Monday, June 03, 2013

Beatriz, Savita, and "Life of the Mother" Abortions

Chicago mayor Rahm Emanuel said, "Never let a good crisis go to waster." Though others have not articulated it quite that clearly, he summed up a political and social strategy that the abortion advocates worldwide are using vigorously to try to demonize prolifers and open the doors to legalized abortion in countries that still protect the unborn and provide real medical care to their mothers.

Two cases in point are the needless death of Savita Halappanavar in Ireland and the health issues faced by a woman known as Beatriz in El Salvador.

Savita (pictured), 17 weeks pregnant, was diagnosed as being in the middle of a miscarriage when she was admitted to an Irish hospital. She asked that labor be induced in order to get the whole thing over with, since she was in a lot of pain. Abortion advocates have latched onto this as being a request for a "life saving" abortion. Savita's doctor did not induce labor (which contrary to what abortion activists are saying is forbidden by neither Catholic doctrine nor Irish law). The doctor did not proceed with the "abortion," and also did nothing to address Savita's pain or to monitor her for infection. In fact, even after Savita showed unmistakable signs of serious infection, the doctor didn't administer antibiotics in a timely manner. Performing an abortion -- which is what prochoice activists insist the doctor should have done -- would not have addressed the infection and in fact would have risked spreading it faster by causing uterine damage. Savita, in short, died from failure to administer antibiotics, not failure to commit an abortion. But "She died because she wasn't given antibiotics!" doesn't make a good abortion-rights poster or slogan, and abortion enthusiasts are still using Savita's death to try to get Ireland -- currently one of the safest places on earth for pregnant women -- to legalize abortion.

Beatriz began suffering from an increase in her lupus symptoms when she was about 20 weeks pregnant. Abortion advocates staged some political theater, complete with professional printed as well as amateur signs, demanding an immediate abortion to save Beatriz's life and expressing additional outrage since the baby El Salvadoran law forbade doctors to abort had anencephaly and thus would most likely die before or shortly after birth anyway.  I'm not clear on whether or not El Salvador allows "indirect abortion" for life-threatening emergencies, as Ireland does, which would involve ending the pregnancy if necessary but delivering the baby alive and providing comfort care. After six weeks of shouting that Beatriz was in mortal peril and about to expire for lack of the "life saving" abortion, the courts ruled that an abortion was not necessary since doctors could simply perform a c-section, which would appropriately address Beatriz's health problems without killing the baby. This is, of course, what prolifers had been advocating all along. The fact that they are not proceeding immediately underscores the fact that there was no immediate threat to her life. Abortion advocates, who are still trying to leverage the case into limiting protection to babies in countries that reject abortion, are still somehow claiming a victory in that Beatriz has "won the right to end her pregnancy." Nobody was opposed, however, to ending the pregnancy. Both Beatriz and her baby will get the best of care in spite of abortion advocates' efforts to "end the pregnancy" by outright killing her unborn child. But worldwide abortion enthusiasts aren't letting the fact that they were dead wrong about Beatriz's needs deter them.

But what if a life-of-the-mother abortion really was necessary?

First of all, cases in which ending the pregnancy is necessary to save the mother's life are rare. As far back as 1960, Planned Parenthood Medical Director Mary Calderone (pictured) wrote "[M]edically speaking, that is, from the point of view of diseases of the various systems, cardiac, genitourinary, and so on, it is hardly ever necessary today to consider the life of a mother as threatened by a pregnancy." Dr. Alan Guttmacher, another former leader of Planned Parenthood, said in 1967, "Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save life."

I have searched for conditions in which the prescribed treatment is abortion, and I've not been able to find any.

This Spanish study of women with lupus during pregnancy (the problem Beatriz had) found no maternal deaths, and of the 8 patients who had "therapeutic" abortions, six of them requested the abortions themselves, and two had abortions performed because their treatment medications were presumed to have harmed the fetuses. None of them was aborted as a live-preserving measure for the mother.

The research these doctors in the UK did is worth noting. I'll bold the particularly important parts:

Between 1967 and 1990, only 151 abortions have been carried out to save the mother's life, a figure amounting to 0.004% of all abortions.

