Does Legalizing Abortion Prevent Unsafe Abortions?


What is the “Coathanger Argument”?

By Dr. John Ferrer| One of the commonly spouted, earnestly supported, eagerly shouted arguments for the pro-choice position is the coathanger argument. Heavy laden with emotion, and with at least some evidential support, this argument is one of the time-tested favorites for swaying audiences to the pro-choice position.

Essentially, the argument is that restricting or abolishing women’s access to abortions would force women to procure abortion in dangerous ways. We don’t want to push women to have perilous abortions endangering themselves through “coathanger abortions” at home, or otherwise dangerous “backalley” abortions. Therefore, we shouldn’t restrict abortions.

The chief evidence for this argument is that illegal and unsafe abortions happened across women’s history before Roe v. Wade. Second to that evidence are appeals to human stubbornness; presumably, many women would still go forward with their desire to abort regardless of whether it’s legal. This notion seems reasonable enough, people can be pretty stubborn especially when it comes to matters relating to sexual practice, and it’s effects. The argument can sound quite compelling when it’s cited with pictures and descriptions to back it up.

The stronger forms of this argument distinguish between “illegal” abortions and other perilous abortions. Illegality, we can expect, will often correlate with increased dangers as abortion-seeking mothers revert to unregulated and non-clinical settings for their abortions. But, the kind of abortion in view here is unregulated abortions, including at-home, back-alley, or otherwise illegal abortions which, presumably, are less safe than we could expect in the safe, sterile, and medically regulated environment of a clinic or hospital.

Mistaken Assumptions

Error #1: Illegal Equals Unsafe/Legal Equals Safe

However, that correlation between legality and safety isn’t perfect, and it would be wrong to assume that illegality, as a rule, equals less safety for the mother. We cannot reasonably assume that just because any given abortion is illegal it is more likely unsafe for the mother. And vice versa, an abortion method could be legal but very unsafe for her.

Before Roe v. Wade there was, allegedly, a thriving medical abortion practice where abortions were conducted, primarily, in sterile and professional setting within hospitals.[1] In 1972 and earlier, many otherwise respectable doctors, were conducting abortions in Ob/Gyn offices, in-patient surgery wards, and Emergency rooms. In these clinical conditions patients benefited from medical protocols regarding sterilization, anesthetics, informed consent, nursing assistance, and so on.

Furthermore, abortion carries its own risks anyway—even under the safest conditions (for the mother). The American Pregnancy Association lists the following “light” side effects:

  • Abdominal Pain/Cramping
  • Nausea
  • Diarrhea
  • Vomitting
  • Spotting and bleeding

These are relatively common side effects, and should be virtually expected in 1st 2nd or 3rdtrimester abortions. But according to the same site, 1 in 100 first trimester and 1 in 50 second and third trimester abortions also incur some combination of “serious” complications:

  • Heavy or persistent bleeding
  • Infection or sepsis
  • Damage to the cervix
  • Scarring of the uterine lining
  • Perforated uterus
  • Damage to other organs
  • Or Death

These sorts of complications are not abundant, but they are more common than many pro-choice advocates admit. And they are common enough, and legitimate enough, risks to where anyone seeking an abortion should be aware of these possibilities, otherwise they haven’t given informed consent. In short, even legality, and firm regulations can’t make abortion “safe” but only safer than it might otherwise be in back-alleys and bathtubs.

Legality only sometimes overlaps with morality or safety. Federal and state regulations do matter but, frankly, medical providers and abortion clinics will adhere to whichever regulations they feel they need to for offering a marketable service. That means some regulations are ignored, if they think they can get away with it, and other regulations could be adopted on a clinic-by-clinic basis as they see fit for their practice. An abortion clinic is liable to offer their own, unique, regulations if they perceive it to be cost-effective and marketable.

For example, they may offer counseling services, follow-up visits, sterilization protocols, above and beyond any state or federal regulations. Just because a federal or state regulation isn’t in place doesn’t mean each clinic will descend into the “wild west” and start escalating dangers to women.

