To Be or Not to Be

I am in awe of the miracle of conception. From the first moment an egg is fertilised, it contains a genetic blueprint for what the completed adult will be like. How amazing is that? In a former life I worked as a midwife, and the moment of birth never lost its wonder for me. How could that little person have developed all their parts in exactly the right order and position, all unseen and without assistance?

I have two children and four grandchildren myself, and I’ve been blown away by their growth and development for all of their lives. Watching them change, and mature, and accept responsibilities, and make decisions, according to their inner codes, is a constant source of wonderment.

For me, human life is a miraculous and sacred thing.

But, in my role as a nurse, a midwife, a researcher in medical ethics, and yes, in our faith community, I’ve also walked alongside other women and girls for whom the picture has been very, very different.

Take Amy, for instance. She was fifteen years old. For six years she’d been abused by her older half-brother – yes, you heard correctly: since she was nine. When she began gaining weight, her mum initially put it down to puppy fat. But then a test confirmed the shocking truth: Amy was pregnant. At fifteen years of age! Expecting a baby by her brother.

Julie’s story was different. She was forty-one, mum to five very energetic boys. Dad, Kamal, had a chronic lung condition and hadn’t gone out to work for twelve years. Julie cleaned offices five evenings a week, but her pay was miserly, and money was always tight. She’d been on anti-depressants for two years and had one spell in a psychiatric hospital when she discovered she was pregnant again. She was at her wits’ end.

And then there was Coral, aged thirty, who’d been trying for a baby for three years. She and husband, Stefan, were over the moon when it finally happened, and threw their energies into staying super-fit, preparing the nursery, and sharing progress with their excited family. Twenty weeks passed. Time for a scan, to check on measurements, find out the sex, actually see the different body parts. But in this case, instead of the expected confirmation, the scan revealed a fatal abnormality. No, there was no room for doubt: this baby would not survive, could not survive. They were given a stark choice: terminate the pregnancy prematurely, or continue, give birth, and watch their baby die soon afterwards.

I could tell you about many other young women whose lives have been turned upside down by the circumstances of their pregnancies, but I’m sure you get the picture. What are they to do? What would you do in their shoes? What role should the church play? (At this point I should perhaps clarify that I am not including the father in this because, whilst in many cases the wishes of both parents are aligned, where they are not it’s the rights of the mother and the fetus which always take centre stage.)

Reality and Conscience

When I was asked to do something on abortion for Press On, I confess my heart sank. It was at a time when the USA was building up to changing the law, overturning the constitutional right of women to abortion which had been in place for 50 years. But here in the UK, as well as in America, emotions run high on this topic, and it’s horribly easy to upset finer feelings, so please forgive me if I inadvertently tread too clumsily over your personal sensitivities. And if you’re looking for a definitive analysis of all the ethical dimensions of this topic, I’m afraid I shall disappoint there too – when a fetus becomes a person; competing rights and interests; moral standing; what makes a life worth living; the relative merits of all the medical and social reasons for contemplating abortion. Doing justice to all the many nuances would take a substantial tome, involve fearfully complicated language, and bore you horribly in the process. No, I’m simply going to share a few of my own thoughts about how we as fellow Christians might better understand the subject, perhaps avoid some common pitfalls, and respond to those for whom abortion is a painful reality in their lives. More a launching pad for discussion than a checklist for decision.

First, I have to recognise that my own experience has coloured my judgement of right and wrong in this area. Here in Great Britain, abortion has been legally allowed since the Abortion Act gained royal assent in 1968. The date is seared into my memory – the year I got married. A couple of years before that, I had worked in a maternity hospital where large numbers of babies were born on three floors of a massive building. On the top floor was an area devoted to women who had tricky problems and complications arising from things like infectious diseases, and it was into this ward that women came who had been damaged by illegal – so-called back-street – abortions. Some were horribly maimed by what had been done to them. Some died. Young fertile women; girls with their whole lives ahead of them. That kind of waste of life leaves an indelible mark.

