The first comment I should make before launching into a review of Carol Sanger’s book About Abortion: Terminating Pregnancy in Twenty-First-Century America is that she is no Ann Furedi. As the name of the publisher (Harvard University Press) suggests, Carol Sanger is an academic, a law professor at Columbia, and she writes intelligently and skillfully about her area of expertise. However, the book begins with what is either a naughty fib or yet another example of how deluded abortion activists are in terms of the way they see themselves. We are informed early on, “This book is neither for abortion nor against it.” I have never kept a tally of how many abortion-related books I have read over the years, but the one thing I can say with certainty is that there is no such thing as a neutral book on abortion, and Sanger’s book is no such thing. The mask of neutrality slips almost immediately. Quite rightly, Sanger criticizes “uncivil and fractious exchange” on abortion, but only refers to a pro-life congressman “who shouted ‘baby-killer’ on the floor of the House in 2010.” In the interests of balance, she might also have referred to abortion campaigners who dress up as giant vaginas and scream obscenities at children on marches, spit in the faces of priests, and taunt pro-lifers as they pray. She informs us that “abortion is, in the first instance, a medical procedure.” Yes, if by that we mean simply that doctors perform them using drugs or surgical instruments and they generally take place in a clinical setting, but if abortion were simply a medical procedure akin, for example, to the removal of a rumbling appendix, it would never have become the subject of such passionate debate in the first place. Throughout the book, there is an underlying assumption that Sanger’s readers will all agree with her and are naturally pro-choice. Therefore, parental consent laws “excite our sense of injustice” and “rightfully rile us up.” Us? Our sense? Speak for yourself, Carol.
Whereas Sanger shows a detailed knowledge of law, her understanding of the dynamics of the pro-life movement is woefully inadequate. “For many people, abortion is about religion.” No one is going to deny that faith plays a significant part in mobilizing resistance to abortion, but Sanger appears unaware of the existence of secular pro-life organizations such as Secular Pro-Life, Feminists for Life of America, and UK-based groups such as the Society for the Protection of Unborn Children, which was founded as a secular, non-partisan organization to oppose the legalization of abortion in Britain. Sanger informs readers that “we do not yet know Pope Francis’ position, if any, on Catholic candidates or voters with regard to abortion beliefs or practices. His statements about abortion so far have been that the Church might lessen its obsession with the topic.” Is this the same Pope who has spoken repeatedly of “the innocent victims of abortion” and has described abortion as “a tragedy” and “an injustice”? Would this be the Pope Francis who has stated, “It is not ‘progressive’ to try to resolve problems by eliminating a human life”?
No book about abortion is complete without the author making shallow attempts at undermining religious beliefs by explaining them away as pseudo-political constructs, and Sanger clearly could not help herself when to trying to explain the point of the Gospel account of the Visitation. I was intrigued to be told that John the Baptist leaping in the womb was all a ploy to settle a power struggle between the followers of John the Baptist and the followers of Jesus; indeed, any reference to the unborn in spiritual writings appears to have been “a piece of a spiritual political project of the time.” It is a pity Sanger did not take the trouble to explore what Jews and Christians actually believe rather than indulging in her own half-baked interpretations, but it does not appear to occur to her that unborn life may only have become a focus of political machinations as a result of the battle over legal abortion. For centuries, a description of an unborn baby leaping in the womb at the sound of a woman’s voice would not have required hastily explaining away. Almost on cue, we are also treated to the much-repeated claim that Catholic doctrine on abortion has changed because that clever chap Aquinas thought ensoulment happened 40 or 90 days after conception. Is Sanger really unaware that, despite centuries of controversy about ensoulment, abortion was always seen as seriously wrong?
Sanger’s understanding of history is similarly lacking in context. She talks about the use of preserved fetuses as part of fairground sideshows, stating that “these displays were not regarded as disrespectful or sacrilegious as they might be today.” The implication is that societies past did not afford the same respect to the unborn. These were, of course, the same societies who displayed “freaks” in sideshows and failed to treat bearded ladies, children with deformed limbs, and conjoined twins as persons deserving of dignity. By the same logic, we should stop treating people with disabilities with respect because people in the past did not always do so. It is hard to see what point Sanger seems to be trying to prove here other than to demonstrate that morbid curiosity has a long history.