Error #2: Legalizing Abortion Reduces Unsafe Abortions

Another problematic assumption common within this objection is that liberal abortion access reduces the number of maternally dangerous abortions. This assumption is problematic because we just don’t have a reliable way to tell whether the numbers of illegal and back-alley abortions went up or down since legalization. People seeking illegal abortions generally don’t report to Guttmacher pollsters that they had an illegal abortion. As a rule, only the legal abortions are reported to the CDC, Guttmacher, etc.

We can theorize that unsafe abortions declined upon legalized abortion-choice policy; there’s a certain logic in this theory. But it’s only a theory. We can also theorize, reasonably, that federal abortion policy helped create a larger market for abortion services—now that women can acquire inexpensive legal abortions, they will live and act accordingly. Effectively, women and men generate more unplanned pregnancies under the expectation that they can abort if they believe it’s necessary.

Statistics from the Center for Disease Control point out that the rate of unplanned pregnancies, and out-of-wedlock pregnancies has risen since 1973, correlating with a declining marriage rate.[2] Without digging too deeply into this point, we can admit that if the rates of out-of-wedlock and unintended pregnancies rose since 1973 it’s at least possible that abortion-choice policy helped facilitate this climate of out-of-wedlock pregnancies.

And it’s within this climate of rising unplanned pregnancies (relative to ’73 and earlier) that the market for abortion rose from less than 100,000 abortions in 1969 (when it was illegal), to 12x’s as many abortions, averaging about 1.2 million abortions yearly since RvW.[3]

This ten-fold increase means that we could, at the same time, have a lower percentage but a higher total number of botched abortions and maternal deaths.

Error #3: Maternal Injury and Deaths from Abortion-related complications are systematically underreported and suppressed.

It would be easy to descend into conspiracy theory and conjecture, at this point, since we are dealing in “back alley” and unregulated medicine. Admitting that possibility, we should be aware that secrecy is the norm for unregulated, malpractice, illegal, or otherwise problematic forms of abortion.

For clinicians, it’s important to guard their own financial interests and suppress any publicity about complications or malpractice. It’s bad for business, and could lead to lawsuits.

For pro-choice politicians, it’s important to guard the narrative of “expanded abortion access lower risks.” If it turned out that expanded abortion access only nominally or inversely affected medical risks, then that could be bad for one’s political platform.

For abortion-seeking patients, it’s important to guard their privacy and their own good name. While laws require reporting clinical abortions in most states, the women themselves aren’t usually “proud” of their abortions, and aren’t excited to tell everyone that they engaged in “unsafe sex” or even were raped.

If complications or fatal trauma ensue, the individual or family and reporting examiner may prefer to suppress the evidence as it might shine poorly on the mother, embarrass her, or testify against him in the court of public opinion.

The truth of abortion fatalities and abortion complications can be embarrassing to the victim. Nurse practitioner Susan Schewell reports a systemic problem suppressing reports of abortion-related complications: “Women have been known to conceal abortions from loved ones, and a physician or coroner may be less apt to report her injury or death as abortion related.”[4]

Medical examiners on their own volition or by pressure from the family, may report the scene in a technically accurate way that overlooks the primary cause. In cases where no criminal or civil case is pending, the medical examiner may just be doing his or her best to honor the wishes of the family or the perceived discretion of the victim.

Scattered studies like this one from the Chicago Tribune show that medical records routinely, and deliberately, misreport abortion fatalities similar to underreporting suicide cases. In that article, Meghan Twohey suggests as many as 7,000-17,000 abortions went unreported in Illinois alone, 11 different abortion providers were operating “off the books” (unregulated), and up to 4,000 medical complications (including death) may have gone unspecified in official records.

Now, we cannot safely extrapolate Illinois’s problem across all of America, but this sort of investigative journalism does show that we cannot assume as true some of the most ridiculously small estimates—”4 abortion-related fatalities this year.”

A study in Finland found a higher rate of unreported and misreported maternal deaths from abortion than from pregnancy. The Finland study is exceptional for digging beneath the data from death certificates, and self-reported stats, to find suppressed information inferred from composite stats of hospital discharge registers, induced abortions, spontaneous abortions, live births, and cause-of-death. They found “94% of abortion-associated deaths were not identified from death certificates or cause-of-death registries alone.”

