Mitigating Abortion in a Fallen World – #onebabyatatime

Down the street from where I practice in Scarborough, a suburb of Toronto, is Rosalie Hall. Rosalie Hall began in 1914 when the Misericordia Sisters opened St. Mary’s Infant Home on Bond Street for maternity and infant care of single women and their children. This later moved to Jarvis Street, where they also began St. Mary’s Hospital. In 1956, both the hospital and the home were moved to Scarborough and opened as the Scarborough General Hospital and Rosalie Hall.

Over the years, I have often watched young women stroll their babies on the sidewalk adjoining Rosalie Hall and Scarborough General Hospital. I have even had the privilege of sometimes treating these young women who chose the services of Rosalie Hall over abortion. Rosalie Hall offers its services, without discrimination, to women ages 12 – 25 who are single and pregnant. The program provides housing, an early learning childcare centre, accredited secondary school education for the single mothers, access to medical care, counseling, parenting support, mental health support and so on. It is a comprehensive model of care for single, pregnant women and mothers, which deserves to be studied, copied, and funded for broader application.

Many single women who face an unplanned pregnancy end up aborting because they feel judged, shamed, condemned, alone, or bereft of family or community supports. We may consider ourselves more tolerant or more forgiving than our biblical predecessors who stoned women caught in the sin of fornication or adultery, but we really are no different now when we toss our words, actions, or judgement towards them as “stones.” Our modern-day stones may not actually kill pregnant mothers, but they can cause them significant emotional and spiritual harm, which can lead to a decision favouring abortion.

Even if a young woman can find the strength to overcome the fear, shame, or guilt of an unplanned pregnancy, and even if she has moral support, she can still find herself confused, lost and overwhelmed by what lies ahead. How is becoming a mother going to impact her education? Where will she live and how will she afford housing and everything her child will need? How will she afford or access day care so she can attend school or work? Suddenly, she not only has her own needs, expenses, and personal development to worry about, but that of her unborn child as well. When a single, pregnant woman searches the internet to find supports and tries to understand and co-ordinate these as separate entities, the task can be overwhelming – unless one can find a comprehensive centre like Rosalie Hall. Otherwise, it becomes a lot easier to just get an abortion, which is exactly what happens in too many cases of unplanned pregnancy in single women.

According to Statistics Canada between, 1974 and 2005 the proportion of live births to induced abortions steadily dropped from 6.6:1 to 3.5:1 in women of all ages; and from 2.5:1 to 1:1.2 in women under 20 years of age. There are no statistics shown past 2005, but assuming these trends have continued, induced abortions have further surpassed live births in the under 20 age group between 2005 and the present. Global News reported that in 2005, a total of 96,815 abortions were performed in Canadian women, while 1.2 million were performed in American women. Not surprisingly, another Statistics Canada report indicates that the abortion rate is 2 to 3 times higher in single Canadian women compared to married Canadian women. The number of currently operating abortion clinics, which far outnumber pregnancy support centres like Rosalie Hall, also attests to this.

I often wonder what would happen to the abortion rate, and the adoption rate for that matter, if we had more centres like Rosalie Hall, where a welcoming community supports single mothers by providing the funding, planning, co-ordination, and provision of all required services under one roof, enabling these women to upgrade, to continue their education, or to work, while raising their children. As in the past, when many single women left their communities to hide their pregnancy due to stigma, a place like Rosalie Hall can also provide a safe, private haven for them until the birth – and even the subsequent adoption if that is what they wish – of their child. As good as this sounds, although more Rosalie Halls would probably lower the abortion rate, they would not eliminate it. Even with every support in place, some women will still choose abortion.

When abortion was illegal in North America, many women sought termination of their pregnancy from amateur back-alley medical facilities or from toxic folk remedies. This resulted in the death of approximately 4,000 to 6,000 women in Canada, between 1921 and 1946. When Nicolae Ceausescu outlawed access to abortion and contraception in 1966, women found ways around the ban, resulting in 10,000 maternal deaths as a result of unsafe procedures and hundreds of thousands of children being turned over to wither away in state orphanages. Clearly, force does not work, nor is it necessarily a traditional Christian approach. St. Basil’s approach in the 4th century AD acknowledged this problem among Christian women, by providing a period of penance and repentance while recognizing abortion as an attack upon oneself and an equivalent to murder.

