Kate Cox, the Texas woman who sued to have an allegedly “medically necessary” abortion, has been at the center of a media firestorm. Initially, a judge ruled that she could go through with the abortion, only for the Texas Supreme Court to put a hold on that ruling and then ultimately say that the lower court decided the case wrongly, upholding pro-life Texas law. Cox has since reportedly responded by choosing to go out of state for an abortion — something she could have done from the beginning — though it is not yet clear if she has already undergone the procedure to kill her child.
There has been much said about Cox, her health, her preborn child, and abortion. But what are the facts?
What happens during a D&E abortion?
As stated in court documents, Cox was planning to seek a dilation and evacuation (D&E) abortion at nearly 21 weeks pregnant. A D&E is the most frequently committed abortion procedure between 13 and 23 weeks gestation. Though Cox has said she wants to prevent any potential suffering for her daughter, a D&E is far from a simple, painless procedure. It is commonly known as a “dismemberment” abortion — because that’s what it does to the living preborn child in the womb.
The standard of practice is for a D&E to take several days, although some abortionists may attempt a same-day procedure, which increases the risk of injury to the woman. First, the abortionist inserts laminaria into the woman’s cervix, forcing the process of dilation to start. Next, after one or two days, the mother returns to the abortion facility, where the abortionist forcibly dilates her cervix. Using a sopher clamp, the preborn baby is ripped apart, limb from torso, with the final step in the procedure being for the baby’s head to be located and crushed. The abortionist then uses a curette to scrape the lining of the mother’s uterus in an attempt to remove anything that remains. The baby’s dismembered body will then be reassembled by the abortionist to ensure nothing was left inside the mother’s womb.
This procedure takes place during a period when a preborn child can most likely feel pain.
Nicole LeBlanc has been in Cox’s shoes, and previously spoke with Live Action News about her experience being pregnant with conjoined twins who were said to have no chance of survival, as they shared the same heart. LeBlanc nurtured and carried them until their natural deaths after being born.
She sent an open message to Cox on Twitter.
“From one mother who had a life-limiting diagnosis for her conjoined twins, and having my life also be at risk, abortion is never, ever the answer,” she said. “If mom is in distress, or baby’s in distress, the proper protocol would be to deliver the baby… not to abort it. Kate acknowledges that the baby won’t really live a very long life, and that’s something that I am dealing with every single day. But abortion is never the solution to a baby who has an abnormality.”
“So, how are you going to choose to honor your baby, Kate?” LeBlanc continued. “How are you going to bury a baby who’s been dismembered and crushed? Whose skull has been crushed? Whose heart has been stopped? How are you going to honor that baby? How can you make little tiny footprints if you’re going to abort your baby?”
She added, “Being a mom to two babies that are no longer here is the most difficult thing I’ve ever had to go through in my entire life. But I can sleep well at night, knowing that I did the right thing. And this is not to brag, but my children died naturally… peacefully. They were not harmed. I know their lives were going to be short anyways, and no, they didn’t experience any suffering, because that’s just how they were forming. If you know that your baby isn’t going to live very long, why would you subject your baby to more physical pain to end their lives?”
Part 1. #CatholicTwitter #ProLife @LifeSite @LilaGraceRose @letthemliveorg @LiveAction pic.twitter.com/TR5ixfkNa1
— Nicole LeBlanc🇻🇦 (@nicolita_d) December 10, 2023
Is the abortion medically necessary?
One of the aspects of this case frequently claimed in media coverage is that Cox “needs” the abortion for medical reasons – namely, so she can have children in the future. Cox has had two prior c-sections, so the idea is that she needs an abortion to ensure she can have other children in the future — ones without disabilities.
What if Cox’s child didn’t have Trisomy 18? There would likely be no discussion of having an abortion; essentially, this case is an issue of not wanting to risk her fertility on a “defective” child, so she can get pregnant again in the future with a “normal” child instead.
Notably, Trisomy 18 is labeled “incompatible with life,” but it actually is that label itself which may lead to the short life spans of children diagnosed with it. Because of that diagnosis, doctors are often unwilling to provide the medical care that children with Trisomy 18 need, therefore leading to an early death, and perpetuating the “incompatible with life” cycle.
Numerous people with Trisomy 18 are proving that they can survive… if they are given the chance to do so.
Doctors at Children’s Hospital and Medical Center in Omaha, Nebraska, are proving that. “If a family didn’t want surgery for an infant with VSD or tetralogy or even pulmonary atresia, we would take them to court, take the child out of the family and take care of them,” Dr. James Hammel, former division chief of Cardiothoracic Surgery at Children’s, previously said, though this is considered the standard of practice for children with Trisomy 18 – despite high success rates. According to Dr. Hammel, 70 to 80% of babies with Trisomy 18 survive heart surgery, and 50% will still be alive 16 years later. Other research has found even higher success rates.