Other sources, often from Pro-life organizations, focusing heavily on this issue, suggest that multiple studies and reports collectively prove a suppressive climate, chronically underreporting abortion complications and fatalities.

Error #4: Repealing Roe v. Wade would return us to the Pre-Roe Era.

Another error that often swirls in here is that repealing Roe v. Wade would doom women to the culture of unregulated secrecy and second-class status that fostered medically dangerous abortions before 1973. The problem here is that the maternal risks were already dropping well before 1973, and not because of abortion-legislation but because of advances in medicine.

Dr. Peter Saunders points out in 2012 post, that by 1968, the rate of maternal deaths from abortion had dropped to almost zero in England before abortion was legalized. The same goes for the U.S. prior to 1973.

The real life-saver isn’t Roe v. Wade, it was penicillin.

Now, of course, if Roe v. Wade were repealed then we are liable to end up in a federal court era similar in some respects to the pre-Roe period. But medical technology wouldn’t have to retreat. We’d still have our medical knowledge regarding infection risks, pain-management, and long-term effects of pregnancy and abortion.

We have no good reason to expect a repeal of Roe to drive doctors or patients to 1940’s era medical practice—back when the complications and fatality rate was sky high—when they could revert just as easily to 1972-era medical practice (which is still old-fashioned) but considerably safer. More reasonably, we can expect doctors and clinicians to use modern 21st century medical practices and technology to ensure as much safety and health as they can reasonably offer their patients.

If a women sought an illegal abortion in this day and age, she could find a panoply of methods through the internet, at a local library if needed, and purchase the materials through local, national, or international sources as she sees fit. Even though Penicillin, for example, is not an “over the counter” drug, it’s still incredibly easy and cheap to purchase and have shipped right to your door.

Moreover, if abortion were banned tomorrow, we’ve already been seeing a decline in abortion rates suggesting that women might actually be practicing safe sex more than they did in prior years. There’s no good reason to expect any concurrent ban on contraception, so “safe sex” would be just as feasible as before any abortion-ban. Some women would follow the adoption option.

And still others would just abstain, and perhaps even avoid foreseeable dangerous situations (wild parties, blind dates with online strangers, etc.). so, for those women, there is reduced chance of pregnancy and abortion. We could reasonably expect the incidence of abortion to decline, perhaps drastically, as women act within their self-interest to avoid illegal and personally risky abortions.

Still, we could reasonably expect some increase in coat-hanger abortions even if abortion were generally banned (say, for all cases aside from rape and mortal threats to the mother). But we cannot know how much so. This is speculative, and we need to guard against wild speculation. If even poor and marginalized women are generally responsible, self-interested, and can appreciate a measure of duty regarding their own children (in-utero or ex-utero), then there might be only a negligible increase or no increase in coathanger abortions. If however, women are generally irresponsible, foolish, and lacking self-awareness then we can expect the number of coathanger abortions to climb high if abortion were generally banned.[5]


So far, we’ve seen how the coathanger argument might still be formed into a plausible argument. Presumably, there would likely be some increase in the demand for “back alley” or “at-home” abortions if abortion were banned. We do not know reliably whether that increase would be drastic, minimal, or entirely false. Nor do we have reason to believe that any ban would force U.S. abortion practice back into 1940’s era medical norms.

And we also have reason to believe that statistics about abortion-related complications and deaths were suppressed, distorted, and misreported, quite possibly, to help maintain a better light on the current abortion-choice policy. Furthermore, it’s not clear at all that the incidence of back-alley and coathanger abortions have declined since 1973.

Sure, legalization brought abortion practice out of the darkness and into the light, but it also helped foster a skyrocketing demand for abortions which, in turn, helped stimulate abortion-providers to arise and meet the demand, often at a lower price, and even with illegal and subpar practices as long as they thought they could get away with it. In this way, characters like Kermit Gosnell were able to operate filthy and illegal clinical practices for decades, committing thousands of unregulated abortions and infanticide killings (i.e., “post-birth abortions”).

