A diverse panel of professionals share their opinions
30 MINUTE READ
From Luke’s Journal 2022 | Termination of Pregnancy | Vol.27 No.3
Editor:
On June 25, 2022, the US Supreme Court overturned the Roe v Wade decision of 1973. There have been reverberations across Western societies, including in Australia, with rallies, protests and vehement posting on social media.
What is Roe v Wade and what does it mean that the ruling has been overturned? What does that mean in the Australian context? As Christians, how might we engage our peers in discussion about the termination of pregnancy in a helpful way?
We asked a number of people from diverse fields to respond to questions distilled from an interview in “Uncommon Pursuit” about this topic. The following is a panel of responses to those individual questions.Others preferred to write more generally – see articles by an Obstetrician, Dr Joseph Thomas, Dr Lachlan Dunjey.
Note: The Luke’s Journal editorial team is aware that this article has political implications and that, since publication, legislation may have changed nationally or in your state of residence and practice. Luke’s Journal advises that you contact your State chair if you have any questions or concerns regarding implications for your clinical practice. Please note that opinions of the authors are not necessarily the views of Luke’s Journal or the Christian Medical and Dental Fellowship of Australia (CMDFA).
Why do you think there has been such an intense reaction in Australia to the overturning of Roe v Wade in the USA?
GP Obstetrician:
I am not an expert on culture, but I would say that most ideas that permeate our culture in Australia are the same as those in the US, especially with the rise of the internet and social media. Given that abortion is common (there are an estimated 50,000-100,000 abortions per year in Australia) with 1 in 6 women having had an abortion, it is something of relevance to society. Given its prevalence, it is likely that many people have personally experienced, or been involved with a friend of family member obtaining an abortion. This unresolved emotion and guilt are potentially the fuel for this discussion.
GP Obstetrician:
Australia likens America to an older sibling who is a few steps ahead of us in decision-making and trends. Since the sexual revolution that began in the 1960s, laws around no-fault divorce, sexual relationships, as well as access to contraceptives and termination of pregnancy have continued to broaden. The right to privacy has been a significant driver in law reform. Access to termination of pregnancy has continued to increase over the last 60 years. Laws evolved to make it easier to access, portraying it no longer as a crime, but instead as a normal part of women’s reproductive health care.
Abortion law in Australia is governed by the states, with no local equivalent to Roe v Wade to control this federally. Australian law has followed the trend of increased access to termination of pregnancy, with every state removing abortion from the criminal code between 1998 and 2021. WA was the first state to do so and South Australia was the last.
Roe v Wade was a landmark case in America where the right to privacy was ruled to include access to termination of pregnancy in the first trimester. This gave federally endorsed access to abortion to 12 weeks irrespective of state law, allowing the states to then decide beyond this what was legal in their jurisdiction. With Roe v Wade overturned, the authority has been given back to the states. This brings US abortion law in line with Australia’s approach.
The intense reaction seen in Australia is in part due to a misunderstanding of what Roe v Wade actually means legally, with a lack of awareness that this is bringing America in line with how Australia legislates abortion already. However, due to the wider spectrum of state values in America, with many conservative governments, the overturning of Roe v Wade has resulted in abortion clinics closing and women having increasingly limited access to termination of pregnancy services now that federal protection has been withdrawn.
The media does not help. For example, significant hype has grown around issues like ectopic pregnancy, with claims that women will be left to die and unable to access care if they find themselves in this situation. Let me illustrate with a statement from a woman, in response to ABC’s coverage of Roe v Wade in Australia:
“I am really, really scared that [the US ruling] is going to come to Australia…so much so that I don’t want to fall pregnant.” 1
This quote demonstrates the huge misinterpretation that exists in the community about what the overturning of this law actually means. It is almost laughable. Regarding access limitations to care for women with ectopic pregnancies, no woman in any jurisdiction would be denied life-saving medical care for this type of non-viable pregnancy. This is due to the significant threat it poses to the woman’s life and the lack of any chance of viability for the baby if developing in the fallopian tube, where most ectopic pregnancies occur.
News reports also like to focus on the rare but heart-wrenching and complex stories about minors who, having been raped, have difficulty accessing abortion services. These represent only a tiny proportion of those affected by this issue. However, it has been used as a cover story to highlight why abortion should be widely accepted and available to all.
