January 23, 2006
"Most commonly, they ingest a whole bottleÂ of quinine pills, with castor oilâ€¦we try to get them to the ER before their cardiac rhythm is interruptedâ€¦Sometimes they douche with very caustic products like bleach. We had a patient, a teen,Â who burned herself so badly with bleach that we couldn't even examine her, her vaginal tissue was so painfulâ€¦."
"Our local hospital tells me they see 12-20 patients per year, who have already self-induced or had illegal abortions. Some make it, some don't. They are underage or poor women mostly, and a few daughters of pro-life familiesâ€¦"If you assume the quotes above come from a veteran of the abortion rights movement, talking about the "bad old days" before Roe v. Wade,Â when desperateÂ women suffered death and injuries because abortion was illegal,Â you'd be partly right.Â The speaker is a longtimeÂ worker in reproductive health, whose involvement with abortionÂ started before Roe. But the situations she describes are occurring now.Â
Jen (not her real name) is administrator of a women's health clinic in the South that provides abortions.Â She has noted with alarmÂ the recent rise inÂ illegal abortion in her community.Â ForÂ some of the women she sees -- after their initial attempts at abortion fail -- whether Roe v. Wade is technically still the law of the landÂ is beside the point. The combination of the procedure's cost,Â the numerous regulations that her state imposes and the stigma surrounding abortion is leading a growing number of women to choose self-abortion or an untrained practitioner over legal abortion.Â Finding accurate data about the number of cases is almost impossible.
However, Jen's abortion-providing colleagues in other parts of the country, whoÂ communicate theirÂ experiencesÂ through a listserv, share her observation of a recent perceptible rise in illegal abortion in their clinics as well. Indeed, in another eerie echo from the pre-Roe era, the increase in illegal abortion in Jen's area is so significant that a doctor from the hospital mentioned above contacted her. He asked for her help in setting up a special ward for the treatment of illegal abortions when Roe is overturned, because he knows the caseload will mushroom then. "He didn't say 'if' -- he said 'when,'" Jen said. "Chills ran down my spine."
Why is all this happening when abortion is still legal?Â Though the cost ofÂ abortion has remained remarkably flat since Roe -- the cost of a first-trimester abortion at Jen's clinic is $380, actually less than it was 20 years ago,Â adjusting for inflation -- it's still too much for a woman who,Â as she puts it, "is on assistance, has two or three kids already and has no money whatsoever."Â Teenagers in the state where Jen works also need parental consent before they can have an abortion.Â And for many teens and adult women alike, the overwhelming culture of shame that hovers around abortion prevents many from going to a clinic.
TheÂ physical tragedies we are witnessing due to theÂ return of illegal abortion are compounded by the social ones. Recently, two teenage couples, one in Michigan and the other in Texas, faced unwanted pregnancies.Â Both states have parental consent provisions; in both cases,Â the young couples received misleading information (in one instance from an anti-abortion "Crisis Pregnancy Center;" in the other, from a private physician's office)Â about how to obtain a legal abortion.Â In Michigan, the young man, with his girlfriend's approval, hit her abdomen repeatedly with a baseball bat until she miscarried; in Texas, again with the girlfriend's consent, the male stomped on his girlfriend's belly, producing a stillbirth of twins.Â Both young men were arrested, and the Texan, Geraldo Flores, is nowÂ serving a life sentence for fetal homicide.
In America's heartland, abortion is both difficult to access and often ground zero in the culture wars. South Dakota and North Dakota, for example, share the distinction (along with Mississippi) of being the states with only one remaining abortion clinic. South Dakota in fact, is currently engaged in a contest with Indiana to become the first state to ban abortion outright. Legislators in each state have introduced bills that they hope might become the vehicles for a friendlier (i.e., featuring two Bush appointees) Supreme Court to overturn Roe altogether.
And if one needed any convincing of the level of stigma associated with abortion in some Midwestern communities,Â consider how the issue recently factored in the confirmation process for an assistant police chief in Fargo, N.D. The candidate for the job wasÂ "outed" by a local anti-abortion activistÂ for having gone through a (legal) abortion some 15 years ago, at the age of 24,Â with his then-18-year-old girlfriend.Â The police officer publicly expressed his deep "regret and shame" over the incident, and the mayor of Fargo called the abortion an "error in judgment." Only then did theÂ appointment go forward.
To add an element of absurdity to the tragedies mentioned above, the very policies that could reduce unwanted pregnancies -- and thus abortions, legal and otherwise -- are resisted at every turn by right-wing extremists and their allies in the Bush White House.Â Funds for family planning services areÂ cut backÂ while millions of dollars of federal funding are spent onÂ "abstinence only" sex education.
Emergency Contraception (EC), a higher-than-normal dose ofÂ regular birth control pills that can prevent a pregnancy if taken within 72 hours of unprotected sex, sexual assault or birth control failure, is denied over-the-counter status by the FDA, even though the agency's ownÂ panel of experts voted overwhelmingly toÂ makeÂ EC available without a prescription.Â Researchers estimate that EC prevented some 51,000 abortions inÂ 2000 -- the last year for which such data is available -- and OTC status would make this optionÂ far more accessible. Â
The latest front in the abortion war is the pharmacy. There are increasing incidents of anti-abortion pharmacists who areÂ refusing to dispenseÂ both EC and regular birth control pills. Even in liberal California, where recently 70 percent of the populationÂ supports legal abortion, these pharmacist refusals are taking place.Â And Wal-Mart pharmacies -- often the only pharmacy in rural areas -- haveÂ long refusedÂ to fill prescriptions for EC.Â Â So, given the current realities of American society -- where teens takeÂ matters in their own hands to end a pregnancy, where anti-abortion lawmakers cut funds for contraception,Â where "pharmacists for life" lecture married women while refusingÂ to refill their birth control prescriptions -- am I suggesting thatÂ American women really are in the same boat as they were before Roe? The answer, of course, is no -- or more correctly, not yet.
The number of illegal abortions in the United States -- and attendant injuries and deaths -- currently is nowhere near where it was in the 1950s and 1960s.Â Most unwanted teengage pregnancies obviouslyÂ do not have as their outcome a life sentence in prison. MostÂ public officials do not have to undergoÂ humiliatingÂ questioning about past abortions in order to get a desired promotion. Rather, these incidentsÂ are cautionary tales.Â They are harbingers of what the AmericanÂ reproductiveÂ landscape could quite quickly become -- unless Americans demand a return to common sense and repudiate the madness that aÂ powerfulÂ minority seeks to impose on us.Â
Carole Joffe is professor of sociology at the University of California-Davis, and a senior fellow at the Longview Institute.