An Abortionist Changes Her Mind

There are two questions on which the abortion debate hinge. First: When do we become a person? Second: When is it permissible to take a person’s life?

For the last decade that I spent helping women gain access to abortions, these questions consumed me. But they were not where I had started. My commitment to support women’s access to abortion was based on an experience I had which had formed my moral intuitions on the matter. A woman who worked as a maid for my family and who had cared for me when I was a child became pregnant out of wedlock by a man who abandoned her. Rizana’s position was precarious. To be an unmarried pregnant woman severely violated the norms of her community. She risked exile.

We lived in Sri Lanka, which outlaws the procedure except to save the life of the mother. So Rizana sought an illicit abortion. She was scammed out of a significant sum of money, given what we think was the equivalent of a sugar pill and sent home. Her pregnancy continued. She went to my parents for help. They found an orphanage run by Mother Teresa’s order of nuns, who took her in until she delivered her baby and then gave her baby up for adoption.

Meanwhile, my parents terminated her employment. Unable to bear her shame, she left the country to find work in the Middle East as a domestic worker. Thankfully, she found a work arrangement where she was neither treated as a slave nor abused by her employers, which is fairly rare for such guest workers in the region. Several years later, she found herself able to return home.

When I learned of Rizana’s predicament and how my parents had treated her, I was outraged. I was angry at the injustice of their decision to fire her and I was angry that she had tried and failed to obtain an abortion. Neither myself, Rizana, nor my parents questioned the morality of the abortion. Making the pregnancy go away was obviously the right option. It was just not within her reach, and that fact seemed to me part and parcel with the other injustices in Rizana’s life. I knew that she had deserved better. The whole world as she faced it seemed unjust. I wanted to help rectify this injustice for women like her.

It’s easy to see why Rizana’s situation was formative in my support for abortion and my decision to work professionally for abortion access. But after graduating from New York University and landing a job at an abortion clinic – once I witnessed the mechanics of an abortion – I began to consider its morality more carefully. What I found was that frequently, arguments for abortion already accepted that it was just and then worked backward to arrive at a justification. That is, it seemed to me that most people making such arguments began with what I myself had: a profound moral intuition that abortion access was necessary for women to experience justice in their own lives. I began to think, uneasily, that there might be other moral intuitions that spoke just as loudly, and that reasoning about these questions was not as straightforward a process as I had assumed.

Photograph by Kristijan Arsov / Unsplash.

I began to think about the popular slogans each faction uses to marshal its troops: those bite-sized arguments that alert us to this reality. “My body, my choice” is met with the reply “The body inside your body is not your body.” What could the counter-reply be? I found that the people who supported the work I was doing at the abortion clinic didn’t engage with this question: What if a pregnancy involves two people? I wanted to know if there was an argument to be made for abortion while taking that possibility seriously.

I could not shake the sense that there was something fundamentally dishonest around pro-choice appeals to autonomy. The dishonesty seemed to me to originate in its refusal to confront the reality of pregnancy. I was unconvinced that opponents of abortion simply wanted to “control women’s bodies.” I mean, maybe some of them did! But it also seemed possible that they had asked the same questions I was asking. I wanted to take seriously their contention that they were advocating on behalf of another person: the baby. If they were right that in fact pregnancy and decisions surrounding it involved more than one person, then I had to contend with the possibility that there was another here who might also be owed something.

If this was so, then any justification for it would involve asking difficult questions about when it is permissible to take a person’s life.

But I was not yet ready to ask those questions. Almost immediately after I began working at an abortion access-focused research institute, I found myself wrestling with the question of the personhood of a fetus. I was an educated woman. I had a master’s in health administration and was working in a medical setting. I was becoming one of the experts to whom others in the debate frequently deferred. But the question of when we become persons, I came to realize, is not one to which we get fully satisfactory answers by appealing to expertise. It has not been settled by legal or scientific consensus, in part because the question is so fraught due precisely to the controversy over abortion, and in part because personhood is a philosophical rather than a medical concept. In the landmark 1973 Roe v. Wade case, Justice Harry Blackmun observed that the Constitution does not provide a definition of “person.” The decision was passed because the courts refused to settle the matter legally, and their continued inability to do so is why even with the subsequent Dobbs v. Jackson Women’s Health Organization decision in 2022 the fetus’s legal status remains uncertain.

