Abortion Q&A

This page is an ongoing project to provide answers to all the questions you might have about the pro-life position. You can skip below to the questions that interest you, or if you are wanting to seriously understand the pro-life position from scratch, you can read this introduction to the pro-life view. My hope is that it helps us to understand each other better, so we can treat each other with more dignity and sincerity. These answers will be (relatively) short, rather than comprehensive, so please get in touch with challenges or more objections and I will do my best to answer. Or else, wait for my book!

Why pro-life?

If you’ve been raised in a Western culture, your impression of pro-lifers is probably a bad one. At best, they are hopelessly out of touch with the realities of the modern world – aliens, in a sense. At worst, they are wicked misogynists wanting to return the world to an oppressive patriarchy in which women have virtually no rights or status. Even if you’ve reached maturity elsewhere in the world, if you have social media (as you probably do, reading this), you’re likely acquainted with such sentiments.

While I never had such a deep cynicism towards pro-lifers, nor was I always pro-life. I don’t know if I ever thought the pro-life view was cruel – I knew pro-lifers who were clearly not – but I did think it was unreasonable. Having gone into Medicine as a proudly radical left-winger, wanting to work in global health to alleviate suffering among the most ignored and despised human beings in our world, I never anticipated that I would end up speaking and writing mostly about abortion.

Yet here I am, trying to convince you to follow the same pastoral and intellectual path I took during my time at Oxford medical school, which I became firmly convinced offers the most compassionate, humane, and reasonable response to women feeling trapped in a crisis pregnancy situation. Not only was I convinced that the pro-life view was correct: I was persuaded that this was a centrally important issue for anyone with a concern for the last, the least and the lost in our world.

This page is an ongoing project to try and provide humane, reasonable, and concise answers to those sincerely seeking to understand the pro-life view – and maybe even open to following the arguments where they lead. The answers won’t be comprehensive – that will come in a later book – but I hope they offer a helpful starting point. I acknowledge that this view will seem counter-intuitive to many people, and that abortion has been so widespread for so long in the West that it is difficult to believe that we could be so mistaken about it. But all societies throughout history have been completely wrong about at least some centrally important moral questions. It would be extremely strange if ours were the only society that was right about all of them. So all I ask for is an open mind. In response, I will do my best to take seriously the claim that women’s equality in the last 50 years has been based on abortion, and to offer serious responses to those – especially women – whose lives may be greatly complicated by an unplanned pregnancy.

So what is the pro-life view I am suggesting? Importantly, it is not that unborn babies are more important, or entitled to more rights, than the women carrying them. That would, in fact, directly contradict the pro-life view, which says that all human beings have equal inherent value, and equal fundamental rights. Although most people claim to accept this position, most (in the West) do not accept that embryos and foetuses have equal inherent value and fundamental rights. So my task here is to convince you that it is impossible to accept a standard vision of human equality without extending that vision to human beings in their earliest stages of development.

This pro-life view says that both lives matter infinitely, and that the mother’s and child’s wellbeing are inseparable. It claims that we need not pit mother and child against each other, as if their interests were in conflict, but that there is a middle way which genuinely dignifies and supports both, without the need for loss of life.

One of the fascinating things about this debate is that almost everyone who considers themselves pro-choice, especially in Western Europe (the US is a bit different), thinks that abortion should be limited in certain circumstances. Almost no one thinks, for example, that having an abortion in the third trimester because the baby is a girl should be legal. In the UK, almost no one thinks that having an abortion in the third trimester in general should be legal (the same polling shows, incidentally, that women are more supportive of limitations on abortion than men). This is clearly in some sense an ‘anti-choice’ position – they are against women having the choice to abort a baby at, say, 36 weeks, because it is a baby girl. Yet all these people would be reluctant to consider themselves ‘anti-choice’. And most of us would not call them that. Nor would we call them misogynists or patriarchs or religious nutters. When I debated a panel of four leading pro-choice advocates on a leading BBC show a few years ago, only one of them supported allowing abortion after 24 weeks. But no one was rushing to call them ‘anti-choice’. Nor did they do so when the UK’s leading parliamentary advocate for abortion put forward a Bill to decriminalise abortion, which included a new provision to ban abortion after 24 weeks, with a possible punishment of imprisonment for life.

