We’ve seen the move now from only first trimester abortions to the second and now the third. We are now told in New York that a baby isn’t human unless it is liveborn. The reality is much, much diﬀerent.
I finished medical school in the late 70’s, not long after Roe v Wade (1973) and became board-certified in my specialty, Obstetrics and Gynecology, in the mid 80’s. So, I’ve had about 40 years of experience in the area of pregnancy and women’s health, during which time I have been able to observe the direction and drift of our culture as it pertains to the abortion issue. Perhaps this is why I was so triggered to speak out when the state of New York passed its very misguided abortion bill this past week.
Though I have posted statements on the sanctity of life on my Facebook page from time to time, nothing has drawn the attention that my post on January 23rd has. It quickly went viral and at this point, 3 days later, has been seen on multiple social media outlets and I lost count after it passed 50k or so views.
Pregnancy is considered to be a 40-week process and begins with the first day of the mother’s last menstrual period. Conception occurs usually about two weeks later, and then the due date or estimated date of confinement (EDC) is 38 weeks after that, or 40 weeks after the start of the last menstrual period (LMP). When the availability of legal abortion on demand first came to be, the slogan that was often used was that it should be “safe, legal, and rare.” It was understood to be primarily a first trimester option (first 12 weeks of pregnancy). That is the embryonic stage of pregnancy- developmentally the organs and systems of the baby are still in their formative stage. By the end of the first trimester, the embryo has become a fetus. At this point, the organs have formed and the next 28 weeks leading up to the EDC is all about growth and maturation of the baby and its various body parts.
The often-used rationalization for abortion is that the baby is just a “clump of cells.” This explanation certainly falls away very early in this process as a “fetal pole” can often be seen on a ultrasound exam during the fifth week of pregnancy (one week after the first missed period) and the baby’s heart beat is typically seen on ultrasound by week six. So, by the time a woman is a week late for her period and has a pregnancy test done, we’re past the “clump of cells” description that is so often used. In the 8-12 week timeframe, we can begin to hear the baby’s heartbeat using a Doppler device applied to the patient’s lower abdomen.
I personally believe that life begins at conception when sperm and egg unite and a new genetic identity is made.
In my mind, good people can debate when a pregnancy actually begins: is it at conception or at implantation when the fertilized egg that has begun dividing and diﬀerentiating into diﬀerent types of cells becomes implanted in the wall of the uterus? We really have no idea how many fertilized eggs fail to implant and thus form an identifiable pregnancy. But it is shortly after implantation that we can begin to detect the pregnancy through laboratory testing and imaging techniques.
One of the problems we have, though, when we try to use a definition of the beginning of life other than conception is that the very notion of life then becomes a point of debate for which diﬀerent people will use diﬀerent definitions or guidelines.
One will say it isn’t life until it implants and we can detect a positive pregnancy test, another will say it isn’t life until we can detect a heartbeat (reasoning that we commonly define death as when the heart stops beating). But this view of life becomes a very slippery slope to the point where we are now.
People are now actually making the argument that life doesn’t begin until a baby is liveborn. I have encountered people who amazingly hold to the notion that an unborn pregnancy is still somehow a clump of cells until the baby is born, as though the human birth canal is some kind of injection mold device or extruder that turns those cells into a baby. It is astonishing how poorly educated many people remain as pertaining fetal development. And Peter Singer at Princeton, among others, has already argued that perhaps “life” is the wrong criterion by which we should make existential moral judgements. Such arguments usually employ the term “personhood” to designate when a new life becomes significant and morally entitled to exist.
The new law in NY now says that personhood begins when a baby is liveborn. Of course, most people are quick to realize that some babies are liveborn at 40 weeks, but some are live born at less than 24 weeks or anywhere in between. So, a pitfall of that view of life is that it puts a whole class of human beings into a no-man’s land that depends on where they happen to be located. A baby delivered at 26 weeks is a person, with all the “rights and privileges thereunto appertaining” as the law puts it, while a baby that is still undelivered at 36 weeks, though much more grown and matured, is not yet a person.
This kind of thinking turns us into schizophrenics as it applies to human rights and the making of law. In one place, harming a pregnant mother and her unborn baby results in two sets of criminal charges, but in another place, the mother has rights but her baby doesn’t.
As I stated earlier, I have seen our culture drift to the point that now there are those who argue that personhood doesn’t begin until an infant child is having thoughts and feelings and making choices of their own. We hear the term “sentient being” tossed around as such thinkers try to redefine personhood as later and later and thus delay the application of an individual’s rights.
Where once abortion was going to be a first trimester option, it soon was extended into the second trimester (13-24 weeks). Where once we said “safe, legal, and rare,” we began to hear abortion should be available “anytime for any reason.”
When done in the second trimester it is by use of a D and E (dilation and extraction) procedure. Basically, the uterine cervix is opened up (dilated) and surgical instruments are used to dismantle the fully formed baby piecemeal. The various fetal parts are then collected, and an inventory is made to be sure the abortionist has removed the entire baby.
Since people had become comfortable with first trimester abortions because it only involved a “clump of cells,” this was a more diﬃcult procedure to sell to the public. The rationalization was given that, while this was a fully formed baby, it’s brain and neural development was still immature and thus the baby couldn’t feel pain. More recently, research has given us much evidence to suggest that the baby at this stage of development can indeed feel the excruciating pain of literally being torn limb from limb. However, we have been doing these long enough now that we have somehow become comfortable with the idea.
