CONGRESSIONAL DEBATE over abortion tends to boil down to "women" versus "babies." On one side are the liberal appeals to freedom of choice, women's autonomy and the dangers of illegal abortions. On the other are tearful conservative portraits of fragile babies deprived of their fair chance at life.
In the wake of the Supreme Court's Rust v. Sullivan decision, Congress will again discuss abortion. But this time, in their effort to pass legislation to overrule the Court's decision, liberals should steal the thunder of their righteous opposition. In addition to stressing the consequences for women, pro-choice representatives should emphasize that allowing Rust to stand unchallenged will contribute to the deaths of hundreds, perhaps thousands, of children each year.
BY MAKING IT impossible for women to receive information about abortion in federally-funded clinics, Rust v. Sullivan will undoubtedly undermine women's health. The reason is simple: It is more dangerous for a woman to go through childbirth than to have an abortion. So concluded eight major medical organizations, including the American Medical Association in a 1989 Supreme Court brief. By restricting access to abortion, Rust will force women to sacrifice their own health for the sake of their fetus--a responsibility not recognized anywhere else in American jurisprudence.
Anti-abortion groups respond to this argument in two ways. First, they claim the trauma resulting from an abortion inflicts untold psychological damage on women. But dozens of studies to the contrary have led the American Psychiatric Association to conclude that "women who have abortions are less likely to suffer psychiatric disability than women who are denied abortions."
Second, abortion opponents argue that repeated abortions late in pregnancy can harm women's reproductive organs. Medical groups have concluded this effect is outweighed by the risks of childbirth. But even if the risk were great, it would actually argue against the Rust decision: Denying access to an abortion at a public clinic will force some women to wait even later into pregnancy before they can afford one, thus increasing their health risks.
Unfortunately, the evident health dangers to women from Rust do not have equally evident political benefits. When matched against a picture of innocent babies being sent to slaughter, images of ill mothers--often minority, unwed and young--elicit little sympathy from moderates and conservatives in Congress.
Fortunately, liberals have another political weapon at their disposal--infants. The Rust decision will likely raise infant mortality rates among low-income populations. And these "babies" are actual infants under anyone's definition, not the potential lives that fall under the right-to-lifers' semantic extension of the word.
PRESS REPORTS have already flooded the airwaves about dozens of health clinics that are sure to close as a result of the Rust decision. Such clinics frequently provide comprehensive prenatal care services to their clients in addition to abortion counseling. By depriving poor women of such services, Rust will increase the shamefully high infant mortality rates in urban and rural areas. Even if displaced women are able to obtain prenatal care under Medicaid from a private physician, the care they would receive would be less comprehensive and effective, according to a study by the Office of Technology Assessment.
Rust will also contribute to infant mortality by obstructing women's access to abortion services. The predominantly poor women served by clinics are also disproportionately unmarried and young--demographic groups at extremely high risk for having their infants die.
Moreover, poorer women are more likely to have health problems that can result in a complicated birth. Although Rust provides for abortion counseling under extreme health conditions, the American Medical Association recently argued that the list is far too restrictive. Heart disease, diabetes and conditions of the nervous system, for example, all have been proven to complicate pregnancies but are not cause for abortion counseling under Rust.
Because of Rust, more unmarried, young and sick women will give birth, and, predictably, more babies will die. A review of the most respected medical literature by Barbara Starfield concluded that reduced access to family planning is the second most important contributor to infant death in the first month. (Before Roe v. Wade, it was the first.)
In 1966, Romania dramatically restricted access to abortion--with staggering consequences for maternal and infant health. While neighboring countries saw maternal deaths due to abortions decline to less than 25 a year by 1978, such deaths rose to more than 450 per year in Romania as the backalley business took hold. Infant mortality rates jumped as well, over the short term as well as long term, and fetal death rates rose dramatically too. What started out as a drive to save babies wound up killing more than before.
NO DOUBT, the infant mortality/abortion rights connection will not sway the most ardent opponents of abortion. If a nine-week fetus is the moral equivalent of a baby, then there is no inconsistency in letting more post-birth babies die for the sake of an equal or greater number of "unborn babies." But the vast majority of the American population (and, arguably, the U.S. Congress) does not accept the radical equation of fetus and baby. Even George Bush agreed with other world leaders at the recent World Summit for Children that "there can be no task nobler than giving every child a better future."
Most Americans will feel more moved by the slow death of an infant in an intensive care unit than by the removal of a fetus at the mother's request. And they will begin to wonder whether something is wrong with a cause that advocates letting babies die in order to save them.
Joshua M. Sharfstein '91 was editorial chair of The Crimson in 1990.
How liberals can support abortion and babies.