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Source: (consider it) Thread: ectopic pregnancies
Josephine

Orthodox Belle
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A friend of mine recently opined that women who get abortions for any reason are selfish jerks.

I told her that a relative of mine had an abortion because of an ectopic pregnancy. I said that I didn't consider this relative a selfish jerk.

But I find myself wondering .... about 1 pregnancy in 50 is ectopic. About half of these end spontaneously. The rest are terminated, either with medication or surgery.*

So, if I did the numbers right, about 1 pregnancy in 100 is aborted because it's ectopic.

I began to wonder what it must be like, in large Catholic or conservative evangelical churches that are loudly and adamantly pro-life, to hear people saying things like, "All women who get abortions are selfish jerks," knowing that you got an abortion, knowing that you really didn't have a choice. How do you deal with your grief, your anger, your sorrow over the shitty choice that got handed to you (which wasn't really a choice), when you hear your friends say that abortions are murder?

Given how common ectopic pregnancies are, those women must be there. How do they cope? Do they just stay silent? If they speak up, what happens?

* It happens exceedingly rarely that the embryo in an ectopic pregnancy implants on the bowel or liver. These may rarely progress to viability, and the mother may survive the delivery. These are so rare that I don't think I need to count them in the statistics.

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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!

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North East Quine

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I can't answer because I don't live in such an area; but here, even pro-lifers wouldn't regard the ending of an ectopic pregnancy as "abortion."

Indeed, given that any delay in ending an ectopic pregnancy results in damaged fallopian tubes and reduced subsequent fertility, I'd say that the mind set amongst pro-lifers would be closer to encouraging swift "treatment" of an ectopic pregnancy and the preservation of maximum fertility.

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Lamb Chopped
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I had an ectopic pregnancy (heterotopic actually, since the other twin was in the right place). We had emergency surgery (obviously, since I'm still here). I never felt bad about it--can't see it as morally wrong. It is a situation where you have two (three) lives and one of them is doomed regardless. The only question is whether you can manage to save the other one (two).

I will say, though, that I was glad to learn that the ectopic twin showed no heartbeat before we went into surgery. Irrational, perhaps, but comforting. I would have done it anyway, of course, having no choice.

I do not consider it morally wrong when one has no choice at all.

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Justinian
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Ectopic pregnancies are one of my two litmus tests for pro-lifers, the other being contraception. If you're prepared to accept abortions for ectopic pregnancies, and to encourage contraception then I'm happy to treat you as decent, honest, and probably actually in favour of saving babies lives.

And the Roman Catholic line I'm aware of - you may not abort the baby by aborting the baby, but may abort the baby by removing the ectopic tube is a line I find simply silly.

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Crœsos
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quote:
Originally posted by North East Quine:
I can't answer because I don't live in such an area; but here, even pro-lifers wouldn't regard the ending of an ectopic pregnancy as "abortion."

This pretty much buys in to the premise of the OP, that "women who get abortions for any reason are selfish jerks". That seems to be the only reason to adopt the philosophically convenient but medically nonsensical position that aborting an ectopic pregnancy isn't "really" abortion.

quote:
Originally posted by North East Quine:
Indeed, given that any delay in ending an ectopic pregnancy results in damaged fallopian tubes and reduced subsequent fertility, I'd say that the mind set amongst pro-lifers would be closer to encouraging swift "treatment" of an ectopic pregnancy and the preservation of maximum fertility.

You'd think so, but no. When given the choice between future fertility and making women suffer, abortion opponents will almost always choose the latter. Consider the case of nations that have adopted the pro-life* position as law.

quote:
According to Sara Valdés, the director of the Hospital de Maternidad, women coming to her hospital with ectopic pregnancies cannot be operated on until fetal death or a rupture of the fallopian tube. "That is our policy," Valdés told me. She was plainly in torment about the subject. "That is the law," she said. "The D.A.'s office told us that this was the law." Valdés estimated that her hospital treated more than a hundred ectopic pregnancies each year. She described the hospital's practice. "Once we determine that they have an ectopic pregnancy, we make sure they stay in the hospital," she said. The women are sent to the dispensary, where they receive a daily ultrasound to check the fetus. "If it's dead, we can operate," she said. "Before that, we can't." If there is a persistent fetal heartbeat, then they have to wait for the fallopian tube to rupture. If they are able to persuade the patient to stay, though, doctors can operate the minute any signs of early rupturing are detected. Even a few drops of blood seeping from a fallopian tube will "irritate the abdominal wall and cause pain," Valdés explained. By operating at the earliest signs of a potential rupture, she said, her doctors are able to minimize the risk to the woman.

