On viability, and why it shouldn’t matter

// 22 May 2008

I’m entirely new to blogging*, and it’s very possible that this is too controversial a topic to be handled by a mere beginner, and that I’ve bitten off more than I can chew. I certainly hope that other feminists more experienced and knowledgeable than I will cover this topic more thoroughly than I, and in a much more persuasive manner, because it deserves more coverage. But because of the media attention abortion has gotten recently, and the focus on viability, I think this is a good time to at least start this discussion.

We know for a fact that current scientific theory does not support the reduction of the time limit, and neither does the Commons Science and Technology Committee or the British Medical Association. Babies born around the limit for abortion (24 weeks) are nowhere near what would be considered viable in real terms. They have a high mortality rate and long lasting health problems. But this isn’t about that.

The issue of viability is misleading, because it is used to draw attention away from the women who would be having these abortions. My aim here is to put forward the idea that viability cannot be the standard with which we decide who gets abortions and when.

What would happen if abortion limits were decided by the gestation period at which babies prematurely born can survive? What will happen when science and care reach the stage at which babies born earlier and earlier can be kept alive? This will certainly be no mean feat, even if it is in the distant future, the babies that do survive very, very premature birth will even then suffer serious complications and high mortality rates. We will not in the foreseeable future be able to change the fact that once born, a premature baby does not mature just as it would if it had been carried to term, and for whatever reason, premature babies will always need a lot of close care and attention, and will always be likely to have health problems as a result. The time at which we can help some of these babies survive might get earlier and earlier, but the damage and the risks of premature birth won’t go away.

But where would that leave women, if babies born at say, 13 weeks start to survive? Pro-life lobbyists would no doubt insist that a limit at 13 weeks would be too long, because some babies born at that time would survive. After all, that was their only rationale behind lobbying for a cut in the time limit this week. The medical evidence and leading medical groups did not support them, and their main argument rested on the emotionally laden comparison between foetuses aborted at the same age as some wanted babies are born, and how they are exactly the same. They are not.

The act of birth divides them, one being a physically separate entity, a live being in its own right, and the other being attached to another body, dependent on that body for all sustenance. The prior is a baby; something legally recognised as alive, the latter is a foetus; something that is not a separate entity, but a continuation of someone’s body, that feeds off someone else.

And hence we come to the idea of control over one’s body, and the legal right to exert it. The idea here is that every person owns their body. Everyone is responsible for what happens to their body, and nobody is allowed to do something to someone else’s body without consent, or to require something of someone’s body without their permission.

Let’s go through a scenario. Carol’s brother, Steve, is ill. He has some kind of kidney problem, and is dying, and the only thing that can save him is a kidney transplant. Carol is the only match for Steve in their immediate family that can be identified.

We can argue that it would be ‘the right thing’ for Carol to nobly give up an organ for her brother. It would certainly be very nice of her. But legally, she has no obligation to do so. Even though Steve may be a model citizen, rescues grandmothers who cross the street, has a Nobel Prize and five kids, and his kidney problem was not caused by any action on his part (in other words is about as deserving a recipient as most people can picture) she has no legal obligation to give him her kidney. Even though she has two, and doesn’t technically need both kidneys to survive. It may be cruel of her in our eyes that she chooses not to. But it’s her right, something the law supports.

Why? Because legally and ethically we see it as wrong for a person to force someone else to give part of their body. We draw a line that stops people from forcing someone else to keep them alive. We value the life of the person who needs that support, yes, and we would very much like it if more people donated bone marrow or kidneys, or even their organs after they died. But we cannot, and do not force them to donate an organ, or hook up that other person onto their body, because we are aware of the serious risks and complications for the donor. It is all about the donor’s choice, and the fact that they must be willing to make the sacrifice themselves.

Now, imagine Carol becomes pregnant. Only for whatever reason, she has carried the foetus to say, 22 weeks. Why should the law force Carol to keep this ‘person’ (if you believe a foetus is alive, I don’t. At least, I don’t believe it’s alive any more than any other clump of cells) alive when she is not under any legal obligation to keep her brother, someone who she has known and loved all her life, alive? It would be the height of hypocrisy to demand that women keep foetuses, and carry them to term, because they approximate real babies enough in your eyes, when real, living people aren’t given the same privilege. Why should we give foetuses more rights than babies or adult humans?