Bioethicist:
The overturning of Roe v Wade seems to have alarmed some Australian activists that legislated abortion rights can be removed in modern times (and remember that abortion is big business). My concern is that there have now been calls for abortion on demand, bypassing any medical or legal screening processes, as they are framed as an infringement on autonomy. Similarly, Medicare rebates for medical abortions are also being discussed. We have seen this also in euthanasia legislation, where proponents see safeguards for patients as barriers to access. It risks reducing the agency of the doctor in medical decision-making and increasing the danger to the patient.
Theologian:
It’s hard not to be both cliched and hyperbolic in describing local and international reactions to the US Supreme Court’s recent overturning of the long-standing constitutional protection of access to abortion services. Suffice to say it’s been met with both glee and anger, celebration and anguish. It seems to have deepened the cultural and political divides that have plagued Western democracies.
Evidence of the erosion of public discourse has been demonstrated through sloganeering, instead of reasoned discussion, the demonising ‘othering’ (to use an ugly neologism) instead of courteous disagreement. This seems to eclipse the possibility of nuanced conclusions on contentious ethical matters or laws that seek to minimise harm rather than legislate morality. This erosion of reasoned debate might even give credence to the notion of ‘culture wars’: that we face a battle in society between those who stand for ‘traditional morality’ and those who seek to erode it for their own personal and political ends.
At the risk of inflaming sentiment or being labelled as a naive victim of an insidiously successful propaganda, I don’t believe the ‘culture wars’ narrative. But even if it was true, I would invoke the long history of Christian conscientious objection and seek to be a voice of peace, perhaps providing a haven and comfort to those wounded by it. More to the point, perhaps, I am of the view that the Scriptures, when rightly interpreted, do not support the kind of ‘right to life’ ethic that opponents of Roe v Wade have raised. All these beliefs colour my responses to the questions that we have been asked with regards to the Court’s decision. So, allow me to turn to the question.
It buys into the ‘culture wars’ narrative. For many who support women’s access to abortion services, the overturning is an illegitimate intrusion of moral and religious views into politics and the law. They are of the opinion that these views belong in the realm of private opinion, not public policy. Moreover, this imposition reflects patriarchal and misogynistic attempts to control women and their bodies, and a desperate attempt by conservative Christians to cling to the vestiges of their waning political power.
To those who oppose access to abortion services, the overturning represents a victory in the fight against the undermining of the ‘Judaeo-Christian ethos’ in Western culture. For those who believe that a human person comes into being from the moment of conception, it also safeguards the lives of vulnerable people who are unable to speak for themselves.
We’re hearing the terms ‘pro-life’ and ‘pro-choice’ being used in commentary around Roe v Wade – can you comment on whether these are helpful to use? If not, are there more helpful terms?
GP Obstetrician:
One of the things that discourage me to engage in public discourse is the simplification of complex issues down to sound bites. People love to be able to simply classify someone as either ‘on their team’, or ‘on the opposition’. This leads to confirmation bias by isolating people into groups that think similarly. Individuals are more complex than the groups. Only by engaging the individual can real discussions ensue. Jesus was often asked dichotomous questions, sometimes to trick him. Jesus refused to respond only with a ‘yes’ or ‘no’ and would often turn a question back on the asker, or tell a story that illustrates the nuance and depth of the true answer. Rather than using simple language, I think we should embrace complexity in discussion.
GP Obstetrician:
‘Pro-life’ and ‘pro-choice’ terminology is actually very unhelpful when discussing the issue of unplanned or unwanted pregnancies. These are very politically loaded and polarising terms that carry with them a lot of negative history.
- The ‘pro-life’ side of the debate is seen by those who are ‘pro-choice’ to advocate for saving the baby’s life at all costs. The mother is not at all important and her needs are not considered. She loses all autonomy for the sake of the child.
- The ‘pro-choice’ side of the debate is seen by those who are ‘pro-life’ as showing complete disregard for the humanity of the baby, and therefore giving it no rights. The mother’s autonomy and rights far outweigh that of the unborn child, who is often considered nothing but a clump of cells.
While there are people on both sides of this issue that are extreme in their views, there are also many who share a common heart for women who find themselves in situations of unwanted pregnancies, and who want to ensure that they are cared for and that their needs are met. The outworking of this desire, though, can look very different.
