Looking backwards: postabortion regret and affirmation

It may well be an inescapable fact of life that abortion and regret go hand in hand in a way that childbearing and regret simply do not. Even regardless of sociological findings, the idea that women on the whole experience (and, for what it is worth, express) far more regret over aborted pregnancies than they do over becoming mothers is one that strikes as credible and intuitively compelling. A relatively higher coincidence of abortion and regret is thought by some to add weight to the argument against the moral justification of abortion, and more specifically, is presented as relevant information for those in the midst of reproductive decision-making. Rhetoric about postabortion regret and its meaning is a persistent feature of abortion discourse, especially in antiabortion advocacy. The idea that abortion and regret go together is both covertly and explicitly channelled through various media. ‘Pro-life’ pregnancy counselling services such as CareConfidential and internet discussion forums like Abort73 litter their web pages with stories of women who avowedly regret their abortion decisions, describing them as a terrible mistake with only negative repercussions (“…I regret my decision hugely…the regret afterwards is a horrible, horrible feeling”).^{i 1 2} The ProLife Alliance describes abortion as a procedure which many women come to ‘bitterly regret’, and notes that ‘while many women regret having their abortions, few regret having their babies’.^{3 4}

But though the strong association of abortion with regret is rife in antiabortion discourse, the exact nature of the proposed connection can often seem obscure. Does regret make an abortion morally wrong? Does it make it more likely that an abortion was wrong? Does it simply suggest that the abortion was a bad idea for the woman concerned—that it was not in her individual interests? The drift of the message at least seems clear. That regret follows abortion around like a bad smell is a reason not to have an abortion. It is a reason to opt for an alternative solution to an unwanted or ambivalent pregnancy, namely motherhood or adoption.

But what is the main idea behind the putative relevance of regret to reasoning about abortion? The answer may seem, at first, fairly obvious: it mirrors the relevance of regret to any other, more mundane, decision in life. Say you are thinking of buying a car, and it happens to be the case that 80% of people who buy that particular make and model of car regret the decision with hindsight. Surely you would want to be informed of this fact, and would regard it as critical information when it comes to deciding whether or not to buy. As in everything else, one might argue that the likelihood of regretting abortion should logically inform the reasoning process of those in the throes of crisis pregnancies. From this vantage point, the relevance of regret might be said to go to the very rationality of the pregnant woman's decision. In line with this notion, proponents of broadly antiabortion views are quick to point out the ‘psychological costs’ of abortion which are thought to reveal how many women come to perceive their choice negatively in its aftermath. In a recent book, and as part of a much wider antiabortion argument, Christopher Kaczor notes that ‘after the choice of abortion, many women bear a burden of guilt that is, for some, never terminated’.⁵ Many, he claims, ‘regret and suffer because of their abortions’, and to this end he refers to a selection of psychological studies which suggest that women who have undergone abortions carry a significantly higher risk of future psychiatric problems, substance abuse and even suicide.^6–8

Kaczor concedes that some women who have had abortions are firmly satisfied that they chose the correct option; clearly not everyone deeply regrets ending her pregnancy. However, he treats it as extremely meaningful that women who, in similar circumstances (that is to say, confronting unwanted pregnancies) choose to complete their pregnancy are ‘virtually all glad that they did not have an abortion’, including even those who initially wished for one.ⁱⁱ While they might well still testify that the choice to have the child was the most difficult choice they ever faced, ‘they are satisfied with themselves in this regard and live without regret’. He continues: What woman mourns the anniversary of her child's birth? But how many women mourn usually in silence the anniversary of an abortion? What woman looks at her child and says “If only I had aborted her?” But how many women consider in the quiet of their hearts, “If I hadn't had the abortion…?” No group calls itself “Women Exploited by Giving Birth” or “Women Victimised by Giving Life.” Yet many groups exist to comfort women hurt by abortion such as “Women Exploited by Abortion” or “Women Victimised by Abortion”, organisations with thousands of members. No books are published to console women who gave birth rather than aborted. But how many books are published, from both pro-choice and pro-life perspectives, to help women with post-abortion grief?

