Is abortion really 'essential health care'?

Hendrik van der Breggen
January 6, 2021
Reproduced with Permission
politics and policy

Some influential politicians (including Joe Biden and Co) claim that abortion is essential health care .

But is it true? Is abortion "essential health care"?

If we're talking about the general practice of abortion in the US and Canada, then the claim that abortion is essential health care is false.

Below I set out three reasons to show it's false. (For reasons two and three I am greatly indebted to insights from Nathan Apodaca, a writer for the Human Defense Initiative and for the Life Training Institute.)

Reason 1: The claim abortion (in general) is "essential health care" is false because most abortions are not done for medical reasons.

The vast majority of abortions are done not for medical reasons but for other reasons.

First, some context. It turns out the hard cases - rape, incest, threat to life of the mother - to which many abortion-choice proponents point as justification for abortion account for fewer than 5 percent of all the abortion cases.

In his 2015 book The Abortion Wars ethicist Charles Camosy reports that the number for the hard cases is 2 percent. (Camosy bases his number on research from the Guttmacher Institute, which is a pro-choice organization.)

But there is more to be said - much more.

Many doctors say abortion is not even needed medically.

Dr Kendra Kolb , a neonatologist, stated this in 2019: "There is no medical reason why the life of the child must be directly and intentionally ended with an abortion procedure."

Yes, treatments for ectopic pregnancies occur, but they're not abortions per se, if we use language accurately. Yes, treatments for heart disease or cancer can involve pre-term deliveries that might result in the death of a child, but they're not abortions per se, if we use language accurately. When we accurately define "abortion" as the direct and intentional ending of a pre-natal human being's life, abortions are not medically necessary.

As Kolb points out, medical treatments/procedures have different purposes, which need to be made clear with language that accurately describes reality. This is important to remember, especially when we are being told by politicians and others that, in general, abortion is "essential health care".

Also in 2019, Omar L. Hamada, M.D. , Fellow of the American College of Obstetricians and Gynecologists, stated this: "There is absolutely no medically justifiable reason for abortion ('the intentional and elective targeted killing of an infant at any stage of pregnancy for matters of maternal choice or convenience') to save the life of the mother. Period. End of story."

Also, Dr C. Everett Koop in 1980 (when he was Surgeon General of the US) stated this: "In my 36 years in pediatric surgery I have never known of one instance where the child had to be aborted to save the mother's life." ( C. Everett Koop, "Deception-on-demand", Moody Monthly, May 1980, p. 27. )

Also, consider that Dr R. J. Hefferman of Tufts University stated this in 1951 : "Anyone who performs a therapeutic abortion (for physical disease) is either ignorant of modern methods of treating the complications of pregnancy, or is unwilling to take time to use them." (Congress of American College of Surgeons, 1951; cited by Dr and Mrs. Willke in Abortion: Questions and Answers [Cincinnati, Ohio: Hays Publishing Company, Inc., 1985], 120.)

And consider this: The Dublin Declaration on Maternal Healthcare (signed by over 1,000 medical professionals) stated this in 2012: "As experienced practitioners and researchers in obstetrics and gynaecology, we affirm that direct abortion - the purposeful destruction of the unborn child - is not medically necessary to save the life of a woman."

So why are there still politicians (and doctors) who say abortion is sometimes a necessary medical procedure? I submit that it's because they are not using language accurately. As Dr Kolb (mentioned above) points out, medical treatments/procedures have different purposes, which need to be made clear. Many politicians (and doctors) are not making this clear.

Summary: (a) Even if abortions are needed to preserve the health of a mother, this small number (less than 5 percent) doesn't justify the abortion practice in general; and (b) according to many doctors (who use language accurately), abortions are not even needed medically nor to save the life of a mother.

Abortion is "essential health care"? In the vast, vast majority of cases this is definitely false.

Reason 2: The claim abortion (in general) is "essential health care" is false because it's logically contradictory.

The claim that abortion is "essential health care" is even more problematic, if we think more logically. (Keep in mind here that we're talking about the abortion practice generally - ie we're not talking about the very few hard cases. And keep in mind that abortion targets and destroys the prenatal human being, which is why an accidental live birth is called a "botched abortion" and why the born-alive baby is called an "abortion survivor".)

Nathan Apodaca astutely observes some problematic logical implications that arise from framing abortion in general as "health care", let alone "essential health care".

Apodaca writes:

When a pregnant woman goes to see her obstetrician for a checkup, is he working with only one patient, or two? Are prenatal checkups an essential part of healthcare? It would seem that, without question, they undoubtedly are.

Then Apodaca adds:

This highlights the contradictory nature of claiming that abortion is healthcare. A doctor who specialises in prenatal medicine is interested in keeping an unborn child alive and healthy through the duration of pregnancy, just like doctors in other specialisations are interested in ensuring their patients remain alive and healthy, even while impacted by a medical condition such as disease, disability, or injury. If healthcare is interested in the health and well-being of a patient, then it's ridiculous to claim that a procedure with the specific intent to end the life of the patient in question is also a form of healthcare.