This lack of consensus among those we typically look to for expert answers seemingly leaves us adrift. Or at least that’s how it felt to me. But taking a look at how we respond to women’s pregnancies might tell us we know more than we let on. When I received news that a friend was pregnant and I knew she had been trying to conceive, my immediate response was to offer congratulations to her and welcome to her baby. Before celebrating with her I didn’t ask if her pregnancy had reached gastrulation or if there had been an emergence of the electroencephalogram pattern, or if the baby had reached viability. Similarly, when a friend grieved the loss of a wanted pregnancy, whether through miscarriage or through an abortion we understood as medically necessary, I did not exhaust this line of questioning before mourning with her. Our language betrays us further. We describe a pregnant woman as “carrying a child,” and when a woman miscarries we say she has “lost her baby.” In these scenarios it appears we have a straightforward understanding that pregnancy involves a baby or a child. And uncontroversially, we can agree that babies and children are persons, so we do seem to acknowledge the presence of another person in a pregnancy.

The problem arises when a pregnancy exists in opposition to our desires.

My own exploration of this issue led through a deep dive into the relevant legal texts, primarily Roe v. Wade and Planned Parenthood v. Casey. I am not a lawyer, and I don’t consider myself a philosopher. I was still looking for expertise. And so I read, and I did my best to reason.

When a pregnancy is unwanted, what we want is a resolution that terminates the pregnancy. We wish we were not pregnant, and we want to be able to take an action that will make that the case. That is, we want an abortion. And so we find ourselves in need of a justification for fulfilling this desire. Usually the way we do this is by going back on those understandings we all express in the case of a wanted child: we say that in fact the fetus is not a person. Usually, those who are publicly pro-choice take this approach rather than asking whether there could be an acceptable justification for a woman to take the life of the child in her womb.

The Roe v. Wade decision built this rhetorical move into law by letting us know that even the appellant in the Roe v. Wade case grants that if the appellee’s argument for establishing personhood of the fetus holds, then, in accordance with the Fourteenth Amendment, the appellant’s case would collapse. In other words, the case was built on the idea that abortion is acceptable not because sometimes it is acceptable to kill innocent persons but because the fetus is not a person. Throughout the decision there is a prolonged deliberation on how unknowable the question of when we become persons is. The court’s later decision in Planned Parenthood v. Casey in 1992 reaffirms this approach. “At the heart of liberty,” Justice Anthony Kennedy wrote in that decision,

is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life. … Belief about these matters could not define the attributes of personhood were they formed under the compulsion of the state.

This is of course true. Legal compulsion will not settle the matter philosophically. But despite Kennedy’s “that’s above our paygrade” rhetoric, it is well within the ambit of legal language to ascribe personhood: the Fourteenth Amendment, for instance, correctly implies that black people are people too. Kennedy’s approach is necessary because if the court were to conclude the personhood of the fetus as knowable it would have to accept one of two conclusions. If it accepted that the being inside a pregnant woman’s body is a human person, by its own admitted logic it would have to close the possibility of permitting abortion, lest it run afoul of the Fourteenth Amendment, which insisted that black people must not only not be enslaved, but as human persons must enjoy the equal protection of the laws of the United States. If, on the other hand, the court decided that the being inside the body of a pregnant woman is not a person, it would have to define personhood as a quality that is bestowed by passage through the birth canal, and permit abortion up until birth.

By refusing to settle the question in either direction, the court in Roe held the fetus’s personhood in abeyance and reached a compromise by appealing to a compelling point in a pregnancy at which the state can claim to have a legitimate interest in the vaguely acknowledged “potentiality of human life.” What is this compelling point? “The ‘compelling’ point is at viability,” Justice Blackmun held. “This is so because the fetus then presumably has the capability of meaningful life outside the mother’s womb.”

When I understood Blackmun’s rhetorical move, I was a bit shocked. This seemed to me to be entirely ad hoc, a standard reached because it needed to be reached for the case to come out “right.” In inventing this standard as the bright red line before which an abortion can be justified solely by a woman’s lack of desire for her pregnancy and after which a more rigorous standard of justification must be reached, the court raised more questions than it answered. The difficulty with viability is that there is nothing in that standard that even claims to relate to the question of fetal personhood. What it relates to, rather, is the point at which people other than the pregnant woman can intervene on behalf of her child (though this is disguised in the language of “meaningful life.”) The argument must go something like this: whatever the contents of her pregnancy may be, once these contents can survive outside of her, they gain the right to be considered a person and cared for by other people, expanding this protection all the way to the jurisdiction of the state. What this does is assert that if there is someone other than the pregnant woman who can take care of her baby, she is now bound to allow them to do so, and the state is bound to step in and ensure the viable child is not neglected unto death.

The inconvenient fact, as Leah Libresco Sargeant lays out in her excellent piece on viability, is that especially given advancements in neonatal science the point at which the mysterious contents of a pregnancy can survive outside of the mother continues to be pushed back. If viability is the point at which we bestow the protections due to a person, this creates a sort of race between a pregnant woman’s window for an abortion and the ability of her child to survive outside her womb. The question it leaves unanswered, because it does not ask it, is: What does a pregnant woman owe her child when she is the only one capable of keeping her alive? That is the heart of the matter: the question that lies behind all obfuscation about personhood and “contents of pregnancy.”

