The Turnaway Study explains the findings of a unique study which follows 1,000 women who sought abortions. Gloria Steinem’s glowing review graces the cover: “If you read only one book about democracy, The Turnaway Study should be it.” Arguably she’s overhyping this book by Dr. Diana Greene Foster, but it was true that I got my hands on it as soon as I could.
For the study that forms the foundation of the book, recruiters went to abortion clinics in the United States that had a second trimester gestational limit and found women who were turned away – that is, denied abortion because they were too far along in their pregnancy – and women who received an abortion just under the gestational limit. Over the next five years, they periodically followed up with these women, asking about their physical and mental health, their aspirations and financial situation, and the well-being of their children.
The goal was to compare the outcomes of women based on whether they received or were denied an abortion. Does abortion hurt women? Is abortion just another medical procedure? Now we have 1,000 women’s perspective on this issue.
The findings of the study are fascinating and don’t lend themselves to quick conclusions. I want to take some time to unpack what the book says, so this is Part 1 in a series of six blog posts about The Turnaway Study. My hope is that by the end you’ll have a clearer picture of the lives of women who seek abortions and how the pro-life message impacts them.
Let’s start with the assumptions made
Dr. Foster begins and ends with the assumption that choice is good for women. Despite this assumption, however, she does ostensibly write for both a pro-life and a pro-choice audience. She works hard to, in her words, “put myself in the shoes of someone who was concerned about the harms of abortion.” I’m willing to take Dr. Foster at her word that she was trying to be unbiased, but the problem is she can’t be neutral, especially when it comes to the heart of the pro-life position: the humanity of pre-born children.
In the introduction, Dr. Foster does acknowledge that this study “will never resolve the moral question of when a fetus becomes a person,” but she gives shockingly little time to even considering the impact of this question on women. The closest she comes to actually dealing with the question of the humanity of the pre-born comes from a story of one of the women in the study who muses, “in the ethics class, we were talking about when is something considered alive. I’ve always thought it was when it has a personality of some sort.” But this question is noticeably lacking from the rest of the book, leaving the reader missing a crucial part of the equation.
When Dr. Foster discusses the children born to women who were turned away for abortion, she says, apparently without irony, that “women’s lives…are not the only lives affected by the ability to access abortion care.” We agree. Pre-born children’s lives are intimately and fatally affected by abortion. But she neglects this entirely, spending the chapter only considering the outcomes of children that made it to birth.
She concludes that, “enabling women to have abortions when they want them increases the chance that they will become pregnant later when they are ready and prepared to parent.” She assumes that future children are interchangeable with the present child, ignoring the reality that each life is unique and intrinsically valuable. She also states that many women “choose abortion with the needs of children in mind,” but we must point out that clearly it is not the needs of her pre-born child that are being considered.
How this plays out in women’s lives
These individual, unique lives lost to abortion are still present in the women’s stories that Dr. Foster tells throughout the book. One example is that of Ariela (all names are pseudonyms), who at 19 chose to abort twins. Ariela’s reasons included wanting to finish school and establish a career, and the book includes her jarring summary that “I gave up two lives for myself.” We are not comforted when she elaborates: “Like, I gave them up so I could have a better job, which I do, and so I could go to school, which I’m halfway there, and to have a better life, which I think I’m doing okay.” Her plans to go to law school and seemingly have a “successful” life ring hollow to those who mourn the lives that were lost.
This oversight by Dr. Foster is revealing of the heart of the abortion debate. As Greg Koukl succinctly put it, “If the pre-born is not a human being, no justification for abortion is necessary. However, if the pre-born is a human being, no justification for abortion is adequate.” If Ariela’s twins are not human beings, then we have no reason to question her decision to prioritize her career. But since we know that life begins at fertilization when a unique, distinct human being comes into existence, no accomplishment will come close to compensating for the tragedy of two lives cut short.
What we are able to resonate with are stories like Jenny’s, who was denied an abortion, had her child, and “started crying at the thought of her then-six-year old no longer being in her life. ‘She is just everything to me.’”