The new law in NY takes away any constraint to abortion based on gestational age. It merely says that in situations where the baby is not viable because of anomalies or conditions that aren’t compatible with NORMAL life OR the mother’s health is in jeopardy, abortion can be done up to the due date.
Under the new legislation, the fetus is not a person unless and until it is liveborn. So, in theory, a baby can be killed in the uterus on its due date if the mother’s health is deemed to be in danger. If an abortion is done this late in pregnancy, there is no dispute that the baby would feel excruciating pain if a D and E were done. At this point the baby is much too big for such an undertaking. So, the killing would be accomplished by a lethal injection of some kind. After a period of time, the fetal death would be confirmed and then the baby delivered by inducing labor.
Abortion doesn’t get the mother out of having to go through the birth process. But instead of a liveborn baby, she will go through labor and deliver a dead baby. And the rationalization for treating another human being in such a way is that it is not yet sentient – it won’t suﬀer because it doesn’t know and understand that it is being killed.
A term that is often used in discussion concerning abortion is “viability.” Medically speaking, the term means the point at which the baby can be expected to survive if delivered. Viability is generally accepted to be reached at 24 weeks of gestation. Such babies are extremely premature and require intensive care until they’ve reached the point that their lungs can fully support them.
There are many potential complications of prematurity but the specialists who treat such babies are becoming more skilled with each decade and our advancing technology allows us to do more and more for the premature baby. We now see the occasional baby born at 22 or 23 weeks survive.
A problem with the new law in NY is that viability is being redefined as the ability to live a “normal” life. The problem with this new definition is that normal becomes a judgement call made on the fly by people who may not have good judgement. For example, someone may say that their baby would suﬀer too much if it were to spend 10 weeks in Neonatal ICU, so aborting it would somehow be a better choice.
Another example would be that it may be determined that an unborn baby has a missing limb and the pregnancy has already reached the last few weeks when this is discovered. Some would understand that such a defect is unfortunate but that many people have overcome such things and lived very happy and productive lives. But someone else may say that this will cause unnecessary hardship and suﬀering for the baby and it is best to just terminate the pregnancy now rather than allow it to be born with an abnormality. The same can be said of many other conditions that may be diagnosed in the last trimester of pregnancy.
Those in favor of this new law say that we don’t know what we’re talking about, that we’re fear-mongering, that we’re imposing our beliefs on other people. They will ask, “what about the mother’s health?”
I can tell you without question that there are no maternal conditions in the last 16 weeks of pregnancy that require killing the baby in order to save the mom’s life. None. There are many times that we must end a pregnancy early in order to prevent serious problems or death in a pregnant patient, but that doesn’t mean we have to kill the baby.
When these issues arise, we already handle them without any new law being necessary. We deliver the baby and then we take care of both patients to the best of our ability. Sometimes the degree of prematurity is such that the baby doesn’t survive, but that’s much diﬀerent than actively killing it. When fetal anomalies that are incompatible with life are identified, sometimes it is advisable to end a pregnancy early. But there is a diﬀerence between actively killing an unborn human being and delivering it and giving comfort care as nature takes its course over a few hours to days.
Sometimes in the course of a normal pregnancy, a patient’s social circumstances will change. It is not unusual for a pregnant mom to lose a job or be abandoned by a boyfriend who isn’t fully committed to the relationship. Such an event in late pregnancy could be emotionally devastating to a pregnant mom who is left feeling like there’s no hope and that she can’t possible meet the demands of raising a child.
This law allows a healthcare provider to deem such a situation as jeopardizing the mom’s mental or emotional health and thus justify an abortion, even if the due date is within sight. Where once, adoption might be the most attractive solution to such a predicament, now abortion might be considered by some women as preferable to giving the baby up for adoption.
Abortion will not lower her risk nor make her delivery easier. It will actually increase her risk and once done will completely take away her ability to consider other options. With a live baby, she can take some time and think through her options, making a thoughtful choice after her emotions have stabilized and her situation has become more clear. She can even wait until after the birth to make her decision. However, once the lethal injection is given, her other options are no longer available and when regret comes, she will have no recourse.
Over the years I’ve dealt with many women who carry intense guilt and shame because they chose abortion many years ago. They torture themselves over their choice and struggle with depression and anxiety. Their relationships suﬀer as well. But the abortion advocates will tell you to “shout your abortion” as though it is a badge of pride. The reality is much, much diﬀerent.
It became clear to me long ago, that the only scientific answer as to when life begins, the only logical answer as to when life begins, and the only moral answer as to when life begins is at conception. Any other suggestion opens up the possibility of allowing the enemy to “steal, kill, and destroy” by moving us to rationalize away the humanity of the unborn baby.
We’ve seen this move now from the first trimester to the second and now the third. We are now told in NY, a baby isn’t human unless it is liveborn. Already some make the argument that a liveborn baby isn’t fully human until it acquires the ability to comprehend what is going on around it. And so we will soon see infanticide advocated for living human babies who are several months old who have developmental issues or neurological disorders.
This, I fear, is where we are headed.
The post’s author has been a board-certified practicing OB/GYN physician for over 30 years. He wishes to remain anonymous.