It is important to note here that psychological trauma and regret are distinct emotional phenomena, though they may coincide. It is entirely plausible, for instance, for a woman to be psychologically scarred by giving birth (to the extent that she never wishes to go through it again) but to not regret it. However, when antiabortion writers invoke regret in this context, they do not mean to invoke a mere psychological or emotional reaction; rather, what they refer to is a retrospective judgment about the wrongness of the abortion decision, though that judgment itself may have predictable emotional and psychological by-products.

One should also be attentive to what such contestants consider to be the particular object of regret for many women who feel negatively about their abortions. It is possible for a woman to regret an abortion in a number of different ways. She may regret that life was such that she had an abortion or that life was such that it was reasonable only to have an abortion. She may regret that she became pregnant in the first place, and any number of decisions which led to that circumstance. However, according to Kaczor, the burden of guilt that is for some women ‘never terminated’ is directly related to the choice to end the life of the fetus. In this respect, it is also very different from the ‘postpartum’ depression that can follow miscarriage. Unlike postpartum depression (which stems straightforwardly from the loss of the fetus) and unlike mere regret that an abortion was necessary, it is regret that, once pregnant, she decided to end the life of the fetus, rather than allow it to continue. It is the kind of regret which we might also understand to entail remorse.

Three theses

It is by no means obvious, then, that most women regret having early abortions, and as seen, some studies have concluded precisely the opposite. Kaczor claims, however, that what really matters is simply that more women regret having abortions than women in similar circumstances regret giving birth, and it seems that the ProLife Alliance thinks in similar terms. I have suggested that there may be a reason to question whether even this claim is really true. Still, let us grant for the sake of argument that it is. What then? It is next necessary to ask precisely what bearing this has, or ought to have, on moral and practical reasoning about abortion. For Kaczor, the relatively high rates of postabortion regret shed light on the comparative psychological and emotional burdens of abortion vis-à-vis childbirth, lending considerable support to the case against aborting unwanted pregnancies. This is the relationship which we may say mirrors the relevance of knowledge about consumer regret over buying a particular model of car. It might be thought to heavily determine a woman's rational or prudential justification for having an abortion. If she is concerned about making a decision which most enhances her well-being, then perhaps she should not choose an option she is likely to regret.

But the meaning of regret in abortion may be thought to go much deeper than this. That is, high rates of postabortion regret can be thought to lend support to the antiabortion argument not just in terms of women's welfare—what might be regarded as prudential or self-regarding reasons for or against abortion—but in terms of overall moral justification. In other words, the relatively higher rate of regret over abortion could be taken to count towards its moral justification for reasons independent of the well-being of the pregnant woman (and as such can be propounded as part of the resolution of the fetal–maternal conflict). This of course is a very different sort of claim. Though Kaczor does not explicitly tie postabortion regret to the question of moral justification, his remarks about the specific object of regret—the decision to bring about the death of the fetus—loosely suggest that such feelings are indeed rationally appropriate and ought not to be regarded as purely pathological. And if postabortion regret, directed at that particular object, is understood to be appropriate, it is plain to see that a connection with abortion's moral impermissibility is subtly forged. For many opponents of abortion, the burden of guilt that is, for some women, ‘never terminated’ should not be disregarded as incidental or irrational, but rather should guide the detached observer towards the conclusion that there is something to be regretted, because abortion is the morally wrong choice.

The proposition that high rates of postabortion regret are indicative of abortion's moral impermissibility can in fact be further divided into two separate claims. One possible claim being made is that regret over an abortion renders that abortion morally unjustified. A different claim is that high rates of postabortion regret are simply strong evidence for abortion's broad moral impermissibility. In other words, the relationship between regret and moral justification in abortion is an epistemic one. If either of these two relationships between abortion and regret hold, it is possible to see why knowledge about rates of regret or the likelihood of oneself regretting an abortion could be relevant to determining whether or not the decision is morally justified.

Let me restate the three putative connections between the justification of abortion and postabortion regret:

1. The moral justification thesis: postabortion regret renders an abortion morally unjustified.

2. The epistemic thesis: high rates of postabortion regret (relative to the relevant comparator field) are good evidence for the moral impermissibility of abortion.

3. The rational justification thesis: high rates of postabortion regret suggest that abortion is an imprudent or unreasonable choice.

