In a room, a waiting room, sits a woman. She might be married or single, teenage or middle-age, in the midst of a professional career or receiving government assistance. She might be in a good relationship, in an abusive one, or not in one at all.
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She is crying into her hands. Or she is calm and not too worried, ready to do what she feels needs to be done. Or she is numb, just numb. She, whoever she is this time, is pregnant and doesn't want to be. Or wants to be, but feels she can't make it. Or isn't sure what she wants, but knows what her husband or boyfriend wants, or her parents, and she wants to please them.
As pro-life people, with a variety of views about whether or not abortion should remain legal, how do we respond to her?
More than 1.5 million abortions occur in the United States annually, one of the highest abortion rates among developed countries. That number represents a vast number of babies not brought to term and a vast number of unique situations—with different human players, different circumstances, different paths, and different emotional freight.
These individually complex situations take place in the midst of the peculiar social situation of America today: a violent, rending debate over abortion itself that draws from and spills over into several roiling cultural currents. What is the role of faith and values in public discourse? How do we achieve and maintain the dignity of women? What are a government's responsibilities? An individual's? Can we find a healthy understanding of sexuality that's not exploitative or repressive? What place in society do children have?
The extremes of the abortion debate are only intensifying a dangerous situation. They might cancel out their opposite extreme, but they add nothing to a solution. The woman sitting in the waiting room and the child who has been conceived both get lost in that maelstrom.
Many people who are pro-life do hold up the life and dignity of the woman as every bit important as saving the child she carries. And then-President Clinton's statement that abortion should be "safe, legal, and rare" is one that many pro-choice advocates can agree with. If pro-life people know that one abortion is too many and many pro-choice people can at least agree that there surely shouldn't be as many abortions as there are, shouldn't we do what we can in the scope of that common territory?
A whole and compassionate approach to reducing the incidence of abortion intertwines that goal with nurturing the life of children and increasing and enhancing the options, dignity, and responsibility of women and men. This means bringing together the rights and dignity of women with the sanctity of all life. As pro-life lawyer Andrew Puzder puts it, "If you're not in favor of abortion, and you are not in favor of expanding a woman's other choices, what are you in favor of?"
No single approach will reduce the number of abortions. Nor will public policy alone untangle the web of issues. Policy matters, but it is the way that it intersects with values and with real people in individual situations that determines its effectiveness. Still, in the hope of making abortion rare, we want to look at a range of factors that may contribute to that goal.
NO SINGLE OVERWHELMING factor leads women to have abortions. The average woman having an abortion gives more than three reasons for doing so, according to the Alan Guttmacher Institute. (AGI is a nonprofit, pro-choice reproductive health research, policy analysis, and public education organization.)
In AGI polls, three-quarters of the women say a baby would interfere with work, school, or responsibilities; about two-thirds say they cannot afford to have a child; and half say they do not want to be a single parent or they have problems in their relationship to their husband or partner. Other sources rank relationship issues—strain with the baby's father or pressure from the woman's parents—higher.
Poor women are three times more likely than women who are better off to have an abortion, not because they choose abortion more often, but because the rate of unintended pregnancy is much higher in the lowest economic group. Still, 11 percent of abortions are obtained by women with a household income of more than $50,000.
The natural first step to reduce the incidence of abortion is to bring down the number of unwanted pregnancies. A place to start is reducing unwanted pregnancy among teenagers, both because they are not prepared for pregnancy and child rearing and they are at a crucial time in their sexual identity.
In her book Young, Poor, and Pregnant, Judith S. Musick describes how a variety of factors combine to result in teen-age pregnancy among low-income girls. A primary task of adolescence is to solidify an identity. In many girls' communities, motherhood (without respect to preparation or age) is often one of the few valued and visible identities available.
Other factors further narrow her horizons. Many pregnant teenagers were initiated into sexuality in preadolescence by older men in their family. Such early abuse teaches a child that she has no control over her body; sex is something that happens to her. By extension it can reinforce an overall sense of helplessness, whether dealing with a persistent boyfriend, sticking with school, or seeking a job. Other research shows that up to 50 percent of babies born to teen-age girls were fathered by adult men, not other teenagers
Adolescent irresponsibility, lack of grounding, and impulsiveness also have a role to play. And the hunger for affection and security, for respect and adulthood, are very deep. Combine these with ignorance and exploitation by adults, and girls will become pregnant.
Musick emphasizes that a strong sense of self is what is needed—not warm, fuzzy "self-esteem," but the empowered sense of self that comes from learning and testing new skills and goals in the presence of strong mentoring, support, and exposure to diverse role models. It is not just teaching girls (and boys) to say "no," but teaching them all the things they can say "yes" to.
