Can We Ever Say a Woman Can’t Choose? A Response to Frances Kissling (CORRECTED)

This article is part of an ongoing dialogue on choice and access to abortion begun in the last part of 2010.  Other commentaries in this series can be found at this link.  Marge Berer is editor of Reproductive Health Matters.

A correction was made to this article at 10:00 am, Monday, January 3rd article at the request of the author to amend the description of Frances Kissling’s original positions of leadership of Catholics for Free Choice (CFFC is now Catholics for Choice (CFC)). Frances was first a board member and later the President of CFFC, an organization which, as the article notes, she “put on the map.”

“Can we ever say a woman can’t choose? It’s hard for pro-choicers to admit sometimes a woman shouldn’t be allowed to choose abortion — but we have to.”  Frances Kissling at, June 21, 2009.

The article quoted above, which I’ve only recently discovered, was posted on the website. Salon long ago closed the discussion, but alongside Ann Furedi,[1] I feel compelled to respond, because I want to exclude myself from the group in which she has placed herself, one she wants to call pro-choice but now believes has the right to refuse women a late abortion.

Frances would not be the first person to move from being pro-choice on abortion to being against some aspects of it, if not becoming completely against it. This article appears to be indicative of such a shift on her part. Yet the Frances I know has been a formidable force in challenging official Catholic doctrine on abortion. As a board member and later first president of Catholics for a Free Choice she became the face of an organization that brought together Catholics from all over the world to take a public stand against a profoundly anti-women doctrine, all of them people who refused to give up their identity as Catholics. She argued then that according to Catholic theology, acting upon one’s own conscience was the most profoundly ethical stance on abortion that a person can take.

So what has moved Frances from there to here, where she calls for refusing some women an abortion?

The case that she says first moved her to rethink her views, which she was asked to respond to on an ethics panel, was the kind of case an anti-abortionist would come up with, of a woman with a seemingly “frivolous” reason for wanting an abortion. There were few details offered, only that the couple didn’t want a second boy (“oh, it’s just that we wanted a girl,” presented as if it were equal to “oh, but I wanted the blue dress, not the red one”). There was no apparent gender discrimination mentioned, as there mostly is when fetal sex is given as a reason for abortion. The couple are one-dimensional; they have no history, no background. Their “case” for abortion is easy to reject. And of course there are always some women and couples who have “lightweight” reasons for seeking an abortion, and many more who could and should have prevented the pregnancy, but should they become the basis for compromising the whole ethos of women’s choice on abortion? You can’t be involved in abortion issues, read the literature or work in an abortion clinic without knowing that people with trivial reasons for abortion form a small minority of abortion seekers and that those who have to confront an unwanted pregnancy do learn (the hard way) about taking responsibility. Mostly they learn well because they never come back. So why didn’t Frances reject the example given and ask for a serious case to exercise her judgement on?

Instead of asking whether the couple should have been refused an abortion, perhaps the meeting should have asked: 1) whether a woman should ever have to justify or give reasons for her need for an abortion to the abortion provider at all, and 2) whether the provider should have the power to refuse a woman a procedure the outcome of which, one way or another, will have a major bearing on the rest of her life. The pro-choice answer to both these questions is no.

In making her case for refusing the woman an abortion, Frances fails to focus on the woman and the woman’s life, or what will happen if she has the baby, and instead decides she has to punish the woman and bring the baby into the world because the request comes late in pregnancy. A baby for whom Frances has no duty of care and for whose life she will take absolutely no responsibility. But it is in fact the absence of responsibility for what happens to the woman and the baby, if the pregnancy is carried to term against the woman’s will, that explains why an abortion provider must never pass judgement on the validity of a woman’s need for an abortion. In my opinion, it is only possible to be anti-abortion if you will never be the one left holding the baby, nor be around to see or take responsibility for what happens to those who are.

And yes, for me that means abortion providers should act as technicians with a clinical skill to offer, as all other medical professionals do, not as judges. Health professionals are not forced to provide abortions, and abortion providers who are only willing to do abortions up to a certain number of weeks of pregnancy should make this clear to everyone who seeks their help, and refer women to someone who can and will help them. The fact that there are so few doctors willing to provide late abortions in the United States is surely due as much to the fear of aggressive and oppressive anti-abortion harassment, violence and the very real threat of assassination as anything else. No morality in that.

