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Abortion and the Exclusion of Reality

Inside Higher Ed claims to “have the largest online audience in higher ed… 3.67 million monthly readers.” Before the most recent Life news in the United States, it published an opinion piece, Texas Abortion Law Threatens Academic Freedom (October 8, 2021), by Andrew Joseph Pegoda who “teaches women’s, gender and sexuality studies; religious studies; and English at the University of Houston.” While I am not replying to the merits or demerits of that law, I am addressing several of Dr. Pegoda’s peculiar or even bizarre expressions and statements. He wrote, for example: “How can we increase the health and well-being of pregnant individuals;” “mandating that abortions go underground only causes harm to pregnant individuals;” and “Lessons might also acknowledge that about 30 percent of pregnancies end in natural miscarriages (also called spontaneous abortions) – a pregnant body does not automatically mean a future human.”

Mamma mia. The circumlocutions “pregnant individuals” and “pregnant body” circumvent a concession that only women can be pregnant. The idea that underground abortions harm only “pregnant individuals” is absurd since the raison d’être of direct abortions, legal or not, is to kill unborn humans. And “a pregnant body does not automatically mean a future human” is another eclipse of the unique capability of women and a disavowal of the humanity of an unborn human embryo or fetus, whether alive now or dead later. Dr. Pegoda’s opinion piece was an exercise in inclusivity, except when it was not.

According to the National Center for Biotechnology Information (NCBI, part of the United States National Library of Medicine, a branch of the National Institutes of Health), it is estimated that “as many as 26% of all pregnancies end in miscarriage and up to 10% of clinically recognized pregnancies.” The Mayo Clinic reported that about “10 to 20 percent of known pregnancies end in miscarriage. But the actual number is likely higher because many miscarriages occur very early in pregnancy” – before the pregnancy is known. Dr. Pegoda’s remark that “about 30 percent of pregnancies end in natural miscarriages” might only be a small exaggeration if at all. Yet 100 percent of childbirths lead, eventually, to death. What will stop those wielding miscarriage data to diminish the perceived severity of abortion from citing the eventual 100 percent mortality of all humans to diminish the perceived severity of killing anyone at any stage of life? And does Dr. Pegoda wish to declare a moral equivalence between natural deaths due to miscarriage and homicides due to direct abortion?

Dr. Pegoda’s inclusive expressions are like others from cloud-cuckoo-land that engendered recent tempests involving J. K. Rowling, The Lancet, and the Academy of Breastfeeding Medicine. In May 2020, a global development news platform, Devex, published an opinion on “the menstrual health and hygiene needs of girls, women, and all people who menstruate,” precipitating this riposte from Rowling: “‘People who menstruate.’ I’m sure there used to be a word for those people. Someone help me out. Wumben? Wimpund? Woomud?” On September 1, 2021, The Lancet reviewed Periods: A Brief History, an exhibition at… wait for it… London’s Vagina Museum, and emblazoned its September 25, 2021, cover with this quote from the review: “Historically, the anatomy and physiology of bodies with vaginas have been neglected.” And in its August 2021 journal, the Academy of Breastfeeding Medicine announced that the “use of desexed or gender-inclusive language (e.g., using ‘‘lactating person’’ instead of ‘‘mother’’) is appropriate in many settings” and its intention “to be inclusive of all breastfeeding/chestfeeding and human milk-feeding individuals.” That takes the prize for snort-milk-out-the-nose ridiculousness. These exaltations of squishy conceptions of gender over sex, of feelings over nearly always unambiguous, palpable biology, demote truth in an attempted abolition of reality, or at least its partial abolition – in these three cases an abolition or blurring of concepts that words like “girls” “women,” “female,” or “mother” signify.

