The Ultrasound Mandate and Personal Responsibility

The Idaho legislature (among others) is considering a bill to require women considering an abortion to have an ultrasound procedure.  The resulting political firestorm has lessons for both sides — as well as the debate about governmental mandates for health care.

First of all, I am not in support of this law, even though I understand and sympathize with the motivations.  Advocates believe that if women considering an abortion could see that it isn’t just “fetal tissue,” but a very tiny baby, with a heartbeat, it will motivate at least some women to reconsider.  Ultrasound requirement proponents hope to discourage what they call a second holocaust — the 35 million abortions (or more than 50 millions by some estimates) since Roe v. Wade (1973).  Until the Supreme Court overturns Roe v. Wade, the states can only pass laws that discourage abortion.

Compare mandatory abortion waiting period laws to gun waiting period laws: Proponents in both cases know that they can’t prohibit what they consider evil, but they can make it more difficult.  Opponents deny that there is any evil in the underlying act, and regard these discouragements as outrageous attacks on fundamental rights.

Do these laws work?  Pro-lifers claim that 72% of those committed to an abortion change their minds after the ultrasound, and point to a survey performed in pro-life pregnancy crisis centers. I am skeptical because many women who go to explicitly pro-life centers are committed to abortion.  They probably have serious misgivings about abortion, or they would have gone to Planned Parenthood.  This would be like to taking a survey about vegetarianism at a steakhouse.

Other studies claim that ultrasound requirements make no difference in attitudes towards abortion; 84% of “254 women who viewed sonograms said it did not make the experience more difficult, and none reversed her decision.”  This may be because first trimester embryos don’t really look much like a baby yet, or perhaps because by the time a woman goes into an abortion clinic, she has made her decision.

The parallel to the health-care mandates should be obvious.  As a nation, we are currently arguing whether the national government has the authority to mandate that individuals buy health insurance.  Similarly, can the national government require employers to either directly or indirectly pay for contraception?

Conservative opposition to the national mandates is vigorous and principled, and will be heard by the Supreme Court this term.  Conservative support for the ultrasound mandate can be defended on the grounds that states enjoy much greater constitutional authority than the national government.  To those who do not appreciate or even fully understand the concept of federalism, this looks like rank hypocrisy.

Opponents of the ultrasound requirement, overwhelmingly liberals, are put in a most interesting situation: they argue that an ultrasound mandate invades the private relationship between a woman and her doctor, but hold that the national government may interfere in other aspects of health care.  Liberals attempt to come up with nuanced distinctions between interfering in the patient/abortionist relationship and interfering in the employer/employee relationship.  Again, it looks pretty hypocritical to those who are not paying careful attention to the subtlety of the argument.  I find myself thinking of the punch line of the story Winston Churchill told. “Madam, we’ve already established [what you are].  Now we are haggling about the price.”

What bothers me even more than bad political theater is something more fundamental: why is the need for abortion still so widespread?  In 2007, there were 1.21 million abortions in the U.S.  If there were no cheap and reliable methods of contraception, I could understand the fierce defense of easy and common abortion.  But condoms are readily available, and cheap: less than thirty-five cents a piece from Amazon (with the added bonus of substantially reducing the spread of STDs).  Even if you have no moral qualms about it, abortion is a terribly inefficient method of birth control: first-trimester abortions cost $350 to $550.  That will buy a lot of condoms, won’t it?

Even ignoring the cost differential, women have a lot to lose, even with abortion readily available.  There are significant infection risks, damage to the uterus or cervix, and the anesthesia risks.  Why would you not use condoms, and use abortion instead?  I think I know the answer: many women do not feel that they can tell a sexual partner, “You want sex?  Here’s a condom.”  (I am discounting rape because there were 84,767 rapes in 2010.  About 8% of rapes result in a pregnancy; this would be no more than 0.5% of abortions.)

It also does not say much for men that they are not doing their part.  When I was young, getting a woman pregnant out of wedlock would have been at least embarrassing.  You would have felt obligated to get married; if nothing else, because you were going to be paying child support payments for eighteen years.  (You might as well enjoy the benefits if you were going to be paying the costs.)

In that sense, making abortion readily available is valuable not only to irresponsible women, but also to irresponsible men.  And this may be the saddest part of this whole madness — that we are rewarding the hopelessly irresponsible.  If you think that I am exaggerating the extent of this irresponsibility, let me share with you a couple of quotes from a 2005 Los Angeles Times article about an abortionist in Arkansas.

His first patient of the day, Sarah, 23, says it never occurred to her to use birth control, though she has been sexually active for six years. When she became pregnant this fall, Sarah, who works in real estate, was in the midst of planning her wedding. “I don’t think my dress would have fit with a baby in there,” she says.

The last patient of the day, a 32-year-old college student named Stephanie, has had four abortions in the last 12 years. She keeps forgetting to take her birth control pills. Abortion “is a bummer,” she says, “but no big stress.”

These outrageous statements are part of what moved me from the reluctantly pro-choice to the reluctantly pro-life side.  I can sympathize with a 14 year old who could not figure out how to say no to her horny boyfriend.  I can sympathize with a rape victim.  I can sympathize with someone who had a contraception failure.  I have no sympathy for men and women who refuse to be responsible.

(Thumbnail image on PJM homepage composited from multiple images.)