You will have your own view about when abortion should be limited. For the purposes of this point, it doesn’t matter what your exact line is. The point is that in supporting those limitations, you are – from another perspective – limiting the choices of women. Maybe for a small minority of the readers, this realisation will move you to the extreme end of the pro-choice position – that abortion really should be legal for any reason, at any point in the pregnancy. But for most people, the intuition against late abortion is more resolute. Most people cannot look at the videos, or consider the science, of babies late in pregnancy and seriously believe that it should be legal for their lives to be ended, despite the burdens they might place on the woman who carries them.

What does all this mean? It means that the overwhelming majority of Western pro-choicers agree with pro-lifers on a certain principle – namely, that when an embryo or foetus reaches a certain status, it can be considered a person and should have the protection of a person – and that this includes protection against abortion. It shows that the pro-life position is not as radically different from standard public opinion as it often appears: all it says is that this point is earlier in development than many in the public think. It reveals that for most people, the fundamental question really is about what the embryo or foetus is and what value/rights it has: if it is a person of equal value to the rest of us, then it should have protection. If you’re struggling to understand how pro-lifers can be OK with limiting people’s choices, this may be the most helpful starting point. (If you really do think that abortion should be legal at any point in pregnancy for any reason, we will examine that position in the Q&A).

You may be on board with this reasoning. You may openly agree that, in principle, abortion could be limited at a late stage, or for certain reasons (e.g. sex-selective abortion), and that supporting some restrictions on abortion is not inherently anti-choice or misogynistic. Your puzzlement may be at pro-lifers having such a low threshold for limiting choice: limiting choice makes sense when there is a fully grown, sentient baby capable of feeling pain and interacting with its mother, as in later stages of pregnancy (arguably the second trimester as well as the third). But how can pro-lifers believe that this protection should start at conception?

To answer this question it will help to go back to international human rights law. One of the foundational treaties codifying the Universal Declaration of Human Rights into binding law is the ICCPR, in which Article 6 reads: ‘Every human being has the inherent right to life. This right shall be protected by law.’ This article therefore asserts both a right to life and its legal implications: that right must be protected by law. It is not a matter of ‘personal choice’ or anything like that – the right to life needs objective legal protection.

But to whom does it apply? This is not a trivial question: to the Greeks and Romans before the Christian period, it would obviously not have included born babies. Today, the foremost moral philosophers writing in defence would be inclined to agree. Nor would it necessarily include certain disabled people who have less sophisticated cognitive abilities – and again, many contemporary moral philosophers would agree. Of course, for most of history, it would not even include plenty of able-bodied/minded mature adults: slaves and those of other races/nationalities may well be exempt. And while women have often (though not always) had a right to life throughout history, they have rarely been considered persons with full equality under the law. The modern ‘consensus’, if it could be called that, is a relatively recent and unusual innovation.

All these groups have been considered subhuman, or not human at all. But we now recognise that the exclusion of some human beings from the scope of human rights has, in virtually every case, constituted a moral atrocity. By contrast, most of the major advancements in human rights throughout history have resulted directly – and often explicitly – from the recognition that being human makes one part of the human family, and therefore in the scope of protection from the rest of that family.

Of course, international law as we now know it resulted directly from one of these atrocities – the horrendous dehumanisation and abuse which precipitated the second world war. This abuse was directed most clearly against the Jewish people – but also against disabled people, gay people, Slavs, and others. Modern human rights arose out of the recognition that no matter someone’s skin colour, ethnicity, sexual orientation, or abilities, if they are a human being, they matter – they are equal, and deserve basic human rights.

In order to exclude a group of humans from human rights, therefore – such as unborn children – we have to say one of two things. Either some human beings really are excluded from human rights, or unborn human beings are not really human beings.

