AMENDED: Second Trimester Abortion Restrictions Are Not an Option: Response to Saletan and Kissling


EDITOR’S NOTE: This article was amended at 10:10 am and than again at 2:01 pm on Thursday, December 9th, 2010 at the request of the authors to include a quote from the Saletan article referenced, to link to that article, and to reflect concerns raised by Kissling in response to the article about the differences between “regulations” and “restrictions.”

The authors state: Our post addresses all the issues raised in the Saletan article, which conflates Kissling’s position on her willingness to roll back the legal deadline for unrestricted access to second trimester abortion and Saletan’s on the “trade off issue.  While Kissling proposes restricting access, she does not do so in the same frame as Saletan, who sees a potential “trade off.” 

The exact quote from the Saletan article is included below.

*****

This article is part of an ongoing discussion and debate hosted by RH Reality Check on women’s rights to abortion care in the context of so-called common ground and abortion “dialogues” with the anti-choice movement.  Other articles in this series can be found here.

When leaders in the pro-choice movement start to speculate about restricting abortion rights to appease the anti-choice movement, they have lost sight of what the pro-choice movement is about: respecting women as moral decision makers.

In several recent articles, both columnist William Saletan and Frances Kissling (former President of Catholics for Choice) stated that they would support restrictions or regulations on second trimester abortions. Saletan’s position is that such restrictions could be exchanged for the anti-choice movement’s support for broader access to contraception, a suggestion we found to be both vague and unlikely.  Kissling has suggested regulating later abortions for other reasons.

In an article published on Slate.com, for example, Saletan wrote:

Frances Kissling, the former longtime president of Catholics for Choice (for whom she no longer speaks—she is now a visiting scholar at the University of Pennsylvania), said that in view of the “evolving potential of fetal life,” she was willing to discuss rolling back the legal deadline for unrestricted abortion to 18, 16, or even 14 weeks. She stated her position this way: “As long as women have an adequate amount of time to make a decision, and there are provisions for unusual circumstances that occur after that time, I would be satisfied. … Women have an obligation to make this decision as soon as they possibly can.”

Similar issues were raised during a Blogging Heads discussion between Saletan and Kissling.

This position illustrates an abandonment of the vulnerable women who need later abortions and a willful ignorance of the circumstances under which second trimester abortions occur. An early choice to end an unwanted pregnancy, while medically easier and to some more politically palatable is not necessarily a better or more moral choice. Women deserve to have all the time they need in order to make the best pregnancy decision for themselves and for their families, even if this means having a later abortion.

As we’ve written before, women have later abortions for a variety of complex, nuanced reasons. Women may diagnose a pregnancy when they are already in the second trimester.  Study upon study has shown that many women face delays in obtaining abortion care after they’ve made the decision to end an unwanted pregnancy, including:

  • Poor referrals and delays in finding a clinic that will perform the procedure
  • Arranging childcare, scheduling time off of work, and arranging transportation which can include airfares and/or several days of travel
  • Raising enough money to pay for the procedure

These are only some of the hoops that a woman has to overcome once she’s made the decision to have an abortion.  These barriers can delay women from one to three weeks or more.

And for many women, the biggest cause of delay is the woman’s own uncertainty about what decision is right for her.  Women have no obligation to make a decision as soon as they possibly can. The only obligation women have is to take the time they need to make the decision that is right for them. Don’t we believe that women are moral decision makers, and carefully consider their options when faced with an unwanted pregnancy?  Don’t we reject the anti-choice rhetoric that women make the decision to have an abortion callously? The pro-choice movement takes a step backward when we judge that a woman has taken too long to make what may be a life-changing decision. Shouldn’t we want women to take the time they need to make the best decision, regardless of where they are in the pregnancy? It is more important that a woman make the right decision for her and her family than an early one.

It is a slippery slope to say that women must make a decision about a pregnancy as soon as they can. Not all women even have this option. Some women don’t find out that they are pregnant until they are in their second trimester. Some women don’t find out about a devastating fetal abnormality until the second trimester.  Others are pregnant as a result of sexual assault and need time to come to terms with what has happened to them.

And, just as important, some women need more time to evaluate if they are in a position to carry a pregnancy to term.

