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Bioethics Forum Essay

Should Pro-Choice Advocates Compromise on Abortion?

In a recent New York Times essay, “A Hard but Real Compromise Is Possible on Abortion,” Jon A. Shields suggests that pro-choice advocates should be willing to live with a 15-week limit on access to abortion. He bases his proposal on the fact that, while most Americans say they support Roe v. Wade, most are also in favor of restricting abortion to the first trimester. This is because of a common moral intuition that predisposes most people “to feel more protective of a fetus as it begins to resemble a newborn.” Thus, pro-choice arguments have more weight early in pregnancy and less as the pregnancy develops.

Shields also suggests that the current battle is between those who support absolute bans and those who support unregulated access. If only both sides were willing to compromise, maybe we could put the abortion issue to rest!

I do not dispute Professor Shields’ premises. He’s right that most Americans, whether they are pro-life or pro-choice, regard late abortions as morally more problematic than early ones. He’s also right about the reason why. A late-gestation fetus looks a lot like a newborn and has most of its characteristics, including an ability to experience pain. For this reason,  it inspires the same feelings of protectiveness. This may not be entirely consistent with the view that a new human being, with a right to life, comes into existence at conception, or with the view that fetuses at all stages of development lack moral and legal status, but there it is.

So, should pro-choice advocates be willing to accept a ban on elective abortions after 15 weeks? After all, most abortions in the United States (92.2%, according to the Centers for Disease Control and Prevention) take place at or before 13 weeks. What would be the harm of accepting a legal ban on abortion after 15 weeks?

I’d be happy to go along with such a ban if, but only if, certain conditions accompanied it. The first would be meaningful access to abortion in the first trimester. Restrictive abortion laws compound the existing problem of a dearth of abortion clinics, especially in rural areas. According to the Guttmacher Institute, 38% of women in the United States aged 15 to 44 live in a county without an abortion clinic. They have to travel, often for hours, to find a provider. If they have a job, they need to take time off. If they have children, they need to find someone to look after them.

Then there’s the problem of cost. Abortion is not covered by Medicaid in 34 states and the District of Columbia, except cases of rape, incest, or where the woman’s life is in danger. The cost of the abortion pill depends on where the woman lives. In some states, the cost may be low or even free.  In California, the average cost of a medical abortion is $306. In other states, the cost ranges between $320 and $500. That is cheaper than a surgical abortion, but still out of the reach of many poor women. Moreover, the abortion pill can only be used in the first 10 weeks of pregnancy. After that, a surgical abortion becomes necessary. Depending on where it is performed and at what stage of pregnancy, surgical abortion could be as high as $1,500. All of these barriers cause many women to delay getting an abortion. Anyone serious about reaching a compromise should be willing to ensure that all women who want to terminate their pregnancies, no matter where they live or how much money they have, can get a first-trimester abortion.

However, not all women who choose abortion really do want to end their pregnancies. Rather, abortion seems the best of bad choices. They may already have children they cannot support or an abusive partner on whom they are financially dependent. My second condition for accepting a 15-week ban, therefore, is that it is accompanied by measures that would allow women to keep pregnancies they want, such as a basic family income and universal childcare. One would think that pro-life advocates would enthusiastically support such proposals, although the evidence for this is slim to none.

Finally, there should be a clear understanding of why abortions in the second and even third trimester occur. As I’ve suggested, it’s rare that women are simply unable to make up their minds. However, it isn’t only lack of access that leads to late abortions. Another important reason is that sometimes a fatal defect is detected late in a wanted pregnancy. Sometimes a condition develops in the woman that threatens her life, her health, or her future fertility. Abortions in such cases are often medically indicated. The decision whether to abort should be made by women and their partners, with the advice of their doctors. I would reject any compromise that takes the abortion decision out of their hands.

If these conditions could be guaranteed, I would gladly accept a 15-week ban on elective abortions, and I suspect that many pro-choice individuals would as well. I’m less sanguine about the response of those who are pro-life.

Bonnie Steinbock,  PhD, a Hastings Center fellow, is professor emerita of philosophy at the University at Albany, State University of New York.

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  1. I also wonder, e.g. for teens without good access to prenatal care, how many women only discover that they are pregnant toward the end of the first trimester, or even later, and then have to scramble to get an abortion, if that’s what they want.

    1. Yes, you’re right about the teenagers. I should have added a 4th condition: access to birth control and adequate sex education in the schools. There may be some other women who aren’t aware they’re pregnant until after 15 weeks: those who are obese or believe they’re past menopause. But I’m guessing that there aren’t a whole lot of women in this situation who want abortions. If I’m right about this, then I’d be willing to sacrifice them if we could get meaningful access to all women in the first 15 weeks, and adequate support for families that don’t want to abort, and no state intervention for late-gestation abortions for health reasons. Would you take that bargain?

      1. Sacrifice whom, Bonnie? Sure, some people will always be left out on the margins, but I am not willing to sacrifice the ignorant teenager (although I have to admit I have no stats on how common that is). Would love to hear from someone who does.

