We are going to end this series on The Turnaway Study where we started: pointing out the lack of acknowledgement of the child who loses their life to abortion, and the impact of that loss on women. Yes, 95% of the women said abortion was the right decision for themselves, but reading through their stories I can’t help but wonder about the path not taken and about the life not lived.
This comes out in Amy’s story. Amy had an abortion when her born daughter was 10. Years later, when her born daughter was a teenager, Amy says “everything that I’ve ever done, ever worked for, has been for her.” Despite claiming to have never wanted more children, she talks about how she has taken in her daughter’s low-income boyfriend, saying, “It’s funny that I never wanted any more children, but here I am helping out another one. So it’s so funny, I tease him, ‘you’re the son that I never wanted.’” It leaves you wondering about how much love she would have had for the “never wanted” child she lost to abortion.
Kiara had an abortion when she was 26 years old. Later on, she tells of her subsequent child. “With the newest baby, my husband and I weren’t actively trying, but we weren’t not trying. It actually happened fairly quickly, so I was like, it was meant to be. I don’t think you’re ever ready fully. You always go, ‘It’s a good time; let’s have a baby.’ Then, you get pregnant and you’re like, ‘All right, wow. Here we are.’”
“I don’t think you’re ever ready fully,” Kiara explains. What would have happened if she had that perspective towards her first child?
And yet, the unexpected love
Melissa describes a subsequent pregnancy after her abortion, when pro-life relatives showed up offering support and asking her not to abort her child. Those relatives now watch her born daughter every day. She concludes with this reflection on parenting: “When I was growing up, I didn’t want any kids. I didn’t picture myself as a mother…I had that first child, and you find out that you love them no matter what…You think, there’s no way I can love anyone in the world more than I love this baby right here. Then you have another one. And you worry when you’re pregnant, am I going to love this one like I do that one? There’s no way; you don’t want it. Then you have that second one and you love them totally different. There’s no amount of love more for one than the other; it’s overwhelming.” Melissa was able to accept her subsequent children and found the love overwhelming. It’s tragic she missed out on that love with one of her children.
All of these women likely said that the abortion was the right decision for them. Many were quite sure they were unable to parent, that it wasn’t the right time, but there is little explanation of the difference between the situations where they had an abortion versus the situation they were in when they gave birth to other unintended children.
A risky endeavor – but worth it
Pregnancy, childbirth, and parenting are all difficult. Dr. Foster goes into detail about the health risks of giving birth, including the rare but tragic cases where a woman even loses her life. She concludes, “The fact that women regularly choose to endure this and are thrilled with the outcome shouldn’t blind us to the fact that pregnancy is a risky endeavor.” So why do women take on this risky endeavor? What is it out being a mother that we view as worth the risk? The answer is the life that comes into existence. The human being born into this world is what makes woman thrilled with the outcome.
It’s hard to read the stories in this book without mourning what could have been. What if these women had opened themselves up to the endless possibilities that bringing a child into this world can bring? No one is suggesting pregnancy and motherhood are easy. Relationships, love, others, bring with them complexity, heartbreak, and pain. But they also bring joy, love, and wonder to our lives. As Erika Bachiochi points out, “In the experience of most women, pregnancy is a serious challenge, but one well worth the sacrifices made because of the profundity of the enterprise.”
As my colleague Anna once put it: “Abortion is a choice. A choice that is easier, maybe, than the very hard choice of parenting. Simpler, maybe, than dealing with the relationship consequences of keeping a pregnancy. Faster, certainly, than carrying to term and giving a child up for adoption. But, morally and ethically, it has the power to make people feel shame because it is shameful to say that your choice is worth more than someone else’s life, that your future is worth wiping out someone else’s future.”
It is this that Dr. Foster misses in The Turnaway Study. It is the lives that are lost to abortion. Lives that, whether intended or not, are intertwined physically and relationally with their mothers. The idea that we can just dispose of these children without consequence to their mothers is absurd and not reflected in the lived experiences of women.
