Indirect Abortion: Terminating the Myth

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The following essay was written by Maureen Francois. It received a grade of A- or higher from Benedictine College. We encourage readers to submit essays to us on our Contact Us page. We hope you enjoy!

We have all heard the argument that abortion saves lives.  Politicians continuously insist that we need a mainstream abortion provider so that women will not die from pregnancy complications.  Women around the world are being rallied to advocate for the normalization of abortion on the sheer basis that their lives could be dependent on it.  But does abortion really save lives?  Are mainstream abortion providers actually necessary for saving women?

Direct abortion, defined by Pier Giorgio Austriaco as “the deliberate and direct killing… of a human being in the initial phase of his or her existence, extending from conception to birth”(Austriaco, Bioethics and Beatitude, page 47), does not save lives.  Abortion clinics only perform direct abortions.  If a pregnant woman comes to such a clinic with a life-threatening condition, she will be referred to her local hospital, as abortion facilities are not equipped to treat pregnancy complications.  The Catholic Church’s teaching on direct abortion has remained consistent.  The Vatican’s statement in 2008 reminded us that “the dignity of a person must be recognized in every human being from conception to natural death”, and that “the human embryo has therefore, the dignity proper to a person.”(Dignitas Personae, verses 1-5)  But what if the life of a pregnant woman is in danger?  In cases of life-threatening pregnancy complications, a process known as indirect abortion becomes necessary.  Austriaco defines indirect abortion as “the foreseen but unintended loss of the baby as a result of a medical procedure necessary for the preservation of the life of his mother.”(Austriaco, 62)  A treatment or procedure that saves a mother’s life but unintentionally results in the end of a baby’s life is considered an indirect abortion.  The loss of the baby’s life in this case would be considered a natural death, since no act ordered toward the destruction of his life has taken place.

Concerning the ethics of indirect abortion, the Ethical and Religious Directives for Catholic Healthcare Services has outlined the Church’s teaching, that “Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”(verse 47)  When an expectant mother, before the gestational stage of viability, has a life-threatening condition that must be treated immediately, she can receive the treatment necessary to save her life, even if her baby will die as a result.  This situation, although tragic, is ethical.  The sadness and horror of losing a child because of a complication in the mother’s health draws attention to the fact that every abortion, direct or indirect, is still the loss of a baby.  Indirect abortions happen most commonly in cases of tubal ectopic pregnancies, but other examples include uterine and cervical cancer, partial and complete placental abruption, chorioamnionitis, and other various pregnancy complications.  A patient going through this should be treated with the utmost care and sensitivity, and their natural inclinations must be duly considered.

Medicine must always be ordered towards helping a patient fulfill their natural inclinations and achieve their human ends.  According to human nature, a mother and father have a natural inclination to procreate in a stable environment and to raise and protect their children.  If a couple who already has children is expecting another one, their natural inclinations will be to protect their preborn child, as well as to provide and care for their children who have already been born.  When a mother is not healthy, she will have natural inclinations to protect her health and preserve her life, for the sake of herself and her family.  These are all inclinations that God has given the human person, for the good of themselves, their family, and society.

In the event that a preborn child is not able to survive until birth or outside the womb, then the parents’ inclinations to care for and raise this child cannot be met.  This is the hardest human inclination to be left unmet.  What can still be met, though, is the mother’s natural inclinations to live and be healthy, and to raise the rest of her children.  While respecting and consoling her in her grief, the ability to live and care for her family is something her doctor should support and help her to achieve.  To put the natural inclinations of a parent into context, a few examples must be considered.

A woman named Ashley is 26 weeks pregnant, and begins spotting.  She goes to the ER, and undergoes a series of screening tests.  When the test results come back, Ashley learns that she has a rare and aggressive case of cervical cancer.  Her doctor recommends an immediate radical hysterectomy, followed by chemotherapy and radiation therapy.  Since the pregnancy is 26 weeks along, they have the option of delivering the baby through Cesarean Section, then performing a radical hysterectomy in the same procedure.  This will be a long and complicated operation, and Ashley’s family history leaves her at a moderate risk of hemorrhage and infection.  But since Ashley is Catholic and Pro-Life, and has already bonded deeply with her pre-born child, she is willing to take any risk for him.

She consults a bioethicist who knows her family history.  After considering all her options, they conclude that since her life can be saved while sparing the baby’s, a procedure that would result in her baby’s death would not be morally or ethically permissible.  She undergoes the procedure, and the baby is delivered.  After 3 weeks spent in the Neonatal Intensive Care Unit, her son Anthony is able to go home.  Ashley begins chemotherapy and radiation therapy straight away.  As long as she is being treated with radiation, she cannot hold her baby or see him, except through a window.  The radiation is a danger to his health, and she must protect him in this regard.  But after 5 months of treatment, she is in remission, and able to go home to her husband and son.  She is now free to be a healthy wife and mother and to be present in her husband and child’s life.

A more recent case example of indirect abortion would be the story of Chrissy Tiegan and the loss of her son, Jack.  Chrissy is an American model, married to singer and songwriter John Legend and mother to Luna and Miles Stephens.  She has politically identified as Pro-Choice throughout most of her career, but recently she suffered the tragic loss of a baby through an indirect abortion and shared her experience with the grief and pain, as well as the bond she had with her preborn child.  She was in the second trimester of her pregnancy with her third baby when she began bleeding.  She was diagnosed with a partial placental abruption and put on bedrest.  Placental abruption can cause several birth defects, and in severe cases, infant and maternal death.  Chrissy’s doctors gave her multiple blood transfusions, monitored her, and tried to keep her stable long enough to deliver the baby safely.  They had a goal of continuing the pregnancy until 28 weeks, so that the baby could be born at a healthy age.  But at 20 weeks, this became no longer possible.  Chrissy’s bleeding greatly increased over one night, and her amniotic fluid ran dangerously low.  She said that she could even feel her child’s arms and legs with her hand from the outside of her belly.  At this point, she and her husband went back to the hospital.  The blood transfusions that had been given to her were of no avail, and she could only continue living in this condition for a few more days.