Accepting restrictions on second trimester abortion, something Saletan suggests as “common ground,” is not an option. Since when has the fight for abortion rights been about placating those who don’t believe in women’s human rights to begin with? Women’s lives and health are not a bargaining chip by which to secure peace with the anti-choice movement.  And what negotiating table is Saletan sitting at, and with whom?  If there are anti-abortion leaders who say, “back off from women’s rights to second trimester abortion and we’ll work with you to secure first trimester abortion access,” they sure are quiet!

We need to re-focus on what the pro-choice movement is about: Trusting women as moral decision makers and promoting reproductive rights as human rights.  Without the right to abortion, including the right to an abortion in the second trimester, these rights are hollow ones.

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  • france-kissling

    While many of the issues raised in this article – concepts of moral obligation, moral agency, abortion at any point in pregnancy, women’s rights, etc are of deep interest to me and worthy of extended discussion. I have a general policy of not engaging in an exchange when so much of an article is focused on accusations such as those in this piece.

    I am not sure what purpose is served by claiming that a colleague has “lost sight of what the pro-choice movement is about” or taken posiitons that illustrate  “an abandonment of the vulnerable women who need later abortions and a willful ignorance of the circumstances under which second trimester abortions occur.”

    It is of course, perosnally useful to know what one’s colleagues think about your values; but perhaps not helpful to sorting through what at least some of us may think are complex issues of ethics and policy.All public figurres are fair game, however and I am not complaining.

     

    I will correct one error in the second paragraph which claims that “In several recent articles, both columnist William Saletan and Frances Kissling (former President of Catholics for Choice) stated that they would support restrictions on second trimester abortions in exchange for the anti-choice movement’s vague support of broader contraceptive access.”

    I have never made such a claim. I have been clear that trade offs are of no interest to me. I am only interested in policy options that combine women’s rights and access to service with a legitimate societal interest in respect for the value of fetal life ( I do not believe individual fetuses have rights.) Each and everyone of those words would take a chapter to define and explore and that is not for this response. 

    Susan and Steph make many good and important points in this article that I agree with, several that I would take issue with, but I have no need of framing that in any negative way regarding their values or commitments.

     

     

     

     

     

     

     

  • freewomyn

    You summarized the point really well, Steph.

  • arekushieru

    Are indisputable human beings given the right to life at the expense of another person’s right to determine who uses their body and when and how it is used, via ongoing, informed and explicit consent?  If not, then a fetus that is given that right at any stage of gestation, has more rights than anyone born, especially women.  The simple part being, that it doesn’t really matter if a fetus does or doesn’t have rights. 

  • colleen

    I would like to add three things:

    The first is that, politically speaking, such a ‘compromise’ is painfully stupid because effective contraception, however much Will Saletan and Jill Stanek disapprove of it’s use, is extremely popular.   Indeed the religious right’s and particularly the Catholic church’s  political opposition to effective contraception is politically damaging for them. It is a public relations disaster and one they richly deserve. 

    The second is that ‘2nd trimester restrictions’ inevitably = a higher maternal mortality rate.

    Finally, I wish the participants in that conference would explain how they managed to have this ‘dialog’ without once addressing one of the realities of human reproduction which is that there is a male who is at least 50% responsible for every unwanted pregnancy. Is it rude to address this reality? Would pointing this out close the ‘open hearts’ of  Will Saletan and David Gushee? Because as far as I can tell the notion of male responsibility for unwanted pregnancies (and, for that matter, all those pregnant teenagers was ignored entirely as it always is. Would not factoring biological reality and social responsibility into the equation change the nature of the dialogue into something slightly less offensive than Saletan going on about the joys of stigmatizing women who have had/want to have an abortion  as  ‘common ground’?

    Because I am seriously appalled that ANYONE believes this crap should be taken seriously by any woman with a modicum of self respect and self worth. Seriously.

  • ann-furedi

    Frances,  I think Susan and Steph’s blog serves an important purpose. It demonstrates that when you talk about accepting a reduction in the time limit for later abortions, others disagree. And it corrects a view that you’ve argued that there is little evidence for why women present for second trimester, rather than earlier, abortions. I think that’s what they meant when they referred to your ‘wilful ignorance’.