Asking that very question is what led me to reconsider my support for abortion. My own incredulity at the muddled insistence that a pregnancy did not consist of a person, until it did, unless it was wanted, in which case it consisted of a person all along, was further betrayed by my own experiences in the abortion clinic. The first time I confronted “aborted tissue,” was in the “products of conception” room, one of the abortion movement’s more egregiously Orwellian nomenclatures. As I poked at the fetus’s minuscule, newly formed bones, I was empirically convinced that these were human remains. Working at the clinic, I witnessed countless women mourn their aborted children. Some of them wanted to see the remains of their fetus in a petri dish, seeking closure or absolution. If there was the potential for them to see fetal parts, by which we usually meant tiny hands or feet, which are visible as early as eight weeks, we always warned them beforehand, preparing them for the possibility that this might not be as abstract a “procedure” as they’d hoped. The larger fetuses, the ones where death is undeniably visible in cracked skull and mangled limbs – those we refused to let them see. Even within the abortion clinic we preserved a shame about abortion.

Despite conceding fetal personhood, I continued to support abortion. After working at the abortion clinic I founded a nonprofit that trained abortion doulas to provide compassionate support to women having abortions and eventually took a job at a leading reproductive health research institute. During the early part of my career, I would openly discuss my position with fellow pro-choicers. It was often received with bewilderment or outright hostility. Sometimes I would encounter a rare curiosity, but mostly I made people uncomfortable and eager to escape the conversation. I learned to keep my thoughts to myself. Quite a few people would no longer attempt to dispute fetal personhood with me once they knew I was still pro-choice. They just seemed puzzled as to how on earth I could possibly make that work.

I was also puzzled. But I remained convinced that the only honest justification for abortion was to concede that it takes the life of a human person and make the case anyway. And I was determined to figure out how to do so. At this point, you may find my commitment to abortion stubborn and unyielding. How could it be permissible to take an innocent person’s life? If I was to pursue the truth and reason behind pro-life claims, it was just as imperative to me that I did the same with pro-choice claims. The appeal for autonomous control of one’s body during pregnancy was deserving of the same honest consideration. The entirely understandable terror of enduring even a normal pregnancy, to say nothing of potential complications, had to provide some grounds for justification. On the other hand, regardless of how hard parenting is, we do not grant parents the right to discard their children. There was something different to me about the case of pregnancy and it had to do with how fundamentally a mother and child were entwined. But what did this entwining mean?

Pregnancy is a difficult experience to communicate. A child vigorously lives out her new life inside the only place safe for her, your body. How do you describe this strange and inimitable intimacy, accompanied by the alienation of your body not being entirely yours? Feeling like a marionette piloted from the inside, not knowing what’s going to be churning inside you? The only thing I could come up with to justify a pregnant woman alone as the arbiter of the life inside of her was to argue that during her pregnancy her baby, though a person, was her property. Or that some persons do not deserve the protection of the law. Or something like that. In realizing that to argue honestly for abortion was to assent to the logic of enslavement, I understood why most supporters of abortion resorted to doublethink. It is morally if not rationally easier to sustain the contradiction that we determine whether a pregnancy contains a child or not based on whether it was desired than to admit we permit the destruction of children based on a mother’s desire.

The legal experts had failed me – or had at least failed to persuade me of the coherence of their vision. My coworkers, and others in the realm of abortion expertise, didn’t seem to want to talk about it. But I couldn’t stop the questions, and so the next step was to talk to a different set of people: the pro-lifers. Since it was early in the Covid pandemic, I found them online, on what was still, then, known as Twitter.

 I thought I would have better luck reaching less abhorrent conclusions if I tried to engage with my opposition. We already agreed on fetal personhood, so if I could just expose their own contradictions maybe we could get somewhere; maybe I could use their contradictions to shield my own. If they were so insistent abortion was murder, for example, why didn’t they call for women to be prosecuted for their crime? Were they not betraying their own sympathies toward women facing unplanned pregnancies, women like Rizana, when they exempt women from facing criminal liability for abortion?

It was only through conversation with one of my interlocutors, who would go on to become a dear friend, that I began to accept the difficulty of a just case for abortion. My friend understood that I assented to abortion from a desire to right the injustice of a woman persevering through an unwanted pregnancy, even as I acknowledged this meant killing her child. It wasn’t that I was eager to kill, it was just that I thought a woman being pregnant contra her desire more unbearable. Before I could reverse my position on abortion, I had to dissect my assumptions about desire and goodness. Whom do we allow into the world of people to whom we owe justice? And is there something more (though not less) than justice we must consider here?