  2. Pro-choice advocates absolutely should not compromise on a 15-week limit. Abortion jurisprudence is clear on the right to an abortion: the state cannot place an undue burden on a pregnant person’s right to seek an abortion pre-viability (Roe v. Wade; Planned Parenthood v. Casey), which is often considered to be 24 weeks. Accepting a 15-week limit would be asking pro-choice advocates to curtail a pregnant person’s constitutionally protected right to an abortion pre-viability. As this article states, there are many reasons why a pregnant person is not able to get an abortion before 15 weeks; many women don’t even know they are pregnant during the first trimester. Even with all of the conditions the author proposes, pro-choice advocates still shouldn’t accept a 15-week limit because doing so runs counter to the goals of the pro-choice movement. Abortion rights advocates are not arguing for reasonable limits on the right to an abortion (even if recent Supreme Courts cases have put them on the defensive). At its heart, this movement is about the unequivocal right to make decisions about one’s body. A 15-week limit runs counter to this goal, asks advocates to accept a limit on an already constitutionally protected right, and ignores the realities that, even with all the conditions guaranteed, some pregnant people simply don’t know they are pregnant until after this period has elapsed.

    1. I get this position, just as I get the position of pro-lifers who say, “How can we compromise when the life of the unborn baby is at stake?” Maybe Shields is right and both sides are absolutist and intransigent. I was trying to show that a compromise is possible if other conditions could be guaranteed. See my replay to Dena Davis.

  3. I feel like talking about pro-choice and pro-life is a very sensitive topic to discuss, as I don’t see how either side will be able to compromise on their ideals and decisions. Would it be ethical to not allow patient autonomy when it comes to cases after 15 weeks? And what about all of the exceptions that. weren’t cited above. From my scarce knowledge of law, treatment becomes available when the majority of law cases have been won in favor of the scenario, in this case, pro-choice. Compromising on a specific time to proceed with the procedure, I feel, is very hard and therefore shouldn’t be an option, as we will never be able to please both sides of the story.

  4. I understand the desire to compromise but in this instance I don’t believe its the right thing to do. 15 weeks may be enough time for most women to discover that they are pregnant and obtain access to an abortion, but that won’t be the case for all women. Some women have irregular periods, PCOS, or may have an IUD that dislodged and was defective at preventing pregnancy (some hormonal IUDs cause amenorrhea), etc., and may not even know they’re pregnant within the first trimester. Banning abortion after 15 weeks would place many women in a situation where they would be forced to have a child they may not be financially or mentally prepared for, all because of their irregular menstrual cycle. Women should always have the right to choose, and have more than 15 weeks to do so.

  5. I appreciate your willingness to compromise. However, I see both sides being absolutist as that is the main idea their arguments are based on – pro-choice and pro-life with no timeline. You listed many barriers that could delay a woman from getting an abortion, however how can we be so certain that if these barriers are removed individuals will be able to obtain an abortion in the 15-week time limit? If the individual is unable to obtain the abortion before the 15 weeks, then they will be forced to have the child even if they are unprepared or unable to care or provide for the child – creating more harm. When we look at the abortion debate, we need to recognize we are talking about human beings lives and it may be impossible to compromise with a specific timeline in order to move on from the discussion. To me, there is no time that seems appropriate to strip women of their right to make their own decisions, no matter the conditions we put in place.

  6. Thank you for presenting a well-rounded, thought-provoking opinion on this controversial matter. As a pro-choice advocate, I cannot say I would agree to “living” with a 15-week limit on access to abortion as presented in the essay of Jon A. Shields. I agree with the sentiment that most individuals who support Roe v. Wade may be hesitant to support abortions in later pregnancy, as the fetus begins to resemble a newborn. However, in my opinion, the moral obligation largely remains the same, as the fetus is still entirely dependent on another’s body, and that individual should have complete control over this decision. One big exception to this would be the fetus’ experience of pain in later pregnancy, and this should be attended to comprehensively and wholeheartedly. This is where the highest moral obligation lies, in my opinion. However, how are we to reach a point where abortion access is safe, effective, and accessible to the greater, diverse population when the entire process is so heavily stigmatized? The majority of the focus has been on determining if abortion is “right” or “wrong” in terms of “morality,” instead of greater issues like how we can make abortion more accessible and affordable for more women in this country.

    Compromises are great in many ways, though I cannot see a compromise in this situation that benefits the population affected by abortion restrictions: people with uteruses. How can we compromise on a situation that forces individuals to give birth when for many reasons that may not be good for them, or society for that matter. To me it seems that many pro-life arguments do not support life at all, and instead resemble more “pro-birth.” If an individual is not equipped financially or emotionally to care for a child, who helps them? The child may end up growing up in adversity, or foster care, or conditions where they will not have the support to thrive. In addition, it is no secret that religion plays a role in many pro-life arguments. Religion is beneficial to many individuals all over the world, bringing a sense of spirituality, wholesomeness, and faith. However, religion has no place in informing legislation and healthcare, which should be solely based on science, principles of present society, and future goals for a more equitable nation.