In 1992, a group of Ireland's top gynaecologists wrote: "We affirm that there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of a mother may only be saved by directly terminating the life of her unborn child."

When Dublin's National Maternity Hospital (where 10% of all births in Ireland occurred) investigated the 21 deaths of pregnant women there between 1970-1979, they found that not a single one of those deaths could have been avoided by abortion.

Ireland, a country where the unborn child is constitutionally protected, has the lowest maternal death rate in the world. The UK, where abortion is available practically on demand, has over five times Ireland's maternal death rate.

Developments in medicine mean that the 'abortion to save the mother's life' argument is becoming harder and harder to justify. It is now possible for women with heart defects to carry a baby to term with expert help and life-threatening conditions such as cancer can often be treated without harming the unborn child. Women facing difficult pregnancies have a right to the best available medical support.

Direct abortion is the deliberate killing of an unborn child. Treatment to save the life of the mother that results in the death of the child as an expected but not intended side effect is not a direct abortion, e.g. in the case of an ectopic pregnancy. In this situation, the baby begins to develop in the woman's fallopian tube and has to be removed or the tube will rupture and cause the death of the woman. This involves the unavoidable death of the unborn baby but the aim of the operation is to save the mother not to kill the baby.
Let me reiterate the most important points, which abortion enthusiasts ignore because these facts don't help their cause:

  • Between 1967 and 1990, only 0.004% of abortions performed in the UK were done with the intent of preserving the mother's life. (I've been unable to find comparable statistics in the U.S., where the only data is on self-reported maternal health concerns among aborting women.)

  • Not a single one of the deaths in Dublin National Maternity Hospital between 1970 and 1979 could have been avoided by abortion. (I've been unable to find a comparable study in the U.S.)

  • Ireland, where abortion is illegal, has the lowest maternal death rate in the world. The UK, where abortion is available practically on demand, has over five times Ireland's maternal death rate. (This can be attributed to the increased risk of complications in subsequent pregnancies caused by abortions.)

    In fact, the successful treatment of high-risk pregnancy is measured in terms of length of gestation and fetal survival; maternal survival is expected. You start seeing maternal mortality when you look at studies of women who suffer catastrophic injuries during pregnancy. The medical literature on these cases mentions "abortion" (the medical term for a miscarriage) as an undesired effect of these injuries, not as a treatment.

    Pro-life physicians note that doctors often recommend abortions for ailing patients because they fear that treatment for the mother might harm the fetus. Aborting the baby to prevent his possible injury or death makes sense from a legal standpoint, for the doctor to avoid a lawsuit, but these abortions are to protect the doctor's malpractice rates, or to avoid the possible birth of a child with a disability, not to preserve the mother's life.

    Even if the woman had uterine cancer, requiring a hysterectomy, doctors would deliver the baby live first if he or she was viable. If the baby was not yet viable, the hysterectomy would indeed kill him or her, but would not be the same as performing an abortion -- which is a procedure performed with the primary intent of killing the fetus.

    Do these rare, tragic cases mean that we need a "life of the mother" exception in abortion bans? Clearly not, as we've seen in Ireland for decades, and as we are seeing in El Salvador as doctors provide appropriate care to both Beatriz and her unborn child. The definition of abortion must be perhaps clarified in the law, to allow for treatment that will as an unintended and indirect side effect shorten or end the baby's life. To prevent doctors from using this loophole to Tillerize their practices (presenting all manner of social stresses as if they are acute threats to the mother) we will have to put measures in place that require a thorough and unbiased review of all such cases before action is taken if possible, and afterward if the procedure was carried out in an emergency. Given abortion advocates' history of creating rubber-stamping panels to approve "medically necessary" abortions before Roe, those review processes would have to be carefully structured to prevent abuse. Perhaps we should take steps similar to those taken by police forces in cases in which an officer uses deadly force, suspending the doctor from practice until the review is complete.

    Whatever course we take, let's stop letting Big Abortion use what's likely 0.004% of abortions (and which didn't have to be carried out as direct abortions in the first place) as an excuse for the other 99.996%.
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