Walking Through Light

Want to have less abortions? Legalize them

This month, I took two weeks off to travel up the California coast in a camper van. Familiar landscapes that have had droughts over the years are now so parched they are unrecognizable. Rolling hills of spring green are now crunchy chaparral, reservoirs dry, rivers on the map now sand and tumbleweeds, and decimated redwoods barely hanging on. When I walked through the “Field of Lights” at Sensorio near Paso Robles, it was 108 Fahrenheit at 8 pm, and I thought about the urgent need to balance all these extremes – heat and drought with the beauty of art and the necessity to find and communicate solutions for the crisis we’re in.

As soon as I returned, the news hit that the US Supreme Court overturned Roe v. Wade, sending shock waves through the country. As a woman married to a woman, there are tangible threats to the rights I currently enjoy. Judge Clarence Thomas implied gay rights should be overturned as well. No matter one’s opinion on the matter, it’s big news. Last month, I wrote about what growing up with guns taught me about gun safety. This month, I am thinking about what it actually means to protect lives.

Decisions around contraception are very personal, so allow me again to get personal. I grew up Catholic, and I understand and respect the belief that life begins at conception. My mom dragged me to the OB-GYN when I was 13 years old, long before I even thought about having sex, and she convinced him to prescribe me contraception pills, “just in case,” much to my embarrassment at the time. That is because my mom had an unwanted pregnancy (me) when she was 19 and was intimately familiar with the hardships of having a child while still being a teenager herself.

“Driving to the Netherlands” was an expression I sometimes heard when growing up in Germany. It referred to abortion, or more specifically, to the women who could afford to drive across the border to get one. Since Germany is a largely progressive European country, some foreigners are surprised to learn that abortion is generally illegal in Germany unless a woman can prove in mandatory counseling that she is emotionally or physically unable to carry the pregnancy to term. Only an estimated one out of ten gynecologists perform the procedure, and even fewer dare to say so publicly.

In the Netherlands, however, any woman can legally have a safe abortion until 24 weeks after conception when needed. What constitutes the “need” for an abortion is not clearly defined – the law trusts women, their doctors, and the courts to interpret this law as they see fit. Almost all Dutch clinics that offer abortions are non-profits, and health insurance usually covers the cost. The result? One of the lowest abortion rates in the world. In that country, just eight out of 1,000 pregnancies are terminated – half the rate in the U.S. and one of the lowest rates in the world.

The fact that this system is working so well has prompted the Netherlands to liberalize its abortion laws even further. This spring, it abandoned the regulation that forced women to wait five days between consulting their doctor and making the decision. In March of this year, it allowed general practitioners to prescribe the “morning-after-pill.”

These policy shifts are based in science. “More liberal abortion laws don’t lead to an increase in abortion numbers,” says Alicia Baier, an OB-GYN in Berlin and co-founder of the advocacy group Doctors for Choice, which advocates for more liberal abortion laws. “The World Health Organization states clearly that punitive measures do not decrease abortions. They only make them less safe, hamper access, and delay the procedure,” she said. “Pregnancy termination is safest the earliest it is performed.”

Historically, outlawing abortion primarily makes abortion unsafe for low-income women, as the affluent can travel to obtain safe care, even in the U.S. The WHO calls unsafe abortions “a leading – but preventable – cause of maternal deaths and morbidities. It can lead to physical and mental health complications and social and financial burdens for women, communities and health systems.” It has recently published data showing that “nearly half of all abortions are unsafe,” with “developing countries bear the burden of 97% of these unsafe abortions.”

Safe, legal, and rare

Switzerland is another country that saw abortion rates plummet after it legalized the procedure. Before 2002, it only allowed abortion for specific medical conditions, but the Swiss laws changed in 2002 to allow abortions during the first 12 weeks of pregnancy after counseling, an approach accepted by 72 percent of voters. Abortion rates dropped from around 12 per 1,000 women age 15 to 44 in the 1970s to around eight in the 1990s. After legalization, the rates kept dropping, to around seven in the 2000s, 6.5 in 2013 and 5.4 in 2020 – a remarkable achievement compared to the United Kingdom (17.5), France (15 in 2009) and the United States (16 in 2008). (The average annual worldwide abortion rate is 28 per 1,000 women of childbearing age.)