This is a time of semantic gerrymandering intended to privilege those claiming to have been “assigned the wrong sex at birth,” “born into the wrong body” or some other implausibility or impossibility (claims to have been assigned the wrong species at birth may yet be looming, but in any case, I mean those who are biologically unambiguous). But it is far, far, far more scientifically parsimonious to believe that these claimants are terribly mistaken, and they possess not the wrong sex or body but rather the wrong thinking. It is also a time of semantic gerrymandering to deny consideration of living unborn humans and to support direct abortion. But while we are only a few seasons into widespread semantic gerrymandering purportedly for the gender dysphoric, we are several decades into widespread semantic gerrymandering against living unborn humans and for direct abortion.

For example, Dr. Pegoda not only resorted to neologisms dubiously on behalf of the gender dysphoric but also slipped into the decades-old, routine rhetoric of abortion advocates when he wrote “…when legal, abortion is a safe, legitimate procedure.”

Were direct abortion understood to be safe, however, it would neither be procured nor protested. (Here the distinction between direct abortion, the intended slaughter of an unborn human, from indirect abortion, the unintended death of a fetus consequent to, for example, treatment of a tubal pregnancy or uterine cancer, is important.) Direct abortion is procured to kill unborn humans, and therefore incites protest. It is deliberately unsafe, homicidally so. The killing of a human fetus – feticide – is a form of homicide. What other things deliberately fatal to innocent humans are described as “safe?” Words are defined by their conventional usage and prefixing “safe” to an expression denoting something purposely fatal to innocent humans is not only unconventional but rare if not singularly limited to “safe abortion” – an oxymoron of extraordinary exclusivity.

Not only false rhetoric but also the underreporting of direct abortion data can downplay its dangers. In the USA, according to the NCBI, “Each year, [the] CDC [Centers for Disease Control and Prevention] requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2015, data were received from 49 reporting areas.” And the CDC affirmed that “[t]here is no national requirement for data submission or reporting regarding abortion statistics.” The United States Conference of Catholic Bishops (USCCB) clarified: “Forty-five state health departments consistently report data [to the CDC] on abortion; California, New Hampshire, Alaska, West Virginia and Oklahoma do not” though the CDC named California, the District of Columbia, Maryland, and New Hampshire as inconsistent reporters. The USCCB added that nationally valid data on abortion are available only from the CDC and the Guttmacher Institute – a research affiliate of the Planned Parenthood Federation of America, and that data from both the CDC and the Guttmacher Institute are “extremely limited.” The USCCB cautioned that “all statistical reports from the Guttmacher Institute should be viewed and utilized in the context of [its] mission to advance abortion services.”

The CDC reported 612,719 abortions in 2017 from “[s]elected reporting areas” (excluding California, Maryland, and New Hampshire) and 619,591 “legal induced abortions” from 49 reporting areas in 2018. Yet the CDC, in reporting that the “10 leading causes of death in 2018 remained the same as in 2017,” twice failed to identify direct (or “induced”) abortion as a leading cause of death. I have distilled the CDC’s leading causes of death data, which it based on the International Classification of Diseases, 10th Revision [ICD–10], into the following table:

Rank Cause of death Number in 2017 Number in 2018
All causes 2,813,503 2,839,205
1 Diseases of heart 647,457 655,381
2 Malignant neoplasms 599,108 599,274
3 Accidents (unintentional injuries) 169,936 167,127
4 Chronic lower respiratory diseases 160,201 159,486
5 Cerebrovascular diseases 146,383 147,810
6 Alzheimer disease 121,404 122,019
7 Diabetes mellitus 83,564 84,946
8 Influenza and pneumonia 55,672 59,120
9 Nephritis, nephrotic syndrome and nephrosis 50,633 51,386
10 Intentional self-harm (suicide) 47,173 48,344
All other causes 731,972 744,312

Table 1: 10 Leading causes of death in the USA in 2017 and 2018 according to the CDC.

