I am sickened by the argument (mostly from the right, but from some on the left too) that the health exception to abortion is too big a loophole because women can get an abortion on the basis of depression or other mental illness. Often, I vent my rage at my laptop screen as I watch some public figure tell people that a disease that makes every day a desperate struggle for life is equivalent to a 'whim.' I scream that it isn't true, desperately hoping that someone will stand up and tell the American people the truth. I am a twenty-four year old woman, but depression has shown me the face of death. And while I have not had an abortion, were I to get pregnant at this point, love for my unborn child would force me to do so.
Ross Douthat wrote an article in the New York Times today arguing, among other things, that Dr. Tiller's critics have "persuasive" evidence "suggesting that Tiller abused the state’s mental-health exemption to justify late-term abortions in almost any situation." One of Douthat's sources, Kansans for Life, used as evidence an interview with "eminent psychiatrist" Dr. Paul McHugh, a doctor who had "reviewed" the medical records of some of Dr. Tiller's patients who had received late term abortions under the mental health exception and found "no file that justified abortion on that basis." Putting aside the fact that such a sweeping conclusion should be suspect in and of itself, this psychiatrist said:
"Oh, I’m quite confident that 100% of psychiatrists would say that those are not irreversible conditions since most of their practice is taking care of exactly those things and restoring people to their mental health. We, we do that all the time."
If this man honestly believes that psychiatrists can cure all of their patients, he needs to have his head examined. I suppose he considers the fact that some of them die before they can be cured a technicality. His final statement was that, "...there’s no psychological condition for which abortion is the cure." Abortion isn't the cure for cancer either, but I think very few would oppose a woman who has just discovered she has terminal cancer having an abortion to avoid the strain of childbirth on her body's resources. Mental illness operates relatively similarly.
Depression does many things to its victims and its survivors. Three people will kill themselves in the time it takes to watch your favorite cable news show. But the disease does more than simply kill; it slowly leaches the life out of people. You've probably seen those ads for depression medication featuring sad people with sweatpants watching tv, who, after taking Bullpuckey-XR, suddenly have colorful, tailored clothes and the energy to run after their young, attractive children without breaking a sweat. For people with severe major depression, the 'before' scenario looks good. On my worst days, I would've done anything to have the energy to stand up for long enough to take a shower (they may wear sweatpants, but they look pretty clean), much less be awake and focused enough to follow the plot of a tv show. I slept 16 hours a day. Sometimes I experienced leaden paralysis, a condition in which you can barely move because your body feels, appropriately enough, as if it is weighted down with lead. After I started medication, when I could follow the Bullpuckey-XR 'before' scenario most days and could go a couple of days without lying in bed crying in agony for hours at the pain that is 'only in my head,' it was a good week. Obviously, my condition has been up and down. Depression is like cancer. (I'm not making this comparison up; one woman who had experienced was quoted as saying that cancer was better, because then people sent you flowers and you knew you weren't alone.) It may go away forever, it may return someday, and it may kill you. You don't know which.
Not only is depression a debilitating disease, sufferers are often surviving on a cocktail of prescription drugs. The FDA classifies prescription drugs into 5 categories of safety for pregnant women: A, B, C, D, and X. A means studies have shown that a drug is harmless. B means it's probably harmless, but they wouldn't bet the FDA on it. C means they have no idea. D and X both mean that studies have shown significant risk to the fetus, but D means the FDA believes there are some circumstances in which the health of the mother might require such a drug, whereas X means they don't believe in such circumstances. A problem with the X category is that some drugs are used 'off-label'; that means that if, for instance, Accutane (a category X drug), which is now prescribed for acne, were discovered to cure depression next week, doctors could give it to their patients, even though the FDA has not approved it for that particular use yet (so it wouldn't be moved to category D). The category system is also problematic because there's no provision for interactions. It is possible that two B drugs taken together consistently produce severe birth defects or miscarriages, but we don't study those effects.
I take eight separate medications for my depression and accompanying anxiety every day. I'm still here, but I'm by no means healthy. One of those is in FDA pregnancy category D, and 7 are in Category C. That means that if I got pregnant, I would have a choice between the medication that lets me live and the likely health of my child. I would not even know the type or extent of the possible effects on my child. If I carried that child to term, not only would I have trouble caring for them (remember, I am alive, not healed), but I would also wonder, even if the child were healthy and happy, about every little flaw, "Did I do that to my child? Did I harm them irreparably? Should I have dropped my meds and risked my life to spare my baby whatever pain I could?" And I would feel the weight of guilt for not doing so, for not being able to just 'suck it up' like other people do. Knowing that, there's a good chance I'd stop taking my medication, even if the doctor told me not to. Wouldn't you do whatever it takes to give your child the best life possible? Unfortunately, stopping the medications would be risking my life. This situation is not one into which to bring a child. When I'm healthier (I still believe I will be, at least some of the time), older, stronger, I want to be a mommy. If bearing a child is not possible because of the medical situation, I will find a surrogate or adopt. But because I love children, I have to stand up for the mental health exception in late-term abortion bans.