Sanger shows a similarly poor understanding of the socio-political situation outside the United States. I actually laughed reading her solemn pronouncement that “in contrast to other places—all of Western Europe, say—where teenage sexuality is accepted as developmentally normal, in the United States it is still taken as a sign of trouble, particularly for girls.” Really? It always strikes me as odd that the very people who are so keen to draw attention to the apparent inconsistency between Church teaching and the views of Catholics “on the ground” nevertheless assume that the pronouncements of out-of-touch sexual health agencies are entirely representative of what parents believe or want for their children. Britain is certainly a more aggressively secular country than the US but I have yet to meet many parents in leafy Surrey who think it a jolly good idea for their little Siennas and Sebastians to start copulating behind the bike shed after school.
Never grasping the nettle
A major flaw in Sanger’s analysis, as with so many books defending abortion, is an unwillingness to admit to the very basic, very straightforward reason people oppose abortion—it ends a human life. That is the reason people dedicate years of their lives to campaigning against abortion; that is the reason people pray outside abortion facilities; that is the reason people sacrifice their careers and endure financial hardship and public ridicule; that is the reason pro-life people find abortion so abhorrent that they feel compelled to fight it at every turn. If abortion were merely a medical procedure like any other, I would not have devoted so much of my own time and energy to fighting it. I would go further and say that I would probably be standing outside abortion facilities protesting in defense of keeping them open.
Instead of acknowledging the obvious, Sanger proposes: “For those who feel anxious about the stability of this once reliable boy-girl scheme, abortion can be deeply unsettling. It frees women to act more like men.” She then cites a pro-abortion legal judgement to justify this position. More chilling is her analysis of female authority in terms of “control over whether and what kind of new persons will come into being—the gatekeeping of human existence.” Apparently, “the radical character of this primal gatekeeping may disturb those not used to thinking in terms of women’s superior authority.” That’s one way of looking at it. Another might be to consider the more serious question of whether a human being—female or male—should have the power of life or death over another, and what the implications are for a society of exalting any section of the population to the role of “gatekeeper” in the first place. Naturally, it disturbs those of us who have no desire to “get used” to the idea of adults as agents of extermination.
A work that is supposed to be “neither for or against” makes no real attempt to engage with the genuine reasons why pro-life campaigners exist at all. Every pro-life argument is a manipulative tactic: “Casting women as killers not simply of vulnerable foetuses but of vulnerable minority foetuses is a clever move.” Not really, no. Women do not need to be “cast” in a role they freely choose—another awkward aspect of “choice” is that it involves accepting moral responsibility for the act chosen. As the book admits, albeit grudgingly at different points, abortion involves killing a fetus, therefore a person having an abortion is a killer of a fetus. This is a fact, not an act of political posturing. The fact that abortions are performed because a baby has a disability or is female ought to be a cause of disquiet among abortion advocates, but that would involve soul-searching, and that was never the purpose of this book.
An unwelcome window into the womb
The message that resonates throughout the book should hearten pro-life campaigners everywhere: abortion advocates really, really hate ultrasound images. The opportunity—through modern technology—to be seen allows the unborn to mount a defense of their own, simply by being visible, and this is not going down at all well with the promoters of abortion. Sanger dedicates a vast section of the book to arguing against state legislation requiring women to view an ultrasound and employs all her rhetorical ability to undermining the value of ultrasound imagery altogether. “The requirement confuses wanted with unwanted pregnancies, as antiabortion legislators seem happy to do,” or just draws attention to the fact that—for all her many attempts at pretending that the fetus is some kind of social construct—a baby will never obligingly become a blob because it is unwanted.