I now wish to demonstrate that none of the theses holds up under scrutiny and that this is particularly evident when directing one's attention to certain unique features of reproductive decision-making. My conclusions, if correct, will in turn cast doubt on whether it is ever appropriate to harness postabortion regret for the purposes of arguing about the morality or prudence of abortion. Moreover, if the three theses are shown to be inherently flawed, there will be no need to resort to debunking explanations of the available data in order to denounce the proposed relationships between justification and regret in abortion. Rather, one will be perfectly able to concede that it really is rare for any woman to regret choosing childbirth over abortion and still maintain that regret has very little, if anything, to say about abortion's moral or rational standing.

The moral justification thesis

I begin with what may be regarded as the most contentious of the three theses: that regret is constitutive of an abortion's lack of moral justification. In other words, the fact that a woman regrets having an abortion is enough to make that abortion morally unjustified. I wish to show that the thesis is problematic because it rests on a foundational premise which can be shown—especially in this context—to be false: that regret necessarily ‘tracks’ moral justification in decision-making. Put differently, it is the idea that regret and moral justification go hand in hand, so that whatever one regrets doing must be unjustified.

It may be wondered whether contesting such a thesis is in truth only attacking a straw man, for who sincerely espouses the view that a woman's regretting an abortion makes it morally unjustified? It is true that antiabortion campaigns tend not to advocate the thesis in clear terms. However, much of the discussion of regret on forums like those mentioned above is notable for failing to account for its antithesis. By this I mean that there is little to no room made for the possibility that even if an abortion decision is regretted, this may not mean that it was morally wrong. Instead, the tales of regret appear to be posited as completely settling the moral question as well as the rational one for the woman concerned. At the very least, the failure by such websites to even distinguish between the meaning of regret for moral and rational justification suggests that such discussants treat the questions as wrapped into one, and that if a woman regrets an abortion, this fact alone is reason to believe in the moral error of her choice.

The binding of regret to moral justification in this way is not entirely without philosophical support. In particular, the philosopher Bernard Williams suggested that one's actions could be morally unjustified in virtue of a certain kind of regret, noting the ostensible implication to be some measure of ‘moral luck’, this meaning, as Williams explains it, that it can be ‘a matter of luck that someone was justified in doing as he did’.^{iv 12} Williams describes the particular species of regret as ‘agent-regret’. Agent-regret is regret not just over how things turned out—that certain states of affairs might have been otherwise—but entails a wish that one had acted otherwise. Williams's argument is that we often come to experience such regret over our actions because of outcomes not entirely within our control. The lorry driver, who, through no fault of his own, runs over a child that steps into the road is likely to feel deeply regretful for his actions notwithstanding that he is not to blame, because of the unfortunate turn of events. Williams therefore claims that agent-regret is largely dictated by uncontrolled consequences and that this is suggestive of the existence of moral luck.^v However, as the philosopher R Jay Wallace points out, the susceptibility of agent-regret to luck is not evidence for the moral luck thesis—that the moral justification of one's decisions or actions is itself hostage to fortune—unless another premise is also true: that regret tracks moral justification. That is to say, the fact that someone experiences agent-regret over a decision or act is pertinent to his moral justification for acting in such a way only if it is true that regret and moral justification are aligned. And this is precisely the same premise that would be required to uphold the claim that postabortion regret entails the moral incorrectness of an abortion. To say that the rights and wrongs of abortion are dictated by agent-regret is to accept the claim that regret and moral justification go hand in hand. The claim, however, is a highly suspect one. In a recent paper, R Jay Wallace illustrates its falsity with the use of a helpful example.^{vi 13}

The epistemic thesis

The foregoing might be considered a rather lengthy refutation of what is, in any case, a highly contentious thesis: that moral justification tracks regret in abortion. But understanding how the moral justification thesis can be shown to be wrong—particularly through the prism of Wallace's analysis—has another pay-off, in that it helps us to see why the epistemic thesis also fails to convince. To reiterate, the epistemic thesis claims that a relatively high rate of postabortion regret is a good indication of abortion's moral impermissibility. As we saw earlier, it is far from clear that most women do in fact regret their early abortions or experience negative emotional reactions associated with regret. Nevertheless, I accepted for the sake of argument the more supportable claim that more women experience postabortion regret than similarly situated women experience postnatal regret (as I pointed out, this suggestion is consistent with the research mentioned, although it may yet be susceptible to alternative explanations). But I believe the epistemic thesis would be flawed even if the stronger claim were true, that is, if many or even most women regretted their abortions. Let us assume then, that this is the case: that abortion begets regret in most cases. Would it be a reason to suspect abortion of being morally impermissible?