This article makes the assumption that a person can be pro-choice sometimes and not at other times. How is this possible? “Pro-choice” is short for “supporting a woman’s choice on abortion.” It’s an unfortunate terminology, because it assumes that women really do have a choice and have more than one viable option to choose from. But this does not reflect the reality of most women’s lives or what women themselves say. Women risk their lives, if they have to, to end an unwanted pregnancy. It is not a matter of choice for them, but of overwhelming need. Nevertheless, even accepting the terminology, if the decision is not the woman’s, then the “choice” has either been denied altogether or it has been transferred to someone else – and that could as easily include George W Bush or the Pope as well as Frances. In my moral universe, anyone who thinks they have the right to refuse even one woman an abortion can’t continue to claim they are pro-choice. It’s a contradiction in terms.

As it progressed, I began to feel offended by this article because it says things such as “These things should make us pause and think hard.” (The “things” being some of the reasons women have given for seeking an abortion.) As if Frances is the only person in the pro-choice movement who has ever paused and thought hard about these things. By this point in her paper, the “we” and “us” who she claims to speak for begins to shift, however, because she separates herself from those of “us” who are pro-choice by such statements as: “I realize that expressing pro-life values, when you’re pro-choice, is much more complicated.” “Pro-life” is it now? 

And then comes the final blow to any lingering concept of “choice” when she says:

“But I have come to believe that women’s autonomy does not require that all efforts be made to protect women from pain or from hearing the word ‘no’.”

Thus does she reject her own historic respect for women acting on their conscience and reduces them to the moral equivalent of spoilt children whose only problem is that they might feel pain or be refused something. In 1993, Frances encouraged me to publish, “An open letter to a Diocesan priest,”[2] a personal statement about the lifelong pain of having to give up a baby for adoption as an alternative to having an abortion. Why does Frances no longer acknowledge this level of pain when she talks about “choice?” What really has made the person who put Catholics for a Free Choice on the map trivialise both much unwanted pregnancy and the women who experience it?”

She goes on to say: “I think it’s important for us to be able to say: When a fetus reaches the point where it could survive outside the uterus, is healthy, and the woman is healthy, and she has had five months to make up her mind, we should say no to abortion.” Who exactly are the “we” that she now considers herself to be part of?

But wait a minute. If the actual subject of this inquisition is only women with unwanted pregnancies at 26 or more completed weeks of pregnancy, which is the point at which scientists agree the independent survival of a fetus outside a woman’s body begins to be feasible, she is actually talking about refusing abortions to only a handful of women. In Great Britain in 2009, for example, the number of women who had an abortion at 24-plus weeks of pregnancy was 136 out of a total of 189,100 abortions. All 136 were on the ground that there was “a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.”[3] None of these women had had five months to make up their minds.

Does this demolish her argument? No, I assume she would point to the 2,036 women that year who had abortions at 20-plus weeks of pregnancy, on grounds of “risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.” Those are the women, I think, whom she accuses of having had five months to think about it and should have acted sooner. The fact that a third of them were less than 20 years of age, and none of them had had their abortions when the fetus was capable of independent survival may not alter her stance either.

Still, why has she singled these women out and stigmatised them and their circumstances as unworthy of the respect that legal abortion provision expresses? And if she would indeed force them to carry an unwanted pregnancy to term, why does she think they would want her compassion, let alone her help. Help? What help can she, would she, give them, year in and year out?

Anti-abortion sentiment like this is creating a climate of rejection of second-trimester abortions, including those that take place well before “viability,” in countries across the developed world where the abortion law has (more or less) supported women’s choice on abortion for decades.