The 612,719 abortions in 2017 and 619,591 abortions in 2018 that the CDC reported should rank second – above cancer (malignant neoplasms) – among the ten leading causes of death that the CDC listed in both 2017 and 2018. And because the abortion data for both years captured only the abortions in 49 of 52 reporting areas and for other reasons (for example, illegal abortions) may have been further underreported, it is possible that direct abortion was the leading cause of death in the USA in 2017 and 2018. Yet the death tolls from abortion for both years are absent. (There is an additional complication: natural miscarriage almost certainly ranks among the leading causes, too, though it would be difficult to accurately quantify and is also missing from the CDC’s rankings.) Note something else striking: in January 2021 the Guttmacher Institute reported that “132,680 abortions were provided in California” and “[a]pproximately 862,320 abortions occurred in the United States” in 2017. Inserting that national datum from the Guttmacher Institute into the CDC table, direct abortion would rank above diseases of heart as the leading cause of death in 2017 (as I write, I do not find Guttmacher Institute data for 2018). The CDC’s publication of the leading causes of death for 2017 and 2018 rendered direct abortion invisible and was an exercise in exclusivity, not inclusivity.

The NCBI noted that since the reporting of abortions is not mandatory in the USA, the number of abortions performed annually in the USA may be underestimated, and added:

Although deemed safe, therapeutic abortions, as well as spontaneous miscarriages, can lead to a variety of complications. Most complications are considered minor such as pain, bleeding, infection, and post-anesthesia complications. Others are major, including uterine atony and subsequent hemorrhage, uterine perforation, injuries to adjacent organs (bladder or bowels), cervical laceration, failed abortion, septic abortion, and disseminated intravascular coagulation (DIC).

But that description does not include several other complications as we shall see.

Recent examples show that the number of complications due to direct abortion might be significantly underreported. Because of the Covid pandemic, dispensing rules for abortion pills were relaxed in the United Kingdom (UK), allowing women to take the pills at home. The Department of Health & Social Care (DHSC) recorded only one complication among 23,061 medical [medication or non-surgical] abortions between April and June 2020. Yet freedom of information (FOI) inquiry requests found that during that time an average of 36 calls per month were made to the UK’s 999 emergency telephone exchange because of early medical abortions (EMA) and an average of 20 ambulance responses per month were made because of EMA. According to Christian Concern, an advocacy group in the UK, “the data shared by the NHS [National Health Service] Ambulance services suggest that a rate of 1 complication in 23,061 [EMA] is significantly underreporting the actual number of women being treated in hospital for complications arising from EMA.” In the same document, Christian Concern remarked that:

some women might make their own way to their local NHS A&E [emergency department or emergency room] rather than calling an ambulance and that some callers might not admit to abortion on the phone and say instead that they are having a miscarriage, both of which might mean that these data are not a complete record of all cases of complications arising from early medical abortion requiring hospital treatment.

The Percuity blog posted about another investigation on the UK Government’s approved use of abortion pills at home. The results are jarring. Also based on FOI inquiry, though with a different methodology (rather than phone records, it mailed FOI requests to hospitals providing general and emergency services), it reported that:

1-in-17 women [about 5.9%] having an induced medical abortion are subsequently treated at an NHS hospital for complications arising from an incomplete abortion with retained products of conception. There have been at least 10,000 cases in England since the Government approved at-home abortion on 30 March, 2020.

Yet it also observed that:

The official DHSC statistics for 2020 show a 1.1% complication rate for all medical abortions and only 0.3% for medical abortions under 10-weeks. The footnote on Table 8 says: ‘Total complications include: haemorrhage, uterine perforation, sepsis and/or cervical tear and are those reported up to the time of discharge. Therefore complications that occur after discharge may not be recorded.’ [x]

Abortion providers and the DHSC are not reporting medical abortion treatment failure as a complication, even though at least 5.9% of women using the abortion pills, [sic] need hospital treatment because of this failure. In any case, since these complications arise after discharge, the current method of reporting, using the HSA4 form, would still miss these cases even if the definition of complication were to include failed medical abortion treatment.

Less than 1-in-5 complications are being reported.

Significant underreporting of direct abortion complications is another example of exclusion softening the perception of direct abortion.

