A Lifetime Of Experience With Abortion

The past two years of a Trump administration have produced an ugly upsurge in controversy over women’s rights, from the serial sexual predation revelations of the #MeToo movement to yet another state following the lead of the 25 white male Republicans (for their photos, click here) who voted to ban abortion in Alabama and send doctors performing the medical procedure to jail for up to 99 years.

Getting a safe abortion is already extremely difficult for women in many parts of the US. In some states, abortion providers are rare and in many states numerous laws have been passed restricting access, including medically unnecessary ultrasounds and days-long waiting periods.

You do know, of course, that when any of the precious daughters of those 25 Republicans discovers an unintended pregnancy, daddy will jet her to midtown Manhattan for a long weekend to have a safe, albeit expensive, abortion.

Sunday morning’s Guardian opened with an utterly cheerless and thoroughly alarming article detailing the anti-abortion religious right’s willingness to engage in an actual physical second Civil War over abortion. The well-researched piece is here and very chilling indeed, especially given the religious right’s vocal support of gun ownership.

With that, I’m reprinting below a Health Tip I wrote a few years ago about my decades-long experience with abortion as a physician here in Chicago.

I believe what anyone does with her body is her own business. You don’t want to take statins? That’s your business. A Japanese Yakuza cutting off his own finger? His choice, not mine. Goth teen wants a Vermeer tattooed on her back? Not my concern. A woman who wants to terminate a pregnancy should be able to make that decision and have a safe, legal abortion. It’s not the business of elderly Caucasians in the White House, Congress, or Supreme Court, and it’s certainly not the business of any religion telling other people how to live their lives.

Historical perspective
Looking at the history of abortion over the past two centuries, you begin to see it’s all about power and control. Whether it’s men, government, or religion, abortion opposition is an issue of dominance, and that can work both ways. Consider the fact that a large percentage of abortions occur because of male pressure to abort.

During the 19th century, women had plenty of abortions. Some occurred because women were simply unable to care for the huge families created during times of zero birth control and a husband’s “entitlement” to sex. Then and well into the 20th century, there were not only abortion opponents, but also strong hostility to women’s suffrage and plenty of opposition to black voting rights that sadly continues to this day.

There were equally strong positions against birth control. How-to birth control books were classified as pornography and burned. Although plenty of professional abortion providers were available throughout the 19th century and up to Roe v. Wade, they were rarely caught, fined, or jailed unless a botched procedure resulted in a woman’s death. Here’s an informative article about abortion in the 19th century.

The more you read about abortion and birth control, the more you appreciate that it is indeed a matter of power, every move possible to keep women in their place. The language used against abortion during the 19th century sounds very much like the opposition language to the (failed) 1973 Equal Rights Amendment. Because the ERA proposed including in the US Constitution the right of a woman to have an abortion, strong anti-abortion voices where among those who most vehemently opposed it.

During the 20th century, up until the 1973 passage of Roe v. Wade, it was illegal for a woman to have an abortion and for a doctor to perform one. Yet certainly many women terminated unwanted pregnancies and plenty of doctors performed the terminations. I don’t remember any Illinois doctor or patient ever being jailed, but are you aware that many states could jail women if it were discovered she’d had an abortion? This lengthy but illuminating link comes from the book When Abortion Was a Crime.

The surge in anti-abortion dialogue began relatively recently. As the feminist movement grew in the 1960s, using anti-abortion language to keep a woman in her place began to lose its effect. It really took Roe v. Wade for the term “right-to-life” to become a rallying cry. But regardless how gruesome the language or imagery (check out the chilling 1970s movie “Whatever Happened to the Human Race?”), at the heart of the anti-abortion movement is control over women.

Lessons from a life
It’s now a lifetime later and I’d like to share some of my own experiences and lessons along the way. Spoiler alert: I am, and will remain to my dying gasp, vehemently pro-choice.

In the 1950s, from age 9 to 18, I worked in my father’s south side drugstore. Even though I was quite young, pregnant women who knew having another child was impossible would ask for something that could bring on their period. Later, my father explained what a period was, though not its relationship to pregnancy. I likely unwittingly took part in numerous abortion attempts, selling this homeopathic product and an herbal bitter apple compound, both purchased by women who were hoping to abort.

Knowing now the contents of these products, I’m pretty certain not only that no one was ever hurt, but also that no successful terminations ever occurred. In all this, I was as emotionally involved as if I were selling Alka-Seltzer. (Today, some anti-abortion enthusiast would probably take steps to have my father arrested for child abuse.)

And, oh yes, by about age 13 or so I did understand what I was selling and a couple of years later when one of my high school friends was convinced he’d gotten his girlfriend “in trouble,” I stuffed one box each of Bitter Apple and Humphrey’s into my jacket and suggested she try them.

