The Problem With ‘Justifying’ Abortion Care

With Roe on the precipice of falling, there's been an intense focus on the most extreme abortion care outcomes. But experts caution it may undermine a push for abortion as a fundamental right.
Zoe van Dijk for HuffPost

This article is part of a larger series titled “The End Of Roe.” Head here to read more.

So often when we hear about a person’s abortion experience, the follow-up question starts with why: “Why did you get your abortion?”

While it’s sometimes well-meaning, the question itself can quickly become problematic. Are some reasons for getting an abortion better than others? If so, how are those reasons weaponized to legitimize one person’s abortion over another person’s?

Say a teenage girl was raped and became pregnant. Is her decision to have an abortion more justified than a mother of two who simply can’t afford a third child? Is that mother’s reasoning better than, say, a person who became pregnant despite being on birth control and simply doesn’t want children? Is not wanting children a good enough reason to get an abortion?

Many lawmakers and advocates who back abortion rights point to the wave of no-exception abortion bans as an example of just how cruel these restrictions are. Last fall, Rep. Nancy Pelosi (D-Calif.) criticized Texas’ six-week abortion ban, writing that its “purpose is to destroy Roe v. Wade” and it “even refuses to make exceptions for cases of rape and incest.” And just last month, Sen. Chuck Schumer (D-N.Y.) shamed “MAGA Republicans” who are pushing a “national abortion ban with no exceptions for rape or incest.” To be sure, these lawmakers want to protect abortion access for everyone, but even the ways their arguments are sometimes framed can encourage focusing on only the most extreme cases in abortion care.

The justification of abortion care is a slippery slope, but it’s deeply ingrained in how we, as a society, discuss abortion ― both as health care and a hot-button political issue. It can be seen in discussions between talking heads on TV, arguments between lawmakers on the floors of state legislatures and around dinner tables across the country.

“The justification of abortion care is a slippery slope, but it’s deeply engrained in how we, as a society, discuss abortion.”

But researchers at Advancing New Standards in Reproductive Health, a leading research group at the University of California, San Francisco, argue that the reasoning behind an individual’s choice to get an abortion should be insignificant.

“We question this question: Why do we need to know why people choose abortion?” Dr. Katrina Kimport, an associate professor at ANSIRH, and Dr. Monica McLemore, a clinician-scientist at ANSIRH, wrote in a research paper published earlier this year on the topic of justifying abortions.

This focus on justifying abortion is “misplaced,” Kimport told HuffPost. “Really, I think the answer to that question is that it may be a health service or a clinical need, but it’s not actually a broader need,” she said. “Instead, there’s real value to trying to center pregnant people and insist on their autonomy to make decisions that are best for them.”

HuffPost spoke with Kimport about her and McLemore’s research, their argument against justifying abortion care, and how this ideology could be further weaponized if Roe v. Wade, the 1973 Supreme Court decision protecting abortion care, falls this month.

In your paper, you and Dr. McLemore argue against the “justification for the presence of abortion in a society” or, essentially, that there must be a good reason for abortion care to exist. Can you give me some examples of how this plays out in public discourse ― how people maybe knowingly or unknowingly try to justify certain abortions versus others?

This pattern of justifying abortions is something we’ve seen across the research literature but also in a lot of public discourse.

There are a lot of ways that happens and it happens across the spectrum of people’s support for or opposition to abortion. For example, most public opinion polls around abortion ask questions like, “Do you think abortion should be legal in some, all or no cases?” Even that phrasing invites the person who’s taking the poll to be in a position to make a judgment, to make a decision. And these questions are being asked when abortion is legal.

The way society encourages conversation around abortion invites people to make judgments. They’re not thinking about themselves, they’re thinking about what they would be talking about in an abstract case. The basic framework of those polls often informs how media and politicians talk about abortion. That’s the initial entry point into a lot of these discussions. And it is built on an idea that this is the legitimate question and we are all legitimate answerers of that question for other people.

Why is it problematic when people attempt to justify abortion care?

Dr. McLemore and I have three primary concerns that we laid out in our research paper. The first is that when there’s an effort to justify abortion and abortion decisions. It then presumes that justification is necessary and that it’s able to be rendered. And that it can be rendered by a third party who’s not actually involved in the pregnancy. So, as soon as you start talking about how to justify something, you’ve already implied that it is a responsible and reasonable thing to do. And we question that ― whether or not justification of abortion is necessary and even possible ― especially by somebody who’s not directly involved in the pregnancy.