Summary: That prenatal health care is "essential health care" means health care is constituted by health/life-promoting care for the prenatal child (fetus), whereas the claim that abortion is "essential health care" means health care includes killing the pre-natal child (fetus). But this means that the essence of health care includes both not harming patients and harming patients, or that some patients aren't patients, or that promoting good health includes poisoning patients and/or tearing off their limbs.

This means the claim that abortion is "essential health care" is false. Logically contradictory claims (or claims that imply logical contradictions) cannot be true.

Reason 3: The claim abortion (in general) is "essential health care" is false because it's sexist.

Things get even worse for the claim that abortion is "essential health care".

Apodaca goes on to challenge the underlying/unspoken assumption that seems to lurk behind the scenes in discussions of abortion in general (ie, in the vast majority of cases and not in the few hard cases). What is that assumption? This: "abortion itself is an intrinsic good for women."

Apodaca writes (and I quote Apodaca extensively here because what he points out is hugely important):

Why should anyone believe that abortion is an inherent good in the first place? What disorder, injury, or illness is it supposed to repair or prevent?

Pregnancy is not in itself a disordered state. Provided, complications can and often do arise (and everyone should be sensitive to those who experience complications), but this in no way means that pregnancy is in itself a malfunction in the body's ordered functioning; it means there is a malfunction somewhere else in the system.

The purpose of healthcare is to correct defects within a system that should be functioning normally. In the case of reproduction, true reproductive healthcare, in order to honestly be called healthcare, is concerned with ensuring that the human reproductive process can take place without hindrance.

To use an example, the purpose of eyesight is to see clearly what is in front of a person. If they are unable to see clearly (such as being nearsighted, like I am) we prescribe glasses or contact lenses to help correct the defect.

Pregnancy isn't a defect; quite the opposite, in fact. It is what results when all the human reproductive organs are functioning as they are supposed to during intercourse. While this can be inconvenient, it doesn't make it a health defect.

Apodaca adds:

An additional point can be made on this matter. If pregnancy is to be treated as a disorder, a defect in the human body, then what does that say about the nature of women? Are we really to conclude that women have a defect in their very nature, and can only be corrected by making them more like men, in not carrying a child?

Summary: The idea of abortion as "essential health care" implies that pregnancy is contrary to the proper functioning of a woman's body. But this standard of health implies that women, to be healthy, should be like men. This is sexist. And sexism is abhorrent - and morally false.


If we're talking about the general practice of abortion, the claim that abortion is "essential health care" is false in three ways.

First, in the general practice of abortion it turns out that the "hard cases" - ie, abortions for rape, incest, and threat to life of the mother - account for a very small percentage of all the cases. A very small percentage: 2 percent to 5 percent. Moreover, many doctors think abortion is never medically necessary. So it's false that most abortions are for health reasons. That is, it's false that abortion in general is "essential health care".

Second, the claim that abortion is "essential health care" is also problematic because it is contradictory (or has contradictory implications). On the one hand, pre-natal care requires protecting and ensuring the health of the mother and child (pre-natal human being); on the other hand, abortion targets and destroys the child (pre-natal human being). So the claim that abortion is "essential health care" is false because it's logically contradictory (or implies logical contradictions).

Third, describing abortion as "essential health care" logically implies something is wrong - unhealthy - about being a woman whose reproductive capabilities are functioning well. It also implies that women are not healthy because they aren't like men. That's sexist. So the claim that abortion is "essential health care" is false because sexism is false (and outrageously so).

Political implications

Because abortion is not essential health care, taxpayers can correctly judge abortion to be a non-essential medical procedure, and thus taxpayers have reasonable grounds for thinking their tax dollars need not fund abortions. These grounds are reasonable, whether one is pro-life or pro-choice.

Of course, many choices for abortion, though not medically necessary, are not made lightly (the Shout Your Abortion crowd notwithstanding, which sees abortion as a badge of honour). Those cases in which abortion choice is not medically necessary and not made lightly seem to be due to social and economic pressures. But if there are social and economic reasons for why mothers feel their only option is abortion, then tax dollars should be directed not to abortion as faux "essential health care" but instead to help pregnancy resource centers, mothers and families in need, foster care, and adoption agencies.

Surely, social and economic problems require social and economic solutions, not the killing of children.

PS: A note for anti-abortionists/pro-lifers

In a recent episode of The Van Maren Show , pro-life activist Jonathon Van Maren's guest was political scientist Michael J. New, PhD. In a discussion about the impact of pro-life legislation on abortion rates, Van Maren asked Dr New what pro-life laws are most effective in reducing the abortion rate. I was expecting Dr New to talk with excitement about some specific piece of pro-life legislation or social program. But Dr New's answer was more general, even somewhat mundane, but achievable. According to Dr New the best way to reduce abortion rates is to get the government out of funding abortions with taxpayer dollars.

So, how do we get the government out of funding abortions with taxpayer dollars? It seems to me that a first step would be to realise that abortion is not "essential health care".