The public schools in Alexandria, Virginia, offer a one-year program for girls called Project Stepout (and a corresponding one for boys called Project Manhood) that has been credited with lowering what was previously one of Virginia's highest city teen-age pregnancy rates. Children in grades five through nine meet in groups with volunteer mentors to discuss how pregnancy, sexually transmitted diseases, and drug abuse can keep them from reaching their goals. They talk about personal strengths, values and behavior, and gender roles and stereotypes. The program emphasizes the skills and confidence teens will need to make assertive, informed decisions, such as whether to become sexually active or not (with the choice for abstinence being stressed).
Teaching abstinence is controversial. Many groups, especially faith-based ones, argue that it should be the only option presented to teenagers because teaching contraceptive methods and making contraceptives available promotes sexual activity. "You undermine abstinence if you have an attitude that it won't work," says Loretto Wagner, co-founder of two homes for pregnant women in the St. Louis area.
Programs that discuss values and facts openly, but stress abstinence to teens as a way to build a sense of self, to be more empowered in their sexuality, and to achieve long-term academic, relational, and career goals, bring together the best of both worlds. The fight over whether to teach abstinence or contraception can be a distraction, because both require information, self-confidence, discipline, and communication skills to have a chance at effectiveness.
Perhaps the need for such information and skills for adults (of all economic and class strata) is underestimated. A survey of 1,000 female college students quoted in The Washington Post states that although 85 percent of them are sexually active, almost a quarter had never had a pelvic exam—a vital component of women's health, and an opportunity to learn about the most effective contraception. Fifty-three percent of unplanned pregnancies occur in women who are not using contraception at all. If abstinence is not an adult's choice, then responsible use of contraception methods must be (including the option of natural family planning and methods that also reduce the incidence of sexually transmitted disease, such as condoms).
WHAT ARE REALISTIC options once a woman is pregnant and didn't plan or want to be? What is needed to expand her choices and give her support?
A woman in this situation needs information, including basic biological facts: How does a fetus develop? What are the risks associated with abortion? What are the risks associated with pregnancy and delivery? In order to continue the pregnancy, she will need education on how to care for herself and the developing child.
She will also be seeking resources: Where can she find emotional support throughout the pregnancy and beyond (especially if the father is out of the picture)? Will she be able to pay for prenatal care and delivery costs? If she wants to keep the baby after birth, how will she pay for shelter, food, and clothing? Even if money and insurance aren't problems, how will she manage schooling or employment once the child arrives? If she doesn't feel able to raise the child, where can she find information on safe, regulated adoption procedures?
What should a woman be required to know if she is seeking an abortion? In 1992, the U.S. Supreme Court ruling in Planned Parenthood vs. Casey didn't overturn Roe vs. Wade but did rule that states are free to restrict abortion, as long as they do not place an "undue burden" on a woman. "Informed consent" (mandatory pre-abortion counseling about fetal development, procedural risks, adoption, child support, and abortion alternatives) was deemed allowable under this standard, as was a 24-hour waiting period following counseling.
Pro-choice advocates usually argue that any modifiers to access to abortion, even information requirements, are unnecessary, burdensome, and open to manipulation. But this has to be balanced with a woman's right and ability to make an informed decision.
"Women don't need to be protected by the federal government or Planned Parenthood," argues Serrin Foster, executive director of Feminists for Life of America. "They need to be informed about their bodies and their options. They need to be empowered to make life-affirming decisions for themselves and their children."
The law in question in Planned Parenthood vs. Casey, the Pennsylvania Abortion Control Act, has many other lesser-known provisions that did not come under public scrutiny. It prohibits coercion by a parent, guardian, spouse, or public official to abort. It regulates facilities, requiring complete reports of resulting injuries and maternal deaths. Abortions for sex selection or after 24 weeks gestational age are prohibited, as is fetal experimentation. And the act prohibits penalties against women who abort. Such legislation, which protects a woman from penalty while giving her protection from both coercion and lack of information about a clinic's record, enhances a woman's ability to make an informed decision.
Crisis pregnancy centers, whether local or part of national organizations such as USA Birthright or Care Net, have for many years provided material aid, counseling, and referrals for women who have unintended pregnancies. While such organizations try to help women get by physically, most also try to offer emotional support and companionship.
Since crisis pregnancy centers are associated with the pro-life movement, many people in the pro-choice movement view such centers with suspicion, assuming they will mislead or manipulate women to keep them from having an abortion when they want them. But at their best, crisis pregnancy centers simply provide much-needed resources for women who want them.