Having a growing mass inside of you compete for your own nutrients isn’t easy, and puts many strains on the host, whether it’s cancer or a foetus. No, I’m not calling foetuses a cancer or a parasite, but medically speaking, they are in the same category of things that take nutrients from the body, grow, and can put the host body in danger. Fortunately, most of the time, women are perfectly happy to be host to a foetus, because they want the baby that will be born in a several months time. Nobody actually loves the at worst physically endangering and at best inconvenient process of pregnancy, but many women are willing to go through with it, because they love the thought of the baby they want to have at the end of it. And that’s fantastic, I’m happy for them. Babies can be a wonderful thing for those who want them.

But what about those women who don’t want a baby? Who don’t want to go through the risk and discomfort of nine months of pregnancy to give away a baby they don’t want, or a baby who will die shortly after birth, or who will be stillborn? What can we say justifies forcibly keeping them pregnant because of the age of the foetus (at 24 weeks a foetus is still very far from full grown) and forcing them to give birth, which is a traumatic, difficult, potentially dangerous process?

Would pro-lifers make a bargain with women, that if a woman doesn’t want to carry a foetus to term, she can have it removed, and it can be kept alive in an incubator and then adopted? After all, according to them, babies born at that age are perfectly viable, and that’s their issue with abortion. Except we all know that this wouldn’t happen. For one, most pro-lifers don’t tend to care much about babies after birth.

More importantly, even they recognise that we do not have facilities that are anywhere near good enough that we can deliver all the babies at 24 weeks, and have them grow up without much difficulty and risk. Otherwise, women (conservatives included) might be queuing up to cut pregnancy times in half, and have a much easier time of things. If they want this to be about viability, they should be advocating that every woman who wants an abortion should be able to deliver this ‘viable’ baby then and there, and pass it on to be looked after by someone else. Conservatives get to keep the babies, and everyone’s happy.

But we know that this cannot be a reality, for the foreseeable future. Women can’t just give birth whenever someone decides babies and foetuses are viable and pass it on to someone else. They would have to carry it to term, taking on all of the risks and dangers of a pregnancy and labour that they did not wish to continue. And that would be wrong. Since we don’t have the ability to magically take away ‘viable’ foetuses and save them, we can’t tell women what to do with their bodies. It’s their risk, and therefore their decision.

The viability argument does not take into account women’s circumstances, or whether they can get an abortion easily. It does not take into account the limits of technology, and how we test for serious disorders at this time. It does not take into account many of the complicated reasons why a woman may need a longer time period to realise that she’s even pregnant, or wants (or needs) an abortion. These should be the deciding factors in where to draw the limit, so that any woman should be able to get an abortion when she NEEDS one. We support all people in their right to keep their organs and not support anybody else with their body when it comes to organ or tissue donation, no matter how much the would-be recipient needs it, or how ‘innocent’ the recipient is. We should therefore support pregnant women in the same manner.

That’s why viability shouldn’t be what decides where we put the limit. We can’t save all ‘viable’ babies, nor can we let all women who don’t want to continue a pregnancy pass on the baby to someone else. Therefore, we still need these abortions, because we should not force any person to support another with their body. Right now, living breathing humans don’t have a right to claim someone else’s body should support them. Therefore an entity which is not alive yet should not be given special rights above those that all living people have.

This being a contentious, difficult topic, I can’t say it’s an easy question to think about. I don’t have an absolute lack of reservations about later term abortions, because the foetus is more developed. But even more, I don’t want to compromise women’s rights, and ultimately, the wellbeing of those foetuses if they are born into an environment that neither wants them, nor can care for them. There is never going to be any easy solution, nor should we lie around expecting one. We need this discussion, difficult though it is, so that we may work to find the least harmful answer we can. I’d love to see what other people think about this issue, so please feel free to comment, even if you disagree.

* Writing comments involves a lot less analysis of one’s own language and disclaimers, and I’m still in fear of starting a blog war, or making a huge faux-pas of some sort. So please tell me if I’m saying something that is privileged and ignorant, or putting my foot in my mouth. I’ll thank you. Really. I haven’t had time to do any reading of all the wonderful feminist blogs I normally lurk at recently (The F Word being the only exception), so it’s perfectly possible that someone will have covered this or done much more justice to this difficult topic, so feel free to tell me if that’s the case. I also don’t claim credit over the old ‘kidney operation’ analogy.