I found that I did not hold – most of us do not hold – an ethics that purports to respect a person’s desires no matter what they might be, but rather, as Aristotle outlines, we defer to someone’s wishes when we assume their desire is aiming at the Good, or at least at a good. The goods we assume when we defer to a woman’s desire to terminate her pregnancy, at least one where there is no adverse fetal diagnosis, are the goods of autonomy and self-determination. And they are actual goods, as the injustice of Rizana’s situation was a real injustice. These are the goods the pro-abortion side seeks to elevate. And yet autonomy-based arguments for abortion rely on shrouding the truth, betraying our inability to confront the limits of those goods.

How do we aim at the Good in the complicated situations of human life? Discerning the Good seems straightforward until the all-too-common condition where goods compete with one another. In my conversations, in my thoughts, I began to fully reckon with the person at the limit of a pregnant woman’s autonomy when I returned to the question of what a woman owes her child when she is the only one capable of keeping her alive. Despite the pro-choice movement’s assertion that being denied an abortion forces a woman to be pregnant against her will, it never confronts the question of who exerts the command upon her. Not the legal command, but the moral command, which the legal one must, if the law is to be just, match. If it did, I thought, it would have to confront the inconvenient truth that it is the woman’s child who, without conscious intent, seeks refuge within her, orienting the continuation of her pregnancy toward birth.

It was with the birth of my own daughter that my own erroneously absolute commitment to autonomy began to erode. In the competition between the goods of my autonomy and my daughter’s command to be loved, the goodness of love triumphed. I found myself accepting a pro-life position for about a year before I became a Christian, and during that time I understood the origin of the ethical command for a mother’s obligation to care for her child as originating with her child. I did not believe in God, but I felt that command to love, to protect. I accepted that it was her child who issues the ethical command for the mother’s body to be that child’s home, the only place hospitable for her until she can survive outside of it: her natural habitat. When we allow abortion, we guarantee our autonomy while forfeiting the possibility for pregnancy to be anything other than antagonistic between a mother and her child. We violently amortize its burdens. To render abortion impermissible requires a mother confronting the ethical commands of her child and reconciling herself to them. For the philosopher Emmanuel Levinas, our ethical responsibility to each other is not a choice, but rather what we discover when we answer the command of the other. He models maternity as the embodiment of our inescapable confrontation with this command and a mother’s response to give her body when it is the only inhabitable dwelling for her child, a realization of her child’s ethical selfhood.

One consistency between the pro-choice ethic I spent a decade attempting to justify and the pro-life ethic I came to adopt before I believed in God was the instability of the axioms on which they rested. Both of these ethics ultimately rested on the pillars of my own reason. I wasn’t satisfied letting them stay there. I had already realized I was gravely wrong about abortion. What else could I be wrong about? And if I relied on my own mind alone, how could I possibly overcome its inescapable limitations? I wanted to know if Goodness existed outside of my own capacity to determine what it was, if it had authority over reality. It is impossible to look back on the story of my conversion of mind on the question of abortion and ignore the way Truth and Goodness itself, which is to say God, was pursuing me.

He pursued me right out of what had been my career. I had taken maternity leave for my daughter’s birth. I am so grateful that my husband’s support meant that I was able to turn in my notice at the clinic with far less complexity, hardship, and fear than another woman might have experienced. My daughter is four years old now, and is expecting a sibling. I do not know what work I will do in the future. I know that my work now is to care for these children, the one in my arms and the one inside my body.

This is not the story of my religious conversion, of how I came to know and accept the God who once walked among us as Jesus Christ. But what is necessary and relevant from that story for this one is how my acceptance of God led to my understanding of him as Goodness itself. And Goodness reveals itself to us, just as Christ did, with love. Across civilizations, the relationship between a mother and her child bears testimony to the archetypical absoluteness of love. In choosing to be welcomed into the world through his mother’s womb, the baby Jesus reveals himself to us as the author of this love.

With Mary, we come to know that it is her son, the Son of God, who alters history with his self-sacrificing love, rescuing us and imparting in us a desire to inhabit the world as he did. When Mary bore her pregnancy through faithful prayers, entrusting everything to the Lord, it was through his grace and protection that her love for her child prevailed. If Jesus Christ did not make a way for us to love, as he did for his own mother, our call to love each other would rest within ourselves, and we might find ourselves, as I did, insufficient. When we call abortion impermissible and ask mothers to endure the harrowing conditions of pregnancy and labor so their children may live, we are calling them to a goodness which will transform and reconcile them with God. We are calling them to hear the voice of Love.