One doctor, who asked to remain anonymous because of the risk of prosecution, explained that there are creative solutions to the problem of ectopic pregnancies: "Sometimes when an ectopic pregnancy comes in, the attendant will say, 'Send this patient to the best ultrasound doctor.' And I'll say, 'No, send her to the least-experienced ultrasound doctor.' He'll say, 'I can't find a heartbeat here.' Then we can operate."

The U.S. Congress is currently considering a measure to legalize the "letting women who need lifesaving abortions die" option for hospitals with a pro-life* position, so this isn't just some wacky fringe position only found in Latin America.


*Offer expires at birth.

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Humani nil a me alienum puto

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Josephine

Orthodox Belle
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quote:
Originally posted by North East Quine:
I can't answer because I don't live in such an area; but here, even pro-lifers wouldn't regard the ending of an ectopic pregnancy as "abortion."

That was what I was told -- my friend and her husband insisted that, in any pro-life debate, and as far as people in the pro-life movement are concerned, and abortion is the wilful deliberate destruction of a viable human being in the womb.

Unfortunately, that is not the medical or legal definition of abortion. So defining it that way for the purpose of pro-life debate seems to me to be deeply dishonest. It seems to be a fig-leaf constructed to allow them to say, "I am opposed to all abortions" and "abortion is murder" when in fact neither of those statements are true.

Lamb Chopped, my moral code includes many, many shades of gray. I believe that taking another human life is always wrong, even in self defense, even if there is no choice. But it is, in so many cases, the lesser evil. When there is no good choice (as you had no good choice), then you take the least bad of the options available.

But you can't have a proper discussion if you refuse to call things what they are. People who insist that the surgical or medicinal termination of an ectopic pregnancy be called a miscarriage and not an abortion are allowing themselves to believe that nice people like them never have abortions, but only people who are selfish and callous and immoral. It allows them to keep the issue black and white, when it is not black and white.

And it allows them to support monstrous legislation like HB 538, because in their mind the bill would not ban the termination of ectopic pregnancies, because they've redefined the word abortion to exclude them. They don't realize the harm they're about to cause.

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Matariki
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Josephine, you show very clearly why clergy need to be very careful what we say about pastoral and ethical topics from the pulpit. We can never know every dilemma a person has faced nor the soul searching that led to a hard choice being made. Glib comments about the selfishness of abortion will wound in ways we cannot predict.

The story of the Sr you linked to who was excommunicated for authorising an abortion to save the Mother's life seesm to contradict what I thought was the Catholic argument about secondary effect. Namely that there are times when, if to save the life of a mother in this case a procedure is undertaken which will result in a termination then it is licit. Still I'm not a Roman Catholic and could have this very wrong, I stand to be corrected.

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Crœsos
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quote:
Originally posted by Matariki:
Josephine, you show very clearly why clergy need to be very careful what we say about pastoral and ethical topics from the pulpit. We can never know every dilemma a person has faced nor the soul searching that led to a hard choice being made. Glib comments about the selfishness of abortion will wound in ways we cannot predict.

Sometimes those comments are in person, rather than from the pulpit. For example:

quote:
Mormons oppose abortion, except in extreme cases like rape, incest or where the life of the woman is in danger — and require that church elders be consulted. In 1990, Exponent II, a Mormon feminist magazine that Ms. Dushku, the Suffolk University professor, helped found, published an article by a married mother of four who recounted her own experience after doctors advised her to terminate her pregnancy when she was being treated for a potentially dangerous blood clot.

