Pro-life and pro-choice circles alike are abuzz over the newest attempt to limit abortion in the United States. Texas Senate Bill 8 (“The Texas Heartbeat Bill”) prohibits abortion of a fetus with a detectable heartbeat. Pro-life advocates see the bill as a win, while pro-choice activists mourn what they see as an attack on women’s freedom.

While among the most stringent regulations of abortion put into place since Roe v. Wade, Texas SB8 provides room for medical emergencies. In these cases, abortion is permissible at the discretion of the pregnant woman’s doctor. Those familiar with the Catholic Church’s reputation as a staunch defender of the right to life might be wondering whether the Catholic Church makes the same exception.

Is abortion permissible to save the life of the mother? How can the Church claim to respect the life and dignity of all when it appears to place the burden of carrying even life-threatening pregnancies to term on the shoulders of women? 

The answer is complex, nuanced, and not always clear-cut. To start, here are three relevant principles that Catholic doctors, hospitals, ethicists, and patients consider when making these tough decisions:

1. The Catholic Church recognizes the inherent dignity of all human life.

All human beings, regardless of age, status, race, sexual orientation, disability, or even criminal activity, are made in the image of God and therefore have inviolable dignity. The Church recognizes that this moral status has been granted to all humans by God, and as such is not something that we have the right to withhold from others.

2. Abortion always ends a life.

Even outspoken abortion advocates like philosopher Peter Singer recognize that human life begins at conception: “Whether a being is a member of a given species is something that can be determined scientifically, by an examination of the nature of the chromosomes in the living cells of the organisms [...] There is no doubt that from the first moments of its existence an embryo conceived from human sperm and egg is a human being” (Practical Ethics). The Church takes a step further by arguing that these lives, no matter how young, are worthy of protection.

3. For any medical decision during pregnancy, the Church will always recognize the good of two unique persons, equal in dignity.

Although a fetus is entirely dependent upon its mother for many months following conception, that dependence does not negate that he is a person in his own right. It follows that pregnancy entails the good of two patients - the woman and the fetus - whose medical care is intrinsically linked.

When Survival Means Ending the Pregnancy 

While in typical, healthy pregnancies, the good of the mother and fetus are one in the same, medical conditions can arise in which the good of the mother and the good of the fetus appear to be at odds. When the goods of a mother and fetus are in conflict, the dignity of both must be respected. “Solutions” that privilege one over the other fail to navigate these difficult situations respectfully.

At times, these situations are gravely difficult and pose serious risk to both mother and fetus. In these cases, ending the pregnancy can improve the mother’s chances for survival. In some cases, this is perfectly acceptable. Early C-sections for preeclampsia, for example, end pregnancy while providing a good chance for both mother and child to emerge safely from the procedure.

The primary moral issue at stake is how the pregnancy ends. Termination of pregnancy by ending the life of the fetus always fails to respect its personhood and dignity, and is therefore always impermissible. We usually refer to this spectrum of options as “abortion for medical necessity.”

On the other end of the spectrum, termination of pregnancy is completely acceptable when a viable fetus can be removed in such a way that our medical capabilities can support a reasonable chance for his survival. We usually call this “birth.”

Gray Areas

In rare cases, medical complications of pregnancy present in such a way that the survival of both mother and child are unlikely, if impossible. The moral process of reasoning that the Church uses in cases like this is called “double-effect.” The clearest application of this principle in pregnancy is in the case of ectopic pregnancy, when an embryo implants not in the uterus but in the fallopian tube where, if it grows, it will rupture the tube and cause severe bleeding that can result in death for the mother. An ectopic pregnancy invariably results in death for the fetus, and so, being the only person who can survive the situation, the mother is the patient whose good should be sought.

Though this principle rarely applies, it can be helpful to women, their families, priests, and physicians in making decisions when treating uterine cancer during pregnancy and other similar conditions.

The Bottom Line

God has uniquely gifted women with what may be the most sacred and miraculous capacity of our human nature: the gift to bring forth life. For all the beauty of motherhood, pregnancy is not always free from complications - unfortunately, not even life-threatening ones. No matter the circumstance, though, both the woman and her child deserve our prayers, our support, and our tireless effort to care for them.