Abortion through the eyes of a neonatal physician

To hear more about whether abortion should be decriminalised, check out the recent Unbelievable? show with Lois McLatchie and Ellie Lee.

Abortion is a controversial topic which engenders fierce emotional responses from both the pro-choice and pro-life camps. Returning to first principles held by both the scientific and religious communities physician and Christian apologist Erik Strandness seeks to clarify the real source of all the anguish.

Conceiving the problem

Ever since life began, fecundity has been an inherently good thing, and whether it was the two becoming one or the evolutionary passing on of beneficial mutations - fertility matters. Without procreation, God plays to an empty house and natural selection is out of a job. It appears then that both religious and irreligious alike believe that bearing offspring is a foundationally beneficial thing. What happened? God’s vision for filling the Earth has become man’s desire to have its glass half full, and natural selection’s voracious need for biological product has been interrupted by a supply chain crisis. How did we get from fruitfully multiplying to promoting crop failure? From reproductive fitness to fertile frailty? How did such a unifying good thing become such a divisive bad thing?

I believe that our predicament is the result of humankind’s relentless desire to make everything that is inevitable, optional. We are no longer content to sit back and read the book of nature but feel compelled to take up our technological pen and rewrite natural history. In other words, ever since we ignored God’s Garden warning and took a bite of the knowledge of good and evil, we see all of life as a decision tree, and rather than accept the divine standard we believe we are entitled to change the rules. Ignoring the expertise of the divine arborist we take our dubious knowledge of moral forestry and get lost in the ethical woods. Ultimately, we are persuaded that our newfound divine powers are most completely realised when we wield the sword of choice.

The fear of the Lord that should have led to Godly wisdom was replaced by fear that God was holding out on us, and in a divine coup we made ourselves judge and jury. Sadly, one of our most notorious judgments occurred when we finalised the divorce between pleasure and pregnancy on the grounds of irreconcilable differences.

The divorce of pleasure and procreation

In a world where natural selection is our maker and its chosen sculpting tools are death and reproduction we are left with very little to enjoy as we engage in the battle to be the most fit survivor. The only reward for an organism in a land red-in-tooth-and-claw is an orgasm. Sex has become the opiate of the masses and our culture is more than happy to be its dealer. We promote sex education for kindergartners because deep down we know that a world without God is unlivable, and we feel obligated to give our youth a strategy for temporarily escaping its meaninglessness by promoting a sexual high without a pregnancy hangover. Ironically, our efforts to minimise the psychic pain of evolution through sexual novelty has made our species less fit by decreasing the birth rate through its associated bedfellows of abortion and contraception. We are hedonistically sending humanity into extinction so because we value the adult sexual high that we deprive the world of childlike innocence.

At its most basic level, sex is linked to procreation. Under natural conditions, without any intervening technology, sex will inevitably lead to pregnancy. Humans are the only creatures that have developed the ability to sever sexual pleasure from its natural procreative function, and a culture steeped in hedonism is inclined to favour fun over fertility. The court of human opinion has issued its verdict by establishing a precedent that makes it possible for us to engage in adult entertainment without being in a family way. The sad consequence of our medical prowess is that pregnancy has become a disease, children have become pathogens, and the termination of life has been rebranded as reproductive health care. 

Read more:

The Abortion Debate: Life, Equality, and Choice

Christianity, the Sexual Revolution and the future of the West

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7 ways abortion harms women

Me and my arrow 

I don’t think it’s controversial to say that once an egg is fertilised it is set on a course to become a foetus, newborn, infant, child, teenager, adult and senior citizen. In other words, it starts what Dr Bernard Nathanson, former abortion doctor, called a life vector which when allowed to take its natural course inevitably proceeds through all the stages of personhood. Before the advent of modern science, this vector defined humankind, and its magnitude and direction were left largely untouched until we became scientifically savvy enough to tinker with its trajectory.

Technology has empowered this life vector through in-vitro fertilisation, fertility drugs, surrogacy, neonatal medicine, vaccines and life-extending medical treatments, but it has also been stopped dead in its tracks by introducing contraceptives, vasectomies, tubal ligations, abortions and assisted suicides. Sadly, whenever humans interfere with the life vector, even when their intentions are noble, they end up creating more problems than they started with.

Promotion of life through in vitro fertilisation has produced freezers full of human embryos, fertility drugs have created octomoms, surrogacy has blurred the lines of parenthood, and life extending medical advances have greatly increased the cost of health care. Conversely, technologies designed to limit life have altered the normal female hormonal milieu, re-envisioned surgery as the art of rendering normal biological functions non-functional, redefined the dismemberment of foetuses as bodily autonomy, and put a happy face on the grim reaper. 

Every one of us began our life vector as an embryo with a unique trajectory. A vector that was knit together in our mother’s womb and whose trajectory was determined before the first points were ever graphed. We must therefore zealously defend the life of the unborn because as we all know wherever we go, everyone knows, It’s me and my arrow.

