Let me start by saying the opinions on the topic of abortion are mine alone and not necessarily those of any staff at WholeHealth Chicago. For Health Tip readers who have commented that I should not voice political opinions and stick to my work as a doctor, I suggest you glance at any of the websites aimed at physicians themselves. Fully one third of the articles are politically themed.
With the president overturning Obamacare and the Republicans having nothing to replace it with except a vague, 27-page position paper, we’re facing a serious health crisis over the next few years. Every doctor worth her salt is invested in the outcome. If you’re thinking about unsubscribing, consider instead using the comments section below to voice your opinion.
The only definite in any Republican proposal seems to be an egregious lack of concern for women’s health. With the new president ready to nominate a Supreme Court justice who will likely vote to overturn Roe v Wade and recent moves to defund Planned Parenthood and contraception counseling in both the US and other countries (via the Mexico City Policy), we get an idea of Trump’s position on the health care needs of women.
The confirmation of Health and Human Services director Tom Price, MD, seals the deal. As this Reuters piece notes, “Democrats also criticized Price for his opposition to Obamacare, his ideas about restructuring the Medicare program for the elderly and disabled, and his opposition to Planned Parenthood, an organization that provides abortions and other affordable healthcare and education services.
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 wanting 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 sense 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, which 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 abortionists 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.
Interestingly, if/when Roe v Wade is overturned, in Illinois both the physician and her patient could face prison time as an old law rears its ugly head (though legislators are currently working on a bill to ensure this doesn’t occur).
The more you read about abortion and birth control, the more you appreciate that it is indeed a matter of power, any steps 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 to 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 pro-life 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 pro-life 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 the herbal bitter apple compound shown below (the label saved from my father’s drugstore), 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 pro-life enthusiast would probably take steps to have my father arrested for child abuse.)
And oh, yes, by about 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 America 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 OB 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 recent 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 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 should be free and advice about which pill to use could come from virtually anyone in health care: physicians, nurses, pharmacists. After a few sex ed classes, they could even be sold over the counter to anyone who has started menstruating. Birth control devices like IUDs would also be free.
- We need to shift the prism on the whole right-to-life concept. If its proponents are serious, guarantee any pregnant woman that her child indeed has a right to life. This means if a woman carries her baby 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