Take the first option. Saying that some human beings are excluded from human rights is a daring claim – we have seen that before. But that is not to say it is false. The problem is that any basis for denying human rights to some human beings inevitably has unwelcome – or even horrifying – implications for the equality of other human beings. Consider the standard reason for saying that embryos and foetuses are not equal: that they do not have advanced cognitive capacities. But – as many supporters and opponents of abortion have noted – neither do newborn babies or people with certain disabilities. Hence some modern countries, most notably the Netherlands, have followed the Graeco-Roman precedent of euthanising some infants and people with disabilities. If we say that advanced cognitive capacities are needed to be a ‘person’, infants and many people with disabilities are not persons and can, presumably, be killed if there is sufficient benefit to society. But that’s not the only problem: if more advanced cognitive capacities are the basis of human value, it is hard to see why people with even more advanced cognitive capacities are not more valuable still. Einstein’s cognitive abilities far exceeded those of the average human being. Why should others be considered equal in value and rights to Einstein? No convincing explanation has ever been provided. Hence, to exclude some human beings because they lack advanced cognitive capacities leads both to the conclusion that it is permissible to kill many other less cognitively sophisticated human beings, and to a more general rejection of human equality even among cognitively mature adults.

Maybe you want to say that humans are persons because they have some minimal cognitive capacities – for example, being sentient (a minimal level of conscious awareness). But this has its own implausible implications: it suggests that any conscious animal – perhaps even an insect – is morally on a par with a mature human being. This is extremely implausible. But even if it were true, it would lead to a far more restrictive abortion law than in many Western countries. There is no good reason to doubt that foetuses can feel pain at just 12 weeks’ gestational age (10 weeks after fertilisation). And sentience short of pain sensation may well be possible significantly before this stage. Brain waves are detectable from just 6-7 weeks after fertilisation. By contrast, abortion is legal up to 12-14 weeks in most European countries, 24 weeks in the UK, and viability (21-24 weeks) or birth in the US and Canada (along with China, North Korea, and Vietnam).

The reality is that there is nothing that all of us hold in common except that we are all human beings. We have different skin colours, hair colours, heights, physical abilities, mental abilities, and so on. If our value, rights and equality depend on something other than this, then some humans will inevitably be left out. The pro-life view simply says that this is unacceptable: the human family is inclusive, equal, and infinitely valuable. To exclude some human beings on the grounds that they are less developed or less capable is the definition of discrimination, inequality, and injustice. It is either discrimination on the grounds of age or on the grounds of ability – neither are acceptable in a modern, progressive world that values all humans equally.

The other way to escape a pro-life conclusion is to deny that human embryos and foetuses are human beings. But this is to deny what appears to be a basic scientific fact. We are not saying that human embryos and foetuses are potential human beings. They are human beings, usually with the potential to experience significant goods in future. Nor are we saying that they are merely human; that is true, but is not enough to be a person, since skin cells are human.

The claim is, instead, that human embryos and foetuses are human beings, that is to say, members of our species, Homo sapiens. They are individual human organisms – dependent, but still individual. They (usually) have their own genetic constitution and their own future. They have all they need to develop into a mature human being, other than nutrition and a normal environment. They need these latter two – but so do infants and toddlers, who will also die without nutrition, oxygen, or the care of others.

Bear in mind that no religious scriptures talk about fertilisation; fertilisation was only discovered in recent centuries. So the idea that a new human organism originates at conception is not grounded in religious tradition. On the contrary, it was a scientific discovery in the late 19th century. It was precisely these scientific developments in the 19th century which led to laws prohibiting abortion during this period – and these laws were promoted first and foremost by the medical profession (see Jones and Keown).

That a human organism is created at fertilisation has remained a scientific fact ever since. It is taken for granted in countless works of embryology. A recent survey of 5 and a half thousand biologists from around the world found that 95% affirmed the view that a human organism is created at fertilisation, with the large majority of explicitly ‘very pro-choice’ biologists affirming this view. When people say that they are not human beings, they are more likely making the claim that they are not persons. That they are human beings is not seriously contested from a biological perspective (and 81% of laypeople surveyed in the same paper said that biologists are the experts on ‘when life begins’, so the biological perspective is clearly what most people have in mind when they talk about the beginning of life. As Ann Furedi, former CEO of the UK’s leading abortion provider, put it:

‘We can accept that the embryo is a living thing in the fact that it has a beating heart, that it has its own genetic system within it. It’s clearly human in the sense that it’s not a gerbil, and we can recognize that it is human life … The point is not when does human life begin, but when does it really begin to matter?’

