A phrase commonly heard is “reproductive rights,” and while there is some variability in what this entails, in most cases, this includes a woman’s right to choose not to be sexually active, to say no to unwanted sex, to access contraception, to receive appropriate and adequate care during pregnancy, and to seek abortion. By definition, rights are “a moral or legal entitlement to have or obtain something or to act in a certain way,” and most of us think of the concept in a positive light. However, an individual’s rights can also curtail the rights of others, and they cannot be fully understood without this in mind. It is easy to argue that the first items are indeed rights of a woman and do not adversely affect another person’s reasonable rights. But what about abortion? It seems to be assumed that what is inside a womb does not have rights, but before we come to this conclusion, it is vital to consider the following questions.
For fetuses at the age of viability (from 23 to 24 weeks of gestation up to term): While there are medical reasons that are routinely brought up for considering terminating a pregnancy (for example, maternal health), these reasons are uncommon. By far, the most common reason for abortions during this gestational age is by choice. Thus, the difference between a 24-weeker being taken care of in a NICU and a fetus of the same age being aborted is whether the child is wanted or not. This, in light of the fact that no neonatologists or NICU nurse believes that the 24-week baby in front of them is not human. Thus, the first question: Does being human entail being wanted? If that indeed is a criterion (and it seems to be used to justify third-trimester abortions), then how about the folks that feel unwanted often, such as war refugees, unwelcomed immigrants, LGBT teenagers, or orphaned children? In fact, we have all felt unwanted at some point in our lives. Does this mean that we lost our humanness at those points?
For fetuses near the age of viability: With major NICU advances and the real possibility of artificial wombs in the near future, the age of viability may drop significantly. Once this becomes a reality, what does this mean for the fetuses of this age? Will they now be seen in the same light as the ones discussed above? This also brings up an issue of health inequalities where better-resourced individuals and countries will be able to keep infants this young alive while those disadvantaged may not. Thus, the second question: “Does viability define what is human or is it something greater than that? If indeed it means being viable, then how can the definition of “human” vary depending on the country, wealth, or expertise?”
For fetuses younger than any possible ability to be kept alive either now or in the near future: Though commonly ignored or dismissed as not worth discussing, there is the very important third question: “What exactly is inside a pregnant woman?” Is it just a clump of cells that may develop into a human? Is it so small and frail that it is not worth even thinking about? Is it subhuman or a “potential human”? History is littered with countless unfortunate situations where a class of people were considered subhuman, from whole ethnic groups, to slaves, to people of certain color or descent. Thus, we need to be very careful not to make this grave mistake with fetuses. Embryology shows that what is inside is a very rapidly growing, changing, and evolving entity whose progress in growth, both size-wise but also at the cellular level, is just astounding. It is definitely not just a clump of cells, and any good embryology video can convince you of this.
The reality is that there are many unexpected and unwanted pregnancies. These women need help, and while abortion can be seen as a solution to this, if there is indeed a person inside the woman, then the questions should focus not just on easier access to abortions but on how to help both the mother and the developing child. This is a landmark change in thinking, but if indeed there are two people involved in this decision (mom and child), then both need to be accounted for and cared for. One recent analogy that comes to mind that may shed some light on this: hundreds of thousands of immigrants have been crossing the border into the U.S. over the last few years. Many in our country did not welcome them, instead asking such questions as: How will we support them? Where will they live? Who will educate all of these children crossing the border? These are legitimate concerns, but they are secondary to the fact that these immigrants are first and foremost humans, as human as you and me, and as such deserving of the same rights that we all have. Therefore, care for them we in the medical field did and will continue to do so.
The author is an anonymous physician.