Her bishop got wind of the situation, she wrote, and showed up unannounced at the hospital, warning her sternly not to go forward. The article did not identify [Republican presidential candidate] Mr. [Willard "Mitt"] Romney as the bishop, but Ms. Dushku later did.

Now the woman has come forward, identifying herself in Mr. Scott’s book as Carrel Hilton Sheldon. (Through Ms. Dushku, she declined to be interviewed.) “Mitt has many, many winning qualities,” she is quoted as saying, “but at the time he was blind to me as a human being.”

In a lot of cases the human element of enforcing dogma is not factored in. That goes double for situations where those charged with enforcing dogma have political ambitions.

quote:
Originally posted by Matariki:
The story of the Sr you linked to who was excommunicated for authorising an abortion to save the Mother's life seesm to contradict what I thought was the Catholic argument about secondary effect. Namely that there are times when, if to save the life of a mother in this case a procedure is undertaken which will result in a termination then it is licit. Still I'm not a Roman Catholic and could have this very wrong, I stand to be corrected.

My (outsider's) understanding of the Catholic position is that procedures which will incidentally result in the termination of a pregnancy are licit, but that nothing can be done if it's the pregnancy itself that's the problem. Hence in the article I cited it's considered legitimate to remove an ectopic pregnancy only after hæmorrhaging has started. Preventing the hæmorrhage before it happens is considered a grave wrong, even if it's medically inevitable.

The never-stated corollary of this position is that pregnancy is always 100% safe. Again we see dogma taking precedence over the human element.

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Humani nil a me alienum puto

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Matariki
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Thank you Croesus for elaborating on the Catholic position.
I think you also make a useful point that it's not just dogma but how individuals Catholic, Mormon, Evangelical engage with women facing hard choices.

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"Nothing we do, however virtuous, can be accompanied alone; therefore we are saved by love." Reinhold Niebuhr.

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Caissa
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I refuse to engage in debate with pro-lifers. I support a woman's untrammeled right to control her reproductive function.
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GreyFace
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This isn't intended to be a personal attack but I doubt that very much, Caissa.
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Caissa
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Which part of my statement do you doubt, Greyface?
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GreyFace
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quote:
Originally posted by Crœsos:
The never-stated corollary of this position is that pregnancy is always 100% safe.

I think this demonstrates that you've misunderstood the Catholic position here. If you start from the understanding that human life begins at or closely after conception, and apply the moral principle that you cannot do something evil in its primary action in order to do good, then it drops into place.

The reason you can't act if it's the pregnancy that's the problem, is that the primary intended action is to end the pregnancy or in Catholic terms kill an innocent human and that's forbidden even to save the life of another human. If the condition becomes such that you can apply double effect though, your primary intention can be to stop the bleeding and save the life of the mother, and this has the unintended (that is, foreseen but unavoidable or you'd do it some other way) consequence of killing the innocent. So, nothing to do with a failure to acknowledge the danger of pregnancy.

I'm not that interested in coming off the fence on this thread but where this is most open to attack is the status of the early foetus as fully human, the amount of wriggling that has to go on in order to apply double effect, the absolute applicability of double effect in the first place, and the moral ambiguity of the whole situation.

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GreyFace
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quote:
Originally posted by Caissa:
I refuse to engage in debate with pro-lifers. I support a woman's untrammeled right to control her reproductive function.

Sorry, I should have gone into this a bit further. By the way, on re-reading I withdraw my doubt but in return I'd like to challenge your second sentence as both irrelevant to the debate and essentially meaningless. I'll explain.

The only real distinction between so-called pro-lifers and so-called pro-choicers is the point at which each considers the reproductive function to be complete, and the nurturing/parenting function to have begun. Presumably we all accept that there is a distinction to be made otherwise pro-choicers would support a mother's right to leave toddlers to die of starvation. UK law certainly also supports the position that viability rather than birth is the proper place to draw the line.

So this dispute over terms aside, your second sentence only makes sense if you're accusing your opponents of advocating forced impregnation of unwilling victims. I assume you're not doing that?

