Terms of Abortion

President Obama's decision to revisit and possibly reverse the Bush policy on stem cell research has reignited the explosive debate about abortion in which the anti-abortion movement has literally dictated the terms of the debate. For example, anti-abortionists have succeeded in getting the emotionally charged, but incorrect, term, partial-birth abortion, accepted into the public discourse and the law. The correct term is intact dilation and extraction (ID&X), which is a medical procedure used only in rare instances where continued pregnancy would place the woman’s life at risk. The media, often unschooled in the correct scientific terminology, unwittingly adopt the language of anti-abortionists in their reporting. Unfortunately, that language is then adopted by the public, and, ironically, even by some scientists and pro-choice advocates.

Perhaps if we were more concerned with the accuracy of our terminology, the abortion debate might be rendered less emotionally laden and the public might actually become objectively informed about the complex issues involved.

For starters, the term abort is often used incorrectly as a synonym for to kill. Such connotations are reinforced by media descriptions of fetuses or babies being aborted. But the verb, to abort, means to terminate prematurely. Thus, it is not a fetus (or even an embryo) that is aborted but rather a pregnancy before the fetus is viable. It is incorrect to use the term abortion to mean anything other than ending a pregnancy.

Many people are unaware that two out of three fertilized eggs naturally don't make it through prenatal development to result in the birth of a baby and, thus, most pregnancies are aborted due to biological causes. At different stages, and for different reasons, including chromosomal abnormalities, the individual stops developing. When this happens after implantation, a miscarriage or spontaneous abortion occurs and the pregnancy ends. We don’t say that an embryo or a fetus is aborted, however.

With the recent debate over stem-cell research, it has become commonplace to refer to the cells as embryos. Although scientists themselves can’t even agree exactly how the term embryo should be used, it is clear that the developing individual is different before it becomes implanted on the uterine wall than after. Before implantation the pre-embryo (as embryologist Clifford Grobstein calls it), or zygote, moves down the fallopian tube toward the uterus. Only when it becomes implanted in the uterus and the placenta and umbilical cord form is it proper to refer to it as an embryo. Thus, embryonic stem-cell research is misnamed, since the stem cells come not from already implanted embryos, but from unattached pre-embryos or, more correctly, blastocysts. The difference is not insignificant because the way the term embryo has recently been used, we are made to actually feel empathy for a small clump of cells.

It is egregiously incorrect to refer to either the pre-embryo or embryo as an unborn child, or baby or infant. A child is a young person between infancy and youth and most people distinguish between an infant or a baby and a child that is usually walking and talking. Thus, to refer to a group of cells as a child or infant or baby goes completely against common usage, and it is designed solely to elicit strong emotions as part of an irrational argument.

Another mistake, which surprisingly many women make, is to assume that pregnancy occurs at conception. Pregnancy, however, is a physical state that only occurs when the fertilized egg becomes implanted on the uterine wall approximately two weeks after conception. A pregnancy test detects the hormones that are then released, which is why such tests will not yield a positive result before then. This also means that if the drug RU-486 is used as it was originally intended, as a morning-after (conception) pill (i.e., as a contragestive), it may prevent implantation; it does not cause an abortion because the woman is not yet pregnant.

In a dissent in the Supreme Court’s 2007 decision to uphold the ban on ID&X, Justice Ruth Bader Ginsburg acknowledged the misuse of language by her colleagues when she said, “Throughout, the opinion refers to obstetrician-gynecologists and surgeons who perform abortions not by the titles of their medical specialties, but by the pejorative label 'abortion doctor.' A fetus is described as an 'unborn child,' and as a 'baby,' previability abortions are referred to as 'late-term,' and the reasoned medical judgments of highly trained doctors are dismissed as 'preferences' motivated by 'mere convenience.'”

Because of its enormous impact on the public debate, scientists and the media and, yes, even Supreme Court justices, regardless of their personal beliefs, have a responsibility to inject precision and facts into a discussion that too easily lends itself to subjectivity and emotion.