The second critique that we had was this question of, where are the pregnant people? So many of these conversations take a population-level approach to justification of abortion that then misses out on the actual needs and wants of pregnant people in their decision-making and in their lives. And that’s a second concern we have about these large-scale ideas of justification, the sort of erasure of the actual person that’s at the center of this.

And the third critique Dr. McLemore and I have relates to this idea that not everyone’s reproduction is encouraged and rewarded, and some populations are actively discouraged from reproducing. When the idea that certain circumstances make abortion justifiable, what happens then to people in those circumstances who want to continue the pregnancy? Their decision-making becomes suspect.

So, essentially, if we are trying to justify or legitimize a person’s decision to have an abortion then it also creates this slippery slope where we need to justify a person’s decision to continue a pregnancy. Did I get that right?

Yeah, but I’d offer a little nuance to that. For example, some people say, “Well, here’s somebody who is already parenting three children and is financially struggling. Those are good reasons for that person to have an abortion.” But what happens when there is somebody who is parenting three children and financially struggling who desires to continue a pregnancy?

To offer another example, one of the reasons for abortion that the general public is consistently comfortable with are situations where there is a serious health issue with the fetus. What happens then for people who have a similar diagnosis or observed fetal health issue who desire to continue the pregnancy? And maybe they don’t have the resources for all of the necessary medical needs.

You end up in situations where, again, the pregnant person is removed from the situation. And so just as somebody’s circumstances may justify abortion, for somebody in similar circumstances who wants to continue the pregnancy that eliminates their pathway.

“Our social ideas of whose abortion is legitimate owes both to the circumstances of the abortion and also the person themselves. Certain people are considered more legitimate and more deserving of care, and that absolutely overlaps with a lot of the existing patterns of racism and classism and sexism.”

- Dr. Katrina Kimport

I reported out a piece in April about how so many of these newer abortion restrictions have very little or no exceptions included in the legislation. One thing I came across while reporting is this argument in “pro-choice circles” that focusing on the lack of exceptions in these bills actually furthers the idea that there are good or bad abortions ― or abortions that are maybe more justified than others.

What do you make of that argument?

I understand some of the desire to carve out particular instances that people think there might be greater sympathy for when it comes to abortion care.

One of the things that happens, though, is it suggests that somebody on the outside can determine what should be legitimate and what should not. And once you have that logic ― that it’s appropriate for the government to intervene in these decisions ― it’s really hard to get to a point where that pregnant person’s desires are centered.

Can you talk to me a bit about how this dialogue surrounding the justification of abortion intersects with certain people or communities more than others?

There are definitely ways in which differential access to health care is mapped onto class, geography and race. Especially because of the United States’ history of a racial wealth gap, which speaks to red-lining and the ongoing legacy of slavery and racism, that tends to overlap very closely with class and geography.

Our social ideas of whose abortion is legitimate owes both to the circumstances of the abortion and also the person themselves. Certain people are considered more legitimate and more deserving of care, and that absolutely overlaps with a lot of the existing patterns of racism and classism and sexism.

Indeed, all of these things are tied into this idea that’s forming in the literature right now around an abortion imaginary: Who is it that people see when they’re trying to imagine a justified abortion?

Given the Supreme Court draft leak, it seems likely that the court will overturn Roe in just a few weeks. What are you most worried about right now? As an expert in this field but also within the context of a culture where certain people’s abortions and health care needs are already legitimized or justified over others?

I am worried that the production of scrutiny of some people and some bodies will be renewed and further entrenched. With the continued role of justification for abortion ― and with what we anticipate to be a patchwork of access to abortion ― what all of this invites is more suspicion, skepticism and scrutiny of pregnant people.

Weeks away from the Supreme Court’s decision on Roe, what do you hope lawmakers, researchers and others in positions of power will keep in mind when discussing abortion care and how it relates to a patient’s personal decision and choice?

The really simple answer is people are trustworthy and they can be trusted to make decisions that work best for them. This is about real people, and their perspectives, needs and wants should be centered in this conversation.

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