[1] Working with the authors who contributed to this issue of JLE, has been an exercise that has renewed my spirit. I admit my spirit needed renewing. The news of the Dobbs decision and the immediate consequences has felt like a forceful slap against women as persons deserving of the rights to moral autonomy and personal safety in a nation that does not seem to honor life in many forms.
[2] I have published essays about the ethics of abortion twice before, once in the Journal of Lutheran Ethics[1] and once in Dialog.[2] Both essays, I would label foundationally Pro-life; they rejected a liberal understanding of individual selves capable of making choices in favor of thinking about the inter-connectedness of life. Both essays spoke about the physical biology of pregnancy being ultimately a state of relationship. There is no such thing as a living fetus in itself, there is always and only the fetus living in relationship with its mother. As any scientist (and any person who has been pregnant) knows, “A pregnant woman uses her own nutrients and blood to grow offspring, breathing for it until birth.”[3] Also, there is no such thing as a mother in herself, there is always and only the mother in relationship with her child. Importantly, there is no such thing as any person in himself. There is always and only an I-in-relationship–to the earth, the air, the water, my community, and of course the God who grounds my being. Thus, the center point on any stance on abortion, I maintain, cannot be grounded in maternal rights vs fetal rights. Pro-life abortion ethics can only be about how to best steward life in community. Pro-choice abortion ethics can only be about how to create real choices for flourishing life in community.
[3] As a Christian (and as a social animal), it seems clear to me that the burden to care for each other is on all members of a community. A pregnancy that results in miscarriage (or abortion) because of poverty, contaminated water, or inaccessibility to adequate health care, is a pregnancy that is lost by all of us. In such cases, the mother’s grief and the baby’s death lies on all our consciences. This is true too when children and adults are gunned down in schools, in the streets, and in dance halls, by mass shooters, gang leaders, or police officers, on accident or with intention. This is true when funding for mental health and physical health resources is cut, when people cannot find safe and secure housing, and when inflation makes food and medicine unavailable.
[4] The well-being of each individual affects the whole of the community; the whole of the community is responsible for each individual. Such fundamental understanding of ourselves as relational has been the ground of all my thinking about ethics, and especially the ethics involved in legislating abortion.
[5] This understanding undergirded my feelings this summer as the Supreme Court handed down two historically important decisions. In the session immediately prior to the Dobbs decision, the Supreme Court dismantled a gun safety law in New York. The same six justices who, said on June 24th, 2022, that there was no constitutional right to privacy, bodily autonomy, or preservation of health and life for those with pregnant bodies said on June 23rd that there were constitutionally protected rights for gun owners that take precedent over public health concerns.
[6] To many people it seemed that these Supreme Court justices simply prioritized certain kinds of bodies and lives over others in these two decisions in a way that denigrates the health and lives of the most vulnerable.
[7] In both decisions, however, I see a consistency, in that even as the justices have sought to interpret the rights of individual citizens according to the Constitution, they have failed to recognize that individuals live and make choices only in relationship with other individuals. One cannot speak of the gun owners’ right to carry a weapon without understanding that this owner lives in a community in which he is physically, economically, morally, and intellectually dependent on the others. He owes the community his very life, and when the community is torn by violence and death, he too is impacted. So too, one cannot speak of the fetus’ right to life without understanding that this fetus lives in a uterus inside a person who is dependent on her community. If the community is dangerous, the pregnant person and the fetus are in danger.
[8] In short, public health concerns are individual health concerns. And (as we learned profoundly in Covid that which has always been the case), individual health concerns are public health concerns. If we want to preserve rights to life and autonomy we must focus on the public health of the community.
[9] Today we see the way these rulings are impacting individuals and webs of individuals. This is especially obvious in states where abortion has recently been banned. In Wisconsin, the day of the Dobbs ruling, all abortion became illegal under an 1849 law against abortion. This law was passed 71 years before woman were allowed to vote. The law has no nuance based on 21st century medical science, thus doctors struggle to understand what it implies for certain cases. Most disheartening, while many in Wisconsin cheered for this protection for life, there has not been a rush of money, labor, and legislation to take care of mothers and children in the wake of the abortion ban. On the contrary, the health care for those who are pregnant has become much more tenuous. This affects all of us.
