There is nothing that my Massachusetts- and California-based Facebook friends like better than heaping abuse on Americans who are too stupid to live on the coasts (Gulf Coast doesn’t count as a Big Brain Coast!). The latest issue that excites them is an abortion law update in the South: “Mississippi Governor Signs Nation’s Toughest Abortion Ban Into Law” (NPR). The law restricts abortions after 15 weeks of gestation.
Premature babies were one topic that we studied last month during my sojourn at the local medical school. Preterm babies can be expensive, so much so that self-insured employers will try to avoid paying for fertility services, such as in-vitro fertilization (IVF), due to the risk that triplets will be born and punch a $300,000 hole in their budget (not all triplets are dramatically premature, of course, but $300,000 is the average cost).
We learned that, from a medical point of view, babies can be viable and will receive treatment after 22 or 23 weeks of gestation (about 70 percent will survive; some babies are surviving birth after only 21 weeks of gestation; a recent example from England). There is an ICD-10 code for babies born at less than 23 weeks.
Here in Massachusetts, abortion is available without any reason through 24 weeks of gestation (the law), but also beyond that date “if a continuation of her pregnancy will impose on her a substantial risk of grave impairment of her physical or mental health.” I’m not sure why, in practice, this leads to any restrictions on abortion. What is likely more harmful to mental health than having a kid, whose own physical and mental health cannot be known in advance, around 24/7? What is more likely to interfere with regular gym visits and other physical health-promoting activities than being responsible for a child? (Note that, based on our interviews with family law attorneys, Massachusetts is one of the U.S. states in which it is most common for abortions to be sold at a discount to the net present value of projected child support cashflow; see “Child Support Litigation without a Marriage”)
So… U.S. society is now at the point where we have people who are outraged if anyone proposes limiting spending on extremely premature babies (a bill of $2-5 million for one child would not be unusual), but they’re also outraged if anyone proposes to restrict the ability of a woman to choose an abortion several weeks after the gestational age at which babies are currently viable (given unlimited health care spending).
This reminds me a bit of a “meet the midwives” event at Mt. Auburn Hospital here in Cambridge a few years ago. Given that it was Cambridge, it seems safe to assume that the audience was at least 94 percent faithful Democrats who supported abortion at 24 weeks (6.5 percent of Cambridge voted deplorably in the 2016 election). Yet they talked about their own 12-16-week pregnancies as though the developing children were already fully human and very nearly out and about.
Readers: Let’s assume that, given the money being poured into this area of treatment, technology and technique will keep advancing such that younger and younger babies are medically viable. Instead of 70 percent of babies being viable at 23 weeks, for example, we’d have a 98-percent survival rate (maybe for $20 million per baby) and 85 percent of children born at 22 weeks would survive. Would that lead to voters and legislators who are currently happy with the 24-week limit changing their minds?
Related:
There’s no cognitive dissonance here. If some women want to be mothers and require reproductive assistance to make that happen, we should enable that if possible. If other women (or even the same women, at different times) do not want to be mothers and want to terminate a pregnancy, we should enable that as well. People’s preferences should be satisfied as long as the resources exist to make that happen.
The point isn’t about making sense of when the fetus is viable… It’s about women’s ability to choose whether they have the baby. If you think about it as a privacy issue first, then the woman can choose either way, and it’s not inconsistent. It’s only murder of the fetus if the woman wanted to have the baby.
According to the Jewish tradition, the fetus does not become a viable human being until it graduates from medical school.
As In your previous post, when the woman is exercising her “choice” there should be a diverse panel that includes babies to decide if the baby’s life is important.
Wonder how “think[ing] about it [“it” i guess refers to the unborn child] as a privacy issue” settles anything? Why not think about “it” as an eggplant and then it is a heck of a lot easier to justify throwing “it” in the garbage?
@Alex,
By your reasoning, assisted suicide should also be legal, correct? How about murder? If I want someone dead, and (according to your hypothesis) there are existing resources to make that happen, then murder should be allowed, correct?
Folks: I didn’t want to turn this into a debate on abortion in general (there doesn’t seem to be an answer that Americans can agree on). I was more interested in the apparent logical inconsistency of demanding that insurers (or employers who self-insure and have an insurance company administer) spend without limit on 22-week babies (because they are precious humans and $5 million is an insignificant amount to spend to save a precious human) while simultaneously demanding the right to get an abortion at 22 weeks (because the 22-week-old fetus is not a precious human).
Philg-
Again, if you take the viewpoint that the woman’s choice of whether the fetus should live or die is the overarching decision to be made, and that all subsequent decisions flow henceforth from this, there is no logical inconsistency. Whether or not the fetus is precious (or precious enough to override other factors for her to consider) is the choice of the woman.
Sam: I think that you’re probably right. On the other hand, the current legal regime seems to have been set up at a time when it wouldn’t have been possible to spend insurance money on the 23-week babies (since there was no technical way of keeping them alive). So it feels as though some new logic must be required!