The term ‘pro-choice’ is a misnomer. It implies a variety of valid options – but the only option this term is referring to is a woman’s right to access termination services. A choice can only be called a choice, if there are other valid options for the woman to consider. A criticism of the ‘pro-choice’ movement is that they are not ensuring choices for the woman. For many women in crisis, they feel that termination of pregnancy is the only option they have. Healthcare providers as well as family and friends may confirm this view and not give her any other options to consider. This approach cannot be promoted as protecting a woman’s right to choose.
Unfortunately, in Australia, aligning yourself with the ‘pro-life’ movement is likely to automatically discredit you from having any valid contribution to make on the topic, in both the healthcare industry and increasingly, in the secular community as well.
Bioethicist:
It is never helpful to use polarising terms that are polarising. We will only make progress ifs we start from a place of consensus, which I expect is that most of us would like abortion to be legal, safe and rare. The discussion needs to move from an all-or-nothing approach to a more nuanced discussion. Perhaps we should be asking why so many women are requesting abortions in an age which that can provide the best reversible contraception we have ever had. Although I have yet to read it, the book, ‘The rise and triumph of the modern self’ by Carl Trueman, has been recommended on this point, even though I haven’t read it yet.
Theologian:
No, they are not helpful terms. Unfortunately, they have become entrenched in the debate, and so it’s difficult to use other terms. In relation to my own views, I prefer to speak of ‘welcoming life’ because it allows for the kind of nuances needed when discussing these contested matters (and which the entrenched terms do not facilitate).
What does it look like to discuss a Christian viewpoint with grace and truth?
GP Obstetrician:
When Jesus sent his disciples around Israel to preach about the coming of the kingdom of heaven, He warned them of being surrounded by wolves. He told them to be as wise as serpents and as innocent as doves. Jesus also tells us to be salt and light, and that salt without saltiness and light that cannot be seen are useless.
Sharing God’s truth in love is not going to be without conflict. If we say nothing about the wrongful killing of children then we are not serving God, nor the people we are hiding the truth from. But it is also wise to know how, when, and who to talk to about a Christian viewpoint on abortion.
Practically speaking, I have never spoken at length to a group of individuals who I know will vehemently disagree with me. If challenged on why I do not perform abortions, I ask if the group would actually like to know since it is a complex answer, and if they are willing to listen to me for at least ten minutes. I have never had that offer taken up. However, one on one with a colleague is a different story. Depending on the situation, speaking in love may mean asking a question to prick the conscience of a colleague and stimulate further discussion. It may mean talking about your view on the sanctity of human life given by God and when you think that life begins. When talking to patients, a truthful, non-judgmental, empathetic approach including talking openly about abortion and its availability is required. I find a majority of patients know in their conscience that abortion causes the death of a child. A non-judgmental approach to pregnancy counselling often leads away from abortion.
GP Obstetrician:
I have a colleague who would consider herself to be very ‘pro-choice,’ and who would consider me to be very ‘pro-life’ if you were to use this terminology to describe our views about the issue of abortion. She works in a local termination clinic, while I am in the process of setting up a crisis pregnancy centre in our town. We both care for pregnant women in the same GP practice and are on the local maternity roster at the hospital for births. We both love our women and deeply want the best for them. We have a close friendship and have talked at length about our differing views. Yet we practice very similarly in most areas and it is a running joke that we are actually the same person, with many people mixing us up, and with our decision-making usually being equivalent in most situations. But our approach to what it means to care for a woman with an unwanted pregnancy is vastly different. She fiercely defends the rights of women to access termination services and offers both medical and surgical terminations of pregnancy to ensure they can follow this through, while in contrast, I passionately advocate to giving women alternative choices, encouraging them to take time and space to consider their decision and ensuring they are aware of the supports that exist for them if they choose to continue on with their pregnancy. Despite the differences in our views, and the way our perspectives changes how we care for our women, we continue to be friends and have great respect for each other. We talk about these issues in a way that tries to learn more about where the other is coming from. Although we vehemently disagree, we are both better people for having each other in our lives.
As Christians, our lives should be demonstrations of grace, while still standing for truth. The issue of abortion and how we approach this should be no different. I seek to be an excellent doctor, to love both my colleagues and my patients well, to be beyond reproach in all areas of my life, and to stand for truth in the decisions that I make. When required, this will also occasionally mean standing for truth when it is uncomfortable, with others who may strongly disagree.