This is the question for both pro-life or pro-choice adherents: Is everything being done (by myself or my church or community) to provide a place where a pregnant woman will be respected, supported, accepted, and given the resources and information she needs? Ideally churches, whether staunchly pro-life in doctrine and actions, or a congregation that endorses or has sympathies with a pro-choice position, should be a place where women can find such support (physical, emotional, and spiritual).
For women who want to continue their pregnancy, but fear or have experienced rejection by their partner or family, a committed person who will accompany them emotionally through their pregnancy and beyond can make a big difference. In Real Choices, a book on alternatives to abortion, Frederica Mathewes-Green writes that the first way to help women continue pregnancies is to be a friend—volunteer for organizations who offer such support or step into such a role when it presents itself in your church or community. Likewise, helping a girl or woman to explore reconciliation, when appropriate, with the father or with parents can be a helpful role.
CONTINUING A PREGNANCY is one decision. Choosing whether to keep the infant or place it for adoption is another. There are complicated cultural factors involved in adoption. Some racial and ethnic groups have not traditionally embraced it as an option, or are cautious around issues of interracial adoption and cultural integrity because of past exploitation.
But in other cases, ignorance about adoption and no sense of having space to explore options play a part. Mariam Bell, a pro-life participant in the D.C. area Common Ground group, says she has come to realize that "what has been happening at abortion clinics up to this point—being yelled at, pressured—is antithetical to what a women needs at that time."
As an alternative, and a way to address the lack of information on adoption at clinics, Bell periodically sets up a table near a clinic in Alexandria, Virginia, with information on adoption. She does not approach clients, but simply tries to be a non-threatening, welcoming presence, offering information packets, coffee, and donuts.
Andrew Puzder has been part of a working group on adoption reform issues within the Common Ground Network for Life and Choice. The three principles he feels are essential are: 1) When a woman chooses adoption, society needs to view that as a loving and self-sacrificing decision, not one she should be disrespected for. 2) The law needs to be changed to protect foster parents (and children) from abrupt removal years after the child is placed. 3) In the adoption process, if the natural father wants to be involved, there should be channels that allow this.
"Adoption is too emotionally straining for some people," Puzder explains. " It's a very difficult decision and should be respected as such. But when a woman chooses this, the law should make it easy."
What about the woman who chooses not to abort and not to put her child up for adoption? Prenatal care, delivery, diapers, food—they all cost money. While cash benefits and other government support aren't the key reasons why poor women get pregnant (despite what some politicians say), they can be key factors in allowing her to choose to continue her pregnancy, keep her child, and find a way out of poverty. As Loretto Wagner in St. Louis describes it, if we truly want fewer abortions, "we have to make it possible for women to have a baby and live in some sort of dignity."
This is why Wagner, and many, many other individuals and organizations, both pro-life and pro-choice, have joined together to fight the Republican welfare reform plan, the Personal Responsibility Act. The act includes several "child exclusion" provisions that would deny assistance to children born to mothers under 18, children born to mothers currently on welfare, children born to mothers who previously have been on welfare for two years, and children whose paternity hasn't been legally established. Several related assistance programs, such as federal food stamps, would be replaced with a single federal block grant to the states.
While reform is needed, this plan has potentially devastating effects. It will serve to punish families and encourage, even coerce, abortions among women in poverty. Organizations working against the legislation include the National Right to Life Committee, Planned Parenthood, the U.S. Catholic Conference, and NOW.
Another factor for many women in the financial viability of keeping their child is child-support enforcement. Despite vast improvements in enforcement during the past 20 years, in 1989 only 37 percent of 10 million custodial mothers received child support. In response to this, a working group from both pro-life and pro-choice organizations has created a comprehensive child-support reform plan. Included in its measures are a federalized collection, distribution, and enforcement effort, possibly under the control of the Internal Revenue Service; a more streamlined process for establishing paternity; and outreach and education efforts.
IF THE PERFECT SOLUTION or outcome could be created for each factor contributing to unwanted pregnancies and abortion, abortion probably still wouldn't be eliminated. And ours isn't a perfect world. But as individuals and a society, we still need to engage the issues, seeking the most life-affirming means and outcomes. Otherwise, the violence of act and word that keeps bubbling up—not only abortion itself and shootings at clinics, but the demeaning House welfare reform debate, sexual domination, abuse and neglect of children, dehumanization and subjugation of women—will destroy us. Finding a way to talk together, to build on shared territory, is an act of faith and life.
Julie Polter is an associate editor of Sojourners.