Other behaviors attempt to cloak the dangers of abortion. Family Planning Associates (FPA) of Chicago, for example, summoned an ambulance in July 2021 with a request for no lights or sirens despite a medical emergency:

‘The patient just underwent an abortion, and she had an injury to the uterus. She’s having some bleeding. It’s controlled right now but she does need to get to the hospital,’ explained the FPA caller, who requested that the 40-year-old woman be transported to Northwestern Hospital. Later in the call, the FPA worker made a special request. ‘And if it’s possible for them to come with no lights or sirens, we’d appreciate that,’ she said. The 911 operator responded, ‘Uh, that’s for their safety, unfortunately.’

Women procuring direct abortions thus may not always be accorded patient sovereignty, another form of exclusion.

A 2013 Canadian study found a significant increase in the risk of preterm delivery in women with a history of prior induced abortion, consistent with the findings of numerous previous studies. “Preterm birth is a major problem in Canada. Despite recent advances in medical care, it continues to be the most important cause of neonatal morbidity and mortality” according to that study. Direct abortion weakens the cervix, increasing a woman’s risk of preterm deliveries in subsequent pregnancies. Infants born “before 37 weeks gestational age have a much lower chance of living to adulthood,” and those that “survive have significant risk of serious disabilities, including cerebral palsy, intellectual impairment, psychological development disorders and autism.” What percentage of women procuring direct abortions are informed of this when they are assured that “…when legal, abortion is a safe, legitimate procedure” by Dr. Pegoda and his ilk, whether in the pages of Inside Higher Ed or elsewhere? Women procuring direct abortions thus may not always be accorded informed consent, another form of exclusion.

Whether from the false rhetoric, the underreporting of direct abortion numbers and complications, the absence of direct abortion from the CDC’s leading causes of death in the USA, the calls for hushed ambulances, etc., much, clearly, is excluded from discussions of the dangers of direct abortion.

Dr. Pegoda admitted he has belonged since 2020 to the Satanic Temple which insists that preventing access to abortion violates religious freedom. He appealed to its tenets including “One’s body is inviolable, subject to one’s own will alone” and “Every tenet is a guiding principle designed to inspire nobility in action and thought. The spirit of compassion, wisdom, and justice should always prevail over the written or spoken word.”

But how does a direct abortion, someone else’s willful slaughter of an innocent unborn human, not violate the unborn human’s body or subject the unborn human to its own will alone? And how is killing an innocent unborn human – often torturously, whether by dissolving it or its attachment to its mother chemically, aspirating it from its mother, dismembering it with forceps, vivisecting it with some cutting device, or some other means – noble, compassionate, wise, and just? Dr. Pegoda thus joined the choir chanting “My body, my choice” while tacitly demanding “Someone else’s living unborn body, my choice” – a heads-I-win, tails-someone-else-loses ruse. A body inside a pregnant woman’s body is not the pregnant woman’s body. And nobody has complete “bodily autonomy.” We are usually forbidden, for example, from taking heroin, from punching others, and from driving cars at tremendous speeds along residential streets. Members of the Satanic Temple have lost not only their souls to the Devil but also their brains and with them any sense of irony.

Dr. Pegoda’s final paragraph begins: “Curriculum should always take priority, not partisan distractions and crackdowns on the vulnerable that have been happening in Texas and in other states controlled by Republicans.” Well, since ancient times Lady Justice often has been depicted with a scale, an attribute symbolizing legal impartiality (the blindfold since the 16th century has been an additional attribute symbolizing her legal neutrality). Yet in describing heartbeat laws as “crackdowns on the vulnerable” with no acknowledgment that these laws protect some of the most vulnerable – living unborn humans, Dr. Pegoda again showed his ironic, extraordinary partiality against them. His Lady Justice had a finger on the scale tipping it against their case, excluding them from justice.

Dr. Pegoda’s final paragraph ends: “Academic freedom and freedom of speech are bedrock principles of our democracy and must be respected and valued as such.” But direct abortion annihilates both: it kills multitudes who would otherwise exercise those freedoms. These most innocent victims are blocked even from nursery school or kindergarten. They are forever silenced, forever excluded.


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