Having clarified and framed the coathanger argument we can now turn to formal rebuttal.

Evidence #1 If abortion violates human rights then it should still be banned (in part or in total) just as other crimes against humanity have been (i.e., slavery).

Abortion can still fail on its own demerits. If abortion isn’t already justified, in principle, then women and doctors who seek abortion would be doubly wrong for pursuing a wicked practice through dangerous ways. If abortion is morally wrong, on par, for example with manslaughter, then it seems silly to argue that manslaughter must be legalized or remain legal so we can keep it safe and regulated. The idea behind an abortion ban would be to make it harder, not easier, nor safer, to commit a great injustice against fellow man.

Evidence #2 The Coathanger Argument Commits the Consequentialist Fallacy [6]

According to the utilitarian fallacy, most anything can be explained away, morally, by appealing to “ends justify the means” thinking. As such, it’s too flexible to direct us toward truly and reliably good outcomes. It easily becomes a rationalization structure for doing whatever one wanted to do anyway. Utilitarian fallacies were commonly used in justifying any given barbarism in communist Russia, “for the good of mother Russia,” or in the 3rdReich for the good of the “higher race,” or in the Marxist uprising in Cuba.

Indeed, utilitarian thinking can be used to justify the worst genocides—so long as the people who would remain afterwards can foreseeably be happier overall than the net total of happiness beforehand. Utilitarian calculus could be used to justify torture, murder, or rape, if all of those behaviors helps the criminal dissipate his urge to ruin multiple lives by, instead, focusing all his criminal urges on one victim.

The coathanger argument commits the utilitarian fallacy by suggesting that legal abortion is a justified means to the desired goal of keeping women out of back alley abortion vans, or coathanger abortions. True to utilitarian form, there is no need for a dilemma where only abortion-choice policy would achieve this goal—it’s still justified as long as that goal is achieved.

To avoid the utilitarian fallacy, the arguer would need to show that liberal abortion choice policy is otherwise morally permissible or good. If it is admitted as “evil,” “lesser evil,” or just “not good,” then the coathanger argument comes unwound, using threats of unknown and conjectured evils to justify present, concrete evils.

However, this “ends justify the means” kind of thinking hasn’t shown all that. The “means,” abortion-choice policy, could still be horrifically evil. Abortion choice policy could still be so bad that it fails on its own demerits. According to prolife arguments, abortion-choice policy is precisely that, a horrible crime against humanity implicating the whole of America in such a vast and barbaric crime against humanity that the “coathanger” argument sounds silly in comparison.

Evidence #3 The Coathanger Argument Fails by Disanalogy.

One of the strange implications of coathanger argument is that we could apply known evils into the same rubric and achieve some weird results, results that prochoice defendants likely wouldn’t want to accept.

We could ban murder, but people are still going to murder. We could ban rape, but people are still going to rape. We could ban child molestation but people are still going to molest children. And if we banned all these things, that would force murderers, rapists, and child-molesters into riskier situations where they don’t just hurt or kill their victims, they might hurt themselves too. Banning these practices won’t stop these practices, and it most likely raises the risks for people who are determined to exercise their “right” to harm and kill their victims.

Do you see the problem? If abortion is not a right, if abortion is not itself moral, if abortion kills defenseless human beings by tearing them to pieces, chemically burning them alive, starving them to death, or crushing their skulls, then it makes good moral sense to ban the practice even if we admit room for some exceptions, such as mortal threats to the mother, or perhaps rape.

Even “Murder” has exceptions, including self-defense or war-time situations. We can expect people who are still determined to treat their children-in-utero this way to be marginalized and pressured into dark and covert corners to make sure they can still kill their baby. But other women might instead opt against abortion, because the legal climate helps strengthen their resolve in favor of protecting their child. People should have to revert to covert avenues before they can find assistance in killing human beings.