    When I read Will Saletan’s Slate article ‘Rethining Roe and Contraception (2nd Dec). This was my comment:

     

    “Frankly, I can’t think of much that has appalled me more than reading this:

     

     Frances Kissling, the former longtime president of Catholics for Choice (for whom she no longer speaks—she is now a visiting scholar at the University of Pennsylvania), said that in view of the “evolving potential of fetal life,” she was willing to discuss rolling back the legal deadline for unrestricted abortion to 18, 16, or even 14 weeks. She stated her position this way: “As long as women have an adequate amount of time to make a decision, and there are provisions for unusual circumstances that occur after that time, I would be satisfied. … Women have an obligation to make this decision as soon as they possibly can.”

    Now, I can understand why anti-choice advocates oppose late abortion if they accord the embryo/fetus in the womb they accord a child. And I can understand why people who are ignorant of the circumstances in which abortion is required believe wrongly that 2nd tri is unnecessary.

    But how does someone with a life time of pro-choice experience descend to this?

    • Has something new been discovered at the University of Pennsylvania about the ‘evolving potential of fetal life’ that has passed the rest of us by?
    • Are we reassured to know that one visiting scholar there ‘would be satisfied’ by a reduction in time-limits as long as women have what she thinks is ‘an adequate amount of time to make their decision’.
    • Do we think women delay their decision out of ignorance of their obligation to the sensibilities of scholars?

    Can someone PLEASE tell me Frances, whom I have long respected, has been misquoted?!”

    Then I was sent the link to Blogging Heads TV – so I guess, you weren’t misquoted … and we stand and fall by our public statements.

    I’m glad this is an open debate. At least we all know where we stand and can reflect on the ethicals and policy implications of the moral ground that we, and others, personally occupy.

  • ann-furedi

    Frances,  I think Susan and Steph’s blog serves an important purpose. It demonstrates that when you talk about accepting a reduction in the time limit for later abortions, others disagree. And it corrects a view that you’ve argued that there is little evidence for why women present for second trimester, rather than earlier, abortions. I think that’s what they meant when they referred to your ‘wilful ignorance’.

    When I read Will Saletan’s Slate article ‘Rethining Roe and Contraception (2nd Dec). This was my comment:

     

    “Frankly, I can’t think of much that has appalled me more than reading this:

     

     Frances Kissling, the former longtime president of Catholics for Choice (for whom she no longer speaks—she is now a visiting scholar at the University of Pennsylvania), said that in view of the “evolving potential of fetal life,” she was willing to discuss rolling back the legal deadline for unrestricted abortion to 18, 16, or even 14 weeks. She stated her position this way: “As long as women have an adequate amount of time to make a decision, and there are provisions for unusual circumstances that occur after that time, I would be satisfied. … Women have an obligation to make this decision as soon as they possibly can.”

    Now, I can understand why anti-choice advocates oppose late abortion if they accord the embryo/fetus in the womb they accord a child. And I can understand why people who are ignorant of the circumstances in which abortion is required believe wrongly that 2nd tri is unnecessary.

    But how does someone with a life time of pro-choice experience descend to this?

    • Has something new been discovered at the University of Pennsylvania about the ‘evolving potential of fetal life’ that has passed the rest of us by?
    • Are we reassured to know that one visiting scholar there ‘would be satisfied’ by a reduction in time-limits as long as women have what she thinks is ‘an adequate amount of time to make their decision’.
    • Do we think women delay their decision out of ignorance of their obligation to the sensibilities of scholars?

    Can someone PLEASE tell me Frances, whom I have long respected, has been misquoted?!”

    Then I was sent the link to Blogging Heads TV – so I guess, you weren’t misquoted … and we stand and fall by our public statements.

    I’m glad this is an open debate. At least we all know where we stand and can reflect on the ethicals and policy implications of the moral ground that we, and others, personally occupy.

