The Structural Abortionism That Remains after Roe v. Wade

How to Proceed

The American abortion debate for fifty years suffered from a lack of imagination about what a world without Roe v. Wade would look like. Now, as some state governments give 100 percent support to abortion and others display 99 percent opposition, Americans are about to find out.

I cannot forecast accurately the changes that will come in the first post-Roe decade. I can, though, list some fundamental things that will still apply. A kiss will still be a kiss. A sigh will still be a sigh. Some men with hearts full of passion, jealousy, and hate will pressure women to abort. Some pregnant women will take desperate measures in a case of do or die. The world will always welcome lovers, as time goes by1—but some churches won’t, and some pastors who fear their congregations will be silent. What this all means is that the need for compassionate help amid crisis pregnancies will remain. Some tiny humans will survive, but most who would have faced a death sentence will still face it, sometimes in New York, California, Illinois, or other abortion strongholds, sometimes in a lonely room where a desperate woman ingests a pill or potion, much as her predecessors in colonial America would have.

The Story of Abortion in America

Marvin Olasky, Leah Savas

Authors Marvin Olasky and Leah Savas detail the long history of abortion and its impact on American culture through vivid personal stories that humanize people on both sides of the debate.

Life or death for unborn children will still depend on the willingness of their mothers to protect them.

Big media, as in the past, will be crucial, and street-level reporting will have more of an impact than suite-level pontificating. Sadly, initial press coverage of the Dobbs decision was largely hysterical. Fearmongers said governments would prosecute women and even use data from apps that millions of women use to track menstruation.2 Journalists rarely told stories of an unexpected pregnancy enriching a life, rather than ruining it. On the other hand, some of my fellow pro-lifers were triumphalistic, foreseeing an era in which abortions vanish.

We need to remember the historical reality: Even when public opinion concerning abortion was more negative than it is now, enforcement of abortion bans was difficult. While millions of abortions occurred, only a tiny percentage of doctors did prison time. It was often hard to get police to arrest, juries to convict, or judges to support jury decisions and turn down appeals.

Activists on both sides should pay attention to a May 2022 New York Times column by pro-life doctor Matthew Loftus, and the reaction to it. Loftus described his “position on the political question of abortion: It should be illegal under nearly all circumstances to kill a baby in the womb because doing so deprives a human being of the right we afford to any other human being.”3 That, in itself, was unusual for the abortion-advocating Times.

Furthermore, Loftus did not make exceptions for rape, incest, or genetic findings. He wrote, “As devastating as pregnancies created by incest or sexual assault are, and as challenging as genetic malformations can be, the circumstances of one’s conception are not used to justify ill treatment postnatally—so why would we discriminate prenatally? Rather, we assume that any disadvantages to a breathing child caused by poverty, violence or poor health are meant to be reckoned with by means of extra generosity and care.”

But Loftus did describe the decision he had to make one day as he served the poor in Africa. A pregnant woman in her twenties had already lost about half of her blood before she arrived at the clinic. Loftus, another doctor, and the senior nurse on duty all agreed about the necessity of aborting the child to save her life, and with the consent of the woman and her husband they went to work. He mourned the need, in this extreme instance, to save one life by ending another, and said only his faith in Christ allowed him to get through the night and continue to view his medical work “as part of a battle against brokenness in the physical health of my patients, a battle whose tide was turned when Jesus Christ rose from the dead.”

I tweeted that column and praised it. One reader responded by calling it “terrible” because Loftus took action rather than relying on “divine intervention” so as to save both mother and child. Then the reader sat in judgment, saying that although Loftus “talks about God, he does not believe in the God of the Bible who can and does do miracles. His guilty conscience is looking to justify his grisly deed so he felt compelled to write an opinion piece justifying himself before the world.”

In one sense, such reaction was no surprise. Basketball is a contact sport, football a collision sport, and Twitter has aspects of both. Some abortion advocates screamed bloody murder and some pro-lifers said anyone against jailtime for women who abort is complicit in bloody murder. That is folly both ethically and practically. Social pressures both micro and macro—an irresponsible boyfriend, a society with many laws and economic imperatives that are not child-friendly—mean that many women are victims.

Leah has pointed out to me that women who have abortions aren’t victims in the same way unborn children are. Women facing economic, social, or psychological pressure can choose not to give in. Here’s where one compassionate friend can be a lifesaver. How to assess degrees of responsibility is hard for me, but not for God: He knows what’s in our hearts, and he shows mercy to millions. What I can say pragmatically is that arresting women is a sure way to arrest the progress of pro-life ideas in the twenty-first century.

American abortion history has also shown me that social and economic pressures are strong: When abortion pressure grows, the only fundamental thing stronger than that is love. Punitive attempts backfire. Harsh measures don’t change hearts. Knowledge of fetal anatomy helps, and ultrasounds are great tools. Knowledge of the Bible helps, but many are resistant. Community pro-life sentiment is crucial not only in prevention but in enforcement as well: Without it, district attorneys won’t prosecute and juries won’t convict.

He knows what’s in our hearts, and he shows mercy to millions.

This doesn’t mean law is irrelevant: Laws can reduce the supply of abortionists and affect beliefs about right and wrong. Laws will not end abortion but they can reduce the body count, similar to the way laws against drunk driving today cannot end the practice but can save lives. Child-friendly public policies and corporate practices can also help.

We can learn something from discussions of “structural racism” during the past several years: American society now has what I’d call “structural abortionism.” The frequent corporate response to Dobbs—we’ll pay travel costs to legal-abortion states for employees in pro-life states—shows abortion’s economic role. We need more career and worktime flexibility. Governments and corporations should have child support stipends and generous maternity leave policies.

Besides those top-down changes comes the question of helping those who provide one-to-one help to women in crisis. States such as Missouri and Arizona are helping to reduce abortion demand by creating tax credits for contributions to pregnancy-resource centers. Tax credits could also help adoption nonprofits, but that will require more trust in God among women who sometimes choose abortion over “giving away” a child. As long as the only two choices for many women are abortion or becoming a single mom, pressure to allow abortions legally or illegally will remain.

Roe v. Wade poisoned children and poisoned American life. Leah and I hope the womb and the political arena will become safer places. Now that success on the supply side is possible, we hope pro-lifers will expand efforts on the demand side by helping more parents visualize their unborn children and by showing compassion in regard to material and spiritual needs. It’s time for all of us to proceed, as Abraham Lincoln proposed in his second inaugural address, “With malice toward none, with charity for all.”


  1. The reference here is to the 1942 movie Casablanca: worth seeing if you haven’t seen it, worth seeing again if you have.
  2. Analysis of Justice Samuel Alito’s opinion sometimes attempted to undermine his refutation of the history that underlay Roe v. Wade. On July 19, 2022, after I completed proofreading this book, a Washington Postheadline declared, “Key Founders Saw Abortion as a Private Matter.” The main evidence: Patrick Henry in 1792 defended two members of the wealthy Randolph clan after gossips said a young man had committed infanticide or a young woman had had an abortion. Accusations of adultery and incest were also part of the story. The Post article, though, did not take note of material in the papers of future Chief Justice John Marshall that render this abortion theory improbable. (See -case-reveals-that-key-founders-saw-abortion-private-matter; and https://rotunda.upress.virginia .edu/founders/default.xqy?keys=JNML-search-1-4&expandNote=on#match1.)
  3. New York Times, May 20, 2022, accessed at -doctor-pro-life.html.

This article is adapted from The Story of Abortion in America: A Street-Level History, 1652–2022 by Marvin Olasky and Leah Savas.

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