Comments From You

joanne // Posted 22 May 2008 at 10:39 pm

I don’t wish to be rude, but you really haven’t said anything here that hasn’t been said a million times already. You’re not ‘starting’ any discussion, because this discussion has been going on for decades. Even your Carol and Steve analogy has been done, which you should already know if you are trying to engage in abortion debate (google ‘violinist thought experiment’ if you don’t). Surely the f-word should be inviting bloggers that will at least attempt to say something original?

John A // Posted 22 May 2008 at 10:44 pm

One difference is a perceptual difference – some people would not consider it murder to have possessions which could be sold to give to charity and save starving children or as in your excellent example, wouldn’t consider it murder for the sister not to donate the kidney. However, in law at least, when you take a pre-conceived action which results in a death – for example, switching off someone’s life support machine – that’s murder.

Personally I don’t think that a foetus “counts” as a human being, but it is difficult to justify an arbitrary limit, because it doesn’t have any logical foundations to defend it from. And the most obvious non-arbitrary limits are conception and birth. Then again, even St Thomas Aquinas accepted abortion up until a certain number of weeks, on the basis that “ensoulment” was not yet completed.

PC // Posted 22 May 2008 at 11:07 pm

Hi Anne,

Great blog and a radical topic – I look forward to reading more of your posts.

On the issue of viability – and the medicalisation rather than moralisation of abortion – I think (‘think’ meaning that likely I’m wrong) that holding the debate on these grounds was one of the factors which allowed the passage of the original act, and so has served its purpose. BUT, now that we’re supposedly in a more progressive society, I agree it has become irrelevant and that new time limits (if any – I personally think there should be some, although as a man will never have to worry about childbirth myself, so cannot ever understand its risk/agony) should be thought about (and I have no idea how to define these).

Anyway – great blog in my opinion, keep it up!

Shea // Posted 23 May 2008 at 12:00 am

I think two main arguments arise here. Firstly the interconnectedness of bodies.

You wrote “Right now, living breathing humans don’t have a right to claim someone else’s body should support them.” and thats true to an extent, although given the context of the debate, the HFEA bill, I think it deserves analysis. Would the same argument hold true to prohibit stem cell (adult or embryonic) research I wonder? Because I do take issue with that. I think on the one hand, we are interconnected irrevocably as a human population and as a species. I exist because of a shared human genome and because someone as you pointed out, was good enough to lend me their body for nine months (and longer if you consider breast feeding). I also hope that should I ever need it blood and organs belonging to someone else might be available for me and vice versa. But, and there is a but, if we expect such altruism of women, which is what prolifers do, we have a moral duty to be similarly altruistic with our bodies and DNA (the old kidney operation analogy). There should therefore be no caveat to exclude yourself from participation in clinical research, or in providing renewable tissues such as liver and bone marrow and blood. Likewise there would be a good case for allowing all the spare embryos created from IVF to be used for research and/or implanted in women, regardless of objections.

If we reject that, we are left with a rights based conception of the body, which allows for bodily autonomy. But on what basis do we grant this right? Human agency? Human dignity? Why privilege our species? At what point do we grant someone rights over their body. When they breathe independently? So do we remove those rights from people who are incapacitated, or on a ventilator?

Which brings me to the second issue of viability. I think it does matter, because it isn’t the pro life people who value human existence. My understanding of viability is the capacity for survival. The 24 weeks is a theoretical and actual cut off point, demonstrated with empirical evidence because of the nature of foetal development. After this the balance shifts in favour of the foetus (although granted the woman still has the right to abort for maternal endangerment and serious disability) because its development puts it at a point where its moral agency is approaching that of it’s mother.

What I think I am trying to say is that the foetus is demonstrating more characteristics of bodily independence, such as the ability to survive outside the womb, it therefore begins to compete for the equal right to bodily autonomy. I don’t want that part of the debate to be hijacked by the prolifers, because there are important issues at stake. It is about achieving the balance of competing rights in a difficult situation, but what it shouldn’t be about is pitting the rights of one vulnerable group against another. It should be about reaching a reasonable compromise, one which is decided on an ethical, rational basis, not the emotional manipulation and intellectual dishonesty of the pro life organisation.

