Medicine, religious freedom support abortion rights

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Permit a good word for procrastination. If Jeffrey Nelson, a retired family practice physician from Cottage Grove, had written his latest book when he first contemplated doing so 20 years ago, it might be forgotten now when it's really needed.

Nelson's book is about abortion.

The doctor's take on whether abortion should remain legal is not instantly apparent from the book's title: "What Should I Do?: A family physician discusses abortion, religious freedom, and difficult decisions." Nelson further foils readers looking for a quick signal of his views by describing himself as "prochoice/prolife."

But Nelson's slim volume offers much for readers willing to join him in thinking deeply and compassionately about what is fast becoming the hottest political issue of this election year. For readers who spent the past two weeks on a no-media diet: That's because a draft U.S. Supreme Court majority opinion overturning Roe v. Wade and ending 49 years of federal protection for abortion rights was leaked and published by Politico on May 2.

To be sure, Justice Samuel Alito's draft is not the court's official word. But judging from the storm it has already generated, this country is in for a political hurricane if the high court's order in Dobbs v. Jackson Women's Health Organization, expected late next month, goes in the direction Alito pointed.

My hunch is that for the last decade or three or four, many Americans thought that legal abortion was settled law (silly us!). A solid majority of citizens were fine with that. Many in that majority cohort were only too happy to leave the abortion quarrel to professional culture warriors. They felt no need to be schooled in how best to make a case to their fellow citizens for keeping abortion safe and legal.

Some of them may be seeking a crash course just now. For them, Nelson's book will come in handy.

Many recent arguments about abortion have been legal ones, focusing on who deserves the law's protection. Instead, Nelson builds his argument for keeping abortion legal on two other usefully persuasive foundations.

The first is medical. Nelson worked in the east metro Twin Cities for 38 years; his practice included full OB-GYN services, including abortion, for about half that time. He cites both national data and personal experience to point out that pregnancy and delivery pose risks for a woman's health that greatly exceed those associated with legal abortion, and those risks have been getting worse. In this country in 2017, the maternal mortality ratio was 17.3 deaths per 100,000 live births, up from 7.2 deaths 30 years earlier.

"A lot of people don't know the medical facts and have bought into the misinformation that abortion is as risky for the woman as pregnancy," Nelson told me in an interview. "That's simply not true . … I don't know of another situation in which the law would say that someone has to take a medical course that gives them a higher chance of dying, rather than taking the safer medical course that that person prefers."

The second argument undergirding Nelson's case for abortion rights relies on the protection for freedom of religion found in the First Amendment. His Lutheran faith does not claim that abortion is murder. Neither do a number of other faith traditions.

Nelson is respectful of religions that teach to the contrary. But a Supreme Court order that imposes the view that abortion is murder on the nation, or allows state legislatures to do so, would amount to government establishment of religion in violation of the First Amendment, he argues.

The fact that Alito's draft went on for 90 pages but did not address freedom of religion or separation of church and state troubles Nelson. He hopes another case will move through the courts that targets that argument. He went so far as to send each of the nine Supreme Court justices a copy of his book, in hopes of preparing them for such a suit.

"Either we decide that we have freedom of religion on this matter, or we have a very different country than we have known," Nelson said. Picture the theocracies that many Americans and/or their ancestors came to this country to escape.

Nelson isn't a politician or special-interest pleader. He's a 68-year-old widower and father who could have opted to avoid controversy in retirement. I think that makes his book all the more worthy of notice.

It says something that politicians in St. Paul and Washington should hear. Something about the power of the threat to abortion rights to move ordinary citizens from complacency to activism. Something about the depth of the case to be made that outlawing abortion would be profoundly damaging to both individuals and this nation.

And something about not assuming that a Republican wave is inevitable in this fall's election.

Lori Sturdevant is a retired Star Tribune editorial writer. She is at lsturdevant@startribune.com.