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Saturday, October 17, 2009

Abortion: An Uneven Progress

It's no secret that I am pro-choice. Anyone who is familiar with the writings on this blog will also know that I am not necessarily "pro-abortion".

As I've often said - and written here - I have never counseled a woman to have an abortion. Neither have I ever counseled a woman not to have an abortion. I have enough 'respect for life' that I also respect the life - and the intelligence and the wisdom - of pregnant women.

I see my role as helping a pregnant woman to explore all the options available to her and to chose the one that is best for her and her family.

I think abortion ought to be safe, legal, necessary and rare. And always, always, always, it is a woman's decision which is hers and hers alone to make, after careful and prayerful consideration and, optimally, conversation with her husband (or the man who impregnated her), her family, friends, and a trusted member of the clergy.

I think the way to achieve those goals is to begin to confront the major reasons women have abortion: poverty, inadequate education, and lack of access to quality health care, including information about and access to contraceptive devices and/or medicine.

We've been making some progress - uneven progress, but progress nonetheless.

The Guttmacher Institute's report "Abortion Worldwide: A Decade of Uneven Progress" has just been released and it estimates that the number of abortions worldwide fell from 45.5 million in 1995 to 41.6 million in 2003 — the latest year for which global figures were available.

However, they also reported that 19.7 million of the 41.6 million abortions in 2003 were unsafe — either self-induced, performed by unskilled practitioners, or carried out in unhygienic surroundings.

A key reason for that drop, the new report said, was that the portion of married women using contraception increased from 54 percent in 1990 to 63 percent in 2003 as availability increased and social mores changed.

Guttmacher's researchers said contraceptive use had increased in every major region, but still lagged badly in Africa — used by only 28 percent of married women there compared to at least 68 percent in other major regions.

The report notes that abortions worldwide are declining even as more countries liberalize their abortion laws. Since 1997, it said, only three countries — Poland, Nicaragua and El Salvador — substantially increased restrictions on abortion, while laws were eased significantly in 19 countries and regions, including Cambodia, Nepal and Mexico City.

Despite this trend, the report said 40 percent of the world's women live in countries with highly restrictive abortion laws, virtually all of them in the developing world. This category includes 92 percent of the women in Africa and 97 percent in Latin America, it said.

The survey concluded that abortion occurs at roughly equal rates in countries where it is legal and where it is highly restricted. A key difference, said the report, is the high rate of deaths and medical complications from unsafe clandestine abortions in the restrictive countries.

"Legal restrictions do not stop abortion from happening, they just make the procedure dangerous," Camp said. "Too many women are maimed or killed each year because they lack legal abortion access."

Listen again to that statistic: the report estimated that 19.7 million of the 41.6 million abortions in 2003 were unsafe — either self-induced, performed by unskilled practitioners, or carried out in unhygienic surroundings.

"Almost all of them occurred in less developed countries with restrictive abortion laws," said the report, which estimated that 70,000 women are killed annually from unsafe abortions and 8 million women suffer complications because of them.

70,000 women are killed annually from unsafe abortions.

8 MILLION women suffer complications because of them.

So much for being 'pro-life', eh? How can anyone make that claim when illegal abortions kill 70,000 women annually? The study's findings show that making abortion illegal does not eliminate abortions.

It just makes them unsafe.

And, deadly.

Religious organizations which prohibit contraception or promote "natural family planing" as the only allowable form of birth control are complicit in these startling facts and figures.

Although the Vatican remains officially opposed to the use of contraceptives, the report said the institute had detected a shift in approach.

"The Catholic Church has informally at least stopped fighting against contraception to the degree it once did and put more of its energies into fighting abortion," an institute spokesperson said. "On the ground there are priests and nuns who refer people to family planning services."

Here are some interesting facts from the Guttmacher Institute's Site about abortion in The United States:

* Nearly half of all pregnancies to American women are unintended; four in 10 of these end in abortion.