I support a womans right to choose and the 24 week limit, because the evidence supports it. If, in ten years the evidence supports a reduction to 20 weeks then we need to reconsider our position. Without it, it just becomes a partisan stance on a polarised issue.

I’m sorry to ramble on, I thought this was a good first post and respect to you for having the courage to confront this.

Marina // Posted 23 May 2008 at 12:03 am

I would say if it is to late for abortion because it can survive on its own then it is perfect time for early induction :)

If an embryo gets status of human then it should be treated as any other human invading another person’s body without consent and any necessary self defence should be allowed.

Shea // Posted 23 May 2008 at 2:34 am

Marina — your comment made me think. In fact most late term abortions are just that–inducing labour too early. The only differences is that the mother who wants her baby will ask for the child to be rushed to neonatal care, heroic measures, anything and everything and only the rarest lucky few will survive. Whilst the woman who doesn’t, wont and will simply let nature take its course.

Its amazingly disengenious of Dorries to give her spiel about holding a 22week old baby in her arms and believing they were “committing murder”. In fact she wanted to stigmatise one group of women and fetishise the other for a difference of opinion (in wanting the child), when both groups had done exactly the same thing— give birth too soon.

Toni // Posted 23 May 2008 at 10:24 am

Marina: Agree entirely. You’ve encapsulated in a few lines what I’ve been trying to articulate for months :)

Great post Anne, look forward to reading more.

Anne Onne // Posted 23 May 2008 at 1:17 pm

John A, interesting point. Though that’s part of the issue. Doctors are allowed, indeed expected to (under certain circumstances) not resuscitate, or switch off life support. Hence being a doctor is not about purely ‘saving lives’, and the idea of ‘quality of life’ is acknowledged. But those same doctors will use the ‘doctors are supposed to save lives’ line to justify denying women abortions.

I personally believe the most important issue in deciding limits is that women who want abortions will in real terms be able to get them as soon as possible, and that when that is not possible, allowances should be made where circumstances warrant them. Right now, with the waiting times and testing technology that we have, it’s imporant to remember that these things affect how early women can get abortion, and not make it purely about how early a few babies can survive.

Shea, interesting reply. But I think it’s key to altruism that it’s just that. An act of voluntary charity.

Also, I do agree that if we can improve survival rated for babies that are born prematurely this is undoubtedly a good thing. However, my point was that if we improve the time limit at which a few babies survive, but don’t do anything about the scientific tests for foetal problems, or the waiting time for abortions, we would be putting the rights of the foetus above that of the mother, because she might not have adequate time to get an abortion before the limit.

I also think it important that women who have suffered abuse, or are very strongly desiring an abortion because circumstances changed should still be allowed to have later term abortions even if science drastically improves. I know people whose mothers remind them frequently that they weren’t wanted, and blame them for their problems, and it isn’t a situation I’d wish on anyone, child or parent.

Marina, I think I pretty much tried to say that at some point (though whether I succeeded in getting the point accross is another matter entirely!) in the post. If technology is such that babies that would be aborted late term could survive, and the women could choose to give up the baby for adoption, I’m sure many women who would want to terminate would prefer that. But the key thing is that the child should not be kept in her body when she does not want it to. And until science has moved forward to such a time where this is possible, and relatively harmless to the baby being delivered early, termination will the the least cruel option between forcing a woman to carry it for another few months, and inducing the baby only for it to die or be seriously affected and not wanted.

Thanks for the comments and respectful disagreement. :)

Sarah // Posted 23 May 2008 at 4:54 pm

I agree, and I do feel that ‘viability’ has been a huge red herring throughout this whole debate. For one thing, there is no new evidence relating to viability and survival rates, secondly even if there was, that is not the issue. Abortion rights are not about the right to kill fetuses or babies, regardless of their state of development, but rather about the right to stop being pregnant. For the moment, of course, that amounts to the same thing in effect, and probably will for the foreseeable future – but I think it’s important to keep that framing of the issue, and keep the focus on women’s human rights, rather than getting sidetracked by cute fetus-baby pictures, or even by perfectly valid discussion about the personhood of the fetus and at what point ‘life’ begins. Because as the ‘kidney donation’ analogy demonstrates (I think bone marrow donation is also a reasonable analogy) even if we consider the fetus to be a person with full human rights like the rest of us, that doesn’t necessarily mean abortion is unjustifiable.

