Medical Examiner

What David Brooks Misunderstands About Abortion

In his latest column, Brooks tries to barter essential health benefits for more votes. But he fundamentally misunderstands his subject.

David Brooks.
Photo illustration by Slate. Photo by Bryan Bedder/Getty Images for The New Yorker.

To: David Brooks
From: One of Many Democratic Women
Re: Comprehensive Medical Care for half the population

Dear Mr. Brooks,

You are a scholar. I have read your commentary for years and while I often disagree with you, I respect your civility and academic perspective. However, as a woman, an OB-GYN, and a mother, I read your column, “The Abortion Memo,” with great dismay. Though you pride yourself on your intellectualism, your article shows a genuine lack of ability to differentiate between far-right buzzwords that are little more than reproductive dog whistles and the reality of women’s medical care. At the heart of it, you distill the choice issue down to a numbers game: If only the Democrats threw away the concerns of the women who needed second trimester terminations, they could “win” more. Haven’t we heard that somewhere before?

I’m disappointed you even brought up “ninth month” terminations. That’s not a medical procedure. It’s simply not an issue. No one wakes up at 36 weeks of pregnancy and thinks, “Let’s have an abortion today.” You are propagating a false issue and that is beneath you.

Yes, most terminations are in the first trimester. In fact, only 7 percent of abortions are after 14 weeks, and less than 2 percent are after 20 weeks. Far and away, these women and families are ending loved and wanted pregnancies due to grave health concerns for either mother or fetus. I assure you, no one wants to have a second-trimester abortion. I certainly didn’t. But in 2009, faced with the alternative of my loved son Thomas horribly suffocating upon delivery, I chose to instead compassionately end the pregnancy. I assume, Mr. Brooks, that you have not witnessed the death of a child whose lungs aren’t developed. It is agonizing. If you had, you might realize that these procedures are intrauterine palliative care and should be viewed as such.

“Late term” abortion is a wastebasket term used by the anti-choice zealots to describe a spectrum of procedures and needs. It is nonspecific and conjures up the worst images, likely on purpose. Most procedures beyond 20 weeks do occur before 24 weeks, the long-standing threshold for viability, but most of these babies would not be viable if they reached term anyway. The reason there is no comfortable upper threshold for ending a pregnancy is that lethal anomalies can be discovered late in a pregnancy. Should a mother be condemned to carry her anencephalic fetus (which would be born without any brain tissue but a brainstem) to term because she received late prenatal care? What is the argument for that?

You distill this issue to a cold statistical strategy. Second-trimester abortions make people uncomfortable. Ultrasound images of babies are very cute. Polls show people love babies. Why not sacrifice the minority of women and families who need these services so we can “win” on other issues?

But only men are spared reproductive complications. For you sir, in your privilege of maleness, whiteness, and economic comfort, this can be an dispassionate intellectual discussion. But for millions like me, it is devastatingly personal. Maternal medical and fetal reasons for these procedures cut across all lines of economics, race, religion, and state. Reproduction does not play favorites. Absolutely any woman can walk this path of grief, and our medical care should not be negotiable, nor should it be dependent on the state in which one lives.

You argue that because some states may maintain legality, it would be acceptable to restrict care in other states. My ability to treat my patients would forever be at the whim of the current state legislature. Rich women would be able to travel, but most women would not.
Multi-day procedures across state lines require money for travel, hotels, and time off of work. Current TRAP laws show what happens with geographic disparity: an increase in maternal mortality.  Women deserve more than medical care dictated by ZIP code.

In fact, Mr. Brooks, it is Donald Trump who has normalized this attitude of throwing away the needs of a minority for the comfort of the majority. We are asked to tolerate racism in exchange for purported “economic benefits.” But the Democratic Party is about standing up for what is right because those whose voices are quieter still have needs, and they are no less relevant. We should not sell out women. We should not sell out immigrants. We should not sell out racial minorities. We should not sell out those in poverty. Democrats are, and should continue to be, the party of the moral high ground—who fight tooth and nail to do what is right—even when it is not easy. Even when it makes “winning” harder.

Sincerely,

One of Many Democratic Women

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Dr. Cheryl Axelrod is an OB/GYN in the northern suburbs of Chicago.