Dr. Foster undoubtedly is aware of the argument for the humanity of pre-born children, but always portrays it as an opinion. She deliberately suggests at times that a woman or those around her could “consider” the pre-born child a baby. But she never confronts the question: what if it isn’t just an opinion, but a woman is actually making a choice to end another human being’s life?
If you are going to ask the question of how abortion impacts women, that must include considering how the loss of her child impacts her. But Dr. Foster is not neutral on this point, deliberately sidelining the central tenet of the pro-life position.
The pro-life movement has thought about the women
While she largely ignores the very truth that motivates the pro-life movement, I generally am willing to take Dr. Foster at face value when it comes to her attempt to be unbiased. However, I must take issue with the way she characterizes the pro-life movement as not even thinking about the women.
She pronounces this judgment by telling a story of a pro-life American politician responding to a journalist’s question of, “’What do you think makes a woman want to have an abortion?” Obviously caught off guard, the politician stammers a bit before offering, “It’s a question I’ve never even thought about.” From that single instance, Dr. Foster concludes that, “In the decades-long battle over abortion rights, this one moment completely captures the disconnect between the politics of restricting abortion and the lived experiences of women who want one.”
In one fell swoop she ignores the many in the pro-life movement, including those of us in the political realm, who have spent countless hours seeking to understand women’s lived experience. People like Frederica Mathewes-Green who detailed the lived experiences of women in her book Real Choices. Or the brave post-abortive women who use their stories to highlight the reality of abortion. Or the countless people across both the United States and Canada that keep pregnancy resource centres going. These centres are devoted to understanding why women are seeking an abortion while promoting options that are best for her and her child.
We have thought of the women. And we have thought of the pre-born child. The reality is that the choice for abortion is not about one person, but two. Some in the pro-abortion movement, like Dr. Foster, will try to claim it is only about the women. Others might view it as woman versus child. But the pro-life movement has the radical belief that we can be for both woman and child.
We’ll delve into that more in Part 2, when we consider what is actually best for women.
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Story #1: More than we bargained for
Catherine showed Andrew the pregnancy test. There was a glow in her cheeks that showed only a fraction of the joy that was coursing through her. After being together for ten years, countless doctors appointments, various medications, and still being disappointed every month, Catherine and Andrew had finally decided to try IVF. The doctor had explained the process in a friendly but serious manner, going over the success rates.
“We will transfer three embryos into your uterus,” he had explained. “That way we improve the likelihood that at least one will implant itself there.” Catherine nodded, determined. She wanted a child.
The joy Andrew felt was only surpassed by his relief. Relief that it had succeeded. Catherine’s joy was all encompassing. Even that first day she began to speak to her child, despite knowing that the child couldn’t hear yet. This child was going to complete their family, going to complete her life. Nothing could lessen her joy.
The unabated joy, however, was sidelined by shock as Catherine lay on the table staring at the ultrasound screen. As she looked at her child, a mixture of emotions that she couldn’t even begin to describe took hold of heart. It was not just her child that she saw, it was her children. Three children to be precise. Every single one of the embryos had successfully implanted in her uterus. She looked over at Andrew, but he just stared at the screen.
When the doctor began to talk to them the shock had still not worn off. Catherine had wanted a child, but triplets? How could she possibly manage that?
“Each of the fetuses is healthy,” the doctor explained. “Of course, a multi-fetal pregnancy always comes with risks, for both you and the fetuses.” He gestured at Catherine. “We should discuss your options.”
“Options?” asked Andrew.
“Yes. We can, of course, reduce the pregnancy.”
“Reduce the pregnancy?” Andrew asked, uncomprehending.
“Yes, terminate one or two of the fetuses. You can also choose not to do so, in which case we will have to discuss how to monitor the pregnancy. With triplets come an increased risk of serious complications, including preterm labour and premature birth, which can have lasting consequences for the children.”
Andrew suddenly understood what was being implied and he looked at Catherine. “Reducing the pregnancy makes sense to me,” he said. “We aren’t ready for three anyway. It might make sense to keep two – who knows if we will ever get pregnant again, but three is just too much. Don’t you agree?”
Catherine didn’t respond right away. Shock still gripped her. She looked down at her stomach – not that there was anything to see there yet. But there would be soon. Triplets. Three babies. Inside her. And then she would have to give birth to them. And then she would have to care for them for the rest of her life. Fear was slowly replacing the shock.
