Is Half an Abortion Worse than a Whole One?
Last week, the New York Times Magazine included an interesting article about abortion by Ruth Padawer. It provoked not a little angst and soul-searching among members of the pro-choice community, as well as some exultant pronouncements from anti-abortionists highlighting supposed inconsistencies in the pro-choice position.
The Times article profiled a number of women who chose to “reduce” their twin pregnancies to a single fetus, recounting the emotions and ethical issues grappled with by women, their partners, and the doctors who perform (or refuse to perform) this type of selective abortion. The procedure, which according to Padawer is “usually performed aound Week 12 of pregnancy”, involves the doctor selecting under an ultrasound scan a healthy fetus whose chest is lethally injected. It shrivels in the womb, whilst its twin is carried to term. In the cases in question, the procedure is not performed for medical reasons, but because the woman has chosen for social reasons to carry only one child to term. Although reductions arose historically as a procedure that was medically indicated – reducing risky quint, quad or triplet pregnancies to twins that had a much better chance of survival – most practitioners have not recognized reduction below twins as having an adequate medical justification. Some practitioners consequently refuse to perform the procedure, but others perform it willingly. As Dr. Richard Berkowitz explained: “In a society where women can terminate a single pregnancy for any reason – financial, social, emotional – if we have a way to reduce a twin pregnancy with very little risk, isn’t it legitimate to offer that service to women with twins who want to reduce to a singleton?” Dr. Berkowitz’s question is a good one, as is the main question that Padawer raises: “What is it about terminating half a twin pregnancy that seems more controversial than reducing triplets to twins or aborting a single fetus? After all, the math’s the same either way: one fewer fetus.”
So what is it that makes “terminating half a twin pregnancy” seem more controversial than aborting a single fetus? Does our almost universal uneasiness about it show a fundamental inconsistency in pro-choice thinking, or is there a consistent pro-choice position that pays sufficient respect both to a woman’s presumed right to choose, and to our uneasy intuitive reactions to twin reduction?
In reflecting on these questions, it is worth considering what kind of specific reasons parents might have for pursuing twin reduction. “Jenny” was quoted in the Times article:
“Things would have been different if we were 15 years younger or if we hadn’t had children already or if we were more financially secure … If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube … and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”
Padawer adds that, “Jenny’s decision to reduce twins to a single fetus was never really in doubt. The idea of managing two infants at this point in her life terrified her … She felt that twins would soak up everything she had to give, leaving nothing for her older children. Even the twins would be robbed, because, at best, she could give each one only half of her attention and, she feared, only half of her love. Jenny desperately wanted another child, but not at the risk of becoming a second-rate parent.”
There is plenty to dispute about Jenny’s characterization of her reasons for seeking twin reduction. No doubt none are in a stronger position to dispute her claims than the many successful mothers of multiples who would rightly bristle at the suggestion that there has been anything “second-rate” about their parenting because of their necessarily divided attention. In addition to this, Jenny draws an odd connection between the rightness of her decision to pursue reduction and the fact that her pregnancy was not “natural”. Together with her rigid focus on providing not less than a certain amount of financial and emotional resources for each of her children, this suggests that she was aiming to produce a kind of “designer” family. But it is probably impossible to exert the degree of control over one’s family that Jenny seems to aspire to. Jenny might well be advised to revise her attitudes and learn to live with less control rather than trying to exert more, on the grounds that her hopes are likely to be thwarted and lead only to disappointment and hardship both for herself and, potentially, for her children as well.
It is considerations of this kind that make us unlikely to sympathize with Jenny’s decision to bring one of her twins but not the other to term. If Jenny’s reasons are typical of those women who choose twin reduction – as we (perhaps unjustifiably) may imagine they are – they make us unlikely to sympathize with the decisions of any of those who would choose twin reduction. Moreover, we may think that a fetus is not just a clump of any old cells, and that it deserves some degree of respect and deference in virtue of being a potential human person (even if not the full rights of an actual person). If so, we will probably conclude that Jenny’s mistaken assessment of her reasons led her to do something morally wrong in having an abortion. We may then worry that twin reduction can never be justified.
Yet we need not conclude from this that abortion is always and everywhere wrong, nor that it should be banned, nor even that the procedure of twin reduction specifically should be banned. To take an analogy: In standing up for the principle of freedom of expression, we endorse the principle that everyone should have a legal right to say what they will; in doing so we need not, of course, morally endorse the saying of everthing that is in fact said. We stand up for free expression not because we believe that every act of expression it permits is good or valuable or morally permissible, but because every alternative to that legal principle would be worse. Similarly, in the case of abortion, we can remain stalwart in our endorsement (perhaps limited by stage of pregnancy) of a woman’s legal right to choose and a doctor’s right to assist based on whichever reasons she sees fit, because we may reasonably think that every alternative principle would be worse. On those grounds we need not and should not morally endorse every woman’s decision, for whatever reasons, to have an abortion. The questions of which abortions are right and of which principles for regulating abortions are right are separate questions, and neither pro-choice nor anti-abortion partisans should confuse them.