This article is part of an ongoing dialogue on choice and access to abortion begun in the last part of 2010.  Other commentaries in this series can be found at this link.  Marge Berer is editor of Reproductive Health Matters.

A correction was made to this article at 10:00 am, Monday, January 3rd article at the request of the author to amend the description of Frances Kissling’s original positions of leadership of Catholics for Free Choice (CFFC is now Catholics for Choice (CFC)). Frances was first a board member and later the President of CFFC, an organization which, as the article notes, she “put on the map.”

“Can we ever say a woman can’t choose? It’s hard for pro-choicers to admit sometimes a woman shouldn’t be allowed to choose abortion — but we have to.”  Frances Kissling at Salon.com, June 21, 2009.

The article quoted above, which I’ve only recently discovered, was posted on the Salon.com website. Salon long ago closed the discussion, but alongside Ann Furedi,[1] I feel compelled to respond, because I want to exclude myself from the group in which she has placed herself, one she wants to call pro-choice but now believes has the right to refuse women a late abortion.

Frances would not be the first person to move from being pro-choice on abortion to being against some aspects of it, if not becoming completely against it. This article appears to be indicative of such a shift on her part. Yet the Frances I know has been a formidable force in challenging official Catholic doctrine on abortion. As a board member and later first president of Catholics for a Free Choice she became the face of an organization that brought together Catholics from all over the world to take a public stand against a profoundly anti-women doctrine, all of them people who refused to give up their identity as Catholics. She argued then that according to Catholic theology, acting upon one’s own conscience was the most profoundly ethical stance on abortion that a person can take.

So what has moved Frances from there to here, where she calls for refusing some women an abortion?

The case that she says first moved her to rethink her views, which she was asked to respond to on an ethics panel, was the kind of case an anti-abortionist would come up with, of a woman with a seemingly “frivolous” reason for wanting an abortion. There were few details offered, only that the couple didn’t want a second boy (“oh, it’s just that we wanted a girl,” presented as if it were equal to “oh, but I wanted the blue dress, not the red one”). There was no apparent gender discrimination mentioned, as there mostly is when fetal sex is given as a reason for abortion. The couple are one-dimensional; they have no history, no background. Their “case” for abortion is easy to reject. And of course there are always some women and couples who have “lightweight” reasons for seeking an abortion, and many more who could and should have prevented the pregnancy, but should they become the basis for compromising the whole ethos of women’s choice on abortion? You can’t be involved in abortion issues, read the literature or work in an abortion clinic without knowing that people with trivial reasons for abortion form a small minority of abortion seekers and that those who have to confront an unwanted pregnancy do learn (the hard way) about taking responsibility. Mostly they learn well because they never come back. So why didn’t Frances reject the example given and ask for a serious case to exercise her judgement on?

Instead of asking whether the couple should have been refused an abortion, perhaps the meeting should have asked: 1) whether a woman should ever have to justify or give reasons for her need for an abortion to the abortion provider at all, and 2) whether the provider should have the power to refuse a woman a procedure the outcome of which, one way or another, will have a major bearing on the rest of her life. The pro-choice answer to both these questions is no.

In making her case for refusing the woman an abortion, Frances fails to focus on the woman and the woman’s life, or what will happen if she has the baby, and instead decides she has to punish the woman and bring the baby into the world because the request comes late in pregnancy. A baby for whom Frances has no duty of care and for whose life she will take absolutely no responsibility. But it is in fact the absence of responsibility for what happens to the woman and the baby, if the pregnancy is carried to term against the woman’s will, that explains why an abortion provider must never pass judgement on the validity of a woman’s need for an abortion. In my opinion, it is only possible to be anti-abortion if you will never be the one left holding the baby, nor be around to see or take responsibility for what happens to those who are.

And yes, for me that means abortion providers should act as technicians with a clinical skill to offer, as all other medical professionals do, not as judges. Health professionals are not forced to provide abortions, and abortion providers who are only willing to do abortions up to a certain number of weeks of pregnancy should make this clear to everyone who seeks their help, and refer women to someone who can and will help them. The fact that there are so few doctors willing to provide late abortions in the United States is surely due as much to the fear of aggressive and oppressive anti-abortion harassment, violence and the very real threat of assassination as anything else. No morality in that.