Although the annual abortion rates in most countries far surpass the maternal casualties from abortion, the double tragedy of losing both mother and child has been significantly mitigated by legalizing abortion clinics – the only secular justification for their existence – much like the provision of a “safe supply” of illicit drugs to drug addicts to prevent their death from accidental overdosing. The rationale here is that if the medical profession does not provide a non-judgmental and safe way of doing something unsafe, wrong, immoral, or illegal, people will still find a way to get or do what they want regardless, and in a more dangerous way. The same rationale is behind the provision of free needles or free condoms in community clinics.

These provisions neither encourage nor dissuade people from engaging in unsafe, immoral, or illegal behaviour, but they do make the behaviour safer, which is why I strongly encourage contraception to my single, sexually active patients and to my married patients who do not wish to bear more children – because not having contraception does not alter sexual behaviour and the end result, whether married or single, will often be – an abortion.

Choice is what everything boils down to. As an Orthodox Christian, I believe in our fundamental God-given Freedom, but freedom without boundaries leads to the slavery of sin, which is why God gave us rules, so that we could safely (spiritually and physically) navigate our freedom. It is our choice whether to navigate our freedom according to God’s rules, or our own standard. My responsibility as a physician, is not to interfere with my patient’s choice, but to properly inform that choice. All too often, however, people think they are properly informed when they are not.

For instance, because abortion is legal and easily accessible, too many of my single, sexually active women think they can use abortion as a form of contraception. These women think that if they are sexually careless, abortion becomes an easy choice; but it is not an informed choice. Many years ago, a single, pregnant woman in my practice panicked. Instead of waiting to arrange an abortion at a nearby hospital, she rushed to an abortion clinic, where she underwent the procedure under physical restraint and without an anesthetic. Thankfully, she survived the gruesome ordeal, and was able to achieve a planned pregnancy afterwards. She had not asked about this clinic because she assumed she would receive the same treatment there as at the hospital.

People need to know that even when done in a controlled, medical environment such as an accredited hospital, abortion carries similar risks for complications as does any other surgical procedure, the commonest of which are bleeding and infection (which can lead to infertility). There are also mental health risks from feelings of guilt, shame, or regret after the procedure, which can be long lasting. The physical and mental health risks from using appropriate contraception are lower by far. It goes without saying that the best form of contraception which carries no risks (for pregnancy, sexually transmitted diseases, and painful regrets) is abstinence, the rule God has lovingly given us to protect us.

However, my ability as a family doctor to counteract the overwhelming influence of peer pressure, the entertainment industry and the unconstrained permissiveness of the sexual revolution is very limited. One strategy I use, is to inform my young patients before they become sexually active with words like, “Contrary to what your friends or the media might tell you, there is no such thing as starting sex too late in life, but there is such a thing as starting too early. Whenever you think you are ready to start, please come and talk to me.” My hope is that this advice will at least delay the onset of sexual activity. I hope that it will validate and strengthen those who are inclined to pursue abstinence longer, and at the same time remove any barriers from those who will need contraception, to seeking it sooner. To those sexually active women who do not use or sometimes use contraception, I pose the question, “If you got pregnant would you keep the baby?” If the answer is “no,” “I’m not sure,” or “probably not” she immediately receives counseling on contraception. In my practice, if a male or female, has chosen to be sexually active but has not chosen parenthood or more children, they need to make one more choice – what type of contraception they are going to use, because abortion is not a form of contraception. There is no way of knowing how effective these conversations are in preventing abortion, but this is how I try to mitigate abortion in a fallen world…one baby at a time.