  • france-kissling

    Dear Ann,

     

    Just to clarify what I actually said abour research on late term abortions. I responded to an article that stated several major reasons for later term abortions. In order, those were listed as fetal conditions, shame over sexual assault that leads to delay and time needed to raise money. What I responded was that we do not know which of those is greater. I also said that there is no evidence regarding shame over sexual abuse leading to pregnancy denial, indecision etc as a major factor. I questioned the extent to which later term abortions occur becuase women who could not raise the fees for early abortion manage to raise it for later abortions. My own reading indicates that fetal conditions are not the most frequent reason for later term abortions ( which is not to say that other reasons make those abortions “wrong”; they do not. ) My remarks were made in the context of what I considered an over the top diatribe that claimed all anti-abortionists are liars. it was an example of the way in which others might take the assertions of the article on late term abortions as also an example of “lying” which I did not.

    I stand by those comments and do not think anything cited in the Yanow/Herold article contradicts what I wrote.

    I have no problem having my views on abortion criticized by others. I don’t even mind outrage, snickering, derision, public flogging and other lower forms of criticism and I thank you for the motherly reminder regarding the pluses and minuses of a public voice.  Criticism is an opportunity to speak again as well as to learn from other views.

    I do have a problem being incorrectly credited or blamed for ideas that are not mine. I have stated above and state again I am totally uninterested in trade offs between the choice/justice movement and the anti-abortion movement.

    On the insights I have “descended” to – a comments section is inadequate and inapproriate to do them justice, but you can look forward to further writing on the issue. Thanks again for your comments.

    All the best

    Frances.

  • france-kissling

    And, nowhere did I suggest accepting a reduced  time limit for later abortions. What I suggested, along the lines of David Garrow, was that abortions later in pregnancy might be treated differently from early abortions ( as is the case in many European countries). Differently might mean medical review of reasons, counseling by more specialized professionals, etc. I know this is odious to some and no more acceptable than actually prohibiting them, but I did not call for a reduction in the time limit of legality. Perhaps that will come later when I have had more time in the academy and descended to a lower circle of hell (This is irony for those inclined to take everything literally).

     

     

     

  • the-abortioneers

    Frances, thank you for being involved in this conversation. Yesterday I read the other article you reference and all the comments to it, but continue to be confused by what you’ve said about second-trimester delays and the supposed lack of information about their reasons. I recognize that you’ve been involved with emergency funds as well as personal donations for women who can’t afford abortion care. I have, too, and what I don’t understand is how, despite this involvement, you feel you don’t know why women who are NOT facing a fetal anomaly “wait” until the second trimester, while I feel I know it all too well. 

     

    They do, they DO suffer from shame and denial — young women especially. They don’t tell their parents, who might beat them, throw them out of the house, or simply ‘be disappointed’ about either consensual sex or rape (outrageous but not uncommon) or the pregnancy itself; imagine how much more complicated and traumatic when incest is involved.

     

    A surprising number of women simply don’t realize for a few months that they’re pregnant: they have urgent things on their mind, like keeping their children clothed and fed, where outgrowing their shoes can be an unaffordable problem, and maybe to scrounge up some shoe-money they’ll forgo lunches at work, so feeling tired and slightly sick all the time is nothing new; you get the picture. Or they keep getting their “period” (actually implantation bleeding, 1/3 of women have it through the first trimester) or are in some other way among the “lucky” women who barely have any symptoms. 

     

    And yes, HELL yes, women do spend months getting the money together. In my area, most of the CAPS or NAF member clinics charge around $500 for a first-trimester abortion; some places are able to discount $100-150 with proof of Medicaid. But of course, if you’re on Medicaid you probably don’t have $350 in your pocket. Sure it doesn’t “make sense” to try to get $2000 instead of $350, but the result of what you’re saying is that if they can’t get the $350 right away, why are they bothering at all? As you know, women are much more determined to decide their pregnancy outcomes than that. Plus, a lot of the second-trimester patients I talked to got their price information when they first called a clinic in the first trimester, and had a terrible shock when they called back several weeks later and the price was higher.

     

    Then, if they are lucky enough to find out about emergency funds, which many clinics don’t even know about (!), they will still be disappointed to find that we can’t always pay everything they are missing. “Can you pawn your TV, get a predatory payday loan or a loan for your car title, can you borrow ten dollars from everyone you know, can you find five houses to clean after work this week?” They painstakingly set that money aside. Then, maybe, a drug-addicted relative steals it from them. (Yes, really.) They’re back at square one. Or they have to help their family move before the eviction date (you wrote about this happening in your own life, actually) and the delay takes them from week 12 to week 13, or they move to another town and have to find a new clinic with a new price, or a ride to the old clinic. And so on.