Proto-choice

Humans have the unique ability found nowhere else in the animal kingdom to choose to bring life into the world, a decision that falls on both partners in a relationship. Pregnancy is the result of a choice and unless we are experiencing a pandemic of virginal conceptions, we need to put aside the silliness that pregnancies are forced. I want to make it clear that I am not discussing the rare cases of rape and incest (< 0.5% of all abortions) or abortions done for maternal health reasons (< 5% of all abortions) because they require a much more nuanced discussion. I am talking about the vast majority of pregnancies that are the result of consensual sex.

The decision should be a mutual one with both parties understanding the potential risks. The decision should weigh even heavier on the man because if pregnancy occurs then the heavy lifting will have to be done by the woman. Men should never be allowed to consider abortion a safety valve for unwanted pregnancy because all the medical and surgical risks fall upon the woman. Men must not be allowed to carve faux notches of masculinity onto their fertility belt as baby-daddy’s but must become real men and take on the role of fathers. Any man who gets a woman pregnant should be held responsible for the care of the mother and baby and any dereliction of duty must be met with legal consequences.

Interestingly, abstinence, the proto-choice, is rarely discussed by the abortion contingent because they seem more interested in severing a life vector than asking whether it should have been plotted in the first place.

Hierarchy of choices

The last time I checked, abstinence was 100 per cent effective in preventing pregnancy. Once a couple decides to not follow the science, and engage in a procreative act, they introduce the possibility of conception, and even if they choose to employ some form of contraception the warning label should be a constant reminder that its success will never reach the level of the gold standard.

We therefore have a hierarchy of choice with each successive choice incurring more serious physical consequences. Once you choose to ignore the 100 per cent effectiveness of abstinence then you take on ever increasing health risks beginning with contraceptive side-effects and possibly ending with surgical complications. It is not, however, just personal risks that are increased because society also takes on a significant amount of baggage. What should have been a choice between two consenting adults becomes a cultural bail out involving significant moral, financial and emotional costs. We seem fixated on treatment when prevention is clearly cheaper. Sadly, the admonition of our mothers to make good choices has been replaced by a culture that encourages limitless choice with the guarantee that the nanny state will always be there to clean up the mess. 

Kids will be kids

We frequently hear critics say that these simple solutions won’t work because kids will be kids, and adults will be adults, and they are going to have sex whether we like it or not, but should we just throw up our hands and give up? Maybe we should teach them that there is in fact a cheap, organic, non-GMO, foolproof way of avoiding pregnancy 100 per cent of the time. The problem is that a postmodern culture that elevates sex to the level of a sacrament considers denying it to anyone an act of apostasy. Interestingly, abstinence doesn’t limit freedom at all but is the ultimate empowerment of choice in a world that believes everyone should drink its Kool-Aid.

I find it interesting that virginity is treated as a human deficit when one could argue that it is the embodiment of human fullness. We all value individuality and autonomy, celibacy celebrates that specialness. Once you surrender your virginity you are no longer unique because you have lost something that was distinctively your own and which cannot be replaced. The #metoo movement helped us understand the consequences that follow when one’s sexual integrity is violated so maybe instead of encouraging our kids to play with fire, we should caution them about what happens when you strike the first match.

Fragrance of freedom

Choice has been elevated to the level of postmodern sacrament where the supreme good in life is the ability to choose and the consequences are nothing but the price of admission for a good time. However, once you remove consequence from choice you gut it of all relevance. The pro-choice movement does a disservice to the word choice because it ignores that which makes it profound - the estimation of consequences. If you really want to stand for choice, then your top priority should be the clear delineation of what is being chosen and anticipation of the potential consequences of that choice.

Choice, therefore, is a decision made after weighing the pros and cons of a particular course of action, in medical terms, informed consent. The pro-choice movement should be demanding prenatal ultrasounds so that the woman knows exactly what she is choosing, a thorough explanation of the procedure, and the latest scientific data on the emotional, physical and reproductive implications of the choice. Sadly, not wanting to offend, they avoid ultrasounds, limit descriptions of the procedure and minimise the potential complications that may arise. In medicine, if a decision isn’t informed then it is coerced and it seems to me that organisations that are so concerned with women’s rights would do a better job of educating their clientele.

Interestingly, the catch all-term used to justify abortion is “unwanted pregnancy”. The problem with this phraseology is that it isn’t a medical diagnosis but a personal preference. An unwanted pregnancy is not a matter of a woman’s reproductive health but a matter of desire.

Sadly, society failed to read the warning label on the drug of choice, and now we all suffer from its inevitable side effects. Unhindered choice has unleashed a tsunami of consequence poisoning our moral wells and generating an epidemic of cultural dysentery. Society’s septic system is overflowing with the stench of our bad choices but instead of addressing our “choice” diet we are told that that foul odour is the fragrance of freedom and we’re encouraged to take a deep breath.