Since we are living in an Era of Apostasy, where secular laws and God’s laws have continuously diverged because of declining numbers of faithful voters, politicians have increasingly made “right wrong” and “wrong right” just to get elected. This does not mean that as Christians we should compromise or remain silent. What it does mean is that there will not be a shift in the legal framework until there is a shift in societal beliefs and behaviours. This shift will only happen when we successfully spread the word of God so that Christian values return to the majority. Considering the extent of our apostasy, this may seem unrealistic, but if we co-operate with God, all things are possible.

A marvelous example of Christian co-operation with God, and in stark contrast to Ceausescu’s forced attempts to increase Romania’s birth rate by simultaneously banning abortion and contraception, is Patriarch Ilia II of the Georgian Orthodox Church. He is credited with single-handedly increasing Georgia’s birth rate by as much as 24% without any public demonstrations or government lobbying. When faced with a declining Georgian population, low birth rates and high abortion rates in 2007, the church leader announced that he would personally baptize and become the godfather to any child born to a married couple who already had 2 or more children. This modern-day saint has been conducting mass baptisms of hundreds of children every three months since 2007, having baptized over 40,000 babies to date. In 2013, the government of Georgia jumped on board by expanding its financial incentives for childbearing with extended paid and unpaid parental leave and baby bonuses.

Fertility changes of this magnitude are uncommon, but Georgia is unique with its relatively homogeneous society and one highly respected religious leader who embraced his people with divine love and wisdom. North America has never seen and never will see that kind of social homogeneity (nor has it yet seen that type of self-sacrificial church leadership) but Christian homogeneity is still possible. In parallel to our Christianizing efforts, our more realistic ‘good works’ can lie in the areas of education, prevention, and the provision of alternative options to the funding of abortion and abortion-based research – like the funding of ethical research and more Rosalie Halls.

So, what does all this mean about my choices as an Orthodox Christian living in this fallen world where so many people misuse their God-given freedom? Where are my choices as a conscientious individual? Where are my choices, period? If others have been given the right to choose an abortion, must I support that right with my tax dollars? Do I also have to fund the use of aborted baby parts or cells in research and the drugs that I prescribe or take when I don’t want to prescribe or take such products? I do not parade Pro-life placards in front of hospitals or clinics that perform abortions because, as I have already made the case, it is not realistic in present-day society to eliminate the ‘demand’ for abortions, or to force Christian ethics upon a population that will revert to back-alley procedures. Even after in-depth counseling on their pregnancy options, someone who is determined to undergo an abortion will find a way of exercising their free will regardless of the legalities or the availability of pregnancy support centers like Rosalie Hall.

While wondering about my choices, I was reminded by a friend that during my adolescence, my parents had to check off on their annual income tax forms, whether they wanted to support the Public School system or the Catholic School system. This choice in our Canadian tax system no longer exists but imagine responding to something like: (i) Please select whether you wish to support abortion clinics or comprehensive pregnancy support centers. (ii) Please select whether you wish to support the use of aborted baby parts/cells in research or alternative cells in research. I cannot think of a simpler, or a more equitable way of giving everyone a voice and the freedom to choose in a society which is so diverse in creed and opinion. I would much rather advocate for this type of change than waste time and resources protesting outside abortion clinics or scrutinizing whether the next political candidate is going to be too liberal with my ethics. Simply put, I want / deserve the freedom to put my money where my mouth is.

As a physician and as a human being, I should be able to approach all women in need with compassion and understanding, while at the same time distancing myself from participating in what I consider to be immoral or unethical. Rather than spending valuable time and resources trying to unsuccessfully eliminate another person’s choice by changing legislation, why don’t Pro-lifers start with the more doable process of changing taxation? If government-subsidized abortion is here to stay in the secular legal framework, can we at least demand that only those who support it contribute to that fund, so that the rest of us can take a step towards disassociating our tax dollars from activities we don’t agree with? Our tax dollars could go towards funding more places like ethical research, like Rosalie Hall, and much needed education and early prevention programs. If we collectively start advocating for more democratic income tax choice, we stand a better chance of mitigating abortion…#onebabyatatime.

Irene Polidoulis MD CCFP FCFP
Assistant Professor, Department of Family & Community Medicine and member of the Orthodox Church in Canada

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