Like Mirror Ball's "Song X," this is about abortion. It's sung from the perspective of a man who abandons his pregnant lover, despite his promises to always take care of her. He offers to pay for an abortion but the holy war brewing around the issue will make it a difficult choice for the woman. Even though Young wrote it specifically for the 1995 Washington Pro-Choice Benefit, the song doesn't take sides.
"There's no bias so you have to make up your own mind, finally," Young explained in a 1995 Mojo interview. "See, personally, I'm pro-choice. But the song isn't! This isn't an easy subject to confront head-on. People who say that human beings shouldn't have the right to dismiss a human life - they have a point. You can't dismiss that point. But then there's the reality. There's idealism and reality, the two have got to come together yet there are always major problems when they do."
Pearl Jam performs with Young on Mirror Ball, a collaboration that began with "Act of Love." Young first played the song with his band Crazy Horse at the Rock and Roll Hall of Fame ceremony, where he was inducted by Pearl Jam frontman Eddie Vedder. Vedder and his bandmates recorded the performance and quickly learned the song so they could play it with Young at the pro-choice benefit the next night. Young was so moved by the newer version, he wanted to record the song with the band as soon as possible. Less than two weeks later, Pearl Jam joined Young at Bad Animals Studio in Seattle to cut the record and ended up recording a whole album. Stone Gossard, the band's rhythm guitarist, recalled: "It was just a beautiful time in the studio in Seattle with candles burning and furniture sitting around. Every 20 minutes Neil would say, OK, I've got something, and then he'd pull it up and we'd play it through once or twice and then we'd lay it down and generally we'd say, That sounds good – let's keep it."
Sony wouldn't allow the band's name to appear alongside Young's on the album, so the Pearl Jam band members are credited individually in the booklet notes.