To be sure, even a federal ban on abortion would not entirely prevent all abortions, but it would deeply discourage abortions, and quite possibly reduce the percentage to a rate comparable to the pre-Roe era. Banning abortion would add a measure of risk to abortion providers and women seeking abortion. This sad but likely reality must be admitted if we are to face this coathanger argument honestly.

Evidence #4 The Coathanger Argument Manipulates Women

The pro-choice position often mentions patriarchal abuses, domestic violence, rape, and various instances where men hurt women. Abortion-choice policy, they argue, is supposed to help level the playing field, protecting a woman’s right to her own body, and her own family planning decisions.

Here the coathanger argument is commonly mentioned in justifying current abortion choice-policy as a new chapter of women’s liberation, closing that old chapter where women had to resort to illegal and dangerous coathanger abortions to exercise their bodily autonomy.

The problem with this narrative is that abortion choice policy may in fact be the more harmful option when compared to a general ban on abortion. It’s manipulative to women to use hypothetical and speculative harms relating to an abortion ban to pressure them into complying with the present, but demonstrably harmful, abortion-choice policy.

Abortion choice policy has done immeasurably more harm to women than pro-choicers let on. Within roughly two years after abortion was legalized, the number of abortions skyrocketed ten fold, from about 100 thousand to over 1 million, and that means a comparable increase in abortion-related risks. Abortion choice policy has facilitated countless cases of abortion-related depression, post-traumatic stress disorder (PTSD), physical complications like sepsis and uterine damage, infertility, and so on.

Abortion remains a terrifying correlate with homicide, with murder being one of the leading causes of death following abortion.[7] It’s not entirely clear why recent abortions correlate so heavily with homicide rates, but it is well known that in many cases the murderer had a history of abuse, was not her husband, and was not interested in settling down yet and raising a family.

Perhaps the murderer had previously coerced her abortion, or perhaps she used abortion to keep her boyfriend or husband from abandoning her only to find out later that she chose the worse of two evils. Whatever the reasons may be, abortion is a demonstrable risk factor for harmful and scary things including homicide.

Abortion choice policy has not exactly fostered much “choice” for women who were coerced into abortion by their families or by the child’s father. Studies have shown that up to 64% of women who had abortions report that they were coerced. And up to 83% of women who had an abortion report that they would have rather kept the baby.

And, of course, abortion wasn’t exactly liberating for the 30 million or so fetal-girls that were killed in utero since 1973. Since those 30 million females are denied their very lives, and any subsequent choices, privacy, autonomy, healthcare, or well-being they might otherwise have exercised, abortion is therefore supremely oppressive to a huge portion of womankind. We may not know of any single policy in U.S. history that has harmed women more drastically and more tangibly than abortion-choice policy.

Abortion demonstrably harms women. Meanwhile, the coathanger argument attempts to fortify and protect the very abortion-choice policy. And what’s the reasoning? Well, banning abortion might increase the number of women who seek out back-alley routes to abortion. But that’s as much as we can say, because women are already seeking back-alley abortion, even while it’s legal.

Abortion-choice policy has (apparently) fostered such a huge market for abortion that even with its legality enough women are still clamoring for abortions so desperately that criminals like Kermit Gosnell, Naresh Patel, and others, were able to operate for years in spite of gross negligence, malpractice, and in Gosnell’s case, homicidal intent.

Meanwhile, numerous abortion clinics have broken federal and state medical regulations, running unsanitary clinics, using uncertified or untrained staff, using expired medicines, and failing to monitor, counsel, or properly inform patients of the risks involved in abortion.

Prochoicers may object that pro-life regulations shut down the better clinics and forced women into those unsafe and illegal clinics. But Gosnell and Patel’s clinics were in Philadelphia (PA) and Queens (NY), in two of the most abortion-friendly districts in the country! Prolife regulations and restrictions, where they exist, have overwhelmingly demanded that abortion clinics exercise fewer and safer abortion practices, thus reducing the effective risk factors for women.

Lastly, the coathanger argument does not just manipulate women by using threats of worse dangers to persuade compliance with present dangers, pro-choice advocates typically swirl in alarmist fears about religious fundamentalism, theocracy, and old-world patriarchalism. This is a fear-based tactic that’s supposed to rile women against the prolife position and comply with the intended outcome of the coathanger argument: liberal abortion choice policy.