[10] The Green Bay Gazette headlined this fall a series of articles explaining ways in which the abortion ban has caused doctors in Wisconsin to delay and even deny care in a number of high risk pregnancy situations out of fear of legal consequences.[4] In the series, reporters told the stories of pregnant people who found out their fetuses’ lives were no longer viable. In these cases, even when the continued pregnancy put the pregnant person’s life at risk, doctors were unable to act legally to terminate the pregnancy. This is because “[t]erminating a fetus with cardiac activity is considered an abortion procedure, even when it’s clear from prognosis the fetus has ceased to develop.”[5] Indeed, a number of national news outlets have published that standard procedures for taking care of patients with ectopic pregnancies (pregnancies in which the embryo or fetus is growing outside of the uterus and whose life is therefore unsustainable and whose growth is life-threatening to the mother) are now being reconsidered post Dobbs.[6]
[11] Even in cases of pregnancy when there is no longer a detectable fetal heartbeat, doctors in Wisconsin have been required to wait one to two weeks and perform a second vaginal ultrasound to confirm the lack of the heartbeat before removing the pregnancy. Waiting this length of time can result in the pregnancy becoming septic, a condition that 40% of the time leads to the death of the mother. Some doctors urge such patients to go out of state for a procedure to lower their risk of death. “It’s heartbreaking, because these pregnancies are so desired. Now we have to ship them out of state and they have to be somewhere unfamiliar with people they don’t know and don’t trust, and they can’t recover in their own home,” explained one medical professional.[7]
[12] Moreover, while some legislators in Wisconsin are advocating removing or, at least, clarifying the law, there is currently no serious movement to do so. “For now, there is no access in Wisconsin,” Velasquez said. “People who are electing to have abortion are still needing to continue to leave the state.”[8] This includes access to abortion pills, and in some places even emergency contraception. A recent University of Wisconsin study showed that a surprising number of doctors in Wisconsin do not understand the basic mechanics of birth control pills and IUDS.[9] “According to the study, nearly half of male physicians incorrectly believed emergency contraception works by causing abortion, compared with 29% of female physicians. (It works by preventing ovulation)” [10]
[13] Reading these articles this fall in my local paper, I realized anew that knowledge about the female body, knowledge about pregnancy, knowledge about saving pregnant people’s lives has not been pursued with the same vigor that legislation to criminalize abortion has been. Importantly, every woman who dies because of this lack of knowledge and because of current legislation is a woman whose death impacts all of us. Moreover, we are all responsible for these deaths. We are called to care for our neighbor. While as a Lutheran I understand that ought does not imply can, I also know that cannot does not imply ought not. Responsibility remains even when we are bound to structures of sin.
[14] We ought to be rushing towards those in need, promoting a culture of life, providing resources to help our neighbors flourish. So, what can we do? I think the first answer is that we need to talk to our neighbors. We need to read their stories, we need to look them in the face and ask what they need. We need to use the wisdom we gain from our own personal experiences and from listening to those of others in accord with reason to find creative, legislative solutions that protect and nourish babies, children, women, men, and all people. And whatever side we may find ourselves on politically, we need to realize that the common ground for us as Christians (and for us as social animals) is that we must make those solutions our priority. We recognize by reason that the life and health of each individual impacts every individual in the web of our community. We recognize by faith that our common vocation is to love and serve our neighbor. We are called to act.
[1] Jennifer Hockenbery, “A Discussion of Procreative Ethics: Philosophical and Christian Approaches to Questions at the Beginning of Life,” Journal of Lutheran Ethics (November/ December 2012).
[2] Jennifer Hockenbery, “Defying the devil: Advocating for reproductive justice without works righteousness,” Dialog 57 (3): 168-171 (September 2018).
[3] Elizabeth Dias, “When does life begin?” New York Times, (December 29, 2002). Nytimes.com
[4] Natalie Eilbert, Benita Mathew, Devi Shastri, “Doctors say Wisconsin’s abortion ban is making them delay or deny care in high-risk pregnancies for fear of legal consequences,” Green Bay Press Gazette, (August 17, 2022) Doctors in Wisconsin say abortion ban confuses in at-risk …
https://www.greenbaypressgazette.com › news › 2022/08/17
[5] Ibid.
[6] See https://www.washingtonpost.com/health/2022/07/16/abortion-miscarriage-ectopic-pregnancy-care/ and
https://www.nytimes.com/article/ectopic-pregnancy-symptoms-treatment.html
[7] Eilbert, Mathew, Shastri.
[8] Jessica Van Egeren, “ Abortion pills will soon be available in pharmacies. But not in Wisconsin.” Green Bay Gazette. (January 5, 2023)
https://www.greenbaypressgazette.com/story/news/health/2023/01/05/fda-ruling-will-not-change-abortion-pill-access-in-wisconsin/69777971007/
[9] Benita Mathew, “Does your physician know how all contraception works? Not necessarily, a UW study finds”
Green Bay Press-Gazette, (November 11, 2022), Wisconsin study finds physicians misunderstand how …
https://www.greenbaypressgazette.com › news › 2022/11/11
[10] Ibid.