     

    Sorry for all the details — I’m sure you have heard similar ones before — it’s just that they come back to me so readily whenever I talk about the women for whom I worked to find funding. These stories and examples are not statistical evidence, but they are not nearly rare, either. I heard them all day, every day, for years, but never lost my trust in women and girls’ good-faith efforts to make things right. What is making you reluctant to believe them? 

  • will-saletan

    I’m afraid the correction requires a correction. This has been added to the top of the article:

    The authors state: Our post addresses all the issues raised in the Saletan article, which conflates Kissling’s position on her willingness to roll back the legal deadline for unrestricted access to second trimester abortion and Saletan’s on the “trade off issue.  While Kissling proposes restricting access, she does not do so in the same frame as Saletan, who sees a potential “trade off.” 

    The authors, having conflated Kissling’s position with my trade suggestion, are now trying to pass off their conflation as mine. Nowhere in my article did I say that Kissling proposed or agreed with a trade. I presented her position on second-trimester abortions solely to make a case that differential treatment of these abortions could be, contrary to Ross Douthat’s argument, a live option.

    I’ve also said that I don’t like the idea of the law and its enforcers getting involved in these abortions. But that’s another matter.

    Herold and Yanow make good points. The reasons for later abortions vary and are often complicated. I put forward the “trade” idea as a way to get pro-choice people thinking about what items on their agenda might be negotiable if a morally compelling offer were available on the other side. Whether such an offer could be delivered (e.g., whom does David Gushee speak for?) and whether it’s morally worth the sacrifice, from a pro-choice point of view, are separate questions.

    I would go further than Kissling and accept legal restrictions on second-trimester abortions in exchange for full coverage of contraception under federal health insurance standards (as preventive care) plus organized support (from evangelical churches, for example) of a culture shift on contraception. Most folks on this site wouldn’t take that deal even if it were offered and spelled out in detail. I respect that choice, though I disagree with it.

  • arekushieru

    First off:

    (This is irony for those inclined to take everything literally).

    I think that was unnecessary, Ms. Kissling.  If you are unaware, there is a learning disability out there called non-verbal learning disability (which I have) and two of the symptoms are to take everything literally and to misunderstand sarcasm (which I do not have, so I am speaking for those who do have these incapabilities), meaning there isn’t always an ‘inclination’, at least not as you implied. 

    Secondly, people who use the term ‘motherly’ are either using it sarcastically and/or making a sexist comment.  That wasn’t necessary, either.

    Now, back on topic.  Going by what I said in a previous comment towards you why should late term and early term abortions be treated any differently from each other, except for health reasons?  You’re suggestion(s) for addressing them indicates another marker entirely, after all.

     

  • arekushieru

    They do, they DO suffer from shame and denial — young women especially. They don’t tell their parents, who might beat them, throw them out of the house, or simply ‘be disappointed’ about either consensual sex or rape (outrageous but not uncommon) or the pregnancy itself; imagine how much more complicated and traumatic when incest is involved.

    Indeed.  This just struck me to the core that I felt I had to respond.  Because, the incest mentioned here is committed by someone in a position of authority, in *their* lives and, I think, that takes a highly destructive toll on women’s trust which needs to be addressed just as much as the aspect of trusting women, themselves. 

  • arekushieru

    I would go further than Kissling and accept legal restrictions on second-trimester abortions in exchange for full coverage of contraception under federal health insurance standards (as preventive care) plus organized support (from evangelical churches, for example) of a culture shift on contraception. Most folks on this site wouldn’t take that deal even if it were offered and spelled out in detail. I respect that choice, though I disagree with it.

    Funny that.  Since you’re not one of those people who would ever be directly involved with that decision.  Do you accept that your wife (if married, actual, if not, potential.  Thanks.) should be able to make a decision under which circumstances you should or should not be able to have a vasectomy?  Now, that’s ‘irony’.

    Btw, the authors of this article weren’t stating that you (not even as the author of the article referenced) were conflating the positions.  They were saying the article itSELF, did so.  Again, thanks.