The real question to be answered, I think, is not whether the fetus is fully human, but whether pregnant women are. Though it’s a terrible thing that we as a society are still effectively having that debate.

Aimee // Posted 23 May 2008 at 5:55 pm

…I actually think this is an astute and insightful first post… so keep up the good work! I am also of the opinion that viability is irrelevant. If the baby is being supported by the woman, the woman must surely have the right to withdraw that support at ANY time. And furthermore, why do people seem to consider it alright to FORCE women to maintain that support, even at the risk of the woman’s own life, against her wishes? This, for me is the fundamental issue regarding abortion; we are essentially debating whether or not it is right to afford a woman full autonomy over her own body, and that is a very sad thing.

Anne Onne // Posted 23 May 2008 at 6:09 pm

Joanne, your comment wasn’t up earlier, and I wanted to respond to it specifically. Yes, you’re right in stating this isn’t something original to talk about. I specifically stated the argument and analogy are not original, so it was a bit redundant of you to point it out.

I felt that in the run up to the vote on the abortion time limit, the focus was very one-sided. This viewpoint, the reasons behind the limit that are related to the mother and not the foetus were not given attention by the media. If I succeeded in nothing more than causing people to examine another possibility than only thinking about the foetus, that’s enough. Originality and whether everybody agrees are both beside the point, at least in what I wanted to get accross.

The F word had not recently covered this aspect of abortions, and I thought that writing this at a time when there is a huge focus on abortions would be better than much later on.

Hopefully in the future I’ll write something more original, though I won’t flatter myself by pretending to come up with anything truly groundbreaking. That kind of stuff happens once in a blue moon. In the feminist blogosphere, truly little that is written is unique, but is the culmination of the theories of many people, each one adding their own viewpoint.

But for now, with the close shave we had, and the ongoing struggle for the right to control our bodies, I think it’s also important to repeat the most important basics, and to keep hammering on, and keep examining difficult ideas, and refining old ones.

It’s your right to disagree, and I won’t blame you for not liking a post, or finding it boring or old news. I just don’t think that has any bearing on whether something shouldn’t or should be discussed.

Sarah, exactly. That was in essence what I wanted to put accross. :)

SM // Posted 23 May 2008 at 8:51 pm

Anne Onne, your post might not have been original but it was very useful in going over arguments which people new to the whole feminist-blog-thing might not have heard before (that would be me). I look forward to your other posts- don’t be put off by mean comments =]

Am I turning Tory??? // Posted 23 May 2008 at 9:19 pm

Although I agree that viability is a red herring in the termination debate, I don’t know how anyone who has felt their baby kick at 16 weeks+ could even contemplate terminating their pregnancy. When that little thing inside you starts responding to tv theme music and familiar voices it’s a different ball game altogether.

I don’t think women should be given social terminations of pregnancy beyond 20 weeks but major psychiatric and medical support.

I don’t really care if this is an unpopular view or if it appears to be anti feminist. A termination within the first trimester is bad enough and a decision that would still be dreadfully upsetting.

I don’t see how having a termination at 24 weeks would, in the long term, feel less awful than giving a baby for adoption, remembering that healthy white babies are adoption gold dust.

Aimee // Posted 23 May 2008 at 10:23 pm

“I don’t see how having a termination at 24 weeks would, in the long term, feel less awful than giving a baby for adoption, remembering that healthy white babies are adoption gold dust.”

Quite simply, because this would neccessitate giving birth to a live baby.

Whilst giving birth for a woman who is emotionally and practically ready for the arrival of a much wanted baby might be described as a positive experience, in adverse circumstances it would certainly be very traumatic and upsetting, not to mention dangerous for the health of the woman.