This manner of argument is blatant manipulation because no one seriously engaged in the abortion debate at the federal, state, or academic levels wants to revert to 19th century inequality laws, where women were denied voting rights, property ownership, and various civil rights (aside from abortion). Religious advocates can be found on both sides of the abortion debate.

Secular and anti-religious advocates can also be found on both sides of the debate. And there’s no clear or reasonable cause for thinking that the prolife agenda would merge church and state, introduce theocracy, or elect the pope as the President. This point cannot be emphasized enough.

Typical abortion-choice arguments retreat to a ridiculous strawman conception of prolifers, as if they want to repeal the 20th century’s worth of human rights legislation just because they want a general ban on abortion. Of course, more sensible and responsible pro-choice advocates understand this and would not be guilty of such egregious mischaracterizations. But these sorts of exaggerations are still common in the mouths of pro-choice advocates.[8]

Evidence #5 The Coathanger Argument Relies on Bad Numbers

According to the Coathanger argument, one would think that liberal abortion choice policy is a vital protection for women, helping to prevent abortion complications and maternal deaths. But despite a globally trending decline in maternal deaths (in pregnancy/birthing), the U.S. rate is rising. Prochoicers may argue that this is because of prolife legislation restricting abortion-access.

But prolifers can equally argue that abortion access is still more liberal in the U.S. than most other countries that aren’t having this problem, and we still have more abortions—total—than all other countries except China and perhaps Russia. Liberal abortion choice policy does not guarantee that women will be overall safer from abortion-related complications. It only guarantees a high rate of abortion. The countries with highest total abortions all have broad liberal access to abortion.[9]

The estimated numbers of illegal abortions pre-Roe are also exaggerated. Former abortion doctor, and the cofounder of the National Association for the Reform of Abortion Laws (NARAL), Bernard Nathanson confesses:

“In NARAL (the acronym for the then-National Association for the Reform of Abortion Laws) we generally emphasize the drama of the individual case, not the mass statistics, but when we spoke of the latter it was always 5,000 to 10,000 deaths each year’. I confess that I knew the figures were totally false…But in the ‘morality’ of our revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics?”[10]

Also, the coathanger argument relies heavily on our relative ignorance about the medical statistics prior to Roe v. Wade. We touched on this earlier. Medical advances prior to Roe v. Wade vastly improved the care for pregnant women and drastically reducing the number of abortion and pregnancy related fatalities. The CDC reports only 39 pregnancy related deaths in 1972.[11]

Now, we also noted how that number is likely an underestimate, but it’s still considerably lower than previous reports from the CDC using the same metric for pregnancy-related deaths in 1935, 1955, or 1965.

Evidence #6 Policy Affects Behavior

Another fault in the coathanger argument is that it’s advocates typically overlook or minimizes the known reality that legal policy affects behavior. We know that policy affects behavior because it already has.

When abortion was first legalized at a state level for special cases in Colorado, North Carolina, and California, in 1967, the abortion rate tripled—from about 2,000 to 6,000 abortions. But those low numbers are small enough to where they are subject to false attribution, and outside causes. By 1970, New York, Washington, Alaska, and Hawaii had legalized abortion-on-demand (or near equivalent).

And sure enough, that policy shift corresponded with a 7-fold increase in abortions, from about 25,000 to 193,000. When abortion was first legalized at the federal level, the abortion rate jumped again from roughly 750,000 to about 900,000 the next year, a million more the next year, and an average of about 1.2 million yearly since then.[12] Only recently have the numbers started to drop below 1,000,00 annually.

Liberalizing abortion policy appears to have stimulated whatever practices were causing unwanted pregnancies, whether that was misusing contraceptives, failing to use contraceptives, the contraceptives didn’t work, or just “second guessing” one’s planned pregnancy. Turning the tables, however, we have no great reason to expect women to continue at the same rate of unwanted pregnancies if abortion were banned.