For Dr. Foster in The Turnaway Study, abortion is fundamentally about “choice,” as we saw in a previous post in this series. This combines with another frequent theme throughout the stories: the hard circumstances of the women seeking abortion. For these women, their circumstances are driving them to choose abortion over parenting, whether those circumstances be their relationship, financial situation, or career aspirations.
Between not choosing to become pregnant in the first place and women’s difficult circumstances, the assumption is that the solution is to be, well, un-pregnant.
The lie of abortion: the unchosen pregnancy is the problem
Abortion at its core sees the pre-born child as a problem that needs to be erased. But women who seek abortions are capable of parenting, as the vast majority of the women denied abortions prove. The fallout out from this misidentification of the problem means that the real problems women face are not being addressed.
This came out in reading Martina’s story. Despite seemingly being sure of her choice to abort, she could not stop crying at the clinic. To comfort herself she read through journals that contained stories of previous clients. “One story I read, a woman’s husband wouldn’t let her get birth control, and she kept getting pregnant. Since she was able to pay for abortions with cash, he didn’t know that she was continually getting abortions because she continued to get pregnant. And they already had, like three or four kids. He basically thought that he was right, she didn’t need to have birth control, they just won’t get pregnant again, you know? But no, she had three additional abortions because he wouldn’t let her get birth control.”
Martina was comforted by this story and others like it. She concludes her personal reflections saying, “Hopefully we can agree that it’s difficult no matter what you choose, and people just need to be supportive. Women don’t need to be told this isn’t the right choice.”
In Martina’s eyes the woman in the story was facing troubling circumstances that necessitated abortion as the solution. Rather than either leaving or standing up to her husband, having a clear conversation about the consequences of their actions, this woman used abortion to continue her life as it was. How is that helping her? I’ll agree with Martina that it is a difficult situation, but I will most emphatically question why allowing the situation to continue is supposed to be good for that woman.
Where adoption fits into this narrative
The assumption that difficult circumstances are fixed by abortion is also starkly challenged when Dr. Foster discusses women who were denied abortion due to being past the gestational limit allowed at the clinic. Dr. Foster had an expectation that the problem would remain the unchosen pregnancy, and the women would still seek a way out of becoming a parent. And yet, she was “surprised how few of the women who wanted to abort their pregnancies decided to place the child for adoption when they were unable to get an abortion.”
Dr. Foster, seemingly logically, assumed that women who wanted abortions would still not want to parent even if they were denied abortions. She assumed that abortion and adoption are comparable alternatives – both ways to avoid parenthood. But the data doesn’t bear this out. Instead, a week after being denied an abortion, only 14% of women were considering adoption and only 9% actually chose that route.
One of the main reasons that women didn’t choose adoption was because they ended up with more support from their community than they thought they would have – their circumstances weren’t as bad as they thought. All this points to the reality that Dr. Foster’s concern over the “chosen” nature of a woman’s position is overstated and we should be paying a lot more attention to women’s circumstances.
To be clear, adoption is a radical, loving, pro-life option. But generally, women don’t choose adoption even when denied an abortion. Abortion and adoption are not natural alternatives to each other, as they are based on very different foundations. Adoption, like parenting, at its core acknowledges the value of the child before and after birth and seeks to place that child in a setting grounded in self-sacrificial love.
Let’s offer real solutions
If adoption is not a common choice for women denied abortion, we need to again consider real challenging circumstances and real solutions. Frederica Mathewes-Green discusses the influence of circumstances in her book Real Choices. She points out that the appeal of abortion is like that of an eraser. “Denial is an attractive response to many difficult situations in life, and abortion serves denial better than adoption or childrearing would.” There can be a desire to return to a life just like it was before. But the problem is that such a rewind is impossible.
In the meantime, the pro-life movement doesn’t want to erase or deny women’s real problems. We don’t want to allow abusive relationships to continue, or leave women unsupported and alone. We want to come alongside each woman and help her realize her potential. She might think she can never finish school and have a child, or never have a career and have a child, or a whole host of barriers. But the pro-life message is that women can succeed without erasing their children.
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.
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.