If she tried to wait eight more weeks, then she would die and her son would consequently die, too.  If the doctors induced an early labor and delivery, Baby Jack would not be able to survive outside the womb for more than a few hours, but Chrissy’s life would be saved.  Her natural inclination to care for and raise her son could no longer be met, but her natural inclinations to live and be healthy, as well as to care for her other two children, still could.  With this in mind, she chose to be induced into labor, and deliver her son at 20 weeks.  Jack was born and lived for about an hour, being held, loved, and cared for, before passing away in his mother’s arms.  All of his perfections and imperfections were loved whole-heartedly.  Jack’s dignity was upheld from conception until natural death, as he was not directly killed; everything possible was done for him.  Chrissy’s public reflection made it very clear that she and her doctor did not intend for him to die, and that she loved him just as much as her other son and daughter.  While ethically sound and medically necessary, this decision to induce labor prematurely was extremely heartbreaking for Chrissy and her family.  Jack was their son, whether born or preborn.  From the moment they knew of his existence, they gave their all to him, loving his every curve and edge.  The joyful sorrow of saying goodbye to a precious baby they loved into existence brings to light that to love is to suffer for the sake of the beloved.  Their loss was not through their own choice, but through medical necessity beyond their control.  They did the best that they could in a complex and tragic situation. 

Many from the Pro-Life community have called out the irony of a Pro-Choice woman mourning the loss of her own child while endorsing the deaths of others.  They said that she would only grieve pregnancy loss if the pregnancy was “wanted” or “planned”.  But the baseline of the situation is that while Chrissy does not ideologically understand what is wrong with direct abortion, her natural inclinations as a mother are to protect a child.  Without being consciously aware of what she is doing, she is longing to protect a weak and vulnerable life.  She does not yet see why she should speak publicly against abortion, but deep in her heart, she is Pro-Life.  Her motherly instincts respect pre-born life, even before “science” declares it “viable”.  In this sense, every woman can be considered Pro-Life.  Even if she has not logically thought through the issues of abortion and the beginning of life, if she is pregnant, she will have the natural instincts to be a mother.  That is what is going on in the beautiful mind of a woman, whether she identifies as Pro-Life or not.

Both direct and indirect abortion are tragic.  The culture of death champions direct abortion and silences the pain from indirect abortion.  This must end.  The human person, from the very beginning, is indispensable, indisposable, and unrepeatable.  No matter how little he or she is known, they are worthy of love and protection.  A person you love is worth risking every loss and rejection for.  To truly love a person is to suffer for them, and to desire them to exist, no matter how much pain and suffering it causes you.  Chrissy Tiegen and John Legend are modeling this love, along with so many grieving parents throughout the world, and planting seeds for a new culture of life.  Every child to exist, whether birthed, miscarried, or directly or indirectly aborted, has left his or her tiny footprints on the hearts of his mother, father, and all those who knew them.  When they are lost, their parents will never be the same.  But they were still worth loving into existence, for however long they would be here.  The good that was lost leaves a beauty in the world that can never be replaced.

Based on the scenarios of Ashley and Chrissy, one can clearly see that while indirect abortion can save the lives of mothers, it is still tragic, and can only be morally and ethically licit when necessary for the preservation of the life of the mother.  Within these cases, no direct attack on the baby’s life is allowable.  Rather, lifesaving procedures which may cause the loss of the baby can be done if and only if they cannot be delayed until after a safe delivery.  It is not the loss of the baby’s life that saves a life, but rather the hysterectomy, salpingectomy, or early delivery that saves the mother.  No one who knows a woman in such a situation would say that she is having an abortion.  When a woman has lost a child through indirect abortion, she is grieving the ultimate pain that a parent can experience, and the single most stressful life event.  The most traumatic way to lose a child is through a medical emergency that endangers the lives of both the mother and child when nothing can be done to save the child.  This is not a situation to abuse for a political agenda or to justify direct abortion.  Even if abortion is made illegal, and every abortion facility in the country is shut down, women like Ashley and Chrissy would still have access to the medical care they need, through their local pregnancy care providers.  Had they gone to Planned Parenthood, they would have simply been referred straight back to their hospitals for treatment.  We must support women in finding the best and most ethical care when faced with life-threatening pregnancy complications, and stand with them through their grieving and healing.  The pain of indirect abortion will guide us to the realization of the injustice of direct abortion, and the tragic loss of children through medically necessary procedures should further motivate us to end the loss of life through unnecessary means.

Works Cited

  1. Ashley, Benedict M., and Kevin D. O’Rourke. Health Care Ethics: a Theological Analysis. Georgetown University Press, 1997.
  2. Austriaco, Nicanor Pier Giorgio. Biomedicine and Beatitude: an Introduction to Catholic Bioethics. Catholic U. of America Press, 2012.
  3. “Ethical and Religious Directives for Catholic Healthcare Ethics.” United States Conference of Catholic Bishops, June 2018,
  4. Ladaria, Luis F. “Instruction Dignitas Personae on Certain Bioethical Questions, Congregation for the Doctrine of the Faith.” Vatican, 2008,

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