First, the regret alluded to would again have to target the right kind of object for it to suggest anything about moral impermissibility. People may regret decisions for all sorts of reasons which have no bearing on their moral soundness. Many people might regret buying a certain model of car because it depreciates quickly, and this would not be a reason to think that buying the car was impermissible. For moral permissibility to be implicated, the specific object of regret would have to meet Kaczor's characterisation, namely, the decision to end the life of the fetus, and take the form of guilt directed at that decision. So let us also grant that this really is the nature of postabortion regret as commonly experienced. If one happens to know that most people come to experience guilt over a certain decision, is this not enough reason to suspect that decision of being morally defective?

It is perhaps true that such a finding should give one pause for thought. But far more would need to be established before it should be accepted as evidence of abortion's moral impermissibility. Specifically, one would have to be satisfied that there are no compelling explanations for postabortion regret other than abortion's moral problematicness. However, Wallace's description of the young girl's child example helps to reveal a very credible alternative explanation. As with the young girl, where a woman chooses to carry a pregnancy to term and bear a child, she will alter her future deliberative situation so that regret over her decision will become inappropriate once her child is born. As I said, this does not mean that she will be altogether incapable of experiencing regret, but that she has an important reason not to embrace that attitude, emanating from her maternal duties. On the other side of the coin, women who choose to terminate pregnancies are under no such parallel duty to celebrate and affirm their decision in retrospect. Given that they are under no such duty—to anyone else, or to themselves—it would first be completely unsurprising to learn that they experience regret more widely than the alternative group. They are under no duty not to form such an attitude. The counterfactual is one in which they have nothing that it is appropriate to regret, whereas it is not altogether inappropriate to regret an abortion.

This asymmetry of duties aptly explains why we should expect a higher rate of postabortion regret compared with postnatal, but it might be objected that it would fail to explain why so many women regret abortion, if this happened to be true. Women who have abortions are not duty-bound to affirm their choice, as mothers may be, but neither are they compelled by any duty to regret it. With both retrospective attitudes open to them, might not a high frequency of regret still count as evidence for abortion's moral impermissibility? Of course, it is entirely possible for whole swathes of people to be mistaken in their retrospective assessment of a decision. But the challenge set by antiabortion advocates might be to explain why postabortion regret would recur with such high frequency if it is not informed by the realty of the moral situation. This, however, is not a difficult task.

First, much might be revealed by considering the effects of the asymmetrical duty discussed on human psychology. With the locus of fear and panic (the unwanted pregnancy) now removed, women who have abortions are left only to dwell on a counterfactual in which they would have a child whose existence they could not but celebrate, even if it were concomitant with challenges for which they are unprepared. This may be partly a function of imagination and its respective limits in the alternative scenarios. Serious psychological barriers may stand in the way of mother's ability to imagine life without a child she now knows and loves, and especially to view such a counterfactual in a positive light. In contrast, women who have abortions do not contend with the same impediments if and when they imagine life with the child they chose not to have. Though there may be goods in their lives incompatible with that counterfactual (career success, greater freedom of movement and so on) the mental exercise of imagining them away may not come up against the same level of psychological and emotional resistance, freeing such women up to concentrate on what they might have lost, rather than forcing them to think only of what they have gained.

Second, I have already mentioned the possible influence of cultural attitudes towards reproduction on what women express about abortion and childbirth. If this is plausible, then there is equally reason to suspect that cultural norms will affect the retrospective attitudes women actually form. It is possible that social expectations account for the actual experience of postabortion regret every bit as much as they account for its expression. There is a persistent message that abortions are to be regretted, that it is appropriate to regret them and that they are a dark blot on a moral record which it can only be hoped will never be discovered. The sheer rareness of women willing to publicly admit to having an abortion attests itself to the widespread moral condemnation of—at best, the public ambivalence towards abortion choice, and one cannot disregard the impact this has on the retrospective attitudes of those women who opt for it.

Women who have abortions have no duty-based reason to affirm their decision in retrospect, are left to imagine only a counterfactual scenario where regret is inaccessible, and are socially encouraged to believe and express the sentiment that their decision was morally erroneous. All of these considerations can provide a ready explanation as to why so many women regret abortions, and not child-bearing, without suggesting anything about the moral impermissibility of opting for the former.

