Texas – Let’s Mind Our Own Business

We are living in some interesting times. As a woman, a mother and a physician who has dedicated my life to serving the health and wellbeing of women, my mind has been reeling since last Wednesday’s ruling in my very own state of Texas, banning abortion for pregnancies over six weeks from the last menstrual period (or four weeks from conception), with almost no exceptions. I’ve sat with this news for a few days, examining my own feelings and trying to understand what’s really going on here and why this is so important. Because it is important. And it is a symptom of a disturbing trend in our country greater than a woman’s right to make her own reproductive choices. 

Most of us recognize that we are fortunate to live in a country where we can each have our own opinions, and that the right to safe disagreement and debate are part of the very fabric of our constitution. I have opinions about lots of things. My opinions are not facts. No one gets upset or argues about facts. We don’t argue about the existence of gravity or get upset about two plus two equaling four. We get upset about our opinions when others disagree with them, and we force each other further and further into our respective corners defending what are in their essence arguable ideas. More and more, we have become polarized, fed by targeted news and social media that appeals to, and feeds our points of view. And by leaders who no longer can have intelligent debates and be open to listening to, and learning from the other side. We are so sure that we are right, and that the “other” is wrong. We seem to have lost our ability to be open-minded and consider all sides.

I have a pretty strong opinion about this new law, and I have a right to that opinion. If you disagree with me, then you have a right to that opinion, too. I have no interest in fighting, arguing, name-calling, bullying or any other divisive behavior. However, I do have an interest in understanding each other, respectfully disagreeing and allowing people to make up their own minds and act in accordance with what they believe is best for them. We need to mind our own business. I have a right to live my life as I choose, and so do you. Of course, I don’t have a right to harm others with my choices, and my freedom doesn’t extend to infringing on your freedom. Your freedom to smoke cigarettes doesn’t allow you to affect my right to breathe clean air, so you can smoke in designated areas. I have a legal right to drink alcohol but not to put your life at risk by driving a car when intoxicated. I have a right to have sex with or marry whomever I choose regardless of gender, but I don’t have a right to have sex with you and not tell you if I carry herpes. These are ideas that most of us accept and understand. Generally, we leave each other alone and mind our own business regarding personal life choices, despite our own opinions or preferences. I feel strongly that people shouldn’t smoke, and as a physician I will inform smokers of the risks and ultimately let them make their own decisions. Making smoking or homosexuality illegal would generally be regarded as government overstepping its role in making laws that are designed to keep society safe and orderly, rather than imposing personal opinions on the population. 

Whether or not a woman or child should be able to choose to have an abortion is something that you probably have an opinion about. I have one too. The subject is so far removed from the scope of “facts” that people on all sides get incredibly upset. Abortion rights probably top the list of long-standing heated controversies in our country and others. People are often pushed to using hateful, violent language, and even to physically harm and kill each other defending their opinions about abortion. And we don’t get upset about facts. We get upset about opinions. Here is another one of my opinions. Government has no business making laws that criminalize behaviors which are personal choices, especially when those laws are driven largely by religious beliefs that are not shared by the majority of people. A foundational part of our country’s constitution was the separation of church and state, which as we know, prevented the dominant church from making laws that restricted the rights of those who had dissenting beliefs and opinions, and allowed each of us to be free to follow and freely practice our own spiritual beliefs, based on our own conscience. A subset of American people holds religious beliefs that make abortion seem like murder to them, and I am respectful of that opinion. I spent many years in a Catholic family, and I am intimately familiar with this point of view. Someone with this opinion would not choose to have an abortion, and that makes perfect sense. If you are Catholic, or an Evangelical Christian, or otherwise think abortion is murder, I respect your opinion, and I would ask you to respect mine. But by no means should your opinion (or mine) be made into a law. It’s an opinion. And we live in a country that respects the freedom of each person to make their own choices. So why is this different?

The crux of the matter seems to be disagreement about when a human has rights, and when it doesn’t. If my right to do what I want is limited to not preventing you from doing what you want, then of course I can’t kill you. That makes sense. But the debate about when a fetus becomes a human with the same rights as a human living outside the womb will likely never end. There is no clear answer. So again, we are back in the realm of opinion. Last week’s Texas law arbitrarily decided that once cardiac activity can be seen on ultrasound, the fetus has the same right to live as a fully-developed human. Prior to that, the fetus or embryo doesn’t have those rights. Hmm, ok, so that’s one way to look at it, which is unarguably arbitrary. Another way to look at it, is that prior to 23-weeks (in medical terms, amounting to 21-weeks from conception), a fetus is completely dependent on its mother for life and cannot survive alone. Prior to 23-weeks the fetus is essentially a part of its mother, and as such has rights that are under the umbrella of its mother’s rights. Under that opinion, a fetus that is “pre-viable” essentially belongs to its mother, giving the mother the right to choose how to manage its existence. I think most people agree that once a fetus can survive on its own in the outside world, it has its own independent rights. I can understand all these arguments and recognize that they are opinions, and recognize that its quite unlikely that this quandary will ever be solved. So, I choose to get out of other people’s business and let them make their own decisions. That seems to be the “American” thing to do and is certainly supported by our constitution. 

Whichever way I slice it, this law seems to be giving greater rights to a six-week fetus with no consciousness than to its mother, who is a conscious, living human being already here on this earth. Sometimes we must choose the greater good. Sometimes choices are hard. Not everyone can win. And this law seems to be dismissing the rights of living human females in favor of fetuses who have no understanding of their own existence. This is not easy. Being opposed to this law does not mean that I am pro-abortion. I am not “for murder” as one of my critics posted today on Instagram. Abortion is horrible. It’s perhaps the hardest decision that an affected woman ever makes in her life. I’ve been a gynecologist for 22-years, and I have never met a girl or woman considering abortion who wasn’t devastated by the difficulty of the decision. It’s a horrible decision to make, but ultimately weighed to be better than the alternative for those who choose it. It’s easy to make blanket statements about what people “should” do when you have never been in their shoes. I have met countless women over the years who were staunchly anti-abortion but felt differently once they or their daughter/relative had an unwanted pregnancy. If it happens to you, suddenly it gets very, very real. 