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Caissa
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I'll assume that was a disingenuous, rhetorical question and decline to answer it. [Biased]

My comment was of course germane to the first sentence of the opening post.

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Justinian
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quote:
Originally posted by GreyFace:
So this dispute over terms aside, your second sentence only makes sense if you're accusing your opponents of advocating forced impregnation of unwilling victims. I assume you're not doing that?

The ones who oppose contraception, yes. I absolutely accuse them of this. And yes, that includes the Roman Catholic position.

The pro-lifers who are in favour of contraception, believe that as a sometimes regretably necessary medical procedure abortion should remain legal (I'm not happy with amputations either), and who want to reduce the number of unwanted impregnations by methods that actually work are more or less indistinguishable from moderate pro-choicers.

I'd accuse pro-choicers who were anti-contraception of the same if they existed. Possibly some do.

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GreyFace
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Justinian, your accusation then seems to have nothing whatsoever to do with abortion. Which is fair enough, but it does hint that my original objection isn't unreasonable.
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Justinian
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quote:
Originally posted by GreyFace:
Justinian, your accusation then seems to have nothing whatsoever to do with abortion. Which is fair enough, but it does hint that my original objection isn't unreasonable.

In a bubble you'd be right. Or if it were true as you claim "The only real distinction between so-called pro-lifers and so-called pro-choicers is the point at which each considers the reproductive function to be complete, and the nurturing/parenting function to have begun."

But the "pro-life" movement is spearheaded by two large and influential groups, one being always officially anti-contraception (the Roman Catholic Church) and one being normally anti-contraception (Evangelical Christians). The so-called pro-life movement does things like having Planned Parenthood defunded when the main services it provides are contraceptive. It also advocates completely ineffectual ideas like "abstinance-only sex education".

People who support pro-Life politicians support practical restriction of access to contraception (definitely including the Morning After Pill which is pure contraception).

For the leaders, and the loud and influential movement, yes the accusation is fair. For pro-lifers supporting them and agreeing with them then yes the accusation is fair.

There is another group of pro-lifers, the ones I think you belong to. Indistinguishable from pro-choicers except that you lend your numbers and weight to the malevolent group above.

The number and significance of pro-lifers who are acting as pro-lifers by supporting contraception to lower the abortion rate is negligable. And if you're supporting the pro-life movement, you are supporting the policies I outlined above.

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Crœsos
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Interestingly enough, the U.N. Special Rapporteur of the Human Rights Council recently issued a report [PDF] that more or less backs up this position. Basic findings can be summarized as:

  • Criminal penalties for abortion don't actually lower the abortion rate but do result in worse health outcomes for women
  • Widespread sex education, contraceptive availability, and safe, legal abortion does reduce the abortion rate

In short, if preventing abortions is your goal we know how to do that. (Hint: it's the second item on the list above.) On the other hand, groups that say they're opposed to abortion will routinely favor option 1 (draconian criminal penalties) and often oppose option 2 (education and contraception).

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Humani nil a me alienum puto

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GreyFace
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quote:
Originally posted by Justinian:
There is another group of pro-lifers, the ones I think you belong to. Indistinguishable from pro-choicers except that you lend your numbers and weight to the malevolent group above.

You used to make reasonable arguments on this forum but when you descend to this sort of nonsense it makes me wonder why I bother to read your posts.

Back in the real world, it's possible to support some positions and disagree with others without being guilty by association. I wouldn't want to accuse atheists of supporting the murder of millions of Christians just because they agree with Mao and Stalin on the question of God's existence.

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Justinian
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quote:
Originally posted by GreyFace:
You used to make reasonable arguments on this forum but when you descend to this sort of nonsense it makes me wonder why I bother to read your posts.

Back in the real world, it's possible to support some positions and disagree with others without being guilty by association. I wouldn't want to accuse atheists of supporting the murder of millions of Christians just because they agree with Mao and Stalin on the question of God's existence.

Mea Culpa. I forgot you in England rather than America, sorry. The debate over here is sane. Most people who claim to be Pro-Life here, where it isn't much of an issue IME genuinely mean what they say and no more. Putting things in the wrong context is a bad plan, and I apologise for this.