This article makes the assumption that a person can be pro-choice sometimes and not at other times. How is this possible? “Pro-choice” is short for “supporting a woman’s choice on abortion.” It’s an unfortunate terminology, because it assumes that women really do have a choice and have more than one viable option to choose from. But this does not reflect the reality of most women’s lives or what women themselves say. Women risk their lives, if they have to, to end an unwanted pregnancy. It is not a matter of choice for them, but of overwhelming need. Nevertheless, even accepting the terminology, if the decision is not the woman’s, then the “choice” has either been denied altogether or it has been transferred to someone else – and that could as easily include George W Bush or the Pope as well as Frances. In my moral universe, anyone who thinks they have the right to refuse even one woman an abortion can’t continue to claim they are pro-choice. It’s a contradiction in terms.

As it progressed, I began to feel offended by this article because it says things such as “These things should make us pause and think hard.” (The “things” being some of the reasons women have given for seeking an abortion.) As if Frances is the only person in the pro-choice movement who has ever paused and thought hard about these things. By this point in her paper, the “we” and “us” who she claims to speak for begins to shift, however, because she separates herself from those of “us” who are pro-choice by such statements as: “I realize that expressing pro-life values, when you’re pro-choice, is much more complicated.” “Pro-life” is it now? 

And then comes the final blow to any lingering concept of “choice” when she says:

“But I have come to believe that women’s autonomy does not require that all efforts be made to protect women from pain or from hearing the word ‘no’.”

Thus does she reject her own historic respect for women acting on their conscience and reduces them to the moral equivalent of spoilt children whose only problem is that they might feel pain or be refused something. In 1993, Frances encouraged me to publish, “An open letter to a Diocesan priest,”[2] a personal statement about the lifelong pain of having to give up a baby for adoption as an alternative to having an abortion. Why does Frances no longer acknowledge this level of pain when she talks about “choice?” What really has made the person who put Catholics for a Free Choice on the map trivialise both much unwanted pregnancy and the women who experience it?”

She goes on to say: “I think it’s important for us to be able to say: When a fetus reaches the point where it could survive outside the uterus, is healthy, and the woman is healthy, and she has had five months to make up her mind, we should say no to abortion.” Who exactly are the “we” that she now considers herself to be part of?

But wait a minute. If the actual subject of this inquisition is only women with unwanted pregnancies at 26 or more completed weeks of pregnancy, which is the point at which scientists agree the independent survival of a fetus outside a woman’s body begins to be feasible, she is actually talking about refusing abortions to only a handful of women. In Great Britain in 2009, for example, the number of women who had an abortion at 24-plus weeks of pregnancy was 136 out of a total of 189,100 abortions. All 136 were on the ground that there was “a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.”[3] None of these women had had five months to make up their minds.

Does this demolish her argument? No, I assume she would point to the 2,036 women that year who had abortions at 20-plus weeks of pregnancy, on grounds of “risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.” Those are the women, I think, whom she accuses of having had five months to think about it and should have acted sooner. The fact that a third of them were less than 20 years of age, and none of them had had their abortions when the fetus was capable of independent survival may not alter her stance either.

Still, why has she singled these women out and stigmatised them and their circumstances as unworthy of the respect that legal abortion provision expresses? And if she would indeed force them to carry an unwanted pregnancy to term, why does she think they would want her compassion, let alone her help. Help? What help can she, would she, give them, year in and year out?

Anti-abortion sentiment like this is creating a climate of rejection of second-trimester abortions, including those that take place well before “viability,” in countries across the developed world where the abortion law has (more or less) supported women’s choice on abortion for decades.

Everyone who is pro-choice would prefer for women not to need late abortions, just as everyone would prefer, in the best of all possible worlds, for there not to be any unintended pregnancies. But there are millions of unintended pregnancies globally every year, because we are imperfect, make mistakes, and are less in control of our lives and behaviour than we would like to be. The pro-choice answer is not and can never be to refuse women abortions. The pro-choice answer is to remove all the obstacles to getting an abortion as early as possible, provide young women and men with the education on abortion from an early age that would enable them to prevent pregnancy, recognize they are pregnant early on, obtain non-directive counselling and support if they need it, and if the pregnancy is unwanted, ensure there is timely access to abortion services. That combination of education, support and service delivery would allow almost all abortions to take place before 24 or even 20 weeks of pregnancy. Countries like Sweden, where women have the right to choose up to 18 weeks but abortion is legal until 24 weeks, have proved it is possible. But there will always be a handful of women who fall outside the net, even in the best of conditions. The moral thing, the compassionate thing, the pro-choice thing to do is to support them and do the abortions anyway.

Frances, come back!