Once the Bill was passed, legal abortions were carried out in that same ward, under medical supervision in clean carefully-controlled conditions – so much safer than the clandestine efforts of little unqualified women in darkened grubby back rooms plying knitting needles and basins of lysol. When, some years later, I returned to work after having my own babies, most of my time was spent in the Neonatal Unit caring for tiny very sick infants at the edges of viability, but just occasionally I was asked to go to this ward where the women having abortions were cared for – handling products of conception not much smaller than the babies I normally looked after. I dealt with it by adopting the approach that it was none of my business why the patients were terminating their pregnancies; my medical colleagues had made that assessment. My role was to care for them non-judgementally, safely, and kindly.

Then, one night, I was sent there in a hurry. The place was hectically busy. I scribbled notes as the day staff handed over to me. They left, and I instantly went into overdrive, doing all the multiplicity of tasks required in caring for a wardful of women as the only qualified person on duty. The drugs round came to the top of my list and away I went, checking, double-checking, at each bed to ensure every person got the correct drug in the right dosage and actually swallowed it. It was only as I was locking up the medicine trolley at the end of the round that it hit me. I had – for the first time – personally handed a tablet to one of the women that would start the process of abortion. I hadn’t prescribed it; but I had administered it. I felt physically sick.

There was no time for dealing with my reaction then, eleven hours of frenzied activity left no space for it, but I did a lot of heart-searching afterwards, and I came to the realisation that there was something intrinsically built into me that made me recoil from taking a life. I’m the same in the garden – slugs, lily beetles, injured birds – their little lives are somehow special. In the case of garden pests, this is nonsensical, it’s illogical, it’s wimpish, but it’s a fact. I resolved never again to give an abortifacient to a pregnant woman; I would play the conscientious objection card if necessary. In fact, it never arose, and I largely shelved the issues until I moved into the world of medical ethics and explored the arguments in much greater depth.

I’m sharing this story to illustrate a number of things.

Just because my instinct is to recoil from ending a life does not mean in and of itself that I think terminating a pregnancy is wrong, full stop. I don’t. There are circumstances where I believe it to be the best option for all concerned. I once held the hand of a mum who was having her fifth pregnancy ended because the fetus had a lethal abnormality. She had already lost four babies with congenital impairments. Continuing this pregnancy would not only put her life in jeopardy, but even if she went to term, she would need major surgery, only to be handed a dead child. I defy anyone to say she was wrong to choose abortion. And I’ve fully supported other girls whose reasons were perhaps less extreme but the decision just as painful.

So, I have my own personal views and beliefs about the sanctity of life and a woman’s freedom to choose, but those particular convictions have not been tested in the fire of real life in my own case. I might think I know, but I cannot be certain, what I would have done had I been Amy’s mum, or Julie, or Coral. However, having seen up close the desperation of women for whom continuing a pregnancy is an appalling prospect which will have devastating consequences, I am sure of one thing: I have no right whatever to insist they must make a particular decision because my conscience is seared; because of my interpretation of Scripture. I won’t be there to help shoulder the burden in that family if the baby is born, or to bear the psychological consequences accruing from a decision if he/she is not. And nor will the academic philosopher, or the podium-thumping Christian crusader, who might well be able to marshal an impeccable argument to support their personal viewpoint. How can they, how can I, in all compassion, impose a judgement on someone in the real world, facing the hardest decision of their lives?

And yet people do.

Feelings run at fever pitch on this topic. I have a mental picture of pro-life campaigners waving placards, shouting, screaming even, outside centres that offer abortions, as scared, traumatised girls and women walk in – showing graphic images of fetuses sucking their thumbs, daubing red paint everywhere to pile on the guilt, handing them religious tracts. I think of doctors being killed by bombs placed under their cars; buildings set on fire; death threats sent. I also have vivid memories of the voices of girls in our own faith community who have told me what elders have said to them, what well-meaning but implacable church members have threatened them with. And speaking of our community, I think there are additional factors that come into play in a church with small numbers, an active grapevine, and strong views about chastity outside marriage. Much harm has been done with the best of intentions.

The Arguments

So, what of the arguments? Churches the world over have been – still are – conflicted on this topic, and ours is no exception. Not all pro-life advocates are Christian, but those who are maintain, often vehemently, that terminating a pregnancy is in contravention of God’s will. But ... is it? And if it is, does this apply in all circumstances, and everywhere? And here it’s important to recognise from the outset that compassion alone is not sufficient grounds to permit an act which violates any moral law.