Please bear in mind that 24 weeks is just over half way through a pregnancy; very much different to carrying a child to term. At 24 weeks, most women are still capable of doing pretty much everything a woman who is not pregnant can do, with regards to work and such. At 9 months pregnant, walking, moving, standing up becomes extremely difficult. Whilst some women are able to continue to work, many are not which obviously has financial implications, among other things to do with independence and autonomy. My base issue is this; why should a woman sacrifice this further 4 months of her life to carry an unwanted baby to term? Why do we consider women to have an obligation to a baby which she did not create of her own volition? Why should women be slave to their own bodies, without the oppurtunity to choose what it does and when it does it?

Also, I doubt you intentionally aimed your comment at white women, but why are we assuming said baby will be neccessarily white? Abortion is not an issue only affecting white people. Or have I missed something?

Anne Onne // Posted 23 May 2008 at 10:33 pm

That’s your choice. Nobody’s asking you to have a termination at all, let alone a late one. Your beliefs as to whether abortions are moral are yours to keep. The problem is ascribing the emotions you might feel in a situation to everyone else. Many people don’t see abortion the way you do.

It’s even more important that if someone can’t imagine a situation where they could empathise with the women who need abortions, that they don’t judge them, or project their own personal sense of morality onto others.

Each person is different, their circumstances and what is best for them is a unique situation each time. There are many women who are relieved to have an abortion, and that’s who it’s there for. The people who would have one illegally if denied a safe, legal one. The people who might try to commit suicide rather than bring that child to term. The people who would suffer, along with the child if they were forced to bring up a child they never wanted.

There’s no guarantee that a woman having an abortion is doing the right thing for herself or for the potential foetus, but if it’s a choice between a woman making a mistake and regretting it, and women never being allowed to have a choice (and regretting that), the former is preferable.

Again, arguing for choice isn’t about demanding everyone has abortions. It’s about making abortions readily available for those that need them, as soon as they realise they need them. And it’s about trusting the women involved that it really is what they need.

Rhona // Posted 23 May 2008 at 11:58 pm

“Again, arguing for choice isn’t about demanding everyone has abortions. It’s about making abortions readily available for those that need them, as soon as they realise they need them. And it’s about trusting the women involved that it really is what they need.”

Anne, you have absolutely hit the nail on the head here. :)

james // Posted 24 May 2008 at 12:28 am

These are pretty well rehearsed arguments. I’m instinctively pro-abortion, but in all honesty the two things that have always niggled at me are:

“My base issue is this; why should a woman sacrifice this further 4 months of her life to carry an unwanted baby to term?”

That’s always struck me as the wrong comparison. The right comparison is not with carrying the fetus to term, but with induced labour. Like Shea says, there’s very little difference between some abortions and some early births. It’s just that in some cases we desire the fetus to live and in others to die. I’ve always suspected that this means we’re not really arguing about bodily autonomy when we get down to it, but instead just talking about people’s preferences, and the autonomy arguments are really just a front.

“Why do we consider women to have an obligation to a baby which she did not create of her own volition?”

I think you can hold this view in good faith. It’s just a question of where you think the line should be drawn. We all have an obligation to accept certain unwarranted harms rather avoiding them by inflicting greater harms upon others. If you go to slap me, and the only way I can prevent that it is to hit you with a glass I have in my hand, then there’s legal precident that this would be disproportionate and I should just take the blow – rather than excape it by handing out a severe injury. I’d agree with that, and while I wouldn’t extend it to the case of abortion, I can see how people who would take a different view to what’s a proportionate harm could come to a different conclusion.

Aimee // Posted 26 May 2008 at 10:06 am

James. At risk of being outrageously PC and presumptuous, I am assuming from your name that you are male. In which case, your right to the ‘front’ which I refer to as bodily autonomy is never threatened in the same way as a woman’s might in the aforementioned situation. Therefore whilst you might consider this argument a front, you will never experience the awful feeling of having something inside you, something living and moving, which you do not want there. It is harrowing and distressing and should not be forced on anyone.

Also, by ‘carring to term’ I was assuming that labour was implied, but yes, I appreciate that would be a better comparison.

Iola // Posted 27 May 2008 at 11:13 am

Thank you for that post – I haven’t seen the kidney analogy before and the whole post put into a structure a lot of the things that I feel about this topic but I hadn’t found a way to express them for myself. For me the Fword is my only regular feminist reading and I really value entries like this that don’t assume a level of indepth knowledge, nor that I am a high level feminist-activist just because I identify as a feminist. I hope you carry on posting.

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