Abortion after 24 weeks is no longer about bodily autonomy

On August 10, the state of Massachusetts passed a law that, in theory, allows abortion throughout the duration of pregnancy.

Governor Healey signed the legislation to the applause of supporters, bringing her state in line with nine others that have no gestational limit on abortion. The move illustrates the downside of the repeal of Roe v. Wade in 2022, a decision celebrated by many in the pro-life movement.

Now that states determine their own abortion laws, some have moved toward what critics see as a troubling principle by which unborn children never truly possesses human rights.

There has been considerable confusion about the new law. Opponents criticise the fact that abortion can now take place throughout pregnancy.

Supporters emphasise that physicians are simply being granted the authority to exercise their own medical judgment when faced with a request for an abortion after 24 weeks. The problem with the latter point is that removing the 24-week limit was not necessary to achieve that goal.

The previous law already specified circumstances under which a medical abortion could be performed after 24 weeks. The new legislation not only removes those criteria, allowing physicians to determine for themselves whether abortion is necessary, but also eliminates the gestational limit altogether.

As a result, the distinction between socioeconomic and medical reasons effectively disappears. It is therefore understandable that many conservative voices in the United States view the change with concern.

Survival Chances

Anyone who reflects on the consequences of removing abortion limits encounters a number of difficult questions. The primary justification for abortion rights is bodily autonomy, often described as a woman’s right to self-determination. In her famous essay from the 1970s, philosopher Judith Jarvis Thomson argued that no one can be forced to use their body to keep another person alive.

Yet, there is something unusual about this perspective. It says nothing about the status of the unborn child, whereas most people base their support for abortion rights on the assumption that a foetus is not yet a child.

This philosophy, which has been highly influential among feminists, does not necessarily claim that embryos and foetuses are not human beings.

Rather, it argues that the question is ultimately irrelevant. Even if the unborn child is a human being, it may be disconnected from the life-sustaining support that the woman provides through her body.

The difficulty with this position is that legal abortion up until birth becomes its logical conclusion. After all, bodily autonomy does not suddenly end at a particular week of pregnancy.

But what if the child could survive outside the womb and no longer strictly depends on the mother to stay alive? What reason remains for ending the child’s life? According to medical consensus, babies born extremely prematurely at 24 weeks have a meaningful chance of survival.

Recent research shows that survival rates at that stage exceed 71 percent. In Western countries, the medical treatment required to support these infants is widely available, making its use a moral obligation in the eyes of those who hold this view.

Moreover, these figures apply to children who are born spontaneously. If labor were induced, the chances of survival might be even greater. After all, the mother can be prepared in advance through the administration of corticosteroids to promote lung development.

A planned premature delivery also allows healthcare providers to create the best possible conditions for both mother and child, without the pressures associated with medical emergencies.

Inducing Labor

This raises the question of why, when a pregnancy is terminated around 24 weeks, abortion is not replaced by induced delivery. Before 24 weeks, restoring bodily autonomy and the death of the child are inseparably linked. After that point, however, the two outcomes can and should be separated.

A woman can regain control over her body by ending the pregnancy through induced labor, while the child still has a realistic chance of surviving. In fact, such an approach appears more consistent with Thomson’s philosophy.

The absence of this discussion in debates surrounding the removal of abortion limits in the United States and elsewhere suggests that even Thomson’s far-reaching argument may be insufficient for the ultimate goals of some activists and politicians.

Although Thomson regarded the question of whether the unborn are children as irrelevant, that is not the same as advocating the death of a child capable of independent survival. Put plainly, once abortion is pursued beyond the point of viability, you are no longer defending bodily autonomy.

To be clear, children are also killed during abortions performed before 24 weeks. Yet even from the perspective of abortion advocates, who prioritise bodily autonomy over the right to life, there is no reason to perform an abortion after 24 weeks.

That is, if we are to believe what the pro-choice movement has traditionally maintained: that the purpose of abortion is not to kill a child, but to end a pregnancy, with the child unfortunately unable to survive as a consequence.

This article was originally published in Dutch. Chris Develing is a policy advisor at the pro-life organisation, NPV- Zorg voor het leven based in the Netherlands.