Abortion — an act performed with the sole or primary intent of ending human life in the womb — is never medically necessary, according to medical doctors and Catholic experts on the issue.
“The direct killing of an unborn child is never necessary, even in an emergency,” Dr. Kathleen Raviele, a retired, board-certified OB-GYN and past president of the Catholic Medical Association, said of abortion.
Instead, these experts said, doctors must endeavor to care for the two patients involved in every pregnancy: the woman and her unborn baby.
“When the lives of mother and child are both in danger, the goal should always be to do all we can to save both patients,” said Bishop Daniel E. Thomas of Toledo, Ohio, chair of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities.
These experts spoke about so-called emergency abortions in emailed comments to OSV News. Life-affirming alternatives to abortion exist in situations where a mother or her unborn baby faces a life-threatening condition, they said. Some procedures, they added, are also mistakenly called “abortion.”
Most of all, they wanted women facing pregnancy complications to know they are not alone.
Their comments followed the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services‘ decision earlier this year to revoke guidance that instructed hospitals to perform abortions in emergency situations regardless of state law under the federal Emergency Medical Treatment and Labor Act, or EMTALA.
The term “emergency abortion,” Joseph Meaney, past president and senior fellow of the National Catholic Bioethics Center, or NCBC, said, is “often used by abortion supporters to describe situations where a pregnant mother’s life is at risk and they believe a direct abortion is indicated as a means to prevent the mother’s death.”
He and the other experts began their discussion by defining abortion itself.
The definition of “abortion” includes the purpose or intent to end human life, experts agreed.
An induced abortion is “a medical intervention to end a pregnancy such that it does not end in a live birth,” Dr. Christina Francis, a board-certified OB-GYN and CEO of the American Association of Pro-Life Obstetricians and Gynecologists, or AAPLOG, cited the definition provided by the American College of Obstetrics and Gynecology, known as ACOG.
“Note the phrasing ‘such that it does not end in a live birth,'” she said, “which reveals that the purpose of induced abortion is to end the life of the child in the uterus.”
Raviele agreed, saying, “Every procedure or medication whose intention is to directly kill a human life from fertilization until birth, is a direct abortion.”
Meaney cited the U.S. bishops’ Ethical and Religious Directives for Catholic Health Care Services, which identify abortion as “the directly intended termination of pregnancy before viability (or before a baby can survive outside the womb) or the directly intended destruction of a viable fetus (who can survive outside the womb).”
With this definition in mind, these experts said that abortion is never necessary.
“It is never medically necessary to purposely end the life of a preborn child in order to save her mother,” Francis said, adding that “under certain circumstances where a pregnancy complication threatens a mother’s life, a physician must separate mom from baby, sometimes when the baby is too young to survive outside the womb.”
This separation of a mother and her baby is not an abortion, she said.
“AAPLOG recommends referring to these interventions as ‘maternal-fetal separations’ given the clear difference of intent between those lifesaving treatments and induced abortion,” she said.
According to the Guttmacher Institute, a reproductive research organization that supports abortion, only 7% of women cited their physical health or possible problems affecting the health of their unborn baby as their “most important reason” for an abortion in 2004.
More recently, a 2022 analysis from Charlotte Lozier Institute, the research arm of pro-life advocacy group SBA Pro-Life America, found that over 95% of abortions are for “elective and unspecified reasons” rather than “risk to the woman’s life or a major bodily function” (0.03%) or “abnormality in the unborn baby” (1.2%).
Raviele and Meaney recognized situations can exist where a pregnant woman may receive life-saving treatment for herself even if it threatens or indirectly leads to her baby’s death. The intent, here, is to save her life, not end her baby’s life.
Both cited the bishops’ directives: “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 child is viable (or can survive outside the womb), even if they will result in the death of the unborn child.”
Raviele gave an example. A woman “who is 12 weeks pregnant and diagnosed with ovarian cancer, could undergo a complete hysterectomy with the baby in utero, even though there is no chance the child will survive,” she said. “The surgery is to treat her cancer, not to kill the baby.”
Meaney cited the principle of double effect attributed to St. Thomas Aquinas, which “involves evaluating certain good actions intended for a good purpose that can also have foreseen but unintended bad effects,” as he describes in an NCBC essay.
“What the church is saying is that the principle of double effect can justify treatments to save the life of the mother if everything is done to also save the child and there is no other option available,” Meaney said of the directives. “What is never ethically acceptable is to directly kill or abort the preborn child as a ‘treatment’ for the mother.”
Francis echoed Meaney and Raviele while responding to claims that women need abortion for complications such as miscarriages or ectopic pregnancies, a life-threatening situation where an embryo implants outside the womb.
“In the case of miscarriage management, the preborn child has already passed away, and the purpose of the physician’s interventions is to help the mother’s body safely pass the baby’s body and pregnancy tissue,” she said. “In the case of ectopic pregnancy treatment, early delivery for preeclampsia, and other similar interventions, the purpose is to save the mother’s life, not to end the baby’s (life).”
She added: “By contrast, in the case of induced abortion, if the baby survives, the procedure is considered to have failed.”
Bishop Thomas also addressed “certain rare and life-threatening conditions” that “may require medical interventions that unintentionally and indirectly lead to the death of the preborn child,” including ectopic pregnancies.
“Ethical treatment for an ectopic pregnancy is not considered an abortion,” he said. “These interventions may include the removal of the damaged fallopian tube containing the embryo or, if the death of the embryo has already occurred, medication may be used to resolve the ectopic pregnancy.”
Addressing church teaching, Bishop Thomas said that abortion is “never the right moral decision” and that “(w)e must make a clear moral and legal distinction between tragically losing a child and intentionally taking the life of a child.”
The Catechism of the Catholic Church, which summarizes church teaching, recognizes the inherent dignity of the human person beginning at conception and condemns any “crime against human life,” such as abortion.
“Since the first century the Church has affirmed the moral evil of every procured abortion,” it reads. “Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law.”
At the NCBC, Meaney repeated that direct abortion is never allowed. “Both the preborn child and mother are human beings with rights. Both their lives are precious and have equal dignity,” he said. “One can never intentionally kill one person to save another.”
These experts shared their guidance for pregnant women who are feeling overwhelmed or scared by their situation.
Francis wanted them to know that no state law prevents excellent obstetric care and that they have access to additional support through pregnancy centers and other programs.
Raviele added that, if a woman has been told to abort her baby, she should seek a second opinion. She recommended women turn to the Catholic Medical Association, which provides a search tool for Catholic physicians, or AAPLOG, which hosts an online directory of pro-life OB-GYNS and other pro-life medical professionals.
Bishop Thomas addressed how the church, including everyday Catholics, can accompany pregnant women facing life-threatening situations.
“First, to accompany with love and pastoral care pregnant women who find themselves in these frightening situations,” he said.
He called on pastors and pro-life family and friends to be aware of the nuances to better help women.
“Many women facing life-threatening maternal health conditions may be offered abortion as their only option and may be unaware of moral and ethical alternatives to abortion,” he said. “It is good to be informed about and to advocate for these ethical treatments.”