But our call is not to argue people into agreeing with our position. Rather it is to be the salt and light that transforms. By living our lives with grace and in truth, showing God’s love in all that we do, others will see that we carry a hope and a joy that sets us apart. We will be a safe space that people come to for advice and wisdom. We will make people thirst for truth and hunger for whatever it is that we have that makes us confident in who we are and what we believe. It is only out of showing people Jesus, and His love for us, His love for the women we care for, His love for their child – born or unborn, that they may start to rethink their position on these delicate matters.
Paediatric and Foetal Cardiologist:
The first step may be to take a mental step backward and see the larger picture of our position in God’s equation. In Romans 3, Paul details our common unrighteousness and that it is only through God’s free grace that we can be redeemed. While in the previous chapter, He also labours the point that we are in no position to pass judgement:
‘You, therefore, have no excuse, you who pass judgement on someone else, for at whatever point you judge another, you are condemning yourself, because you who pass judgement do the same things. Now we know that God’s judgement against those who do such things is based on truth. So, when you, a mere human being, pass judgement on them and yet do the same things, do you think you will escape God’s judgement? Or do you show contempt for the riches of his kindness, forbearance and patience, not realising that God’s kindness is intended to lead you to repentance?’ (Rom 2:1-4)
I believe it is easier to have a dialogue on controversial issues (particularly those that may bring up strong feelings for us as Christ-followers) if we are speaking from a place of true perspective. Both we and the person we are talking to are equally broken and in need of equal volumes of grace. Dr Martyn Lloyd-Jones puts it bluntly, ‘If what you call your faith hasn’t pushed right out of your life every sense of worthiness you’ve ever had, you haven’t got faith’. This also allows us to see more clearly the counterarguments to our beliefs. Those on the ‘opposite’ side of the fence are, like us, trying to find the best path through their life and circumstances that make the most sense to them. Those who do not have God as a reference point, they will reorder their priorities to a different goal.
With this in mind, a Christian opinion on termination of pregnancy can only be meaningful if we look to identify the motivations for choosing termination. On a broader level, this is often defined as ‘pro-choice’, which from a Christian perspective can come across as quite self-centred. In my narrow experience in maternal care as a foetal specialist, I think the factors behind a decision to terminate a pregnancy are often more nuanced than we might like to think. A mother’s decision to end the life of her unborn child appears to almost always be accompanied by significant emotional and mental trauma. Any public (or private) judgement of these families moves completely against Jesus’ call to act as servants in bringing love, compassion and grace to people who are hurting. It also completely misunderstands where the seat of judgement is. If God can show kindness, forbearance and patience with us as our righteous judge, how much more should we show the same compassion.
Bioethicist:
It would be refreshing to look at the facts, which are that abortion involves the death of a human being, and that most women who choose abortions do so from a lack of support for the pregnancy. The long-term risks of abortion are grossly under-reported, and it would be better if appropriate standards of informed consent are enforced so that women are not misled into thinking that abortion is a trivial procedure. We will not make progress by making abortion illegal. From the response to Roe v Wade, we know that women will still seek abortions. Rather, we need to talk about abortion so that it is unthinkable, with compassion and practical help for those women who believe they cannot support a child. However, we need to remember that some of those with whom we discuss these issues have a personal history of abortion (themselves or someone they love) and we need to be sensitive to what they will have to lose if they embrace an anti-abortion position.
Theologian:
It is increasingly difficult to avoid the oppositional character of public discourse mentioned earlier. But that shouldn’t stop us from trying. Here are some key ideas:
Be sensitive. If we are to have a meaningful conversation, we need to be sensitive to the hurt and fears that lie beneath people’s words. That’s something Christians like me need to be particularly attuned to, given our lamentable history of wounding those we are called to love.
Respect the other, their integrity and their ideas. Respect, of course, does not necessarily mean agreement. Indeed, a sign of respect is to take someone else’s views seriously enough to seek to understand them and, where you do disagree, to say so and figure out why.
Listen well and listen hard. Listen not just to the words people say, but to their tone, the way their body speaks. Listen, not to store up ammunition to shoot back in debate. Instead, listen empathetically with a desire to understand, to try to see things from their point of view.
Listen more than you speak and listen before you speak. And when you do speak, speak out of love and deep respect. The book of James puts it well: ‘Everyone should be quick to listen, slow to speak’ (James. 1:19). Speak with a desire to grow in shared understanding rather than to beat your conversational ‘enemy.’
