• Paul Stark

The coat hanger is a lie: Why the 'back-alley abortion' argument fails



The image of a coat hanger has long served as a symbol of the importance of legalized abortion. That symbol is based on a lie.

Before the U.S. Supreme Court's Roe v. Wade decision, which legalized abortion nationwide, many advocates of legalization claimed that thousands of women died each year by undergoing dangerous abortions, sometimes performed in back alleys or using coat hangers. Today, abortion defenders warn that bans or even modest restrictions on abortion could lead to more deaths. Legal and accessible abortion, they say, ensures the health and safety of women.

Every death or injury is a tragedy we should seek to prevent. The unsafe abortion argument, however, suffers from both a justice problem and an evidence problem.

The justice problem

First, if abortion is unjust, then the dangers of choosing to participate in the injustice are not a very good reason to make it legal. Consider any number of illegal acts (e.g., drug dealing, robbery, kidnapping). Engaging in these acts is often very risky. But we would never legalize those crimes in order to make them easier to commit.


Indeed, no one would say, "Society should authorize the killing of children so that parents don't have to jeopardize their own safety when they decide to get rid of their children." Children are valuable human beings who have human rights. They deserve protection under the law. If human beings in utero are also valuable members of the human family, then they too deserve protection, regardless of the risks some people might assume by trying to kill them.

The back-alley argument, therefore, "fails to meet the [pro-life] claim that abortion is the deliberate killing of an innocent human being," writes Princeton ethicist Peter Singer, a defender of abortion. "The fact that restricting access to abortion has tragic side effects does not, in itself, show that the restrictions are unjustified," adds philosopher Mary Anne Warren, who also supports abortion, "since murder is wrong regardless of the consequences of prohibiting it."

The evidence problem

Second, empirical evidence shows that laws against abortion do not have the terrible consequences that the back-alley argument alleges. Dr. Bernard Nathanson, the NARAL co-founder who helped lead the effort to legalize abortion, later acknowledged that his movement's claims about the number of deaths from illegal abortion were wildly inaccurate:

[I]t was always "5,000 to 10,000 deaths a year." I confess that I knew the figures were totally false, and I suppose the others did too if they stopped to think of it. But in the "morality" of our revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics? The overriding concern was to get the laws eliminated, and anything within reason that had to be done was permissible.

What do honest statistics reveal? The incidence of maternal mortality—and abortion-related mortality specifically—declined dramatically through the middle part of the 20th century as a result of antibiotics and other medical advances. By 1960, Dr. Mary Calderone, Planned Parenthood's medical director, concluded that "abortion, whether therapeutic or illegal, is in the main no longer dangerous." This steep drop in deaths occurred before the 1973 legalization of abortion, which had no apparent effect on mortality rates.

"[T]he data suggest," observes Joseph Dellapenna, author of the most definitive work of U.S. abortion history, "that there have been as many maternal deaths in the United States annually from legal abortions (estimates range from 15 to 35 per year) as there were maternal deaths from illegal abortions in the years immediately before Roe v. Wade was decided."

Those who offer the unsafe abortion argument frequently appeal to examples outside of the United States. They point to some countries (such as many in Africa) that prohibit abortion and experience high maternal mortality rates and to other countries (such as most in Europe and North America) that permit abortion and boast low mortality. They infer from this correlation that laws against abortion cause a high incidence of maternal death. But that's a fallacy.

The highest-mortality nations are developing countries with poor maternal health care; the lowest-mortality nations are developed countries with advanced maternal health care. This is true irrespective of abortion policy. Some countries, for example, permit abortion and have high rates of mortality because their health care system is lacking. Other countries prohibit most abortions and have very low rates of maternal death (often lower than that of the U.S.). These countries include Chile, Ireland, Poland, Malta, the United Arab Emirates, Kuwait, and Lebanon.

The evidence from both the U.S. and around the world is clear. Legalized abortion is demonstrably unnecessary to have an excellent standard of women's health.

We can protect both

Of course, we should never minimize the horror of any pregnant woman's death from an abortion. Nor, however, should we ignore the deaths of nearly one million unborn children in the U.S. each year. There's no such thing as a "safe" abortion.

We can protect the right to life of all human beings, including unborn children, and safeguard the health of women at the same time. That's what a just and compassionate society ought to do.

This article first appeared in the October 2017 issue of NRL News.

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