Abortion was practised in Biblical times – using very rudimentary methods, and there’s evidence that there were different schools of thought on the issue even back then. But in spite of that, our Bible is silent on the subject. And Jesus himself said not one word about it. Nothing. What then, do these Christians use to back their claims?

Well, moral intuition and natural reason play an important part. A feeling in one’s bones. The Bible doesn’t say anything about paedophilia, or genital mutilation, or honour killings, either, but I suspect not one of us would support such practices. We are outraged by these violations. Abortion comes into this category for some people.

Religious opponents of abortion also argue that, even though not explicit on the issue, the Bible gives us indicators of what is right and wrong:

• God himself is a God of life. Human beings are created in his image. It is sacrilegious to think of deliberately taking a life.

• The 6th commandment says you shall not murder/kill (Exodus 20:13).

• Every fetus is a child of God (Genesis 9:6), a precious potential person. We ought to give every human life equal protection and rights. Abortion is a slippery slope to devaluing all life.

• Exodus 23:7 says you must not put an innocent person to death, and unborn babies are innocent.

• God hates hands that shed innocent blood (Proverbs 6:17).

• God knows us even in the womb (Psalm 139:15-16). Jeremiah, Isaiah, the apostle Paul, were called by God to their sacred tasks from the womb (Jeremiah 1:5; Isaiah 49:1; Galatians 1:15).

Now, it’s not my intention to unpick each of these texts, rather I want to leave you to consider whether this kind of approach being used to tell girls and women that they absolutely must not terminate a pregnancy for any reason today in the 21st Century (or indeed at any point in history) because the Bible says so, is fair and justified. And let’s not ignore the fact that understanding of fertility and conception and pregnancy was very different thousands of years ago.

Those Christians who take a different view, and support freedom of choice for women, on the other hand, also turn to the Bible:

• The value of a pregnant woman is placed above that of her unborn child in the Mosaic law (Exodus 21:22-25).

• How can the instruction not to kill be applied in the case of a fetus when the Old Testament is full of examples of God instructing his people to kill whole cities and tribes – including, specifically, infants? (e.g. Deuteronomy 20; Joshua 6; 1 Samuel 15:1- 3; Ezekiel 9).

• There are hundreds of texts that instruct us to be compassionate and loving and supportive and caring and it’s a fundamental message of the gospel.

• Jesus himself put love and compassion in the number one slot (Matthew 22:35-40).

• He defied the social conventions of his day to give women a voice and respect their autonomy (e.g. John 4; John 8:3-11; Luke 13:10-17).

Whether or not a woman’s right to choose trumps the right to life of the unborn child, we have to recognise that where pregnancy is concerned, their interests can be in conflict. The reasons for considering terminating a pregnancy fall into two categories: medical and social.

Medical factors include the physical health of the mother – maybe she has advanced cancer and delaying treatment will worsen her prognosis, or an existing condition where the strain of pregnancy and birth would put her life at risk. Or perhaps it’s her psychological health that’s at stake – this baby would exacerbate a pre-existing mental illness, or make her suicidal, or in some way push her beyond her capacity to cope. Maybe the fetus has a condition which is incompatible with life. Or perhaps one fetus is compromising the well-being of other fetuses in the pregnancy.

Social factors include things like the pregnancy is the result of abuse or assault. Maybe the timing doesn’t fit with the bigger plans of the parent(s), or another child would impose too great a strain on the family.

A dispassionate observer is likely to view the medical reasons with more sympathy than the social ones, particularly where there is no possibility of the child surviving, but for women personally reeling from the adverse implications for their reputation, their career, their family life, their religious life, their eternal wellbeing, any situation can seem monumentally daunting.

So, the next question could be, if we recognise that compassion for a woman’s plight might in some circumstances overrule a basic right to life for the fetus, how do we decide? And here we might ask some questions. What kind of relationship brought about the creation of this embryo?Was pregnancy a foreseeable consequence? How does the woman perceive the fetus? Inconvenient? Burdensome? Dangerous? Offensive? Distressing? Is continuing the pregnancy perpetuating the injustice that brought it about in the first place? Are the reasons purely self-interested or do they have wider implications? Is there a viable alternative?