    Again, I thank you for your posting and I appreciated reading it. I just believe this is not an issue pro-choice advocates can compromise on, given the generous amount of extenuating circumstances (finances, age, safety, rape, incest, unaware of being pregnant, etc.) to the fact that it is someone else’s body who must bear the newborn, and therefore their decision.

  7. Thank you for presenting a well-rounded, thought-provoking opinion on this controversial matter. As a pro-choice advocate, I cannot say I would agree to “living” with a 15-week limit on access to abortion as presented in the essay of Jon A. Shields. I agree with the sentiment that most individuals who support Roe v. Wade may be hesitant to support abortions in later pregnancy, as the fetus begins to resemble a newborn. However, in my opinion, the moral obligation largely remains the same, as the fetus is still entirely dependent on another’s body, and that individual should have complete control over this decision. One big exception to this would be the fetus’ experience of pain in later pregnancy, and this should be attended to comprehensively and wholeheartedly. This is where the highest moral obligation lies, in my opinion. However, how are we to reach a point where abortion access is safe, effective, and accessible to the greater, diverse population when the entire process is so heavily stigmatized? The majority of the focus has been on determining if abortion is “right” or “wrong” in terms of “morality,” instead of greater issues like how we can make abortion more accessible and affordable for more women in this country.

    Compromises are great in many ways, though I cannot see a compromise in this situation that benefits the population affected by abortion restrictions: people with uteruses. How can we compromise on a situation that forces individuals to give birth when for many reasons that may not be good for them, or society for that matter. To me it seems that many pro-life arguments do not support life at all, and instead resemble more “pro-birth.” If an individual is not equipped financially or emotionally to care for a child, who helps them? The child may end up growing up in adversity, or foster care, or conditions where they will not have the support to thrive. In addition, it is no secret that religion plays a role in many pro-life arguments. Religion is beneficial to many individuals all over the world, bringing a sense of spirituality, wholesomeness, and faith. However, religion has no place in informing legislation and healthcare, which should be solely based on science, principles of present society, and future goals for a more equitable nation.

    Again, I thank you for your posting and I appreciated reading it. I just believe this is not an issue pro-choice advocates can compromise on, given the generous amount of extenuating circumstances (finances, age, safety, rape, incest, unaware of being pregnant, etc.) to the fact that it is someone else’s body who must bear the newborn, AND make arrangements to transform this newborn into a fully functioning human being that is completely dependent on them. It is therefore their decision.

  8. Thank you for this essay, I really appreciated your thoughtful solutions for abortion care benefits. I fully agree that there should be additional resources in place to support families who elect to have abortions for socio-economic reasons such as universal basic income and universal childcare. These measures would give families additional room to make the best choice possible. Regarding the issue of compromise, a more cynical part of me thinks that the expectation that either side of the argument will concede their positions is unrealistic. Pro-choice advocates are not seeking to secure the right to abortion within a reasonable time frame but instead, aim to make sure every pregnant person has the access and ability to have an abortion without having to meet arbitrary requirements. On the other hand, the pro-life movement will not be satisfied until abortion is fully outlawed given that their ideology firmly believes that abortion is murder no matter the stage of pregnancy. With both sides so resolute in their viewpoints I think the opportunity for compromise, or being able to please both sides, is slim. For this reason, I think that what makes both sides happy should take a back seat to what is safest and most equitable for as many people as possible.

  9. As a pro-choice person, I am fearful to impose any regulation on a woman’s right to choose. However, as stated in the article, 92.2% of abortions in the United States take place at or before 13 weeks. Unlike the pro-life community, which advocates for stringent, inflexible regulations that usually include banning all abortive procedures, the pro-choice movement allows for multiple compromising solutions. However, each compromising solution comes with new ethical debates that revolve around defining the beginning of life. Pinpointing a specific organ or ability as the emergence of life seems impossible. Yet, few people view unregulated late-term abortions as morally sound. Thus, a middle-ground answer seems sufficient.
    Although I would prefer an 18-week ban, which gives additional time for vulnerable populations to overcome the hurdles to obtain abortive services, I believe a 15-week ban can be a justifiable time regulation. If a 15-week regulation becomes the norm, I think all other barriers to abortive services such as: obtaining parental consent, requiring the request and authorization of abortive measure to occur on two separate occasions, and monetary burdens should be dismantled. Finally, I would like to clarify that regardless of proposed “bans” on abortions, whether 6-weeks, 15-weeks, or 23-weeks, I believe no policy or governmental entity should interfere with a woman and her physician’s ability to seek action when the woman’s health is at risk, the child suffers from diseases only detected in later-stages of pregnancy, or in situations in which sexual violence has occurred. Government does not have the right to impose regulation during such vulnerable, life-altering, and horrific times. To pass judgement and/or policy that hinders a woman’s choice during such times will never be justifiable.

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