Laws making the viewing of ultrasounds mandatory (or at least offering to show the woman the ultrasound, as some state laws demand) are acts of punishment, as far as Sanger is concerned, because they are unnecessary. “Women—even young women—understand very well what an abortion is,” she writes. “They understand that abortion ends pregnancy and that if they have an abortion, they will not have a baby: that is its very point.” Yes, except that there is a difference between knowing that you are ending the physiological state of pregnancy and knowing that you are ending a life, and abortion promotors go to considerable lengths to avoid that thorny subject. Margaret Cuthill, co-founder of British Victims of Abortion (now ARCH—Abortion Recovery Care and Helpline) speaks candidly about her two abortions and the repeated assurances she received that it was “nothing” and “just cells,” only to undergo an ultrasound scan to work out why she still felt pregnant following her abortion. She saw the grainy image of a tiny baby—a surviving twin—and realized the full horror of what her two abortions had involved. Yes, Margaret had known the pregnancy would end, but by her own admission, she would never have gone ahead with the abortion if she had had the scan beforehand, and she could not face another abortion when she could clearly see her baby.
The desperation to avoid talking to women, not just about the reality of abortion, but even the alternatives, exposes the hypocrisy behind the rhetoric of choice, but this hypocrisy is merely repeated and reinforced throughout the book. Sanger approvingly quotes a Supreme Court judgement against the provision of information about the risks associated with abortion on the grounds that “the Commonwealth does not, and surely would not, compel similar disclosure of every possible peril of necessary surgery or of simple vaccination.” Leaving aside the fact that abortion is not “necessary surgery” or anything akin to a “simple vaccination,” the statement is patently false. An uninformed choice is hardly empowering in so far as it constitutes a choice at all—we value your choice, sisters, but we’re not going to tell you anything about the implications or risks of your choice, and we are certainly not going to suggest that there are alternatives which would make your choice an actual choice. In other areas of medicine, patients are obliged to hear all sorts of information they might rather not know: I am not sure my father was absolutely thrilled to be informed by his doctor that open heart surgery would involve his ribs being broken; I did not particularly appreciate the ominous warning before eye surgery that there was a risk—albeit tiny—of permanent sight loss. But that information is given out for a reason. If a patient is to sign his or her name on a consent form, that consent must be given freely and in reasonable knowledge of the potential consequences. All of them, not just the ones a clinic feels like talking about.
The determination of abortion advocates to prevent women from receiving full information about abortion and, indeed, about the gestational development of their own offspring, is a major contradiction in feminist thinking that simply cannot continue to be ignored. Sanger, like many abortion apologists, expresses extreme hostility to mandatory ultrasounds for abortion-minded women but it is in the act of dismissing these laws as “unsavory” and “pernicious” that the moral confusion of the pro-abortion position is most in evidence. Comparing such laws with a court case involving a woman who witnessed her little boy being hit and killed by a car, Sanger informs us that viewing an ultrasound image of a baby prior to abortion is being “in effect, asked by law to witness her child soon before its death” and to acknowledge “the reality of its impending death.” Sanger dedicates pages of verbal and intellectual gymnastics to turning the viewing of an unborn baby into a massive pro-life conspiracy, whilst ignoring the central points raised by such legislation. Firstly, if it is so distressing for a woman to see her child immediately before it is killed, surely this raises the rather larger question as to whether it is morally acceptable to kill the baby at all? Secondly, if women are to be treated as fully emancipated, empowered adults, it is hardly unreasonable to ask women to face the full consequences of their actions. Short of turning the planet into one vast safe space replete with Playdoh and films of gamboling ponies, it is difficult to see how or—more pertinently—why women should be protected from the reality of their own choices in the name of empowerment.
The now-routine use of ultrasound was, according to Sanger, “not a bad deal for pro-life advocates,” though she might just as easily have said that it was a pretty good deal for both women and the unborn. Where Sanger has a point about the invasion of privacy is in the rare instances in which there is a legal requirement for a vaginal transducer to be used rather than an abdominal wand (this involves the insertion of a probe into the woman’s vagina rather than being drawn across her abdomen). This would seem to be a more obvious violation, as it forces a woman into an unnecessarily physically invasive and potentially painful examination. What is harder to comprehend is Sanger’s insistence that any form of scanning is “physically and psychologically intrusive” because “it underscores for women that what they are about to do is wrong.” If abortion is merely a medical procedure like any other, it is difficult to see why seeing the fetus constitutes “harassment masquerading as information” to Sanger. If abortion is an act of killing—and this is hardly a controversial position any longer—then the viewing of an ultrasound scan merely confirms the obvious.