In Britain, the abortion debate is not a serious political issue. It's generally agreed that abortion is a medically necessary procedure if a regrettable one. And therefore banning it is foolish - although we want to lower the numbers. It's managed under the NHS - and PCTs try to lower the numbers of abortions.

The difference in Britain between a pro-lifer and a pro-choicer with very rare exceptions is IME a matter of emphasis. (Off the top of my head there's Nadine Dorys MP, the head of Christian Voice, and the Archbishop of Westminster who advocate the insane pro-life take and there's no one clamouring for the extreme pro-choice side).

In America, the debate is not sane - and I was treating you to the American version of the debate. This was stupid. The pro-life lobby runs pickets outside abortion providers. It inserts conscience clauses so pharmacists don't have to dispense contraception while mandating "abstenance only sex-education". Groups of people literally move house to picket the homes of doctors that provide abortions. They deliberately legislate delays in the abortion process to run the clock out on the women that need them. They ban the safest and most effective types of late-term abortion (a D/X extraction, sometimes known as a "Partial Birth Abortion"). They set up "Pregnancy Crisis Centres" which are supposedly to counsel women who are pregnant but are actually set up to do their level best to counsel women to do anything other than have an abortion under any circumstance. (This, incidently, is almost certainly what was behind Nadine Dorys MP's spurious claim about a conflict of interest on hospitals and counselling a while back). And every so often in this poisonous climate, one of the pro-Lifers gets it into his head to follow through on the abortion-is-murder rhetoric by taking arms and shooting one of the few remaining doctors who will perform late-term abortions.

And yes, I do fundamentally and thoroughly consider the pro-life participants in the American abortion debate to be everything I described. And had you been an American pro-lifer my comments would have been deserved. Guild by association does apply when the debate is that heated and that immediate.

But that was the wrong debate and context is important. Guilt by association does not apply in the same way when there aren't pickets and guns involved. You have my sincere apologies.

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GreyFace
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I intended to get back here and say thanks for the apology a bit quicker than two weeks after it was made, but better late than never I suppose. Thanks.

I think you're taking a mistaken approach to US moderate pro-lifers, though. If you want to recruit them against the bombing of clinics and the like, you're not going to get very far if you accuse them of complicity with murder just because they're against or even actively working against the legalisation of "lifestyle" or "on-demand" abortion.

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Justinian
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quote:
Originally posted by GreyFace:
I intended to get back here and say thanks for the apology a bit quicker than two weeks after it was made, but better late than never I suppose. Thanks.

I think you're taking a mistaken approach to US moderate pro-lifers, though. If you want to recruit them against the bombing of clinics and the like, you're not going to get very far if you accuse them of complicity with murder just because they're against or even actively working against the legalisation of "lifestyle" or "on-demand" abortion.

That depends on two points.

The first is who they are providing active political support to. The triumphs waved around are things like the ban of D/X abortions (erroniously called "partial birth abortions"). Third trimester abortions of any sort are the least "lifestyle" abortions that there are. By that point things are pretty decided and abortions only take place for medical reasons. Likewise there are almost no political pro-lifers who support policies that would actually reduce abortions. Like contraception or actual sex-education. The reason I damn American pro-Lifers isn't the blowing up abortion clinics. It's the general destruction of all the civilised mechanisms that lower the need for abortions. And once they are providing political support, they are helping destroy the very mechanisms that prevent abortion. If you had been an American pro-lifer (and I apologise for assuming you were) then claiming the equivalence you did and then trying to uncouple the abortion debate from contraception could only have IME been muddying the waters. However it makes much more sense in a British context where the debate hasn't been radicalised and that should have been a huge clue if I needed another.

The second is who else is in the debate. For instance Crœsos often provides the valuble function of the hardliner whereas Louise or Josephine are no less implacable but are much much nicer. (My apologies if I'm taking anyone's name in vain - this is just my reading of the situation). I'm quite capable of taking either route. And the mix is worthwhile.

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My real name consists of just four letters, but in billions of combinations.

Eudaimonaic Laughter - my blog.

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