Hence, if embryos and foetuses are human beings (a biological fact), and if all human beings are persons, equal before the law, the pro-life conclusion is inescapable. This is the logic which leads pro-lifers to hold that the life of human embryos and foetuses must be protected. It is not based on the idea of ‘potential human being’, or on religious dogma. It is a straightforward implication of a biological fact combined with a widely held and plausible view about human equality. If this view is correct, then all human beings – including those at the very beginning of development – deserve the same legal protection, and it should not be legal to end any human’s life except in extreme circumstances (e.g. in self defence). This would make the overwhelming majority of abortions impermissible, both morally and legally. To reject this conclusion, one of the premises must be rejected, or it must be argued that the circumstances are, indeed, extreme.

It has famously been said that ‘facts don’t care about your feelings’. This is true and important – the pro-life argument works regardless of how offensive it might be. But while facts don’t care about your feelings, good, compassionate people should. It is one thing to say that abortion violates a human being’s right to life in the abstract. It is another thing to say it to a survivor of a horrific sexual crime who is distraught at becoming pregnant from it. It may be true – but it is not sufficient as a compassionate response to women in desperate situations. Sometimes doing the right thing requires considerable sacrifice or heroism, and women who have been failed – by men, by a system, by their parents, or otherwise – deserve both compassion and support when being encouraged to do so. And they deserve good answers to their questions.

This brings us back to the question of the wellbeing of women. If pro-lifers claims about the embryo or foetus are correct, then every case of voluntary abortion seriously harms a woman in at least two ways: it ends the life of her child, and implicates her in something seriously wrong. Pro-lifers often claim that justice involves restoration of relationship, not just any resolution of a problem. They also often claim that pitting mothers against their children harms both. They often claim that it is impossible to harm a child without at the same time harming their mother, because that intimate connection is just part of being a parent.

Maybe you don’t believe all these things – but they are certainly plausible, if embryos and foetuses really can meaningfully be called ‘children’ or ‘offspring’ (of course, ‘offspring’ is the literal translation of the Latin ‘fetus’). What almost everyone can agree on is that abortion is, in itself, a bad thing that we would be better without, even if it is a necessary solution to a bigger problem still.

The pro-life view says that women deserve better than abortion, and that even aside from the inherent harm in losing a child or in being involved in injustice, abortion is, on the whole, harmful to women in other, empirically identifiable ways. In other words, it rejects the whole framing of the debate as a battle of the woman’s interests against those of the child. Rather, it says that we can and should help both together. Abortion is worse for the child, but is also worse for the mother and for society. We can do better, because women deserve better.

There is, of course, much more that needs to be said about the relationship between abortion and women’s wellbeing, on an individual level and on a societal level. I’ll try to do some of that in this Q&A, though many volumes have been written on it. As I say, this isn’t intended to be comprehensive – all I am offering is a starting point for better, more sincere, more evidence-based conversations about a fraught and challenging topic, which for so many people is far, far more than a theoretical debate. Please do get in touch with me if you think I have been unfair, or could phrase something more compassionately. And please forgive me if I offend by carelessness or insensitivity at any point. Thank you for your forgiveness and patience in advance.

Contents

Debating abortion

Can men speak about abortion?

“Abortion shouldn’t even be debated”

Are there other arguments for the pro-life position?

“Don’t like abortion? Don’t have one”

Embryology and the beginning of life

When does life begin?

“No one knows when life begins”

What about foetal development?

When is the first heartbeat?

When does consciousness begin?

When can babies feel pain?

When is viability?

Which terminology is most accurate?

Is the foetus a parasite?