All in the eye of the beholder?
In fairness to Sanger, I can hardly fault her for the ludicrous material put out by some lone pro-life groups, such as the news release by the group Columbia Christians for Life in which they claimed that the satellite pictures of Hurricane Katrina looked like “a six-week unborn human child.” The idea was that this proved the hurricane to be divine retribution on America for abortion. As Sanger is kind enough to point out “there are, of course, more scientific explanations about why disasters happen and why”—which is very helpful as pro-lifers are, by definition, flat-Earth-believing, tin-hat-wearing luddites who don’t understand science at all. Where I do fault Sanger is in her use of a straw man argument, a trap into which no serious academic should fall. The use of a, frankly, off-the-wall news release by a fringe organization as the starting point for exploring the increasing significance of the unborn child in contemporary culture, was too obviously an attempt to undermine the increasing awareness and importance of the unborn within society.
It is not just the legal requirement to offer an ultrasound scan to women that Sanger appears to find problematic: the increasing social awareness of the unborn is similarly beyond the pale. Sanger writes: “Many Americans have been socialized, or perhaps indoctrinated, into accepting fetal interests as part of what concerned citizens and legislators think about.” Indoctrinated? Warnings to pregnant women not to drink alcohol, smoke, or take part in aggressive contact sports are a form of indoctrination? It may well be that in contemporary America, pregnant women are forced to stand in serried ranks chanting the rights of the unborn as part of their ante-natal care—as a foreigner I might well be missing something. More seriously, it is difficult to see how our increased understanding of prenatal development can be anything other than welcome in a society which claims to value scientific progress.
Sanger is very keen to suggest at different points in the book that pro-lifers are essentially reading too much into images such as hurricanes and ultrasounds, but is quick to fall into the same trap herself. Sanger gleefully recounts the disastrous campaign led by a group of Christian students who handed out tiny model babies to their fellow high-schoolers, who then proceeded to abuse the models, flush them down toilets, set them on fire, and turn their heads inside out to resemble rubber penises. Where most readers would see examples of puerile teenage behavior here, Sanger thought that “the conversion of fetuses to penises was distinctly transgressive, a sort of campy form of defiance.” No—still seeing a group of teenage boys being gross.
Few of us would, I suspect, be gullible enough to believe the old adage that “the camera never lies.” It is hardly a revelation to discover that photographic images can be manipulated, Photoshopped, and made to look markedly different to the person who originally stood in front of the camera. However, Sanger’s obsession with trying to prove that ultrasound images are by definition manipulative constructs reads like a particularly persistent case of denial. Her deconstruction of the film The Silent Scream is a case in point. She quotes critics who describe the footage of an unborn baby being killed in an abortion as fusing “the anerotic sentimental structure of the infomercial and the docudrama with the pornotropic fantasies of a snuff film.” The only way The Silent Scream may be compared with a snuff film is that it involves a vulnerable human being getting killed. I could not possibly gauge whether or not abortionists become sexually aroused whilst performing or filming abortions, but that is surely not the issue. The Silent Scream shows an unborn baby dying in an abortion. Whatever weird and wonderful ways abortion advocates respond to the film says nothing about the film itself, but the imputing of pornographic connotations to an abortion film may say a great deal more about the beholder than the beheld.
A half-truth Sanger is keen to exploit in her skilled dismissal of the obvious, is the tendency of human beings to see human forms and faces everywhere—for example, seeing the Moon as a giant face, or seeing a humanoid figure in a cloud. However, the glaring difficulty about the unborn child is that it looks like exactly what it is. There is no need for “the desire to see a human form”; the human form is evidently there on the grainy ultrasound screen, wriggling, sucking its thumb, or having a snooze. It might be fairer to say that abortion advocates have conditioned themselves so thoroughly to see a blob of cells that they cannot bring themselves to see anything else.