* About half of American women have experienced an unintended pregnancy, and at current rates more than one-third (35%) will have had an abortion by age 45.

* Overall unintended pregnancy rates have stagnated over the past decade, yet unintended pregnancy increased by 29% among poor women while decreasing 20% among higher-income women.

* In 2005, 1.21 million abortions were performed, down from 1.31 million abortions in 2000.
* Nine in 10 abortions occur in the first 12 weeks of pregnancy.

* A broad cross section of U.S. women have abortions:
  • 56% of women having abortions are in their 20s;
  • 61% have one or more children;
  • 67% have never married;
  • 57% are economically disadvantaged;
  • 88% live in a metropolitan area; and
  • 78% report a religious affiliation.
While the hysteria remains unabated from the Radical Right, there's nothing quite like statistics to mark the inevitable progress of education and enlightenment.

We certainly have farther to go. Praise God for the progress we've made!

May God continue to give us strength to continue to eradicate poverty and hunger, provide education for women and girls, and continued expanded access to adequate health care, including contraceptive information, devices and medication, as well as safe, legal abortion.


Jane Priest said...

What about mental illness as a reason for abortion? I don't mean that women with a mental illness should be counseled to receive one. Instead, I wonder if another reason to add is that a woman understands that she is not stable enough to get through a pregnancy and either adoption or raising the child. I wonder about the rates of women who had PPD with a previous child and abortion of a second pregnancy.

Elizabeth Kaeton said...

An interesting situation, Joie and, after all these many years, I've never been called in as a counselor in the situation. In my experience, most women with a long-standing diagnosis of mental illness seek abortions themselves.

PPD with a previous child and abortion of the second pregnancy I think has become a significant component to abortion. Having had a daughter who suffered PPD, I can tell you that she spent every day of her second pregnancy deeply concerned about what was going to happen after the baby's birth. It took lots of family support, but we got through it. All of us. Together. If that component is missing, well, I would fear about more than an abortion . . .

The most difficult case I had was with two young people - both with Down's or Trisomy 21 Syndrome - who wanted to be married and have children. Their parents "allowed" them to live together in their own apartment next to his parents. She was on contraceptives but conceived anyway.

The heartbreak on both sides was palpable. This was a "good" RC Family. Both parents wanted abortion. The couple, however, did not. Finally, they had the child and the families helped them care for their perfect newborn little girl. It was enormous amounts of work, but I think they did the right thing for them and their situation at that time.

No easy answers to life's complicated questions.

Kay & Sarah said...

I, too, am pro choice but not pro abortion. In my many years working in Family Planning clinics, I counseled many women with unplanned and/or unwanted pregnancies. Never would I have suggested that any woman have an abortion but felt I was there to be sure she explored all options.

The woman who stands out in my mind was a young woman who had some intellectual challenges, no family and lived in a group home. The first time she came in pregnant her social worker encouraged her to give her baby up for adoption which she did.

She always had difficulty remembering to take her birth control pills and was very easily taken advantage of. As a result, a couple of years later, she came in to clinic for a pregnancy test(with her social worker). When I told her her pregnancy test was positive, I will never forget her scream of anguish followed by sobbing and saying over and over again, "I can't do it again. I cannot give another baby away." It was heart breaking. She had an abortion with this pregnancy.

I do not advocate for anyone to have an abortion but I do believe that abortion should be legal, safe and rare. I do believe that contraceptives should be readily available and even free.

Elizabeth Kaeton said...

Thanks for writing, TA. I just want to make one thing clear - and I suspect you will agree with me. I am pro-choice but not pro-abortion but that does not mean that I am "holier than" those who are pro-abortion. It just happens to be where I land on the spectrum of choices.

My passion is about choices. I wish I could find the article wherein Sarah Palin talks about the time she understood that she was carrying a Trisomy-21 baby and considered abortion. She actually thanks God that she made the CHOICE not to abort. It's as close as we're ever going to get from the Radical Right that it is a blessing to have the CHOICE for or against abortion.

