorrhage, dysfunctional labor that requires surgical intervention, infection risk….I could go on and on. Also – how are the women having their pain managed? I doubt you can get an epidural at a “clinic” or in a hotel! What about morphine or other narcotics?

    Bottom line – this should have been done in a hospital. (Yeah, flame me about it…..but I’m thinking safety here).

  7. Kathy, I think you are quite wrong on this. I would urge you to read – with an open heart and open mind – the posts on this blog

    http://www.uppercasewoman.com/wastedbirthcontrol/2004/10/houston_we_have.html

    http://www.uppercasewoman.com/wastedbirthcontrol/2004/10/oh_god.html

    http://www.uppercasewoman.com/wastedbirthcontrol/2004/10/the_end.html

    http://www.uppercasewoman.com/wastedbirthcontrol/2004/10/hard_times.html

    http://www.uppercasewoman.com/wastedbirthcontrol/2004/10/status_report.html

    Okay, so it is one woman’s story – but it is consistent with what we know about early onset pre-eclampsia.

    I recently cared for a woman carrying a fetus with Edwards syndrome. One of the complications is polyhydramnios (too much amniotic fluid) since Edwards syndrome often causes oesophageal atresia. Now, in this situation, the mother wanted to continue the pregnancy and have palliative care for the baby when born. And I would 100% support her in her choice. However, severe polyhydramnios represents a huge physical challenge for the mother – very uncomfortable/painful and causes contractions – and is treated in pregnancy with amniodrainage. A different woman might well choose to have feticide at the time of amniodrainage and have a late termination of pregnancy. And I would 100% support her in her choice.

  8. Hi Kathy, I tried to post a reply but it got lost in the ether – possibly because I included links in my message and your system thought I was a spammer. As you don’t believe that late abortion is ever indicated for maternal reasons, I urge you to read this woman’s story at

    www dot uppercasewoman dot com /wastedbirthcontrol/2004/10/mind_if_i_whine dot html

    (you’ll have to replace the dots with actual dots! I’m trying to circumvent your anti-spam).

    Start reading with that post and keep reading.

    I recently cared for a woman carrying a fetus that has Edwards Syndrome. The parents do want to continue the pregnancy and have palliative care if their baby is born alive – a choice that is theirs to make and in which I support them 100%. However, Edwards Syndrome in the fetus is often accompanied by severe polyhydramnios (because the condition is associated with oesophageal atresia and other abnormalities of the GI trace). So, it is not as simple as serenely carrying a fetus to term knowing that the chance of a live birth is low, and a neonatal death certain – but in the meantime having a painfully distended abdomen, the extra fluid causing painful contractions and undergoing procedures such as amniodrainage. A decision to have an induced abortion is also the woman’s choice to make, and one in which I would support her 100%.

  9. Yehudit,

    Thanks for the links, and the second comment — your first did go to spam because of the links, but I rescued it.🙂 I’ve got my comment moderation set so that the first time anyone comments it has to be approved, but after that they will automatically be approved, so you can post multiple links in a comment now and it shouldn’t go to spam. [Or if it does, you can leave me another comment like you did above and let me know to check the spam folder.]

    I haven’t had a chance to read it yet, but will. I do know that there are cases like this — a friend of mine said that she thought an acquaintance of hers had an abortion due to the opposite problem — the baby had kidney problems or no kidneys so was swallowing amniotic fluid and had no urine output, leading to little or no amniotic fluid to cushion the baby’s movements, which my friend said was painful for her friend. She wasn’t close enough to the situation to know more details (I think it was her husband’s coworker or the wife of a coworker or something). I wonder if she could have something like amnio-infusion as palliative care, and an alternative to abortion or pre-term induction.

    In these types of situations, the waters get a little murky because of where the line is drawn between “induction” and “abortion.” Obviously, if the baby is given a lethal injection prior to the induction procedure starting, that’s an abortion because it is with the intent of giving birth to a dead baby; but there are many pre-term inductions which may basically be live-birth abortions, if they are not done for the mother’s health or life (for instance, fetal anomalies such as cleft lip, or some heart defect), in which the baby is induced with the possibility of a live birth but no attempt made to resuscitate the baby or give any but palliative care. Or perhaps no care at all. Sometimes things don’t fit in nice, neat little boxes. If the intent of the procedure is to terminate the pregnancy before the deformed baby has a better chance of living, I’d have to agree with those who call it a “live-birth abortion”; but if the intent of the procedure is because the mother is in pain or she is showing other symptoms of health problems, then that may be a straightforward induction. Sometimes preterm babies are given every possible care and help available in the hopes to keep them alive; other times parents may choose no care be given — either because the baby had a defect, or because the accidental birth was so early that the risk of future problems is so high. Murky waters indeed.