Everyone who is pro-choice would prefer for women not to need late abortions, just as everyone would prefer, in the best of all possible worlds, for there not to be any unintended pregnancies. But there are millions of unintended pregnancies globally every year, because we are imperfect, make mistakes, and are less in control of our lives and behaviour than we would like to be. The pro-choice answer is not and can never be to refuse women abortions. The pro-choice answer is to remove all the obstacles to getting an abortion as early as possible, provide young women and men with the education on abortion from an early age that would enable them to prevent pregnancy, recognize they are pregnant early on, obtain non-directive counselling and support if they need it, and if the pregnancy is unwanted, ensure there is timely access to abortion services. That combination of education, support and service delivery would allow almost all abortions to take place before 24 or even 20 weeks of pregnancy. Countries like Sweden, where women have the right to choose up to 18 weeks but abortion is legal until 24 weeks, have proved it is possible. But there will always be a handful of women who fall outside the net, even in the best of conditions. The moral thing, the compassionate thing, the pro-choice thing to do is to support them and do the abortions anyway.

Frances, come back!

[2] Wolch Marsh MJ. Reproductive Health Matters 1993;1(2):87-91.

[3] Department of Health. Abortion Statistics, England and Wales: 2009. London: DoH, 2010.

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  • merriemelodyxx

    “[O]f course there are always some women and couples who have “lightweight” reasons for seeking an abortion, and many more who could and should have prevented the pregnancy, but should they become the basis for compromising the whole ethos of women’s choice on abortion?”


    Ah, but that’s the crux of almost every philosophy that seeks to deny basic rights (including personal autonomy in medical decisions, not to mention having enough to eat, a place to sleep, and all that other socialist claptrap).  Someone, somewhere, might do something different than I myself will do, so we can’t allow it.


    As I have been repeatedly reminded while escorting at the local Planned Parenthood clinic, there are plenty of people who are anti-abortion, except for when it comes to themselves (or their daughters).

  • jayn

    One thing that pro-choicers have to accept is that there will be women who make a choice that we find anywhere from distasteful to offensive.  Personally, I have faith that these women will be few in number, and I can live with a handful of women making such choices far easier than I can live with us becoming arbiters of when abortion is ‘okay’ and when it isn’t.

  • ema

    It goes without saying that I nominate Ob/Gyns to be the Supreme Arbitrators of the Committee to Ration Efforts for Pregnant Patients.


    On a more serious note, I have only one question for Ms. Kissling about the ethics panel couple:


    If we shouldn’t allow the woman to make a decision about abortion, a relatively simple, low-risk procedure, why exactly should we allow her to make any decisions about her pregnancy, delivery, or child-rearing, all far more high-risk and complex matters? I mean, what if this frivolous scatterbrain elects to have an epidural just because she doesn’t want to experience any discomfort in labor?


    Let us pause and think hard. We (and by that I mean pretty much everyone other than the patient, her family, and her physician) already know what’s best for pregnant women and what they should, and shouldn’t, be allowed to do.


    No need to admit that pregnant women are competent to make their own medical decisions.

  • julie-watkins

    I can think of only two cases where I don’t think it might be appropriate to say a woman can’t choose, both related to medical standards.

    1. It’s so late in a normal pregnancy that an abortion would cause less risk to the woman’s health than going ahead and bringing to term.

    2. If the woman isn’t mentally competant to make the decision.

    … and both these cases would be included in my usual wish: reproductive issues should be a matter for medical standards, not laws …

    I think the case of “takes 5 months to make a decision” might or might not come down to mental competancy. OtOH, if the woman made her decision much earlier but had barriers & barriers, then I think I’d lay any ethical problem with the people making the barriers.



  • crowepps

    A person who is diagnosed as being mentally ill, senile, or suffering from some other debility that prevents them from managing his own affairs may be declared mentally incompetent by a court of law. When a person is judged to be incompetent, a guardian is appointed to handle the person’s property and personal affairs.

    The legal procedure for declaring a person incompetent consists of three steps: (1) a motion for a competency hearing, (2) a psychiatric or psychological evaluation, and (3) a competency hearing.

    I find it interesting that this is approached on the assumption that medical decision making in reproduction is entirely unique.  There are other areas of medicine where lives are at stake: medical decisions for children, blood transfusions, organ donations, mass vaccination campaigns.  In every one of those circumstances the people involved are assumed to have a right to make their own and their children’s decisions without interference.  At some point the interest of society overrides that of the individuals and that is established by jumping through a lot of legal hoops and presenting the facts in the individual cases.


