The procedure used to treat Beatriz's health issues was carried out past the point of typical viability at 24 weeks, so it was not any kind of abortion, be it direct or indirect abortion, but was rather garden-variety emergency c-section. However, the most strident abortion rights activists are insisting that the delivery was a hysterotomy abortion, which is performed like a c-section but with the direct intent of achieving the baby's death. The plan when performing a hysterotomy is to set the child aside to die alone from hypothermia and oxygen deprivation. Clearly this was not the case when Beatriz's baby was delivered, since she was taken to the nursery, placed in an incubator, and provided with all the care that was appropriate for a baby with anencephaly. However, just to avoid getting sidetracked into an argument about whether an emergency c-section to deliver a moribund baby is actually a hysterotomy, for the sake of discussion I will proceed as if this life-saving, baby-sparing c-section was actually an indirect abortion.
There is a thought experiment that I think illustrates the distinction between direct abortion (the deliberate killing of the fetus) and indirect abortion (treating the mother's health problems even if that inevitably causes or hastens the death of the baby).
Imagine that two people are trapped in a collapsed building. Sally is fatally injured; she has suffered such severe crush injuries to her internal organs that nothing can be done to save her. However, the pressure of the rubble on her body is pinching shut major blood vessels and keeping her from rapidly bleeding to death.
Jane, on the other hand, has treatable injuries, and needs to be transported to a fully equipped hospital. The faster she is rescued and gotten to the hospital, the greater her chances of a full recovery.
The dilemma for the rescuers is that they can not reach Jane without first getting Sally out of the way.
There are four options:
- Do nothing that would hasten Sally's death, but wait for her to die before rescuing Jane, even if this might mean that Jane dies. This would be comparable to taking no action to end a life-threatening pregnancy.
- Carefully remove Sally from the rubble even though this will hasten her death. This would be comparable to an emergency delivery that would hasten the baby's inevitable death.
- Kill Sally via lethal injection prior to removing her body from the rubble. This is comparable to the abortion methods that use lethal injection to kill the baby before either mechanically removing it or inducing labor.
- Simply wrench Sally out of the rubble, pulling her body apart by force so that the dismemberment, rather than the removal of the rubble, is what directly causes her death. This is comparable to a standard D&E abortion.
Prolifers advocate Option 2, which is to treat Sally with respect and gentleness while saving Jane's life, and taking no action to directly kill her.
This is the option that the courts in El Salvador instructed doctors to follow when caring for Beatriz. From our perspective, prochoicers are angry that doctors did not legally have Option 3 or Option 4 -- flat out killing Beatriz's baby -- as a choice. And we're shocked and bewildered that doctors had to be forced to treat Beatriz's baby with gentleness and respect, that they wanted to just flat out kill the baby rather than allow her to have her short time experiencing the world outside the womb. She was kept warm and comfortable, and if there was not such indifference or outright hostility toward her, she could have been held, loved, and nurtured if only for a brief time. We can't understand why anybody would begrudge her that.
Nobody wanted Beatriz left to die. We just didn't want her baby to be utterly forsaken and treated like a burst appendix or a tumor. We just wanted her to have the simple dignity that is due to every human being.
To us, that doesn't seem to be that much to ask.