    With the greater increase of medical knowledge comes greater ethical complications, and more difficult decisions. I’ve toyed with the idea of ultrasound in future pregnancies — I don’t like routine ultrasound, but what if the baby had something wrong with it that could make a difference knowing after birth? For instance, a heart defect that required immediate surgery in order for the baby to live? That’s a possibility, however faint. But with that knowledge may come other knowledge, with the pressure to abort. I didn’t include these links, but they’re in my sidebar, to websites of parents who have faced a “difficult prenatal diagnosis” — many include stories of attempted coercion or being coerced by medical staff into having abortions (up to the legal limit) or preterm inductions (after the legal limit for abortions had passed). I wouldn’t want to set myself up for that; but once the knowledge is there — for good or for bad — it can’t be unknown. It’s a Pandora’s Box. And one I’m hesitant to open, even though most parents who find out about their babies’ diagnosis prenatally and continue the pregnancy are glad for the time to prepare for the future.

  10. I don’t see any pressure on parents to terminate the pregnancy where I am – we offer palliative care, including the option for parents to go home with their baby and be supported by neonatal nurses in the community. However, there are many women who don’t want to continue a pregnancy in those circumstances. Even if the research evidence suggests that continuing the pregnancy may be better for them psychologically (and note these are not – and could not be – RCTs!) – it is for individuals to make an informed choice about what they want for themselves, regardless of what is true in population studies.

    I do think that we have to be pretty clear cut about terminations. It seems to me that there are two possibilities:

    1. The fetus is a person, in which case termination of pregnancy is killing a person and since we only kill people in very specific circumstances (acts of self defense, war, captial punishment) abortion is almost always wrong. If we believe this, we need a better reason than that the person has a lethal abnormality (since we don’t have legal euthanasia). [Though in situations where the mother’s health is undermined, the termination of pregnancy could certainly be regarded as self-defense].

    2. The fetus is not a person, and it is for the person who supports that life with her body that should decide whether she wishes to continue doing so. Women have always brought unwanted pregnancies to an end, using whatever technologies are available to them, because they have felt that they are self-determining people and understand that the fetus is not.

    What I don’t understand is people who oppose abortion as ‘murder’ in most circumstances, but want to make exceptions for victims of rape, or in cases of abnormalities.

  11. Kathy,
    I think some other posters have addressed comments I would have made. But I will add that two independent doctors had to confirm the need for a risk to women’s health (medical or psychiatric); an investigation was even instigated against Dr. Tiller on whether he was following these guidelines, and he was acquitted of all charges. Here’s the story of a woman who was referred to Dr. Tiller because she was suicidal, although the story doesn’t end quite how you might think: http://www.huffingtonpost.com/alice-eve-cohen/dr-george-tiller-saved-my_b_216720.html She credits him with saving her life.

    I’m also skeptical that all these women were just interested in continuing their lives of leisure. When you read the stories about women who got late-term abortions, notice how challenging it is for them to even obtain one. Late-term abortion is so expensive, so difficult to get, such a physically and emotionally demanding process. I find it so hard to believe that there are women who traveled to Kansas just because otherwise “I won’t be able to go to concerts”. I am also curious where you got the figure of 8% of late-term abortions being done for fetal defects.

    Ultimately, when we say that the women – who clearly went to great expense and difficulty to arrive at the clinic at all – who came to Dr. Tiller were unthinking, more interested in themselves and their own experiences than their babies, and not able to make rational medical decisions for themselves, it starts sounding an awful lot like some of the anti-VBAC and anti-homebirth stuff out there. For example, “It’s not all about you getting to have a nice experience with candles and chanting and soft music, it’s about having a baby”. If you can force a woman to continue a pregnancy because you don’t believe she can make good medical decisions for herself, her family, and her future, can’t you force a woman to have a c-section? If the rights of the fetus trump the rights of the mother, why allow women to make decisions in labor at all? Dr. Tiller’s motto was “trust women”. I think that sounds like a pretty good motto.

  12. And not just “Trust women” but also

    “The woman’s body is smarter than the doctor” and “Women are spiritually, morally and intellectually capable of struggling with complex, ethical decisions and arriving at the correct decision for themselves and their family.”

  13. While I disagree with you on this issue, there are certainly others that I agree with you on. =)

    I lost a friend to complications of pregnancy as she and her husband were contemplating traveling to another state in which she could safely terminate a borderline viability pregnancy. I have also lost a friend when she died unable to receive an abortion when her fetus had died. There is so much vitriol and rhetoric for both of these types of cases, that often the anguish of those that experience it — either a necessary late abortion or maternal or fetal death — have been forgotten by those on both sides of the issue.

    I personally, choose to focus on those things that I can help change. Making it safer for women to choose home birth, making it so that those that cannot afford home birth can at least try to make payment arrangements. And further, I spend time and money to support things that would truly make most abortions unnecessary, such as information and birth control for teenagers and young adults, and access to services and financial resources for those that choose to give birth. Hopefully some day we will see the money that gets put into fighting abortion put into legislation to support improved educational opportunities for parenting teens, as well as legislation that would require colleges and universities across the nation to provide some maternity services as part of their health packages. To say nothing of access to a pumping room or the like.

    In a society in which the majority of women making choices feel backed into a corner by circumstance, or torn by the judgmental tenor of the debates, we are doing something wrong.

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