There are, of course, other non-biblical reasons why people take a stand on one side of this debate or the other. Abortion is not a procedure without implications, like having a tooth pulled or an appendix removed. It carries a myriad of emotional connotations relating to life and death, fertility and womanhood, sexuality and identity, often laden with ambivalence and conflict. And indeed, many people who don’t believe in abortion in principle, when actually confronted with an unwanted pregnancy in their own lives, can find the alternative intolerable. So, it’s hardly surprising that ending the life of one’s own unborn child can have long term psychological consequences. I’ve known women who’ve had mental health crises years later even after a relatively early termination.

It can also happen that the woman is subsequently unable to carry a child to term because of damage done during the abortion – psychological as well as physical; a heavy price to pay, and one which doesn’t always appear in the equation when decisions are being made at times of high emotion. I’ve held women as they wept with regret and guilt, long after the event. I’ve also seen a couple expecting a multiple birth, go through the process of selective reduction to remove two fetuses in order to give the others a sporting chance, only to lose all the longed-for babies one after another following the procedure.

Then there’s the bigger picture. Even in cases where the child has serious abnormalities, some would question: do we want a society where certain infants are judged unfit to live, or too burdensome on family or resources?

Another powerful argument relates to the approach of any given country to abortion. In Great Britain, the tight rules, originally laid down in law, have weakened over the decades since the Abortion Act was drafted in 1967, and today it’s usually permitted in most circumstances. As a result, according to the latest government statistics published in May this year, 209,917 pregnancies were terminated in 2020 in England and Wales alone. I’ll say that more slowly: 209,917. That’s the equivalent of wiping out the population of a town like Ely in England, or Rochester in the USA, in one year. For someone who won’t kill a slug, that’s a tough thought to dwell on. But, in the interests of fairness and balance, let’s not forget that huge numbers of pregnancies end prematurely quite naturally: more than one in five – around a quarter of a million in the UK each year.

The numbers may well be eye-watering, but the alternative to abortion has troubling consequences too. The wholesale banning of abortion, as in some states in the USA now, may well save the lives of some babies, but it will unfairly impinge on the already marginalised and oppressed in society – the disadvantaged, the poor, people of colour, the unsupported, the abused; the very groups Jesus told us we should reach out to and love and champion.

Open Acknowledgement

So, what can we take from all this?

• Abortion is an emotive, complex, and difficult issue. There are no easy one-size-fits-all glib answers.

• Not everyone will wish to share their experience; you might be completely unaware of the history of someone you think you know well. Any reference to the topic should be sensitive and respectful.

• The Bible does not provide definitive answers.

• Human life is God-given but in the case of abortion, two lives are involved, and rights and interests may be in conflict. Decision-making is rarely a clear binary choice, and supporting freedom to make up one’s own mind does not of itself imply being against the sanctity of life.

• We need to form our own opinions carefully and prayerfully, based on the facts, not inherited conviction.

• There’s nothing wrong with having personal beliefs, but it can be a dangerous thing to impose them on others who are actually facing this traumatic decision.

• Whatever the result, it is our responsibility – collectively as a church community and personally, where appropriate – to support those grappling with these troubling questions in real life and facing such momentous options.

• If you are called upon to get involved in such a situation, please, please, do not harangue the pregnant woman, threaten her with God’s punishment or ecclesial rejection, or force her hand. She is the one who must live with the consequences, not you.

In the past, strong prohibitions have forced many a troubled sister to hide her situation, and the related pain and anguish. But burying the reality, hiding the emotion, merely perpetuates the trauma, and can indeed exacerbate it. By openly acknowledging that unwanted pregnancies do happen, and that sometimes it can be unwise or unsafe to continue with a wanted one, we can start a healthier dialogue. Being available to listen compassionately, offering a shoulder to cry on, a presence to lean on, can help the troubled soul at the centre think through her options more clearly in a safe space, and arrive at the best decision for her. And again, that’s the key: for her.

I recently came across an interesting challenge that stopped me in my tracks: If you don’t know anyone in your community who has wrestled with this issue in their lives, ask yourself, Is my church open and compassionate, or is it closed to difficult discussion?

Is it?

And perhaps more importantly, are you?