I leaned over the crib and stared at her.  She wouldn't stop crying, so I picked her up and then realized that the diaper was wet.  The sun was setting, leaving the room dim and quiet, disturbed only by peripheral noises in the hospital hallway and the sound of her distress.  I gingerly held her up, setting her flat on the bed, and watched her arms wave from side to side as I puzzled over how to change my first diaper.

"Hey," I whispered.  "Stop crying."  She didn't listen.  I spent a few moments fumbling with the pacifier before cradling her in my arms and sitting down in the rocking chair, swinging back and forth easily.  A plastic music box hung on the crib's stainless-steel safety bars began playing a lullaby.  We swayed to the simple music in the quiet of the dusky, twilight shadows.  It was as if the hospital, that crazy world of pain and light and noise, had rumbled into the distance and forgotten to pester us.

That morning during report, the residents said that the infant was recovering well from some treatable illness or other.  I couldn't recall the details; all I remembered was the small fact that we were now responsible for her.  We, meaning the hospital and the State, were granted temporary custody in the place of the parents, who were "currently indisposed of."  I thought about the other rooms on the pediatric floor, each of which held two beds: one for the patient and one for the caretaker.  Each room had its own guardian: an anxious mother or grandparent or cousin or other relative.  Each room except this one. 

I remembered the words of the overnight nurse who stood by the bed at rounds, updating us on the baby's condition.  "She's doing well," the nurse said absently, thoroughly distracted by the baby.  The team continued talking about the details of custody and social work; meanwhile, the nurse remained preoccupied.  She cooed at the baby.  "Hey," she said quietly, gently caressing the swaddling clothes: "It's going to be a tough world out there."

We had been caring for this patient for several days but I, being overwhelmed with concerns about my own patients, had never paid much attention to this one.  However, that last comment caught me by surprise and pushed the rhythm of my thinking out of sync.  One of the residents said, "If you have time, come in and hold her.  It's okay."

For the rest of rounds, throughout lunch, and into the hustle and bustle of afternoon errands, my mind and feet wandered back to that room.  Whenever I peeked in, I found someone at her bedside: a nurse, a social worker, another floor staff member.  It seemed that word had gotten around and everyone quietly came together to do what they could.  I didn't get my chance until the end of the work day, just in time to hear a few cries from the crib.

So we rocked back and forth while my mind wandered.  What kind of person would she become?  Did she have any sense of how alone she was in this world?  Who would recognize her weakness and rise up to defend her from frailty and vulnerability?  In ten, twenty, or thirty years from now, would she still let me hold her in my arms?  Would it be possible for me to adopt her?  And why did I hesitate at the thought?  How different would things be on the day I held my own child?

Unfamiliar feelings of affection, anger, and helplessness swilled around inside of me, unfocused but centered on this loose bundle of warmed clothing and weak, spastic movements.  I didn't know what to think or how to feel or how to respond.  I still don't.

I couldn't wait to write this stuff down, mainly because I didn't know what to do with all these ambiguous thoughts.  I held her for a few minutes and yet it's taken me two days to articulate what I've been feeling.  Who will love her?  Who will watch her first steps?  Who will dream good dreams and sing lullabies for her?  Who will give her the first cherry ice pop, a first kiss on a scraped knee?  Who will keep her safe in this world of terrors?

I was walking outside my apartment tonight, thinking about these things.  I stared up through the bare tree branches, past the rosy buds and into the lamplight that stood transfixed beneath a muddied sky.  I asked my Abba, father, to provide one for her, and then realized that I didn't know her name.

Much molehill-mountaineering is in the media mix over President Obama's recent repeal of the Mexico City Policy (MCP, otherwise known as the "Global Gag Rule").  I wrote the following a few years ago when I had first heard about and investigated it:

MCP is based on the Helms Amendment, a piece of US legislation enacted in 1974 that ensures that no US money is used to fund abortions performed in other countries.  Non-governmental organizations (NGOs) receiving money from the United States traditionally upheld this policy by storing US funds in a separate bank account, ensuring that that money would only used for expenses unrelated to abortion.  However, supporters of MCP argue that this is not a sufficient safeguard for US funds.  The argument is that “a dollar saved is a dollar earned”, and so money saved from non-abortive procedures can be used for abortive ones indirectly.  MCP attempted to protect against this by legislating beyond the Helms Amendment in order to establish that “no U.S. family planning assistance can be provided to foreign NGOs that use funding from any other source to: perform abortions in cases other than a threat to the life of the woman, rape, or incest; provide counseling and referral for abortion; or lobby to make abortion legal or more available in their country.”  What this means for foreign NGOs is that, in order to receive any money from the United States, they must abstain from participating in all-things-abortion, which includes providing information about safe abortion providers, counseling women about abortion options, advocating for the legalization of abortion, or even speaking at public events that address abortion-related issues.  NGOs are also not permitted to use funds given by other donors for any of these activities.  Through MCP, they are voluntarily and effectively “gagged”.  In fact, MCP enables stricter requirements than apply to domestic maternal health clinics and services.