Do you believe there can be medical justifications for the termination of pregnancy that fit within Biblical ethics?
GP Obstetrician:
Although there is much nuance in the many situations that present to us in consultation, there are rarely morally ambiguous scenarios in common practice. However, some cases may be very complicated and specific in context. The approach I would take to grapple with these scenarios is to engage in discussions with mentors and Christian colleagues, and to put in thought, study and prayer. Fortunately, these scenarios are unusual.
Before considering the case of ‘medically justified abortions’, we should consider the majority of abortions that we have in Australia. There are multiple parties involved. In any abortion, you need a mother, a father, the unborn child and the doctor. Generally speaking, the only party given a voice in this discussion in Western society is the mother. The most common reason for abortion in Australia is the mother’s ‘choice’, with little to no justification required. Talking about medically justified abortion takes away the focus from the majority of foetal death. Therefore, despite the confusion deliberately created by the society around us, I think that if we take a step back and ground ourselves in faith we cannot, as Christian doctors, call the majority of terminations ‘good’.
For the more complicated scenarios, they can probably be broken down into a few categories:
- Scenarios where there is a congenital abnormality incompatible with life outside the womb.
- Physical or mental impairments in the foetus.
- Pregnancy abnormalities that threaten the life of the mother (and subsequently that of the foetus).
- Cases that could be seen as causing severe psychological harm such as rape or incest which we will address in the next question.
In answering the first two scenarios, let us consider foetal life as a human, which I think most Christians would agree on. Would it be morally permissible in the view of Jesus to further cut short the life of a child or adult with a severely life-limiting illness? What about a person with a physical disability or intellectual impairments? Would it be permissible for Christians to euthanise a person with Down syndrome (Trisomy 21) to spare them from the theoretical torment of living with Down syndrome? (Anyone who has had anything to do with individuals with Down syndrome knows how joyful they mostly are). The answer to these questions would be, “No, it is not permissible to shorten the lives of these individuals.” And the answer is the same when it comes to the foetus.
The third scenario is very different. A pregnancy condition that physically threatens the life of the mother if the pregnancy continues, will ultimately also lead to the death of both the mother and unborn child. A similar scenario may be seen if conjoined twins had to be surgically separated as both their lives were at risk, but separation could cause the death of one of them (a scenario which does occur). In such scenarios, our intention is not to cause death in one individual, but rather, to at least save a life. To save the life of the mother in an ectopic pregnancy, severe early pre-eclampsia or severe maternal cardiac disease, it may be necessary to cause death in the unborn child. It would seem immoral to withhold action to at least save the life of the one that could be saved. But when this happens it is to be mourned, not celebrated.
GP Obstetrician:
I think that the termination of pregnancy is never God’s “Plan A” for a woman or her baby. But we live in a fallen world and there are situations where you could argue that termination of pregnancy may be permissible. Such situations may include:
- A baby with anencephaly who lacks adequate neurological tissue to live outside the womb. You might equate continuing the pregnancy with continuing someone on life support who has no brain function left. Continuing a pregnancy with a child with this condition poses an increased risk compared to a normal pregnancy. This might be a situation in which you could rationalise termination of pregnancy based on the likely outcome for the baby and the increased risk to the mother’s wellbeing.
- A very young child who falls pregnant and whose body cannot sustain growing a baby.
- A woman who has significant underlying conditions that actually make pregnancy incredibly dangerous for her to continue. Or perhaps she requires life-saving treatment that she cannot undergo while pregnant (e.g. certain cardiac conditions, advanced cancer requiring treatment that cannot occur while pregnant).
Paediatric and Foetal Cardiologist:
As a foetal specialist, I am involved in the care of foetal congenital abnormalities, and with pregnant women and fathers who sometimes decide to terminate the pregnancy based on a particular foetal diagnosis. As a follower of Jesus Christ, I am called to apply Biblical truths to this aspect of my work. While I am not directly involved in the termination process, I have keenly sought God’s direction in how to provide the best medical and spiritual care to families with such a foetal diagnosis. I should note that I am in no way theologically trained, and therefore these comments come from my own personal reading. It only takes a quick Google search to see how perspectives can be very different when applying the Scriptures to this area, so I would commend everyone to their own prayerful investigation of God’s Word.