A tactic Sanger uses throughout the book to belittle the pro-life position is to create false comparisons, taking a contemporary image or debating point and comparing it with something regarded today as backward or ridiculous. Therefore, concerns over the existence of a visible embryonic tail in the early stages of development and the stir it caused in the 1920s around the time of the Scopes trial, is effortlessly placed alongside awareness today of the fetal heartbeat and the symbolism of the “tiny feet” lapel pins popular among some pro-lifers.
A particularly bizarre comparison involves a grindingly long account of spiritualist photography in late Victorian times, where grief-stricken families would be made to believe that a photographer had captured the spirit of a dead relative. “A modern variation of spirit photography is the prenatal, sometimes preconception, visualization of children.” In a word—no. Neither the fraudulent activities of Victorian charlatans nor the happy dreaming of what a future child might be like are anything like a picture of someone who is actually there. The comparison is pointless and absurd.
Teenagers going to court to request an abortion are talked about in the same chapter as a “16th-century pardon seekers.” There is apparently a great deal of similarity between a minor requesting an abortion before a judge and a prisoner pleading with the king of France to be spared a very bloody execution. Apparently, there is also a comparison to be made between teenagers in court and the McCarthy hearings. I am amazed Sanger didn’t squeeze in a reference to the Inquisition for good measure.
Elsewhere, some of Sanger’s comparisons unwittingly play into her opponents’ hands so catastrophically that if a pro-life advocate had made the comparison, they would be greeted with shrieks of faux outrage. Sanger sees similarities between a fetal scan which “exists in relation to the impending demise of the thing represented” and wartime photographs of people about to die, including prisoners of the Khmer Rouge: “Looking at these photos—some of prisoners with children—is always deeply distressing. One is aware of the impending loss even now. Ultrasound images are meant to create a visual construction of loss for women awaiting an abortion.” Quite.
There are some areas about which Sanger is quite simply wrong, such as when discussing the rare situation in which a pregnant woman is kept on life support to try to save the baby. The very title “post-mortem pregnancy” shows a failure to understand what is medically involved in such cases, as is her reference to the woman’s body in this case as a “corpse.” This particular issue is complex and very distressing, but a fundamental point when a person is on life support is that they are not dead. They may be being kept artificially alive and the means used may be unduly burdensome, but the patient is not actually dead. Sanger betrays her own confusion by describing a woman kept alive in such a way as becoming “an incubator,” but much as society tends to be repulsed by the mistreatment of dead bodies, only the living have rights. If the woman’s rights were violated by being kept on life support, she was by definition alive, not dead.
When discussing cases involving men demanding the destruction of IVF embryos, Sanger makes an unfounded assumption about public opinion to reinforce her views about the way women are judged. “Women who choose abortion are selfish; men who destroy frozen embryos are self-regarding.” In reality, when Natallie Evans hit the headlines in Britain after her failed legal battle to stop her ex-fiancé from ordering the destruction of their IVF embryos, the man was forced to acknowledge in a press conference: “I can absolutely understand people saying I’ve been heartless.” The media did not look entirely favorably toward the man who had human embryos destroyed in the face of tearful resistance from a woman rendered infertile by cancer treatment.
Nothing to shout about
Sanger quite rightly points out at different stages of the book that women do not talk about their abortions, causing abortion to remain secret within many families. However, in seeking to define the difference between privacy and secrecy, she takes a wholly irresponsible position regarding abortions among minors. She cites attorney general Phil Kline’s attempts to gain the medical records of underage girls who had obtained abortions, a case that collapsed because the legislature determined that “sexual activity of a minor did not in itself and without proof of harm constitute reportable child abuse.” The widespread toleration and ignoring of underage sex by medical professionals, schools, and the police is coming back to haunt the authorities in Britain in the wake of the inquiry into the Rotherham and Oxfordshire abuse scandals (for non-UK readers, a ring of pedophiles situated in Rotherham groomed and abused girls over a lengthy period of time under the noses of the authorities, helped by an underlying assumption that underage sex was acceptable and should not be queried).