  • colleen

    I would go further than Kissling and accept legal restrictions on second-trimester abortions in exchange for full coverage of contraception under federal health insurance standards (as preventive care) plus organized support (from evangelical churches, for example) of a culture shift on contraception.

    Why would we want a cultural shift on effective contraception? Contraceptives enjoy wide  acceptance and popularity and the vast majority of people use them. It’s main foes are a minority of Catholics (judging by the 90+ of Catholic women who report using effective contraception). Besides, if insurance reform actually takes effect it is in the best interests of the insurers to provide excellent contraceptive coverage.

    I respect that choice, though I disagree with it.

     

    Your deeply offensive article told me all I need to know about what you mean by ‘respect’ when it comes to women.

  • crowepps

    Most folks on this site wouldn’t take that deal even if it were offered and spelled out in detail.

    I can’t speak for all the folks on this site, but speaking for myself I do not feel privileged to do so if the ultimate costs are going to be imposed on other people whom I do not represent and for whom I am not entitled to “take that deal”.  Just like David Gushee and Frances Kissling and you, I am entitled to speak only for myself and make only my own decisions.

     

    Part of the reason this subject is so contentious is the underlying assumption that the various groups of activists have the right to control other people’s sex and reproductive lives, impose their personal faith/morals on strangers, and better decide how those strangers will be ‘allowed’ to conduct themselves.

     

    Certainly in a free country everybody with an opinion gets to self-appoint themselves as a moral arbiter, but it’s the position of the majority of people in the country that on issues where consensus has NOT been reached, and particularly those with a strong religious component, nobody gets to harness the power of the government to force others to comply with such  personal/religious beliefs.  There are a lot more people who think adultery is immoral than there are that abortion is immoral, and nobody is suggesting bringing back the historically ineffective and pointless effort to use the government to eradicate that.

  • saltyc

    Mr. Saletan, That’s what I think of your idea.

    Your anti-choice bias is revealed here, because the anti’s would get so much more and give up so little.

    I volunteer for a grass-roots abortion fund. Lately, all I’ve been funding are second-trimester abortions.

    I live in a fairly anti-choice state, with exceptional towns.

    We are in a crisis where the funding is low and the abortions are very expensive. The result is that many women are being forced to have babies against their will, which the constitution is alleged to protect against.

    Anyway, the anti’s would L-O-V-E for second trimester abortions to be outlawed, because that will lock in more unwilling mothers for them.

    They do everything they can to make women wait to get an abortion, by making abortion expensive via the Hyde amendment and local lawmakers who refuse to cover the cost through medicare. And by using billboards, radio and television ads, and churches to make them not want to have an abortion, or to be in denial, until very late when they can’t deny it any longer. If the anti’s can just make the window of opportunity smaller, they will catch more women.

    And what we’re telling women, with the withholding of funding and many restrictions is, that you don’t get to decide on this ONE medical procedure, which will profoundly impact the whole course of your life, but rather that decision goes to the church ladies, tea-party wackos and male supremacists and terrorists of the Right. Oh and BTW, we (the government) still fund Embryonic stem cell research and fertility treatment. So an embryo isn’t a person, until it is pressing down hard on a woman.

     

  • j-parker

    I just want to be sure I understand what you are saying here, Frances. Did Saletan misrepresent your position when he said

    she was willing to discuss rolling back the legal deadline for unrestricted abortion to 18, 16, or even 14 weeks.

    Or are you saying that the emphasis in that sentence should be on ‘unrestricted’ – ie, you would limit elective abortion this way but not put a legal limit on later abortion for some other reasons (to be determined). That is what I am hearing you say above, and what I would guess you meant when you referred to exceptions in the original quote.

    I also wanted to respond briefly to your comment about the way Europe differentiates between early and later abortions in terms of regulations or restrictions. This comparison is meaningless and misleading if it does not acknowledge the fact that European countries also provide universal health care, contraceptives, sex education, living wage, higher education, maternity leave, child care, and usually cheap or free uncontroversial access to early abortion. To me the outrage is not that we have so many women seeking later abortions here in the U.S., but that we allow so many women and families to live in poverty, without access to health care, education or opportunity. If we addressed those issues I suspect the ‘problem’ of so-called ‘elective’ later abortions would all but solve itself.