The rational justification thesis

Perhaps, though, the discussion so far has only strengthened the third and final thesis about abortion reasoning and abortion regret. Faced with the dilemma of whether or not to continue an unwanted pregnancy, the pregnant woman might truthfully be told that whereas she will not reasonably be able to regret continuing the pregnancy, the same cannot be said if she terminates. Should not she choose the course of action that she cannot reasonably regret? Presuming that a life which carries serious regret is the worse off for it, it might be suggested that the rational course of action is to choose the option which simply bars it. Hence, the relative likelihood of postabortion regret undermines the rational justification for abortion.

What is amiss in this reasoning? We can certainly understand why the avoidance of future regret can be a pertinent consideration in determining the rationally best course of action, but only insofar as that regret is parasitic on a failure in rational deliberation. Returning to the car example from earlier, the reason why high rates of consumer regret should dissuade the new customer from buying the car is that it suggests the car was a bad choice for all of the reasons that are important in the customer's initial decision-making process (the car's durability, efficiency, depreciation rate, etc). But when it comes to abortion and childbirth, the asymmetry in attitudinal duties (the mother must affirm her reproductive decision; the women who has an abortion need not) undermines the relationship between retrospective attitude and best choice. The woman who becomes a mother will be duty-bound to celebrate her decision whether or not it was the optimal one for her and her well-being. Consequently, if the inaccessibility of regret to mothers is invoked as a reason to choose against abortion, this cannot be because it suggests that the abortion is unlikely to be rationally justified. It can only then be the avoidance of regret per se which is being propounded as a reason to choose against abortion. You should choose the course of action which certainly avoids regret, whether it is the best one or not.

The idea that avoiding regret is, in and of itself, a reason for acting in a particular way is an interesting one. It is of course difficult to imagine that the resistance of a particular course of action to regret could be a reason for doing it. The exhortations “go on a long walk today, you won't regret it” or “have children, you won't regret it” fail to provide any positive reason for following the suggested course of conduct. We usually require more in the way of reasons for doing things than that we will not regret them. On the other hand, the possibility or likelihood of regretting an action or decision can be intelligibly deployed as a reason against that course of conduct (“don't go out in the rain, you'll regret it”). If there is a decent chance of one's regretting an abortion, then, perhaps this ought to count against the decision.

However, when regret is deployed as a negative reason in this way (“don't go out in the rain, you'll regret it”), its persuasive power only derives from the belief that the regret will reflect justification. What is really meant by ‘don't go out in the rain, you'll regret it’ is ‘you will regret it because it is imprudent’. In other words, it is merely a more powerful way of impressing on a person the folly of an action which does not derive from its propensity to cause regret. Yet this is not the same thing as invoking the possibility of experiencing regret as a reason itself to avoid the action. This would only be sound reasoning if it were the case that experiencing regret over the relevant thing was so bad for a person, and so ruinous, that absolutely ensuring its avoidance is a consideration which trumps all other reasons in favour of a course of conduct. But in most cases this would be to wildly exaggerate the impact of regret on people's lives. Living with regrets does not mean that one's life is dominated or seriously marred by those regrets, which may be reflected on only from time to time.

Returning to the young girl in the crisis pregnancy, it is clear that the question of what is best to do is still one that she must grapple with at the time of the decision, and that she cannot be helped along by the understanding that she would, in any event, ultimately be unable to regret choosing motherhood. Since the choice which maximises her own well-being will not inevitably be the choice which leaves her with no regrets, she will fail to engage in serious reasoning about what best to do if she merely exchanges the sum of reasons for or against procuring a termination for a conclusion on how best to avoid experiencing future regret. That a decision may yield regret is not enough, by itself, to suggest that it is the wrong one, and as we saw, regret over abortion decisions in particular can often be encouraged by factors not having to do with the moral justification of the decision or its effect on women's welfare. Consequently, using the possibility or likelihood of regrets to deter women from abortion is rationally unfounded at best, and at worst, emotionally manipulative.

Nothing I have said here is meant to be conclusive of the moral permissibility of abortion, which I believe substantially depends on what moral standing is rightly accorded to the fetus. My aim has only been to disqualify knowledge about postabortion regret as salient to that question, and to others.