She made the choice that was right for her. It may not have been right for another woman at another time in another situation, but she still had the CHOICE. Why can't people see that the choices other people make which differ from the ones we would make are still valid choices? Thank God we still have the CHOICE!

The story you told is an example of why abortion may well be the best choice in that situation. I could have listened to that woman's decision to have an abortion, gone home, rested my head on my pillow at night and slept peacefully.

Now, the next step, of course, is getting her to be more compliant with her contraception method so she wouldn't find herself in that situation again.

I've also known women in similar situations who opt for permanent sterilization - which is fine, as long as there is no coercion in the decision. It has to be the woman's decision - even if she is 'intellectually challenged'.

Thanks again, TA, for your brave comment on a difficult subject.

JimB said...

I very seldom comment on this issue as I dislike the almost inevitable hate mail. I am particularly fond of the 'pro-life' people who threaten to kill those who disagree. So my hat is tipped for your honesty.

The most telling numbers are those that show that abortion is a rough constant. It is not more common in Western societies where it is legal it is merely safer. So the same people who want to kill doctors, supporters and dissenters also want to kill pregnant women. Not really a surprise but I think worth highlighting.

It is my l view that women should be given every chance to avoid pregnancy, men should be given no chance to avoid responsibility for paternity and the choice of how to deal with an unplanned pregnancy or one going wrong while it should involve input from family, partner and hopefully clergy and counselors must be the young lady's. She is the one who simply must make the call as she is the one at greatest risk.

Yes abortion is terrible, ugly and should be the last resort. But despite what the anti-choice think, sometimes a person reaches the point of last resort. Young women in that position need support and love, not someone shouting at them or threatening them.

If anti-choice people really want to stop abortions, they should fix the system to reduce the pressures on young women.


Elizabeth Kaeton said...

Amen, Jim. And, "fixing the system" means that we all work to eliminate poverty, increase access to good health care for all, educating women, and providing contraceptive information, education, devices, and medicines for women. And yes, teaching men about responsible behavior and eliminating sexism and misogyny.

Göran Koch-Swahne said...

Amen, dear Elizabeth!

Erp said...

I would say that boys who are the victim of a statutory rape should not be required to be responsible for any resulting children. This may be uncommon but not unknown.

I agree with the legal, safe, and rare. I would also add that when possible early. Rape victims or those for whom condoms or other birth control knowingly failed should have access to "morning-after" pills (not abortion but often treated as such).

Elizabeth Kaeton said...

Early? Absolutely. By the look of the stats in the Guttmacher chart, that would be more the norm in this country.

Karen said...

Excellent post. All I can say is Amen.

Kirkepiscatoid said...

I'm in much the same boat as you on this topic, Elizabeth...and having trained in medical school with "pre-Roe" gynecologists, who told some of the saddest stories going about young women coming in the ER with the sequelae of septic back-alley abortions, I don't know how we can even think as a society to deny the choice of a safe, legal abortion, no matter how we personally feel on the topic.

Elizabeth Kaeton said...

Thanks, Karen.

Absolutely, Kirke. Except, of course, if you are a Radical Right Wing Nut and you believe God's mouth is right to your ear. Which is fine to believe that. Just keep it between you and God.

What's that old bumper sticker? Don't want abortion? Don't have one!

JimB said...

Rev. Elizabeth,

Yes that is exactly what fixing the system means.

Even with a better system, some women, sometimes, will inevitably find themselves at the point of last resort. Which leads not indirectly back to legal, safe and rare. Unless and until the allegedly pro-life start giving a half a damn for the children of poor people, I for one am not real interested in their views.


Honest Bob said...

19.7 million of the 41.6 million abortions in 2003 were unsafe
Strikes me that all 41.6 million abortions were 100% unsafe for the baby.

Elizabeth Kaeton said...

Well, that would be true, Honest Bob, if there had been a baby. Turns out, it's just a fetus. A zygote in most instances. Thanks for stopping by.