Is abortion necessary when a woman’s life is in danger?

The question of whether abortion is moral when the mother’s life is in danger is often the exception that stalwart pro-lifers concede to. At first glance, it does seem logical. If the mother dies, her pre-born child dies. It makes no sense to allow two people to die if we have the opportunity to save at least one. However, abortion is not merely allowing someone to die, it is an active facilitator of the death of a pre-born child. Since we already know that ending the life of an innocent human being is never justifiable, we seem to have run into a serious problem. We know that we cannot kill an innocent human being in order to save another. For example, if a close friend has a heart condition, we may not kill a stranger, remove the stranger’s healthy heart, and use it to save our friend’s life. Though a good result was achieved—our friend’s life was saved—it was achieved through an immoral act, and the ends do not justify the means. We cannot kill to save.

That being said, this does not mean that we can do nothing. First, it is important to note that a situation in pregnancy where a woman’s life is actually threatened is extremely rare, making up less than one percent of abortions. Secondly, abortion is never necessary to save the life of the mother. This statement requires explanation; Dr. C. Everett Koop, who operated as the United States Surgeon General under President Ronald Reagan, stated that in his thirty-eight years as a paediatric surgeon “he was never aware of a single situation in which a pre-born child’s life had to be taken in order to save the life of the mother.” Further, the Dublin Declaration on Maternal Healthcare states: “As experienced practitioners and researchers in obstetrics and gynaecology, we affirm that direct abortion—the purposeful destruction of the unborn child—is not medically necessary to save the life of a woman.” This declaration has, to date, been signed by over 1013 medical professionals, including obstetricians/gynaecologists, midwives, and neonatologists.

The important distinction here can be found in the words direct abortion. In the medical community, the word abortion does not necessarily refer to the direct and intentional killing of a pre-born child. For example, a miscarriage is often called a ‘spontaneous abortion.’ In other words, it is important to be aware that certain ethical life-saving procedures—such as early induction of labour or emergency caesareans—may still be called abortions by the medical community. As pro-lifers, our issue lies with procedures that directly target the body of the pre-born child in an act of violence.

In order to illustrate that direct abortion is never necessary, an important question to ask is outlined by Stephanie Gray in Love Unleashes Life: “What medical condition in the woman’s body will be fixed by us attacking the baby’s body?” Rarely is a medical issue completely solved through direct abortion, additional medical treatment is necessary. In order to understand what medical treatment is ethical, we must apply what is called the principle of double effect, summarized as the following four conditions:

1. The action must be morally good or at least morally neutral.
2. The good effect must not come about as a result of the bad effect, but must come directly from the action itself.
3. The good must be intended, and the bad effect merely tolerated.
4. The good effect must be at least equivalent in significance to the bad effect.

When addressing this question in conversation, many people wonder: what, actually, is the difference between an abortion and another procedure if the end result in both instances is a dead child? However, we can all agree that intent matters. An analogy that is often helpful in conversation is as follows:

Imagine that you see two people drowning in a river. You can only save one at a time, so you dive into the water, swim to the middle of the river, and pull the person closest to you to shore. By the time you turn around, the other person has sunk under the water and disappeared. Are you guilty of the death of that person? Of course not!

In a second situation, you swim out and grab the person closest to you, and then you push the other person’s head under water until they have drowned. Now are you guilty of the death of that person? Yes, you are!

What this analogy illustrates is that though the result is the same—one person has drowned—how that result came about is very different. In one case, a person died because you directly and intentionally killed that person, whereas in the first situation, a person died simply because you were unable to save them. In the same way, we are never permitted to directly target the body of a pre-born child in order to end their life, but we are permitted to target a medical problem, where a child dies not as a direct result of our intervention, but because we were unable to save them.

In complicated medical cases, such as HELLP syndrome or pre-eclampsia, there are times when in order to save the life of the mother the pregnancy must be terminated. In these cases, the ethical response is not abortion, but rather early induction of labour or an emergency c-section. While both of these would result in the death of the child if the child is not yet at the age of viability, the child passes away as a result of a lack of technology able to save them, not because he or she was torn apart through abortion. The child in these tragic circumstances was still treated with the dignity and respect they deserve, due to their inherent dignity as human beings.

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Previously in this series: Contraception is the best way to reduce the abortion rate