“If we just reduce the pregnancy,” Andrew was saying, repeating the phrase he had only just learned. “We could see if we can have a boy and a girl. A perfect little family of four.”
Twins I can do, she thought. “Yeah, a boy and a girl would be perfect. What a gift that we can get two children instead of the one we were hoping for. That would be perfect.”
Andrew and Catherine went home to sleep on it, and decided to find out the sex of the babies she carried. Two girls and one boy. They talked, they cried, and then they agreed – a boy and a girl would be perfect. When they returned to the doctor, they were sure.
“Let’s reduce the pregnancy.”
And a girl lost her life because she was a girl.
Story #2: Plenty of girls
Janine was putting together the finishing touches on her middle daughter’s costume. Just that morning, Annaliese had announced that she wanted to go trick-or-treating as an octopus. Despite searching every costume and thrift store in their small town, there was no octopus costume to be found. The look of disappointment on Annaliese’s face grew as they went to store after store, finding a princess dress for Sarah and a Batgirl outfit for Ellie. “What about a turtle?” Janine had asked her 6-year-old. Annaliese hadn’t said anything, but tears filled her eyes. Janine was not one to spoil her three girls, but her hearts strings were pulled. She loved her daughters dearly and wanted them to see the world for all the possibilities it had for women.
“Maybe we can be resourceful.” Janine said. “Let’s see if we can figure out how to make an octopus costume.” Annaliese was enthralled and they spent the rest of the day looking up patterns and finding the material they needed. Janine was proud of her daughter. She had worked hard and carefully all day. All that was left for Janine to do after her daughters were in bed was the finishing touches.
As she looked with satisfaction at the 8-legged costume, she heard the front door open as her husband Spencer arrived home from work. He was up for a promotion that kept him at the office longer these days. The costume was laid aside as another more serious topic took over her mind. Janine was unsure whether the wave of nausea she felt was the morning sickness or the dread of the conversation she intended to have.
Spencer was pulling food out of the fridge when she walked into the kitchen. She sat at the island as he turned to her.
“I found out today that it’s a girl,” Janine said. Spencer didn’t react right away, but Janine knew he must be feeling disappointment. He loved his daughters, she knew, but he had wanted a son. He had wanted someone to play catch with, to take fishing, and to carry on his name. Spencer would never have voiced this, but Janine knew. She knew, because she had wanted that to.
“So, a family of four girls,” he finally said.
“Well,” Janine said. “I was thinking about it. This isn’t a great time to have another child anyway. With you up for the promotion and working so much, maybe it would work better to wait. Three children is already a lot – wouldn’t it be better if we are going to have a fourth that we try again for a boy?”
Spencer pondered this for a moment. “It’s not too late?” he asked.
“I can still have it done at the clinic,” she responded. “And we haven’t told the girls yet so there won’t be any questions from them. The only people who know are our parents and we can just say it was miscarriage.”
Spencer nodded. “Ok. And when the timing’s better, we can try again for a boy.”
And a girl lost her life because she was a girl.
The stories themselves do not always overtly show the misogyny in sex selection – the stories are not all filled with women-hating men coercing their wives into abortions every time they’re pregnant with a girl. Yet, in a country that claims to to value equality of the sexes, evidence has been found that a cultural valuing of males in some communities means girls are overwhelmingly targeted for abortion, especially if the family already has girls. Countries like China and India are dealing with this problem on wide-spread scale, but this is also a Canadian problem.
New assisted reproductive technologies have also made multiple pregnancies more likely, and those who practice these types of medicine look for ways to build a designer family and reduce potential risk. Sadly, “risk” in these case is too often a pre-born child.
If we say that equality of the sexes is important to us as Canadians, we need to back that up with laws that recognize their equal value from the earliest stages. Life is meant to be lived, not controlled. When we focus on designing our families to perfection, we will target those who do not fit our mold, be it based on sex, potential disability, or anything else. If we allow this kind of selection in the womb, that kind of thinking will impact our treatment of born human beings as well. We need a law that bans sex selection abortion, and everything it stands for.
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