    When it comes to pregnancy, however, suddenly the opinion of unrelated onlookers with no stake in her situation whatsoever is preferred.  “We” need to “thoughtfully consider” what she is going to be “allowed to choose”, and “we” get to “say no” because her reasons are presumed to be inconsequential or selfish.


    I cannot escape the conclusion that what tips the decision is the inherent ‘debility’ of being a sexually active female (immoral/unclean/impure) and the presumption that any woman who doesn’t want to be pregnant is, ipso facto, mentally ill, because “that’s what women are for”.

  • canbuhay

    Thank you for this article. It confirms what we’ve been saying all along: abortion advocates truly aren’t pro-choice – just pro-abortion. That’s why you don’t talk about providing unhindered access to adoptions, ivf or even free birthing classes. The only thing you want is unfettered access to is abortion.

    Everyone is pro-choice. Everyone is anti-choice. It simply depends on what is being chosen. Even by writing this article, you show that you are anti-choice when it comes to what one woman (Kissling) has chosen to argue because you say it threatens women’s lives. But that’s the point – when an act is so wrong and evil that it takes away or threatens human life, we all become anti-that-choice. The rhetoric that women (or men) should be allowed to do whatever they choose can simply be rebutted by pointing to laws and moral duties, particularly those we have to towards the weak, like our children. Laws against drinking and driving, murder etc. apply to women too.

    Oh and just because women are the only ones who can give birth, that does not change what the unborn are and our duties to them. Besides, if that’s the best argument you have, there are many choices that only apply to one gender that are still restricted. Only men can pass on the AIDs virus through their sperm –  but the law still restricts what they do with that sperm! The law is anti-the-choice of men to have sex with a partner without telling them of their condition.  Men are the only ones who can penetrate during sex – should that be an unrestricted choice? The law restricts choice all the time if that choice harms someone else – which is the issue that honest abortion advocates like Kissling, are struggling with.

    Please keep writing and clarifying for the public just how extreme the pro-abortion position really is: that you believe abortion should be legal for any reason or no reason at all throughout all nine months of pregnancy. This kind of extremism will only help make abortion part of our history, not our future.

  • crowepps

    Oh and just because women are the only ones who can give birth, that does not change what the unborn are and our duties to them.

    No, it does not change the fact that fertilized eggs are not children.   You have every right to continue to believe that women have a ‘duty’ to be pregnant and I hope your 12 children make you very happy.  Women who do not acknowledge such a duty have a right to disagree with you and to end unwanted pregnancies when they feel it is necessary.

    Happened to see this today:

    Yes, Mr Barnard began as a zygote. That does not mean the zygote was Mr Barnard. My car began as a stack of metal ingots and barrels of plastics; that does not imply that an ingot of iron is a car. My house began as a set of blueprints and an idea in an architect’s mind; nobody is going to pay the architect rent for living in his cranium or on a stack of paper in a cabinet. The zygote was not Justin Barnard, unless Justin Barnard is still a vegetating single-celled blob, in which case I’d like to know how he typed his essay.

    Since Barnard claims to be a philosopher, I’ll cite another, a guy named Aristotle. This is a quote I use in the classroom when I try to explain to them how epigenesis works, in contrast to preformation. Aristotle did some basic poking around in chicken eggs and in semen, and he noticed something rather obvious—there were no bones in there, nor blood, nor anything meatlike or gristly or brainy. So he made the simple suggestion that they weren’t there.

    “Why not admit straight away that the semen…is such that out of it blood and flesh can be formed, instead of maintaining that semen is both blood and flesh?”

    Barnard is making the classic preformationist error of assuming that everything had to be there in the beginning: I am made of bones and blood and flesh and brains and guts and consciousness and self-identity, therefore the zygote must have contained bones and blood and flesh and brains and guts and consciousness and self-identity.

    It didn’t.

    Why not admit straight away that the zygote is such that out of it selfhood may arise, rather than maintaining that the zygote is the self?

    In that case we have to recognize that the person is not present instantaneously at one discrete moment, but emerges gradually over months to years of time, that there were moments when self was not present and other moments when self clearly was present, and moments in between where there is ambiguity or partial identity or otherwise blurry gray boundaries. This is a conclusion that makes conservative ideologues wince and shy away — I think it’s too complicated for their brains, which may in some ways be equivalent to the gormless reflexive metabolic state of the zygote — but it is how science understands the process of development.