Does twinning suggest life doesn’t begin at fertilisation?

Abortion in practice

How many abortions are there per year?

Why do abortions occur?

What proportion of women aborting are married?

What proportion of abortions are repeat abortions?

What proportion of abortions occur among women with children?

What proportion of abortions occur among ethnic minority women?

At what gestation do abortions occur?

What does abortion involve?

Is abortion killing?

Is medical abortion just a heavy period?

Which disabilities are abortions performed for?

Is sex-selective abortion a serious problem?

Is abortion on demand legal?

The ethics of choice

What about women’s choice?

Judith Jarvis Thomson, the violinist argument, and bodily autonomy

“No one should be forced to be pregnant/give birth”

“No one should be forced to be a mother”

Is abortion self-defence?

The ethics of foetal moral status

Is the pro-life view speciesist?

Why is being human morally relevant?

Is personhood based on viability?

Is personhood based on sentience or consciousness?

Is personhood based on birth?

Is infanticide permissible?

How can killing an early embryo be seriously wrong?

Would you save a 5 year old or a frozen embryo?

Why prioritise abortion over miscarriage?

“Most embryos are miscarried”

“Skin cells are human life”

“Potential is morally irrelevant”

“Acorns are not oak trees, and embryos are not humans”

“Sperm have the potential to become a human”

Are all abortions equally wrong?

Other ethical and metaphysical questions

Abortion and politics

What does international human rights law say?

Should abortion be illegal?

Should women having abortions go to jail?

Should women having miscarriages be investigated for murder?

Is it reasonable vote based on abortion alone?

How to reduce the abortion rate

Do pro-life laws work?

How many abortions occur when abortion is illegal?

Does welfare reduce abortion?

Does sex education reduce abortion?

Does contraception reduce abortion?

Democrat Presidents reduce abortion rates more than Republican Presidents

Abortion and mental health

What are the major studies?

Does abortion improve mental health?

Does abortion harm mental health?

Is it because of the stigma?

“Women having abortions have worse mental health to begin with”

Is the link causal?

“95% of women having abortions feel they made the right decision”

“Women suffer emotionally if they don’t get abortions”

What about the APA review?

What about the NCCMH review?

What about Gilchrist’s study?

What did Fergusson’s meta-analysis show?

What about the Turnaway study?

What about Steinberg’s Lancet study on suicide?

How common is ambivalence before an abortion?

Summary of abortion and mental health

What are the policy implications?

Physical consequences of abortion

Immediate complications of abortion

Does abortion cause breast cancer?

Does abortion cause preterm birth?

Does abortion cause infertility?

Does abortion cause sexually transmitted disease?

New abortion technology

Is telemedicine abortion safe?

Does abortion pill reversal work?

Abortion and maternal mortality

“Abortion is 14 times safer than childbirth”: abortion and mortality risk

Do women die from not receiving abortions?: Savita and Izabela

Does legalising abortion prevent women dying from backstreet abortions?

Hard cases

What about abortion in cases of rape?

What about abortion in the case of disability?

What about life-limiting conditions, or fatal foetal anomaly/abnormality?

What about abortion to save the mother’s life?

Economics and the environment

Is unsafe abortion economically burdensome?

“Abortion is cheaper for society than raising a child”

Is the world overpopulated?

What about the environment?

The impact of unwanted children

Does restricting abortion lead to more unwanted births?

Who will adopt all the extra children?

“Pro-lifers are hypocrites and pro-birthers”

Unwanted children lead to educational and career problems

“Unwanted children lead to poverty”

Unwanted children and child abuse

Does abortion reduce crime rates?

How abortion harms women

The effect of abortion on women

How common is coercion?

Are abortion providers linked to eugenics?

Abortion and religion

“Being pro-life is just a religious view”

“Religious views shouldn’t be imposed on others”

Does Christianity prohibit abortion?

Does Judaism prohibit abortion?

Does Islam prohibit abortion?

Does Hinduism prohibit abortion?

Does Sikhism prohibit abortion?

Does Buddhism prohibit abortion?

Do any Biblical passages support abortion?