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Helping Christians think through a pregnancy that endangers the mother’s life

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December 23, 2020

Although it is not without controversy, even those who defend the sanctity of every unborn human life recognize that there might be at least one exception. What do we do when a mother’s right to life conflicts with an unborn child’s right to life?

What is a “right to life”?

Before dealing with a potential exception, it’s important to know what we mean by the term “right to life.” First, what is a right, and where do they come from? A right is a natural or legal entitlement that imposes a duty on others either to leave one alone in the exercise of that right, or a duty to provide that to which one is entitled. So-called natural rights come from our Creator. They are not dependent on civil authorities, customs, or laws, they are universal and inalienable endowments of God. The United States Declaration of Independence, for instance, recognizes the rights to “life, liberty, and the pursuit of happiness” as natural rights. 

The “right to life” is a right not to be unnecessarily harmed. Because it is a natural right, everyone has a responsibility or duty not to interfere with that life without just cause. So, my right to life means that I should not be harmed unless I act in such a way that harming me would be ethically justified. If I act to harm someone else unjustly, we would grant them moral (and probably legal) permission to harm me in their own self-defense. Generally speaking, of course, the harm of self-defense must be proportionate to the degree of harm in my act. For instance, if I harm you by blocking your car in your driveway, you do not have moral permission to kill me. If, however, I draw a pistol, aim it at you, and threaten to shoot, most people would agree that you have permission to defend yourself either by running away or by doing harm to me, and in that case, inflicting lethal harm if necessary.

In the case of the unborn, there are two natural rights bearers: the mother and the unborn child. Both of them have a natural right to life, the right not to be unjustly harmed. Abortion is a clear harm to the unborn. So abortion on demand—to avoid inconvenience, embarrassment, or to remove an obstacle to a mother’s life plans—is unethical. Because both the mother and the unborn child have a natural right to life, abortion due to rape, incest, and fetal disability are also unethical. That is not to deny that in rape and incest a terrible injustice has occurred to the mother, but it is to recognize that abortion is a wrong way to right that injustice. It punishes the wrong person, the unborn child. 

Among the many ethical and legal tragedies of the 1970s, were the Supreme Court’s decisions in Roe v. Wade (1973) and Doe v. Bolton (1973). Roe provided legal protection for abortion when a woman’s life or health were at risk, and Doe infamously expanded the definition of “health of the mother” to include “all factors—physical, emotional, psychological, familial, and the woman’s age—relevant to the well-being of the patient. ALL these factors may relate to health.” This essentially ensures a legal right to abortion on demand, despite the law’s violation of the natural rights of the unborn. Abortion on demand and in cases of rape, incest, and fetal deformity cannot be justified under the demands of natural rights.

A rare exception? 

Might there still be one exception, however?  What about those extremely rare cases in which the physical life of the mother is at risk through, say, an ectopic pregnancy or cancer requiring chemotherapy? Although lamentable and tragic, many pro-life Christians acknowledge that abortion may be permissible in that case (assuming that a proper diagnosis has been made and that there are no alternative treatments available). In the case of an ectopic pregnancy the embryo is developing in the Fallopian tube, not inside the uterus. If the developing embryo is not removed, the mother may die because the Fallopian tube is not designed to support pregnancy. And if the Fallopian tube ruptures, the mother may die and the child will die anyway. Protecting the child’s right to life endangers the physical life of the mother because the Fallopian tube could rupture, causing the mother to bleed to death. Protecting the mother’s right to life might mean, in those extremely rare cases, delivering the embryo with a section of the Fallopian tube. 

The United States Council of Catholic Bishops has some useful guidance in this matter:

Very rarely, continuing a pregnancy may put the mother’s life at risk. In certain cases, such as aggressive uterine cancer or an ectopic pregnancy, it is morally licit to remove the threat to the mother’s life by removing the cancerous uterus, or by removing part or all of the Fallopian tube where the child implanted, even though it is foreseeable that the child will die as an indirect and unintended effect of such surgery. Abortion, a direct and intentional attack against the child’s life, is never morally licit. The unborn child and his mother have equal human dignity and possess the same right to life. When a medical crisis arises during pregnancy, there are always two patients involved. Doctors should do whatever they can to save both their lives, never directly attacking one—through drugs, surgery or other means—to save the other. 

Similarly, as recently as 2018 the messengers of the Southern Baptist Convention recognized this exception in a resolution “On Reaffirming the Dignity of Every Human Being”:  

RESOLVED, That we affirm the full dignity of every unborn child and denounce every act of abortion except to save the mother’s physical life; and be it further

RESOLVED, That we affirm the full dignity of every human being, whether or not any political, legal, or medical authority considers a human being possessive of “viable” life regardless of cognitive or physical disability, and denounce every act that would wrongly limit the life of any human at any stage or state of life; . . . 

In addition to the ethical issues, as always, there are profound pastoral issues here. It is important to recognize that there is no moral obligation to deliver the embryo prematurely. That is a decision couples have to make in good conscience themselves. Whatever their decision, couples who are caught in the pincers of this moral dilemma need the spiritual support of their church family as they grieve the loss of their child and all the hopes and dreams that are lost at the same time. Being pro-life means not only opposing abortion on demand, but also providing compassionate care to families who lose children through miscarriage or ectopic pregnancy. 

C. Ben Mitchell

Ben Mitchell, Ph.D., is a research fellow of the Ethics & Religious Liberty Commission and a member of the Ethics Committee of the Christian Medical & Dental Associations. In 2020, he served as a member of the NIH Human Fetal Tissue Research Ethics Advisory Board. Read More