Of course, legalization alone isn’t likely to lower abortion rates. Sexual health experts point to three main factors: education, contraception and a relatively high socioeconomic level. Both Switzerland and the Netherlands have adopted the mantra “safe, legal and rare.”

Health experts agree that the easiest way to prevent abortions is to prevent unwanted pregnancies. This is why Switzerland, the Netherlands, Canada and most European countries have made the prevention of unwanted pregnancies a priority. In Switzerland and the Netherlands – where almost every school teaches sex education, and contraception (including morning-after pills) is easily accessible and affordable or even free – the rate of unwanted pregnancies is just 28 percent, a little over half the rate in the U.S.

The U.S., by contrast, where several conservative states have banned sex education from the curriculum and where reproductive care is unaffordable for many women, leads the industrialized world in unwanted pregnancies – nearly half are unintended, and they disproportionately affect poor and uneducated women.

Since moving to the U.S., I have spoken to many members of the anti-abortion movement. Here is what I don’t get: If the goal truly is to protect lives, there are numerous proven ways to save the lives of mothers and children.

What “Pro-Life” could mean

The United States has the highest maternal mortality rate of any developed country and while it is decreasing worldwide, it keeps increasing in the U.S. (An average of 23.8 maternal deaths per 100,000 live births in the U.S. compared with 5 in the Netherlands and Switzerland.) If Christians are worried about the most vulnerable among us, how come conservative U.S. states have the worst maternity death rates, with Louisiana (58.1), Georgia (48.8), Arkansas (37.5), Alabama (36,4), and Texas (34.5) leading the statistics? Black mothers have the highest risk (55.3), nearly three times the maternal death rate for non-Hispanic White women. A woman in Texas is about ten times more likely to die in childbirth than a woman in Sweden or Germany, a black woman more than thirty times. Why? Because the same states that want to force women to carry pregnancies to term, have slashed the measures that let give mothers access to affordable health insurance, maternity care, and they have closed many of the public health clinics that were often the only affordable option in underserved areas. Houston, we have a problem.

The same states have the worst infant mortality rates. Mississippi, Louisiana, Alabama, Georgia, Arkansas, Kentucky, Florida and Texas lead that sad statistic with more than 5 infant deaths per 1,000 live births (compared with 2.2 in the Netherlands and 3.1 in Switzerland). What about that “sacred gift worthy of protection“?

The same politicians who argue so vehemently for the protection of unborn life are often the same who want to eliminate affordable healthcare for all, which pays for prenatal care and the first years of health care for the young child. Alabama, by the way, is also the state with the highest rate of cervical cancer in the U.S. — not least because it hampers preventative health care for low-income women. Instead, it tortures women after miscarriages with legal threats.

If one wants to prevent abortions, making contraception free or at least affordable is the fastest way to achieve this goal. So, why do lawmakers allow exceptions for Christian employers who routinely exclude contraception costs from health care while paying for viagra?

And lastly, if one indeed does believe, despite all the evidence, that criminalizing mothers helps, it begs the question: Why not criminalize the fathers, too? According to the knowledge I had as an 8-year-old, men are at least partly responsible for any pregnancy.

Why force women who do carry their pregnancies to term after having been raped, to share custody with their rapist, which happens far more frequently than I believed until I spoke with half a dozen women who had to bear such court decisions?

Why is a rapist who rapes an 11-year-old in Ohio likely to get away with a much lesser sentence (if any at all) than the 11-year-old who cannot carry this pregnancy to term or the doctor willing to perform that abortion?

And lastly, while anti-abortion activists argue that the personal freedom of a woman ends when her decision impacts another life, then what about the 45,000 firearm deaths in the U.S. every year, of which about a tenth are children? Does the personal freedom of gun owners not end when it guns are the leading cause of death for American kids?

For someone to call themselves pro-life, they need to favor ALL life.

A longer version of this essay is published on Medium. Check it out and comment here or there: https://michaelahaas.medium.com/want-to-have-fewer-abortions-legalize-them-9d4248ba1d7c

With love,

Michaela

P.S. What we’re reading:

In June, the Top New York Court Ruled that Happy the Elephant Isn’t Legally a Person.

The ruling ended what appears to be the first case of its kind in the English-speaking world to reach so high a court. And while it keeps Happy where she is, the outcome is unlikely to quell the debate over whether highly intelligent animals should be viewed as something other than things or property.

I wrote about Happy on Reasons to Be Cheerful here.