If abortion were banned tomorrow, a lot of prolifers would be personally unphased since they had no plans on getting an abortion, and have no need for one in the foreseeable future. We can also expect that some hardline prochoicers would only grow more fervent, perhaps getting pregnant for the sole purpose of having an illegal abortion—as a political statement.

But there are also liable to be a lot of women in the middle, along the spectrum of moderate prochoicers and moderate prolifers, who would either carry their child to term, refrain from unsafe sex, or refrain from intercourse entirely, because the federal policy lent just enough social pressure to help them avoid abortion. In practice, even many prochoicers will admit that abortion is a tragic and unpleasant experience and they’d avoid it if they could.

But, as long as it’s legal, they will conduct themselves in such a way that they can always resort to that “escape hatch” if necessary. For those women, if abortion were generally banned, many of them would change their behavior either for fear of punishment (a fine, probation, jail time, etc.) or perhaps because they adapt their sense of social mores, or shift to different moral foundations, in accordance with the new social standard. People will more easily make the connection that because abortion is illegal it is most likely bad.

We don’t even have to dip into the metaethical foundations here. People tend to acquire some sense of right and wrong, in part, from social standards, and we have no reason to expect a general ban on abortion to operate any differently.

Evidence #7 Abortion is Never Safe

The last and most crucial point to be made here is that abortion is never safe, whether legal or illegal. Legalizing abortion can and has fostered a higher rate of abortion, hence less safety. It’s less safe to the mother in that she incurs all the potential risks that come with the abortion procedure, even though abortion is purely elective surgery in about 98% of cases (i.e., there’s no pending physical threat to the mother).

And it’s absurd to call abortion “safe” with regard to the child. The very notion of “safe” abortion is self-contradictory, like a “harmless murder.” It only makes sense to people who’ve already dehumanized and dismissed the life (and potential rights) of the child. If you are familiar with pro-choice terminology, and the typical means of describing the child-in-utero, you have seen how far people have gone to treat a fellow human being like a subhuman blob unworthy of life.

Meanwhile, abortion kills a morally and legally innocent, typically healthy, defenseless, non-threatening, living human organism, a homo sapiens, and fellow member of the human race. Abortion kills human beings.

Now, we can grant that it’s more safe to the mother to have an abortion in a sterile professional medical clinic than, for example, a coathanger abortion. But the coathanger argument errantly assumes that those are the points of comparison: a safe clean clinic versus a dirty dangerous back-alley.

We’ve seen above, how federal policy has helped generate more of those abortions in the first place, including legal and illegal abortions. The current federal policy has led to vastly more legal abortions—which tears children-in-utero apart limb from limb, crushes their skulls, starves them to death, and desecrates their corpses in horrific ways, all while introducing unnecessary risks to the mother including sepsis, uterine damage, and psychological trauma. And federal policy has also corresponded with a thriving black market, and DIY (do it yourself) abortions.

Comparing legal to illegal abortions we find that, “Any marginal improvements in the safety of legal abortions, as compared to illegal abortions, are more than offset by the astronomical increase in the number of women exposed to the inherent risks of induced abortion, legal or illegal.”[13]


Summing up things, the coathanger argument hangs on several mistaken assumptions the most dangerous and dehumanizing of these being the wholesale oversight of imperiled fetal children. The coathanger argument also fails by committing the utilitarian fallacy, disanalogy, and using faulty numbers. But, it’s hard to excuse the most glaring omission, the persistent and willful assault aimed at fetal humans.

Add to that fact how current liberal abortion choice policy helps foster a wide range of dangers and risk factors for women, including medical risks inherent to the abortion procedure, to socio-psychological risk factors, as well as the current thriving black-market abortion industry, we have overwhelming reason to think that the coathanger argument serves the greater harm of women.

It does not serve their greater good. When a policy is generating a culture of abortion that psychologically and physically traumatizes countless women, while  killing roughly 500,000 females in utero yearly, it’s a little hard to take it seriously as a “feminist” victory.