In looking to answer the question of medical justifications for termination, unfortunately, it is not a straightforward search of the Bible for the right verses. The Scriptures do not directly comment on the active termination of pregnancy in the first place. But also, it is noteworthy that the Bible seems to spend a proportionately small amount of time addressing the details of the daily decisions that we all come across (whether ethically simple or complex) and so the absence of a clear directive does not mean we do not have Biblical principles to apply. There are, however, a handful of instances in the Bible that do seem to, at least indirectly, address the sanctity of life.2
If we agree that God views an unborn baby like any other person (though there is much variance among denominations), the question then becomes, ‘Are there any circumstances that may arise that can overrule this?’. If we are basing our belief about termination on God’s position regarding the sanctity of life, then any situation where the mother’s life is threatened and can only be treated with termination of the pregnancy justifies a case for abortion. This does remove the recourse of the Lord’s divine intervention and healing. However, as doctors, we have a duty of care to the patient. If both will likely die without termination, then I think this is defendable as a Christian to consider termination.
Beyond this situation I think it becomes very grey and much more open to interpretation. If we widen the statement ‘the mother’s life is threatened’ to include her overall health or mental health, this opens a broad range of potential scenarios to justify abortion, e.g. a victim of rape, or someone with extremely difficult social circumstances, or a foetus with a severe congenital diagnosis. I find it very hard to argue any of these cases from a Biblical standpoint and would feel a responsibility to care for a parent to the end that they might still be able to continue with the pregnancy. God has certainly worked powerfully in people’s lives through tragedy. As someone who has not experienced significant tragedy myself, and as a healthcare professional, I am misplaced to argue strongly for continuation at all costs. Speaking from my clinical experience, a foetal diagnosis that is likely terminal or severe severe in nature can be a very difficult journey. What I do see though, is that those parents with a strong faith have a reference point and resources for continuing. I only wish this was present in everyone’s case.
‘Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.’ (2 Corinthians 1:3-4)
Bioethicist:
Personally, I support the termination of pregnancy only to save the mother’s life. Some cancers, preeclampsia, heart disease, can require termination of a pregnancy before the child reaches viability. This is a situation where you can either lose two lives or one life, and I would elect to lose just one. (Editor’s note: ‘Fearfully and Wonderfully Made’3 has a good discussion of the theology around this topic.)
Theologian:
Yes, I do. I do not believe that the Bible supports the view that a human life begins at the time of conception. Indeed, I do not believe that it addresses that question at all (let alone the matter of termination of pregnancy). The key passages are addressed briefly in the CMDFA discussion paper..4 My view is in line with those who believe that the Bible does not allow us to draw clear conclusions about the personhood of an embryo. While the gift of life is to be valued, there are circumstances where other factors overpower the good of a woman continuing with her pregnancy. These include cases where a foetus has a congenital abnormality that is incompatible with extra-uterine life, or where continuing the pregnancy carries a serious risk to the mother’s life or well-being.
What do you think is the Biblical position on termination of pregnancy in cases of rape or incest, particularly when a minor has been violated?
GP Obstetrician:
There is biblical precedent to consider the foetus as an unborn human child. If a man rapes a woman with whom he has a child, who has committed the wrongdoing? Obviously, it is the man. It is not the woman, but neither is it the unborn child. So, is it right to punish the child with the penalty of death? Similarly, in incest, though the Bible views incest as an abomination, God uses the wrongdoing for good. There are perpetrators of incest in the genealogy of David and Jesus.
The modern justification for abortions in the cases of rape or incest is based around protecting the woman from the child who will remind her of that crime. The literature in this area is difficult and subject to bias, but some suggest that there are better health outcomes for those who keep the child of rape. We also must remember that a woman is not obligated to keep and raise the child conceived out of rape or incest but may choose to have that child fostered or adopted. In my experience, I have seen three cases where women kept their babies conceived in rape and several where an abortion occurred. Those three women had no diagnosable mental illness years afterward, whereas my other patients had depression and anxiety after their abortions. For some, the joy of parenting their child brings unexpected blessings out of trauma.
GP Obstetrician:
Cases of rape and incest (particularly where minors are involved) comprise <1% of cases seeking termination. Those in favour of liberal abortion laws use this group to showcase why access to termination of pregnancy services should be protected. Since these make up such a minority of cases, laws should not be made on this basis. As Christians, we struggle to make sense of how to respond to these scenarios.
I think these situations break God’s heart. His daughter has been violated in the worst possible way. This is not how God intended new life to come into the world. The abusive sexual violence that led to these children coming into being does not represent trust or respect or love or commitment, and they will not be raised by a mother and father who love each other and provide a stable family foundation.