Before Roe v. Wade, abortions were illegal, but like much else in the US safe abortions were readily available if the family had money. The pregnant girl would disappear for a few days and return a little pale but freshly “chaste.” (Not infrequently, she’d return sporting a bandage over the bridge of her new Gentile nose, a surgical rite of passage for middle class Jewish girls that legitimized an absence from school.)

Pregnant girls without family money had one of three choices:
–She married the putative father if possible.
–She went into seclusion until delivery and then put the baby up for adoption. There were several Dickensian-sounding “Homes for Unwed Mothers” around the Midwest, most owned by the Salvation Army.
–She attempted to self-abort or had a notorious back-alley abortion.

Giving up a newborn for adoption after a stay in the “home” was psychologically brutal for most. After enduring labor and a bevy of stern-faced nurses, delivery and relinquishment was society’s way of punishing a woman for having sex before marriage. She delivered and her infant was immediately swaddled and whisked away, the young mother not even allowed to see the baby.

When I rotated through obstetrics as a resident, I witnessed a young woman screaming “My baby, just let me see my baby!” and never forgot it. I also never forgot this sign posted in the delivery room: “This is a Catholic Hospital. When faced with the decision of saving a mother’s life or her baby’s, you must always save the baby.”

A study published in JAMA Psychiatry showed that the psychological risks of having an abortion are minimal. The authors concluded: “Abortion denial may be initially associated with psychological harm to women and findings do not support restricting abortion on the basis that abortion harms women’s mental health.” More here in the New York Times.

In the 1960s, before legal abortion, if you had the cash an illegal abortion could cost a stunningly expensive $500. Because I was in medical school, non-medical friends seemed to think I knew the ropes about where to get an abortion. When asked, I did the sensible thing and asked a senior Ob-Gyn resident.

“SSSHHH!” he whispered, but wrote down a phone number. “When you call, ask for Virginia. Then they’ll know what you want.” With pleading eyes, my friend begged “Can you make the call?”

“Virginia” (who had a male voice, and was indeed the doctor himself) was pleasant. He asked how long it had been since her last period, and said the price would be $350 cash. Three of us drove from the medical center area to an address on the south side, parking in front of a respectable-looking medical building.

Once inside, the reception room was spotlessly clean and distinctly memorable. The physician, who hadn’t yet materialized, was clearly successful and apparently wealthy, if having an oversized waiting room filled to capacity with stuffed hunting trophies from Africa and India were any indication.

The patient was soon escorted through a pair of frosted double doors while her friend and I sat among a full-sized lion, two zebras, a tiger, and several antelopes

She came out about an hour later, pale and gaunt. “How was it?” we both asked.

“It hurt, you bastards.”

Botched abortions and the facts today
According to the Guttmacher Institute, in 1965 illegal abortions made up one-sixth of all pregnancy- and childbirth-related deaths, with low-income women disproportionately affected. I saw botched abortions when I was on emergency room duty. God only knows who had inserted what tools into these frightened girls with huge clots between their legs. Not a few left the hospital a few days later without a uterus. When someone attempts a D and C with kitchen cutlery, the results can be savage.

I’d already started my practice when Roe v. Wade passed on January 22, 1973, and because we still had some of the milk of kindness in our veins from Lyndon Johnson’s Great Society, the situation changed immediately. Pregnancy termination was a phone call away and performed by a board-certified gynecologist in the outpatient surgery section of a hospital or clinic.

Today a first-trimester abortion is one of the safest medical procedures. For more facts on abortion, review this Guttmacher Institute report.

A return to the brutal past?
It’s hard to believe we might return to the days when I called “Virginia” to arrange an illegal abortion. I have three suggestions to end the abortion controversy. Don’t expect much movement soon. We’ll likely need a woman in the White House to get it done.

–There would be far fewer abortions (something everyone purports to want) if there were unrestricted access to birth control. Birth control pills and devices should be free and advice about which form to use should come from virtually anyone in health care: physicians, nurses, pharmacists. After a few sex-ed classes, birth control could even be sold over the counter to anyone who has started menstruating.

–We need to shift the prism on the whole right-to-life concept. If its proponents are serious, they would guarantee any pregnant woman that her child indeed has a right to life. This means if a woman carries to term, she receives an immediate government stipend for herself and her child until the child reaches age 18. In addition, mother and child are guaranteed full healthcare coverage and, for the child, a fully-funded college education. Limit two children on this proposal. If more children are wanted, the family supports them.

–If, even though a pregnant woman is aware she’ll be financially supported by the government, she still wants an abortion, she could have one at no cost.

Are there honestly people who want to return to the bad old days of death by illegal abortion?

Be well,
David Edelberg, MD