The coathanger argument may have some good intentions behind it, and for all the critiques mentioned above, we can all agree that women’s lives matter. Struggling mothers need tons of support, understanding, and respect. They need communities and families, as well as state and federal policies that help them overcome adversity.

No one in this debate wants to see women harmed unnecessarily, or see women pressed into dangerous and back-alley settings as their only option. And those are great reasons why we should reject the general premises of the coathanger argument and shift allegiances to the prolife side. Liberal abortion choice policy hurts women. Abortion hurts women.

This article was originally featured on Abortion History Museum and was republished with permission from the author.


[1]Other great sources on this subject are: and
[3] and
[4]Quoted in,
[5]Perhaps men may play a coercive or otherwise influential role. It could be that women are smart, self-aware, and generally able to handle themselves regardless of the laws permitting or banning abortion, but patriarchal oppression would force women to get coat-hanger abortions (or back alley abortions) if they didn’t have safe legal access to abortion. However, this rebuttal goes both ways. Legalized abortion certainly doesn’t constrain coercive men, rapists, or bullies, indeed, it might encourage them to act worse since federal law permits them to influence their girlfriends, lovers, and wives to acquire abortions. And it’s notoriously hard to prove illegal coercion between lovers.
[6]For more on the problems of consequentialist or utilitarian thinking see:
[7]See and . see also, I.L. Horton and D. Cheng, “Enhanced Surveillance for Pregnancy-Associated Mortality-Maryland, 1993-1998,” JAMA 285(11): 1455-1459 (2001); see also J. Mcfarlane et. al., “Abuse During Pregnancy and Femicide: Urgent Implications for Women’s Health,” Obstetrics & Gynecology 100: 27-36 (2002).
[8]For example, see: and
[9]Reports vary. It appears that China is usually #1, with some combination of the U.S., Russia, Vietnam, and Japan next, followed by former Russian block countries like Ukrain and Belarus behind them. See: and
[10]Quoted on page 1 of Source: Bernard Nathanson, Aborting America (Doubleday, 1979), 193.
[11]Morbidity and Mortality Weekly Report (MMWR). (Centers for Disease Control and Prevention, Sept. 4, 1992, Volume 41), Table 15.
[12]For reasons stated earlier (shame, secrecy, fear of prosecution, etc.) it’s difficult to get exact numbers for the abortion rate prior to its legalization. People aren’t exactly eager to risk prosecution just to fill out a CDC survey. Some estimates ran as high as one million, but that’s unlikely since the abortion rate would then have dropped immediately upon legalization (744,610). The introduction of the birth control pill to the general market, with expanded legal access to contraceptives, combined with various cultural factors in the “free love” movement undoubtedly fostered a growing trend towards libertine sexual practice, so it’s unlikely that the illegal abortion rate in 1972 was terribly low (say, 10,000 or fewer). The more conservative estimate is around 100,000. Most abortions, in that event, would have been done in states that had already legalized abortion (say, around 650,000 abortions) across 19 different states. Furthermore, one need only stretch back to 1969 to find a time when the abortion rate was likely 100,000 or lower. So, it’s not unreasonable to suggest that liberal abortion choice policy, at the state and federal level, facilitated a 10 fold increase in abortions.
[13]See Myth#5 in
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Dr. John Ferrer (B.A., MDiv., Th.M., Ph.D.) is an educator and former associate pastor hailing from the great state of South Carolina. He has earned degrees in religion, communication, Christian Apologetics, and finally his PhD in Philosophy of Religion. John is married to an accomplished apologist in her own right, Hillary Morgan Ferrer. He's very proud of her. Just ask him. John has taught at the high school and undergraduate level as well as in churches, conferences, and various special events. He's addressed audiences from Texas to Turkey, South Carolina to South Africa, and from North Carolina to Naples, Italy. John was recently employed at Pantego Christian Academy in Arlington Texas where he for six years in upper level Bible courses like Ethics, World Religions, and Apologetics. John has also taught at Tarrant County College in Logic and Philosophy. Besides Christian apologetics and critical thinking, John is passionately pro-life and encourages everyone in the audience to seriously consider the case against abortion.