Families travel from around the country to Omaha to receive care at Children’s multi-disciplinary unit, where children with Trisomy 18 are actually given the chance to survive. “Most physicians view this as a hopeless diagnosis – but there is always hope,” Hammel said. “Yes, these kids have functional limitations, but there is plenty of room to make their life better… I’ve always said if I can improve a child’s chance of survival from five percent to 10 percent, I’m perfectly happy to take that on if that’s what the parents want to do.”
Hammel further told the Omaha World-Herald that the “incompatible with life” label given to children with Trisomy 18 now was previously given to children with Down syndrome; in just a few decades, the life expectancy for people with Down syndrome has more than doubled, thanks to medical advancements and the willingness of the medical industry to actually treat them. “What’s changed is the understanding (that) if you treat the issues they typically have, they can live a long time. They can learn and grow and participate in life,” he said.
The problem is not that children with Trisomy 18 can’t survive. Thanks to medical advancements, they often can, if they are given the chance. Whether that’s true for Cox’s child would be impossible to know without seeing her medical records. Additionally, Cox’s team has been spreading the notion that her health is at risk simply by carrying her child with Trisomy 18 — something that does not make medical sense.
“A preborn child’s condition of having Trisomy 18 does not put his or her pregnant mother’s life or health at risk, nor does it endanger her future fertility,” Dr. Christina Francis, board-certified OB-GYN and CEO of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), told Live Action News. “Furthermore, having Trisomy 18 does not spell certain death for preborn children with a health care team that’s committed to their well-being. One study out of Japan found that 15-17% of Trisomy 18 babies live to at least one year post-birth with appropriate interventions. That number vastly contrasts with the picture that the media paints by describing these babies as ‘non-viable.'”
Are multiple c-sections dangerous?
Cox has said she will need to have a C-section to deliver her child when the time comes, because she cannot have a vaginal delivery, which she says puts her life at risk. Yet it is not uncommon for women to have more than two C-sections and, according to Mayo Clinic, there is no research saying how many C-sections are considered safe.
“Though the answer to the question of how many C-sections a woman can safely have will vary on a case-by-case basis, Ms. Cox’s prior history of two C-sections is a common scenario and does not pose a significant risk to her current health,” AAPLOG’s Dr. Francis said. “Though I cannot comment on her specific case without seeing her medical records, I have personally treated many women with two or more prior C-sections, and they have been able to deliver healthy babies.”
It’s an answer echoed by other medical sources, such as Dr. Robert O. Atlas, chairperson of the department of obstetrics and gynecology at Mercy Medical Center. “There are some people who have had six or seven C-sections without any issues, and others with only one C-section whose next pregnancy is associated with a very difficult problem such as placenta accreta spectrum disorder, or a horrible adhesions (things stuck together),” he told Healthline.
There is no reason to argue that a third C-section would prevent Cox from having other children in the future, and it certainly doesn’t make a intentionally dismembering a preborn child “medically necessary.”
And in fact, in its seven-page opinion rebuking the lower court for approving Cox’s abortion, the Texas Supreme Court stated that the doctor involved in the case “asked a court to pre-authorize the abortion yet she could not, or at least did not, attest to the court that Ms. Cox’s condition poses the risks the exception requires,” which included, according to a press release from Texas Alliance for Life, “endanger[ing] a mother’s life or risk[ing] substantial impairment of a major bodily function (such as fertility).”
Isn’t the abortion risky too?
In a sign of just how radically pro-abortion the talking points of this case are, it is frequently argued that Cox “needs” an abortion because another c-section, or an induced delivery, will cause catastrophic damage to her uterus… as if an abortion would somehow pose no risk to her apparently already fragile uterus.
With Cox, consider, for example, the scraping of the uterus after the abortion has finished. One issue with multiple c-sections — which Cox has already had — is that the uterine lining can become thin, leading to rupture. This is ostensibly one of the reasons she claims her abortion is necessary… yet in that scenario, a curette scraping against that thin lining could lead to a rupture.
Surgical abortions are known to come with risks, and those risks only increase as a pregnancy progresses. And, as Dr. Francis explains, an abortion has the potential to negatively affect fertility.
“While any C-section has potential risks, surgical abortion has, in fact, been shown to affect a woman’s future fertility,” she said. “Specifically, evidence in peer-reviewed literature from more than 160 studies over fifty years points to a causal relationship between surgical abortion and subsequent preterm birth. This may be due to factors such as damage done to the cervix when it is dilated and inflammation that may be caused by the procedure. She would also have a higher risk of other complications, such as hemorrhage, from a D&E at this stage of pregnancy compared to earlier gestational ages.”
There is no doubting that Cox’s case is tragic, difficult, and sad. But she does not need to kill her preborn child; it is not medically necessary, and killing human beings with disabilities is not compassionate or loving, in or out of the womb.
Editor’s Note, 12/12/23: This post has been updated to add further information on the Cox case.