There is no straightforward answer to this. We live in a fallen world where evil abounds.
Yet babies that are conceived in cases of rape and incest are still members of our human family. They did nothing to decide the situation that brought them into being. There are many stories where women have suffered extraordinary abuse that has led to them falling pregnant, and the child inside them becomes the only thing that saves them. The hope and joy that a child brings is a light in the darkest of times. It is unfathomable to many who advocate for abortion access that a woman may choose to continue with a pregnancy that resulted from rape. Yet these stories are not uncommon. There are significant mental health implications for women who suffer sexual violence. Termination of pregnancy does not bring freedom from this. It is instead another cause for despair. These situations are good examples of where adoption can have a real place in our society. It can give a woman who faces this difficult situation an option to continue with the pregnancy and bring the child into the world, but not necessarily to raise the child herself. Unfortunately, adoption in Australia is the ‘un-choice’. It is incredibly difficult to coordinate, and to this day, remains very rare.
While the Bible does not explicitly address these issues, we know that God values all human life, including while we are still being formed in the womb. The Bible also makes it clear that we have all fallen short of the glory of God and are saved by grace. This means He loves and values the woman who is so often the victim. But He also loves and values the man who inflicted harm on her. And He loves and values the baby who was conceived through this union.
There will be cases where it is actually unsafe for a minor to carry a baby to term. The 10-year-old who is raped and falls pregnant may be irreversibly harmed physically (and emotionally) by continuing with a pregnancy, and it could potentially put her life at risk. Perhaps this is a time that the life of the girl needs to be protected by the ending of the child’s life. But these cases are very few. While we need to stand for truth, we also need to do this with grace. This, in part, means realising the complexity and heartbreak of these rare situations.
Our primary goal as Christians and healthcare providers needs to be to show these women love and hope, and to help them find what is true, good and beautiful in these devastating situations. In most cases, abortion will not be the solution.
Bioethicist:
I do not see anything in the Bible that says abortion is okay in these situations. It is too complex an issue for this article. (Editor: for a more extensive discussion of this issue, see “Fearfully and Wonderfully Made.”3) Abortion may not be the quick fix it appears to be, since women in this position have reported that after the initial sexual assault, termination of the pregnancy may be experienced as a second assault. Also, it disregards the long-term psychological impact of abortion.
Theologian:
In my opinion, it is permissible and, in many instances, preferable as the lesser of two evils. We need to consider a woman’s mental and physical well-being. As a man, I cannot imagine the trauma of discovering oneself pregnant as a consequence of rape. Some adult women may be able to cope with that and choose to carry the pregnancy to term. That strikes me as an act of moral heroism. It should not be imposed on any woman—and certainly not by way of legislation. I do not believe a minor should ever be required to make that decision. The risk to her physical well-being is significant, and the potential emotional and psychological harms are incalculable.
Are there organisations and resources we can advocate for and support to care for women seeking abortions more holistically?
Bioethicist:
Yes, there are many. Still, there are not enough of them. We particularly need more residential centres to support women who have nowhere to live and no support in late pregnancy. It would be great if more churches lined up to support one of these centres. Churches usually have a family program and there are probably spare prams, clothes and other baby paraphernalia they can donate.
GP Obstetrician:
Locally, you may know of individuals or groups that may be able to take a personal approach to a woman in crisis – maybe through local community women’s groups, church or church groups. However, I would be careful with referring directly to a church or ministry team. Social history-taking with enquiry of a patient’s support network might reveal a spiritual or religious background that could be utilised to support the patient in a difficult time.
GP Obstetrician:
As Christians, we have a great opportunity here to show love in really practical ways that can make a significant difference to women who find themselves with unexpected or unwanted pregnancies. As Christian healthcare providers, the consultation of women with an unwanted pregnancy is a complex one. For many of our colleagues, this is a brief consultation where the woman is sent in the direction of the local termination centre without much thought – a standard-length consultation in most cases. Increasingly, GPs can prescribe the MS-2step MTOP (mifepristone and misoprostol medical termination of pregnancy) medications during that consultation. Meaningful conscientious objection is not allowed in most states (without referring them to another provider who is willing to refer them for termination of pregnancy, or the state Health Pregnancy Choices Hotline [or equivalent] who can direct them to termination services). There is no requirement for women to take time to think about their options. There is no requirement for any kind of counselling to take place prior to making an irreversible decision about the life of their child.