Here are some of the things that really scare me about this current law. (They should scare all of us, in my opinion.) Of course, this law was designed to make abortion practically impossible, since one would have less than two-weeks to find out that she is pregnant, carefully consider what to do, then find a way to make it happen. That’s an almost insurmountable timeline. People who would be able to jump over all those hurdles would be much more likely to be well-educated, have significant financial resources, and either be over 18 or have parental support. As often happens, much more of the burden falls on less-educated, poor minorities. Family members of privileged people like me, Mitch McConnell and Governor Abbot, could hop on a plane to California and have a safe abortion in a clean comfortable facility with a highly skilled doctor, if that is what they chose. Those with the least ability to take care of an unwanted child would be the most likely to be forced to have the child, or to seek an illegal abortion. 

Which brings me to my second fear. Making abortion illegal will not stop people getting abortions. We know this from our past. Abortions will be pushed underground, to more and more unsafe settings, the price will go up, truly criminal elements will take advantage of the situation, and mothers will get sick and die. Unregulated abortions will lead to life threatening infections, uterine perforations with bowel injures, scarring and infertility, and death. And these horrible outcomes will fall on those least able to get help. And let’s talk about some of the largest groups of people who seek abortion: girls who are not yet adults, and do not have the mental capacity to understand the ramifications of sex and pregnancy (we don’t let teenagers under age 18 make life-changing decisions about anything because we know their brains are not fully formed yet); and girls and women who did not consent to sex. This is not a matter of “teaching girls to think twice before they open their legs” as another one of my critics posted on Instagram today. All too often she didn’t open her legs. Her legs were forced open. Or she didn’t have the capacity to consent because she was a child, was uneducated about sex and pregnancy, and/or didn’t have the resources to get birth control. 

I am not sure if I can count my fears about this law, but here’s another one. This is just one law. And it is indicative to me that this country is heading in a scary direction. It has nothing to do with democracy, as most Texans are not in favor of it, nor were we asked. It was pushed though using political loopholes and clever manipulative behavior to serve the interests of a powerful minority. These things happen in other countries, not ours (so I thought). We spent over 2 trillion dollars (that’s 2 million million dollars) in Afghanistan over the past 20-years, and countless lives were lost or irrevocably damaged fighting against a regime that seems to laugh at democracy, treats women as second-class citizens and engages in horrendous human rights abuses. Yet on our own soil, we are stripping away the rights of women and at the same time allowing greater and almost unlimited access to guns that kill or injure over 100,000 people every year. Shouldn’t we be worrying more about that, than what an individual girl or woman decides to do with her own reproductive life? 

 I’m scared. Sometimes I think our country has gone crazy. And paying people $10,000 to turn each other in? That sounds like the plot from a scary futuristic movie about a place where I don’t want to live. How is this helping make a better world? At the same time, we have the right to choose not to get vaccinated against COVID-19, and Texas now has all its ICU beds filled with unvaccinated people who are terribly sick and dying as a result of their choice and are taking beds (and lives) from those who have other critical illnesses and injuries. How can we pass a law preventing abortion to protect the rights of a 6-week pre-conscious fetus, when we support freedoms in so many other ways that outwardly lead to countless deaths of people who are alive and breathing right now? Sometimes I think we just have to stop and look at how inconsistent this all is. We need to rethink things. 

Here’s a fact: At the time of puberty a woman has about 300,000 eggs in her ovaries, and only several hundred will be released during her lifetime (generally one every month from an average of ages 12 through 50, with breaks during pregnancy and when on birth control). Each one of these is part of a potential human, when combined with just one of the 200 million sperm that are present in the average ejaculate. More than 50% of pregnancies (fertilized eggs) die in the first week after conception, before pregnancy is even recognized. Eggs and sperm, as well as lots of tiny embryos, come and go every day without us even batting an eye. This is nature. We regularly “interfere” with nature’s processes by using natural family planning (avoiding sex when we are fertile), using withdrawal, preventing egg release with birth control pills, or creating barriers to conception with condoms, IUD’s, tubal ligation or vasectomy. No matter what your opinion is about birth control, all of us use our intelligence to manipulate the process to some extent. Now for my opinion. The idea that egg fertilization and the resulting embryo is somehow preordained seems to me to be magical thinking and completely ignores science. Egg fertilization is the absolute epitome of randomness. Being born as a unique human is an incredibly random event in the course of a reproductive life. And the world arguably has too many people already. Overpopulation is right up there with climate change on the list of current planetary emergencies. Which makes me think that we should really focus on carefully choosing the children that we want out of the billions of potential possible ones that we could have, and not be forced by law to have ones that we don’t want. 

Here’s the bottom line for me. Why do we care so much about what other people are doing, when it doesn’t affect us? Perhaps we could spend more time examining our own lives and ways in which we could become more kind, compassionate, open-minded and loving, less time being “right” about things that are simply our opinions and stop trying to force our opinions on others. If you don’t want to get an abortion, you absolutely should not do so. You have freedom to do what your conscience supports, so long as it doesn’t infringe on my freedom. That’s American. We hold ourselves up as the leaders of the free world, and right now I feel embarrassed. We simply must do better. The world is watching us, not to mention that we must look at ourselves in the mirror.  How about this? Mind your own business and be kind. That’s a platform I can stand behind.