Abortion as Birth Control

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

That’s what this reader perceived among her fellow patients:

I have something called secondary infertility. I was able to have some normal pregnancies resulting in live, healthy births. But we wanted our family to grow and that’s when my problems began. Everything would be fine until weeks 11 - 15. Then the baby would stop thriving and die in utero. The medical term for this is “missed abortion.” Usually after a few days, a woman has a miscarriage but sometimes labor needs to be induced. Regardless, a D&C is in order. So on top of a “missed abortion,” a woman must go through what is essentially an abortion procedure (albeit with a fetus that’s already dead). I lost several babies this way.

I remember being in an outpatient surgical center affiliated with a local hospital.  I was in a waiting room filled with women who were aborting their babies by choice. Many of these women were Russian emigres who used abortion as a form of birth control. That was perhaps the most painful thing for me: desperately wanting a child, not wanting to go through this procedure, and sitting in a room full of women whose babies I would have eagerly welcomed for adoption but who were destined to be killed that day. 

These women showed no emotion. They discussed their nails, their hair, and other trite subjects as though it was just another day. I was trying so hard to have a baby, and they were so dismissive of their own, like their babies were something frivolous. It just about killed me.

This next reader also had a miscarriage and consequently struggles with her pro-choice stance:

While I was losing my babies around the six-week mark, many women across the U.S. were heading into clinics to voluntarily terminate their pregnancies. I find it striking how the exact same process—the loss of a growing embryo or fetus—can evoke such different reactions and understandings.

Ask any woman who has lost a wanted pregnancy: A miscarriage is an absolutely agonizing experience. Most women strongly identify their lost little ball of cells as a baby, not some impersonal collection of DNA. To watch your little one slip away before you even knew him or her is one of the most heartbreaking and isolating experiences for a woman. You are left dealing with the physical aftermath for days, and you watch other pregnant women happily waddle by in the grocery store as you continue to bleed from your loss. You put on fake smiles as people ask you when you want to have a baby, completely unaware that you just lost yours a few days prior.

The psychological effects never really leave. Most mothers will never forget her missing little one(s), and for many the hurt is still there even decades later. I know women who went on to have many healthy children but still get emotional when they talk about their loss. Having healthy babies doesn’t make you forget.

Compare this to the experience of many who voluntarily seek abortions. Some women are filled with guilt and regret, but as your reader series has shown, many (if not most) are very relieved and thankful. For these women, the loss of the embryo or fetus made their life better, happier even. Many of these women do not identify the lost ball of cells as an actual baby. This makes sense, given that it is much easier to terminate an impersonal clump of cells than something you consider to be an actual child.

When a woman refuses to look at an ultrasound prior to termination (and when pro-choice advocates fight against mandatory ultrasounds), it is to preserve this distance between the woman and the contents of her uterus. Ironically, many of these same women do go on to have other children whom they love very much.

The two experiences could not be more different, and yet they are identical in their outcome: The woman is no longer pregnant. It seems as if the act of wanting the pregnancy is what makes the difference. Wanted pregnancies have “real”  children—growing babies with personalities and spirits. Unwanted pregnancies don’t involve children at all, and are just a biological consequence of a biological act.

I am reminded of that scene in the movie Knocked Up, where the main character tells her mother about the unexpected pregnancy. The older woman responds that her sister had an abortion and then went on to have a “real” baby. I think this scene sums up the confusing pro-choice vs. pro-life debate regarding personhood absolutely perfectly:

As someone who is pro-choice and experienced with miscarriage and healthy pregnancy/childbirth, I do find it hard to square my emotional feelings with my pro-choice beliefs. Before I became a mother, I was very much in the “embryos are just cells” camp. If you wanted or needed to terminate, go for it. But after getting pregnant, and then miscarrying, I realized that I didn’t view that little ball of cells as a useless clump of matter. I viewed it as a baby. I had lost my baby. And I was heartbroken.

This puts me in a tough place. I do not view my miscarried baby as any less “real” than my living, breathing, smiling infant who now sits in front of me. So how can I claim to believe that a woman who terminates her pregnancy is not terminating an actual child? It was so much easier to just be aggressively pro-choice before I actually had to confront this moral ambiguity in my own life.

If I dismiss my miscarriage as not the loss of a baby, but just a clump of cells, I dismiss that child’s importance and my own pain over the loss. But if I wholeheartedly accept that the embryo was just as valuable and important as my living daughter, then I must admit that when I say I am pro-choice, I am actually supporting the termination of children and not just some silly cells. I would be advocating not really for abortion, but for something more along the lines of medical infanticide.

So yes, I am certainly pro-choice, but my experience with my own loss has made me more understanding of why so many are very much against abortion. Now I can no longer hang my pro-choice feelings on some argument of mortality, personhood, and the dismissal of the rights of an embryo or fetus. Instead, I support choice for purely pragmatic reasons. History has shown that nothing good happens when women do not have access to safe abortion procedures. [CB note: see this reader’s story of a DIY abortion gone horribly wrong.] Women will terminate if they want to, so we might as well make it safe for them. It may not be morally right, but it is necessary.

Update from a reader:

I know that you wrote that this was how she “perceived” her fellow patients, but was there more to the original email? [CB: Nope] Does she have any confirmation for her, frankly, damning statements?  Some questions:

- How does she know that these women were "aborting their babies by choice" as opposed to some medical condition etc.  After all, SHE wasn't aborting by choice, but she was in the same room.

- How does she know that the Russian emigres specifically are using abortion as birth control?

- How does she know that everyone in the room is even getting an abortion? They don’t announce the procedure when they call someone into the doctor’s office and everywhere I know of the performs abortions also provides numerous other services.

- Does she really think public waiting room conversations are an accurate gauge of how women feel about something?  Was she openly weeping and telling everyone her story while in the waiting room?

I don’t ask these questions to rag on the writer, but rather I think it should be pointed out how easily we accept other people’s assumptions and judgments about a situation. It’s very common, even for women who are getting abortions to assume that they are there for the “right” reasons, while everyone else in the room is morally inferior.  That’s what seems to be happening here. See also the essay, “The only moral abortion is my abortion.”