In towns where there is a local pregnancy centre, we can refer these women onward. We can know that these centres will provide a team of support that can offer space and guidance for these women through this difficult decision-making time, without you as the GP having to be the sole person helping to guide them. Pregnancy centres that are run with a medical model in combination with social services can offer informed discussions around screening results and foetal anomalies, if that is the motivation for considering termination of pregnancy. There is also scope for ultrasound to be used as a tool for women to see their babies, to help them make more informed decisions about what/who it is inside of them. Sexually transmitted infection screening, mental health care plans, referrals and treatment can all be initiated where appropriate. Routine antenatal care and comprehensive education and support can also be provided.
Being a doctor involved in a crisis pregnancy centre inevitably means that your colleagues, who know and respect you, will refer women to you rather than to the local termination centre, knowing that you will spend the time needed with the woman to figure out what she needs. As I have already experienced in my work setting up such a clinic, colleagues who work within the termination centres will also refer directly to you if they have a woman they perceive as not appropriate for termination. The referrals I receive like this bring me great joy as I know the only reason for it is the respectful relationships I share with these colleagues, who know my position on this issue. I have done my best to approach this issue in my workplace with grace and truth, and I am starting to see the fruit from this.
Women who come from situations of significant disadvantage may, for the first time, be seeking care for themselves in their pregnancy. This is a great opportunity to find out who the woman is, where she has come from, what her hopes are for the future, and what support she needs to equip her for this journey into motherhood. Pregnancy can actually be a turning point in her life where she suddenly has a reason to hope, to step up and put past decisions behind her for the sake of her new family. While many see pregnancy in these situations as an additional risk factor that is likely to bring greater disadvantage to the woman if she continues on to parenting, as Christians, we can instead see that pregnancy can be a powerful turning point in the woman’s life, that changes the trajectory of her future. It is a privilege to be a part of this transformative time in a woman’s life.
A list of Australian Pregnancy Support Organisations is available here
Collaborative Interview Panel
Thank you to the authors who generously wrote about this topic for Luke’s Journal, for the benefit of the CMDFA and the wider Christian healthcare community.
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- https://www.abc.net.au/news/2022-07-02/australians-demonstrate-support-for-abortion-access/101203588
- Some examples that are commonly referred to (and debated) include:
• Exodus 20:13 and Deut 5:17 read, ‘You shall not murder’. This does not specify killing someone after birth, although to apply this to an unborn child would need an assumption on when life begins.
• Exodus 21:22-25 gives guidance for if a pregnant woman is injured in a fight between two men. There are interpretations on both sides of the argument that favour a pro-choice or pro-life position! As John Piper has explained, (desiringgod.org) this comes from differing translations of the Hebrew phrase, ‘and her children go forth’ within the passage. He shows good evidence from the original script that this verse values a foetus to the same extent as any other human life.
• Numbers 5 gives instruction for if a man suspects his wife of infidelity. This involves the priest giving the woman ‘bitter water’ which, if she has been unfaithful, ‘may … cause you to become a curse among your people when He makes your womb miscarry and your abdomen swell’. While this is an example of an active step that may end the life of a foetus, the one ending the life is God himself. This does not seem to speak against the sanctity of human life as a foetus any more than it speaks against the sanctity of any life, with many examples in the Old Testament of God’s wrath against sin resulting in death.
• Psalm 139:13 and Job 31:15 are two examples of many where God’s handiwork of knitting together and knowing a person before they are born is demonstrated. This may be the clearest (even if still indirect) way that the Bible speaks on the topic of pregnancy termination. Embryonic growth and the creation of a person in the womb is God’s process much more than it is ours. And while debate rages around when life begins, and body-self dualism argues that a foetus cannot be called a person, I believe the Bible is clear that God is involved in the pregnancy even before conception. ‘From birth I was cast on you; from my mother’s womb you have been my God’ (Ps 22:10). ‘Before I formed you in the womb I knew you, before you were born, I set you apart’ (Jer 1:5). - Best, Megan – “Fearfully and Wonderfully Made: Ethics and the Beginning of Human Life”. 2012. Matthias Media.
- https://lukesjournalcmdfa.com/emt-discussion-paper-on-the-ethics-of-termination-of-pregnancy/