Like many abortion apologists, Sanger is very keen on women talking about their abortions to “normalize” the process, imagining that this will bring abortion opponents round to the understanding that all kinds of women have abortions and abortion is therefore no big deal. She quotes the claim that people who oppose abortion are “much less likely than their pro-choice peers to hear abortion secrets and as such think they do not know any woman who has had one.” This is a common argument—pro-lifers think the way they do because they live in a bubble and have no idea the way the real world works. I wonder if Sanger has any idea of how many women actively involved in the pro-life movement have themselves had abortions? In my experience, being known as a pro-life campaigner makes a person a magnet for abortion stories, either from women determined to educate me into understanding that abortion really is absolutely fine or, more commonly, from women who need to talk to someone and tell “the secret.” Talking about abortion apparently “reframes abortion’s status from presumptive moral outrage to that of a simple medical procedure,” but this is perhaps the most absurd generalization in a book replete with them. No one can predict how much talking about abortion is likely to influence the listener. I have known people break down talking about the moment their wife/mother/sister talked about her abortion, because they were made aware of lost offspring, a lost sibling, or another lost relative.
More problematically for the pro-abortion side, the desperation to get women talking about their abortions very quickly turns nasty when women start talking about how much they regret their abortions. Talking about abortion is fine as long as women are good little girls and stick to the script. As soon as women start getting all negative about it, they are bullied, insulted, and have various syndromes attributed to them (but not Post-Abortion Syndrome, we don’t talk about that either), and every possible attempt is made to shut them up.
Abortion and miscarriage
Almost inevitably in a book about abortion, the discussion about miscarriage is depressingly insensitive and flawed. Miscarriage, readers are told, “appears natural, in contrast to abortion’s deliberate quality, and miscarriage has a lack of materiality; some early miscarriages manifest as a heavy period.” Where to begin? Miscarriage does not “appear” natural, it is a naturally occurring event, however unintended and unwanted by the woman concerned. That is the reason it is different from abortion. Nor is it correct to say that miscarriage is not a political issue. The need for more research into the factors behind miscarriage and the treatment of women who miscarry are pertinent political issues for anyone concerned about women’s health. The lack of “materiality” is another non-sequitur. Depending upon the timing, miscarriage can be distressingly material with a woman left to deal, usually on her own, with a tiny body, but even when miscarriage is early enough to “manifest as a heavy period,” it does not lessen the distressing reality for the woman that she has experienced a terrible loss. In my own experience, the absence of a palpable body following pregnancy loss only made the pain more difficult to bear because I had nothing, no proof whatsoever that I had ever been pregnant, beyond the excessive pain and bleeding, and the slow return of my body to its pre-pregnant state. Women who suffer miscarriage are almost as much of a nuisance to abortion advocates as women who regret their abortions, grieving mothers who draw the world’s attention to the lost lives they mourn.
Important points raised
Unlike many abortion advocates, Sanger has the intellectual honesty to raise a number of pertinent points which others tend to avoid or dismiss out of hand. She admits that abortion can be painful for women: “For some women, abortion registers as a profound loss, the date or the projected birth date reflected upon, sometimes commemorated, for years to come.” She also acknowledges the morally dubious issue of rape exceptions, which “produces a rather sharp inequality among fetuses.” Sanger draws attention to the terrifying collusion of millions in the abortion industry—though she would not see this as problematic: “If each of the 700,000 or so women and girls who terminated a pregnancy in 2015 interacted with only a few others along the way—one nurse, one partner, one pastor, one babysitter for the kids, one good friend, one receptionist—several million more people are involved.” When individuals dismiss anti-abortion arguments with the old cliché, “If you don’t like abortion, you don’t have to have one,” it is worth remembering that when abortions are carried out on a massive scale within society, few individuals avoid any direct or indirect responsibility.
Sanger concludes her book with a reflection that reveals how out-of-touch abortion advocates are with social trends. “As abortion becomes less stigmatized,” she muses, “as it will in time, it will come to be regarded like other medical decisions—thoughtfully taken and exercised without a gauntlet of picketers on the pavement or hard looks at home.” I cannot vouch for how hard anyone will be looked at in the future, but if surveys are anything to go by—not to mention the rise in the number of young people involved with pro-life advocacy—Sanger’s prediction may be very far from the mark.
by Carol Sanger
Harvard University Press, 2017
Hardcover, 320 pages
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