When it comes to abortion, why wait?

At the Battle of Ideas festival in London on 29 and 30 October, Will Saletan, a writer for Slate, debated Ann Furedi of the British Pregnancy Advisory Service on the question of: ‘Abortion: how late is too late?’ An edited transcript of his opening comments is published below.

The question that was posed to us is: ‘How late is too late for abortion?’ I am going to violate the rules by not answering that question. What I would prefer to do is bring some facts to bear, put some things on the table, and hope that we can have a conversation and that each of you can think about how late might be too late from your point of view.

The first page of the handout [which Saletan distributed to the audience] has polling data on it. I don’t propose that polls really resolve any issue. But I have put these numbers here in the hope of making you think a little bit, especially if you come from a perspective of believing in women’s rights or personal freedom.

If you look at polling stats and polling data in the US and UK over the past 30 or 40 years, you see massive, progressive shifts in public opinion on questions about the role of women and personal autonomy. So in the UK, you can see in the British Social Attitudes Survey shifts of 24 to 30 points on questions of women staying home when they have kids and whether the wife’s job is to look after the home and family. You see shifts on sexuality, on the rights of lesbian couples; you see shifts on whether certain things are wrong or not. You see huge shifts in relation to the issue of same-sex sex and premarital sex.

When we get to abortion, we don’t see this kind of shift. We see it in the opposite direction, in fact, when the social attitudes survey asked about whether abortion is wrong. So we are seeing people moving on questions of personal autonomy and on questions of women’s rights and women’s roles, but not moving on abortion. Why? I will point out one other thing from the British Social Attitudes Survey: look at the polling on capital punishment. From 1986 to 2009, the percentage of people who said that for some crimes the death penalty is the most appropriate sentence went from 74 to 55. So there was nearly a 20-point drop on this issue.

So perhaps people are seeing the issue of abortion in terms of life, not merely in terms of choice. If you look at data in the US, you’ll see the same patterns on homosexuality and pre-marital sex. Some morals are moving and some are staying the same. One thing I would like to point you towards is the question, ‘Is it all right for a wife to refuse to have children if her husband wants to have children?’. That is a straightforward question of the woman’s rights vis-à-vis the man and vis-à-vis childbearing. And there has been a significant shift in the pro-choice direction on that question, with more people saying women should be able to choose whether to have a family, but not on the issue of abortion. As we can see, the abortion numbers have gone in the other direction.

Again, polls don’t settle questions like this, but they should make us think. And my proposal is that we should realise that there is more to the issue of abortion than feminism or personal autonomy. Abortion is not just an issue of personal rights; it is an issue of one person growing inside another. I am not saying that personhood begins at conception. I do not believe that. What I am saying is that personhood grows and it does so during gestation.

My handout looks at the developments by week of gestation – and this is not information from right-to-life organisations, but from the Royal College of Obstetricians and Gynaecologists and several other sources that I trust. It’s a composite timeline, but what I want you to note is how early on the development of certain capacities begins and how continuous it is. We talk about viability. We talk about what happens at 22 or 24 weeks. But as early as week three, we begin to see differentiation of tissues. You start to see the beginnings of the nervous system as early as week six. You start to see networking within the brain around weeks nine to 12. You start to see movements at weeks 13 to 14. You start to see rudimentary perception at week 16.

And at week 18, you start to see a brain-generated stress response to tissue damage. This is not a question of pain. There has been a lot of debate about fetal pain and there is a lot of legislation going round the US trying to ban abortions at 20 weeks, sometimes earlier, on the basis of the idea of fetal pain.

Pain is a very complicated question. We just don’t have evidence of fetal pain. The Royal College says you can’t have pain until you have the completely wired system. I think the pain debate is a distraction, but what I want you to see is the development of the nervous system. At weeks 22 to 23 you start to see pattern recognition in fetal behaviour. You see habituation, responses to impulses. The fetus is in some sense… I wouldn’t say cognitive, but it is recognising patterns of stimuli and responding accordingly. All of that is happening before the legal abortion limit of 24 weeks. The growth of the rational capacities that signify personhood is a gradual process. It is underway long before the legal limit of abortion rights.

In some of our exchanges online, Ann Furedi has asked: ‘Is there anything qualitatively different at 28 weeks that gives a fetus a morally different status to a fetus at 18 weeks or even eight weeks?’ This timeline is my answer to that question. If you go beyond the 24-week limit, you are starting to see, essentially, viability: the development of lungs and, from weeks 24 to 28, a huge progress in brain construction. There’s another one at about 33 to 37 weeks. So if we are talking about a 28-week fetus, we are already seeing, according to the timeline, ‘spontaneous brain activity of cortical origin’. That, I believe, is a scientific term for ‘thinking’.

Let me skip to the reasons why women are having later abortions. Let’s look at some polling for the US. The number one reason that was given in the US for having a second-trimester abortion is that it took a long time to make arrangements. I think that has to do with the American healthcare system more than anything else. But if you look at reasons for delay that are more prevalent in the second trimester than in the first, the biggest difference is women who say it took a long time for them to decide.

I think we should talk about the reasons why those women take a long time to decide. It isn’t a huge number of women, but still we should talk about the reasons. If you look at data in the UK, it’s a little bit different. A study in England and Wales in 2005 found that the number one reason given by women who had second-trimester abortions as to why it took as long as it did was: ‘I was not sure about having the abortion and it took me a while to make my mind up and ask for one.’ Ann Furedi, in what I think is a commendable act of candour, published a BPAS list of 32 women who had come in for late abortion during a four-week period in 2008 and she published what their stated reasons were and what their circumstances were. It’s worth looking at the reasons given. Several of the women said things like, ‘I had to push it out of my mind, I found the decision hard to make’. This is not the only reason; there are lots of other women who were in totally wrenching circumstances. But some of these cases to me are problematic. If you look at client 18, she said: ‘At first I decided to continue the pregnancy.’ And then she changed her mind based on some circumstance: she thought she couldn’t cope with the child.

I hope we will talk about separating two acts – about separating the choice to have an abortion from the choice as to when you have the abortion. Once you know you are pregnant, my argument is that to delay is a choice, or at least it is something for which you bear some responsibility. And even if you have freedom of choice, you don’t have the right to wait and wait and wait to make a decision. You have a moral obligation to make it as expeditiously as you responsibly can. And that last woman I mentioned, she also said that she was not aware there was a legal time limit on abortion, so she didn’t feel the need to act.

Have we developed a mindset that whatever is legal is moral? Perhaps it is time we talked about the question of what is moral within what is legal, and how long it is moral to wait.

William Saletan is a journalist for Slate and the author of Bearing Right: How Conservatives Won the Abortion War (University of California Press, 2004). The above is an edited transcript of a speech at the Battle of Ideas festival.