Dr. Foster, in her book The Turnaway Study, begins and ends with the assumption that choice is good for women. This represents a pretty standard expression of pro-choice philosophy and it is worth emphasizing – it is the act of choosing that is considered positive. There is no inquiry into what is being chosen or how that choice bears out. As long as she chose it, it is good. This is not to say they ignore regret, but it assumes that “at least I chose it” will be a comfort.
This philosophy comes out in the chapter on mental health. Before comparing the results of women denied abortions verses women who had abortions, Dr. Foster hypothesizes about why abortion might or might not harm women’s mental health. This idea of “choice” makes both the positive and negative list.
Under ‘why abortion might be negative for women’, Dr. Foster mused that “an unintended pregnancy is a moment when your life feels like it is out of your control. Your body is creating another life against your will.” She follows this up with “having an abortion is something that women choose to do” as a reason it wouldn’t negatively impact women’s health. Notice the assumption. The unintended pregnancy is a problem because she didn’t choose it, while the abortion is not a problem because at least she chose it.
Dr. Foster does admit that an unintended pregnancy does not necessarily translate to an unwanted child, but for her it is all about what the woman chooses, concluding: “Abortion is not just about a woman’s right versus an embryo’s or fetus’s rights; it’s also about whether women get to have children when they are ready to care for them.” She even goes so far as promoting “the idea that personal bodily autonomy is a universal human right, as are the rights to have children or not have children.” Choice is foundational and it excludes examination of what is being chosen.
How you view life
This choice-focused philosophy naturally follows the ideal of an independent, autonomous life. Autonomy is a word that translates into auto (= self) and nomous (= law). Autonomy is self law. If your ideal life is one in which you, and you alone, choose and govern for yourself, then Dr. Foster is right. Being pregnant against your choice will harm your mental health, and taking back the choice by ending the pregnancy will alleviate that harm.
I am putting aside for a moment the reality that women generally choose to do the act that gets them pregnant. For the sake of assessing Dr. Foster’s approach, let’s grant that absurd argument that consent to sex is not consent to pregnancy. The problem with this philosophy is that once you are pregnant you are not solely an individual. Your life has become inextricably tied to another. We are never primarily independent beings; we are interdependent beings. We are relational creatures in the midst of a web of interconnecting relationships that each come with obligations and pressures.
And we don’t necessarily enter into these relationships by choice. As one scholar put it, “We are born into some obligations, and some are born to us.” You might choose your friends, but you don’t choose your family. Abortion ignores this relational reality. It ignores the fact that whether a mother chose it or not, she is relationally and physically interconnected with her child.
As Erika Bachiochi points out in her article Embodied Equality, we easily acknowledge that parents have duties, legal duties even, to at least provide their children with the basic necessities of life and hopefully much more in terms of physical and relational needs. We don’t base this duty on the parent’s consenting to take on that duty, nor are they able to revoke consent on a whim. Rather, we recognize a child’s dependence on their parents as placing special obligations on the stronger party. This becomes even more stark in the womb, where a child is completely physically dependent on their mother. Applying consent and the ability to revoke consent in that context has fatal consequences for the weaker party.
Deciding the value of life based on whether you chose it or not strikes me as strange. Especially this year, when we all are finding ourselves in situations that we did not choose in response to Covid-19. I don’t mean to undermine the stress that is felt due to these current unchosen circumstances. But the remarkable finding of The Turnaway Study is that removing that choice does not automatically harm mental health. Just because we are in unchosen circumstance does not make them bad circumstances.
Choice doesn’t end up being the key difference for women
When Dr. Foster concludes that women who had abortions were ‘better off’ than women denied abortions, it is not in the area of mental health. Rather, she is pointing to the fact that pregnancy takes a toll on a woman’s body and raising children costs money. Those differences between women denied abortions and women who had abortions do not come down to choice.
This is seen most starkly in the findings around mental health. Dr. Foster explains “I admit I was surprised by this finding. I expected that raising a child one wasn’t planning to have might be associated with depression or anxiety. But this is not what we found over the long run. Carrying an unwanted pregnancy to term was not associated with mental health harm. Women are resilient to the experience of giving birth following an unwanted pregnancy, at least in terms of their metal health.”
If choice really is vital for women’s well being, if the harm of unintended pregnancy is that lack of control which can be alleviated by choosing either parenting or abortion, if Gloria Steinem’s endorsement of the book that “without the power to make decision about our own bodies, there is no democracy” were true, then surely we would expect that to come out in the stories of women denied abortions. What we actually see, though, is women changing their minds about wanting the abortion in the first place. While a week after being denied 65% of women surveyed still wanted an abortion, by the child’s first birthday this was down to 7% and five years later it was only 4%.
Remember, these are women who chose abortion. These are women who made it to the abortion clinic, despite travel expenses and the logistics of actually getting there. These aren’t women who just thought about abortion, these are women who made tangible steps to have an abortion. And yet the vast majority found that this initial choice was not actually what they wanted. In the end, it was not their choice to have the child, and they don’t regret that.
How access to abortion impacts women’s health both mentally and physically is a complex question, as The Turnaway Study reveals. But one thing is very clear: it does not come down to choice. Choosing one way or another is not the deciding factor in what impact abortion has on women.
Dr. Foster ends her book saying that ultimately abortion “is about women’s control over their own lives.” But this is not borne out by the very data included in her book! Her assumed premise leads to a forced conclusion that does an injustice to the real impact of abortion on women.