I first heard about MCP during a college campus campaign to collect signatures for a petition to repeal the policy.  A friend of mine participating in the campaign assured me that the global gag rule was not really about abortion; it was about a repressive policy that caused inequity and the attrition of maternal health care.  My friend also happened to be a Christian.  Perhaps a dozen or so of our mutual Christian friends signed the petition, though I wondered about how much they had thought about the policy before signing.  I nearly signed it myself but wanted to investigate the issue more.

MCP deals exclusively with abortion and says nothing about contraceptives or other family planning measures.  However, this is not to say that its effects are restricted to abortive procedures, advocacy, or counseling; NGOs and clinics that are willing to lose US funding over the argument that “abortion services are vital to community health” claim to have been forced to scale back spending on other family planning services or even shut down.  Opponents of MCP also fear a “chilling effect”, where organizations providing pre and post-natal care are hesitant to provide post-abortive care for fear of revoking their funding, even though such care is permitted under MCP.  These misunderstandings by both the health care providers and those in need of care tend to inhibit proper post-abortive care, legal or not.  MCP was repealed by President Clinton but reinstated by President Bush (who added the clause allowing abortive procedures and referrals in cases when the mother’s life is endangered by the pregnancy) and has now again been repealed by President Obama.  Advocates in favor of ditching MCP argue that the confusion generated by the on-again-off-again treatment of MCP enhances the chilling effect and has actually increased the rate of unsafe abortions performed in areas where MCP has been implemented.

While there is often no reliable data tracking birth/death registrations or causes of death in affected countries, MCP's "chilling effect" undeniably complicates a mother’s ability to acquire family planning and maternal healthcare services.  (Note that Planned Parenthood, while being the best known and most prolific of family planning/abortion providers, is not the only one; again, this policy also affects clinics that deal with any form of maternal health or family planning.)  This observation alone makes the argument to repeal MCP compelling.  Shouldn’t I oppose a clumsy policy that contributes little towards the goal of eliminating abortion, in terms of either policy or practice?  And if MCP could potentially contribute to worse maternal and fetal care, shouldn’t I, as someone who considers fetal life to be valuable, adopt a political stance that makes such access easier?

Even today, the political hubbub (and dubious reporting by special interest groups) surrounding the policy has muddied the issues.  So, to clarify:

1) The change WILL NOT DIRECTLY FUND abortions overseas.  The Hyde amendment still applies, which states that US aid money CANNOT be DIRECTLY used to fund abortions.  Since MCP was an add-on that placed foreign aid under tighter restrictions than US domestic policy, its elimination simply puts things under equal treatment.

2) More tax dollars will NOT be used.  MCP only forbids ways in which government money can be used.  Re-enabling funding is NOT the same thing as giving out more money.  Aid agencies still have to work within a budget, as do the clinics & services they fund, and there is no indication that newly eligible funds will necessarily go immediately towards funding abortions; what is more likely is that cash will go towards more common and pressing needs to sustain maternal/fetal life (though this is only my speculation).

Regardless, MCP is fundamentally an issue of ethics & politics rather than truly one of public health.  It was implemented to protect fetal life in a restrictive manner; it does not in any way actually provide more services for maternal, fetal, or reproductive care.  This conclusion stands in stark contrast to my friend’s earlier assertion that the issue is not one about abortion.  As in the abortion debate, the assumptions one makes about the value of fetal life are fundamental to one’s approach to MCP.

If we are to assume that the mother’s life and autonomy are more valuable than that of the fetus, then MCP is truly a repressive policy that should be repealed on both an ethical and public health basis.  From such a perspective, MCP does nothing but interfere with the administration of a complete set of maternal health care services.  It even strikes me as somewhat hypocritical, as the United States itself has legalized abortion and does not restrict its funding to the same severity of MCP.

But if we give fetal life similar value to that of the mother, then abortion truly is legalized crime.  In such a case, the argument that revoking MCP would minimize abortions (an already dubious argument) is fundamentally and unacceptably consequentialist.  Consider the following analogy: a health clinic provides substantial health & family planning services to the community with the sole requirement that ethnic minorities are denied care.  Would the US be justified in providing any funding to such a clinic?  What if the clinic were to execute all ethnic minorities that came to the clinic for help?  Would any government be justified in funding such a clinic?  Though such an example seems extreme, it is directly analogous to MCP IF we are to take the view that fetal life is valuable human life.

[Disclaimer: The following arguments are less objective.]
Would you donate money to a health clinic that participates in genocide?  What about one that only advocates genocide?  One that treats everyone but victims of the genocide?  If you wouldn’t individually support such a clinic, would you have objections to the use of tax money for such a clinic?  Now that the issue involves abortion instead of genocide, would you engage in as much careful deliberation about that case?  Even if you don't believe that fetal life is valuable human life (or life at all), the fact of the matter is that a significant proprortion of US citizens is still uncomfortable (if not downright upset) with the entire concept of abortion.

At this point, I find myself puzzled.  Though MCP intuitively strikes me as an awkward and clumsy policy, I am hard pressed to find a reasonable argument to repeal MCP from a non-consequentialist perspective that honors fetal life.  But I hope that, as Christians, we do not shy from discussion of an issue so critical to global public health policy and that we do not swallow propaganda and misinformation fed our way that distorts the reality concerning policies & their implementations.