As we approach Jan. 22, the 47th anniversary of Roe v. Wade, an increasingly right wing U.S. Supreme Court threatens to overturn the decision. One voice that is largely absent in the public discourse is that of abortion providers.
I came of age before abortion was legal. In 1970, the year I started medical school, New York passed a law approving abortions up to 24 weeks. This was a safety net for those who could afford the trip and the cost.
Abortion became legal in the U.S. during my third year of medical school. Before the Supreme Court decision, emergency doctors frequently cared for women with septic abortions, hemorrhage and perforated uteri, with the possibility of future infertility and death. Safe, low-risk abortions almost eliminated those complications.
During my almost four decades of OB/GYN practice, I offered women a full spectrum of reproductive services, including pregnancy counseling and care, abortions and contraception. These were deeply personal and complicated choices that were central to women’s autonomy and well-being.
In 1994, a gunman walked into two Boston-area abortion clinics, Planned Parenthood and Preterm, and killed two female staff workers, wounding five others, and terrorized the community. The next day my 11-year-old daughter asked me as I left for work, “Mommy, are you going to die today?” For decades, not only have providers been threatened, but women seeking abortions have been forced to enter facilities often passing a phalanx of pickets, gory posters and harassment. There has been an upswing in protests, including videotaping women entering facilities.
Access to abortion is a controversial topic in the political and culture wars in this country, but a majority of U.S. citizens consistently support a woman’s right to control her reproduction. I marvel at the new language I hear, “protecting the unborn,” “fetal pain,” “consensual rape.” I wonder how “exceptions for rape or incest” would actually work. Would a pregnant woman be forced into a court trial to “prove” that she was raped, in the midst of a traumatic assault and an unwanted conception? Would a pregnant 11-year-old victim of incest be compelled to confront her uncle before her pregnancy could be legally terminated? I often think of the 12-year-old girl who hid her pregnancy until 24 weeks. When she sought an abortion, a work-up revealed a 24-week fetus with extreme anomalies and an unusually large placenta. Would forcing this child to carry this nonviable pregnancy to term with all of the medical and emotional risks really be “pro-life”?
While the attacks on abortion for some are a reflection of religious beliefs, other more sinister forces are at work. Political organizations are using culture wars to whip up their conservative base while the policies of these organizations do little to protect the actual lives of living, breathing women and their families. Closing abortion clinics with increasingly restrictive rules and regulations has the same impact as banning abortions. If pregnant women cannot easily access a facility and face repeated visits and delays, it does not matter that abortion is “legal” in this country.
Every person needs to make their own moral choice, but for me, to be “pro-life” means working to create a society where every woman has universal access to health care, including contraception and abortion if she chooses. The current right-wing campaigns are largely about disempowering women, particularly poor black and brown women, as the wealthy will always be able to get safe abortions if they need one.
At a May Seattle Stop the Ban rally, Mayor Jenny Durkan said that when she is asked about the heartbeat rule, she responds that if a woman has a heartbeat, she will fight to defend that woman’s reproductive choice. Because abortion restrictions now include efforts to criminalize abortion providers, we cannot afford to be silent for our patients and for ourselves as well.