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Baby bumps

I find it interesting that the tabloids are obsessed with getting exclusive pictures of celebrities with baby bumps. It appears that pregnancy sells magazines. However, we then don’t hear or see from them again until nine months later when they struggle to reacquire their pre-baby bod. At the very time we should be asking questions about the baby’s weight gain, we are subject to reports about the progress of maternal weight loss. Our natural curiosity over whether the baby is attaining his or her developmental milestones is replaced by interest in whether the actress is once again climbing the ladder of success. The baby ends up as an item to check off on a human bucket list rather than the purpose of life itself.

Jordan Peterson said: “You’re not mature until someone is more important than you.” One of my professors, commenting on the birth of his son, said that once he cut the umbilical cord after delivery, he now knew that there was someone on the planet he was willing to die for. In both cases, childbearing is a prerequisite not only for maturity but also sacrificial love. If we consider pregnancy and childbearing forced labour, and abortion a better alternative to parenting, then we are adopting a Peter Pan attitude where we believe that if we just sprinkle enough postmodern pixie dust we will never have to grow up.

Welcoming committee

During the 20 plus years of my neonatal practice, I encountered many courageous women who battled through incredibly difficult pregnancies. Committed to giving their babies every possible chance to live, they endured multiple hospitalisations, endless periods of bed rest, and persistent bouts of nausea and vomiting. In each case, despite all the difficulties, the pregnancy and birth were considered a blessing and not a burden. Interestingly, neonatal medicine continues to push the gestational age of viability earlier and earlier yet stunningly the pro-choice movement insists on making abortion available later and later.

Sadly, the pro-choice movement treats pregnancy as if it were a sexually transmitted disease. Passionate about eradicating it, they enlist the help of a medical profession whose motto is ironically: “primum non nocere – first, do no harm.” In order to make it a part of the healing arts, they must make abortion a key component of women’s health, but then are surprised when most people don’t share their view that pregnancy is pathology. Pregnancy is a normal physiological phenomenon not a social disease acquired from a dirty cultural toilet seat. Ending a pregnancy, therefore, is malpractice, not therapy. If abortion is women’s health care, then pregnancy is a disease, and the baby is a pathogen. Explain that to your children!

The once noble role of the obstetrician as the head of the human welcoming committee has been restructured to include stints as an immigration officer restricting foetal entrance into the land of the living. The once irrevocable passport into the world of equal opportunity has been reissued as an organ donor card. The first parental act of comparing the baby’s fingers, eyes and toes to their siblings is replaced by the calculated cataloguing of foetal body parts for a purchase order. Planned Parenthood treats birth as if it were a form of illegal human immigration and then builds an insurmountable wall guarded by armed medical personnel. It appears, at least in the United States, it is easier for an immigrant to cross our borders than a foetus to enter the world and that our sanctuary cities are more welcoming to the undocumented than the unborn.

Last safe space

Pregnancy is either a burden or a blessing. A foetus is either an oppressor trying to take away the inalienable right to have unprotected sex, or a fountain of youth from which flows the next great generation of movers and shakers. So, which is it, a reproductive disaster or procreative miracle? You can’t have it both ways.

When we violate the sanctity of the womb, we unwittingly remove the last safe place on the planet, and every womb becomes a potential tomb. In a postmodern world where safe spaces are at a premium to protect one from trigger words it appears we have denied such a refuge to the most vulnerable. Hurtful words pale in comparison to abortive macroaggression.

Walking with the wounded

The social conditions and desires of the woman may change her life situation, but they do not change the life status of the unborn. When another life is at stake, we cannot base our decision on the inalienable right to choose but on the inalienable right of the one chosen.

We cannot, however, just condemn the deception of abortion, but must also grieve with the women who have been deceived. We cannot just criticise the lack of informed consent given to those who undergo the procedure but must also have compassion for those who have been misled. We cannot just disapprove of the culture of death but must also be willing to walk the difficult path of those who choose life.

I will give the final word to the great English journalist Malcom Muggeridge.

“Mary’s pregnancy, in poor circumstances, and with the father unknown, would have been an obvious case for abortion; and her talk of having conceived as a result of an intervention of the Holy Ghost would have pointed to the need for psychiatric treatment, and made the case for terminating her pregnancy even stronger. Thus, our generation, needing a saviour more, perhaps, than any that has ever existed, would be too humane to allow one to be born; too enlightened to permit the Light of the World to shine in a darkness that grows ever more oppressive.” (Malcom Muggeridge)

To hear more about whether abortion should be decriminalised, check out the recent Unbelievable? show with Lois McLatchie and Ellie Lee.

Erik Strandness is a physician and Christian apologist who has practiced neonatal medicine for more than 20 years.