  • kfem

    Thanks to Marge Berger for restating the groundwork of the movement for legal abortion — principles so battered and bruised by anti-abortion forces that even supporters sometimes forget what we’re fighting for.

    We lost a great deal when the anti-abortion movement succeeded in seizing the language of the debate. They are not pro-life; a woman’s life is human life. And “choice” positions legal abortion as frivolous, when it is in fact the foundation of individual freedom.

    I also appreciate Berger’s emphasis on the emotional, spiritual and psychological burdens placed on women compelled to bear children against their will.

    This is about physiological autonomy, a right that men do not have to defend. I, too, hope that the great Frances Kissling returns to her senses.

  • cc

    “that you believe abortion should be legal for any reason or no reason at all throughout all nine months of pregnancy.”


    My body, my property, my right. Nuff said.

  • cc

    “That’s why you don’t talk about providing unhindered access to adoptions, ivf or even free birthing classes”

    We talk about unhindered access to comprehensive sex ed and contraception – both of which are opposed by the forced birth community. And re IVF – according the the anti-choice movement, particularly the Catholic church, IVF involves the “murder” of “babies.” Shouldn’t you be advocating the shut down of IVF?

  • canbuhay


    “My body, my property, my right. Nuff said.”


    Funny, that’s the same thing many abusive men said in the past to justify beating their wives…

  • canbuhay

    Thanks for the ad hominem attacks as well! I’m actually not Catholic so what you say there doesn’t really apply. But good try.

    Yes, IVF does destroy zygotes and anything that kills people intentionally shouldn’t be legal. But since abortion advocates don’t believe the unborn have any value (as Kissling said is an untenable position) but do claim to believe in “choice” – they should be the ones pushing for unrestricted access to IVF and adoptions just as much as they are fighting for unrestricted access to abortion. The operative words are “just as much”.

    As I said earlier, because the movement really doesn’t do this, the article proves that your movement is rightly named pro-abortion, not pro-choice.

  • arekushieru

    What makes you think the ProChoice movement ISn’t?  Perhaps THAT is what she was talking about, the visiBILity of these actions, rather than your fantasy that it is about the ACTual actions?

    And I saw no ad hominem attacks.  Unless, of course, you think being called a Catholic is an attack.  All the other mentions were a GENeral reference, NOT a reference to you, specifically.

    Non-consent to organ donation results in someone’s death, intentionally.  If you refuse to categorize it as such, your misogyny is apparent.  The ONLY reason abortion involves direct action is because of the way a woman’s uterus and its function is developed (something comPLETEly outside of her control).

  • arekushieru

    ‘Slight’ difference, that I’m not surprised you didn’t notice.  The woman wasn’t infringing on his bodily autonomy.  A fetus inside a woman…?  …DOES.

  • colleen

    Funny, that’s the same thing many abusive men said in the past to justify beating their wives…

    How amusing that you who are posting here not to communicate but  because verbally abusing and denigating women gives you pleasure and enjoyment should pretend that spousal abuse is a thing of the past.

    How pathetic  that you’re unable to imagine a world where women own their own bodies

  • crowepps

    I challenge you to read every single article on this site and find one, just ONE, that seriously advocates promoting the idea that all women SHOULD have abortions.  I can’t think if one poster here who holds that position.  Most of us have a great of respect for women who CHOOSE to continue futile pregnancies to meet their own emotional needs, and women who CHOOSE to have many children because they believe their faith requires them to do so.


    Certainly I do not advocate abortion or want to prevent people from having children, but instead want it to be available when necessary to save women’s lives.  One of the things that “kills people intentionally” is refusing to provide women appropriate medical care.


    Your position seems to be based in the idea that anybody who doesn’t want to ban something must be advocating it, as though the only two choices available are forbidding things or forcing them on people.  Most of us here can see that there are more than two options, which we allow people to CHOOSE for themselves.  But then, we’re not totalitarians.

    “Everything not forbidden is compulsory.”  Gell-Mann’s Totalitarian Principle

    Or, as the religious would put it, “anything that’s not a duty is a sin.”

  • beenthere72

    Funny, he sounds awfully familiar, too.