Sunday, July 24, 2005

Ain't I a Woman?

We've all heard the mantra: "Abortion must be legal or women will die." It's presented as an either/or proposition. If abortion is illegal, women will die. If abortion is legal, women won't die. Well then, what were Leigh Ann Alford, L'Echelle Head, Diana Lopez, Kimberly Neil, Holly Patterson, "Myra" Roe, Tamia Russell, Brenda Vise, Nicey Washington, and the other entities that went into American abortion clinics and are moldering in their graves now as a result?

These entities had all the appearance of women. Their families and friends apparently opperated under the assumption that they were women. Even the abortion facilities treated them as if they were women -- or at least as if they were primates with female reproductive organs, which is probably the most you can expect from an abortion clinic anyway. But, the prochoice assure us, legal abortion is safe. It is criminal abortions that kill women. So we're left looking at what appear to be dead women, but we're not supposed to actually see women.

When abortion enthusiasts were pushing for legalization, they tended to trot out individual sad cases of abortion deaths. Strangely enough, the cases they chose to display were not typical. Roughly 90% of pre-legalization abortions were performed by doctors. About 80% of the rest were performed by nurses or other professionals, usually with training, equipment, and emergency support provided by a physician. The 2% of abortions performed by people with no formal medical training included abortions performed by the Jane syndicate in Chicago, a cadre of female laymen trained and supported by doctors.

Only a tiny, tiny fraction -- fewer than 2% -- of pre-legalization abortions were the grueseome Lysol or coat-hanger abortions we're told were typical. And -- this is even more important -- the gruesome self-induced abortions were most often seen in women with severe mental illness, women with a history of other self-mutilating and/or self-destructive behavior. What it boils down to is that abortion enthusiasts took the rare and abberant behavior of women who were desperately in need of psychiatric care, and pretended that this was the common behavior of women who simply needed to have their pregnancies ended.



The other disengenuous claim was the numbers. Abortion enthusiasts told the American people that 5,000 to 10,000 women were dying every year from criminal abortions. The numbers were patently absurd, and their origin was recently traced to a flawed piece of guesswork published in 1936.

The truth of the matter is that all the efforts of public health officials to detect and prosecute abortionists led them to discover most abortion deaths, and one has to go back to the pre-penecillin era to find more than 1,000 women dying of all abortions -- legal, illegal, and spontaneous (miscarriages). Given that before WWII country doctors routinely performed all manner of surgery -- tonsilectomies, removing an appendex -- in the patient's home, stories of kitchen-table abortions in the 1920's and 1930's need to be placed in context. After the advent of antibiotics and blood transfusions, abortion deaths began to plummet, falling to fewer than 50 per year in the late 1960's. Widespread availablity of contraceptives made avoiding pregnancy much easier, advances in medical technology made abortion injuries easier to treat, and psychiatric treatment of women with certain mental disorders was the primary thrust in eliminating dangerous "coat-hanger" abortions. The problem was being contained rapidly. Then came legalization.



The criminal abortionist lived a precarious life. If he botched the job, he could lose his license or even go to jail. Natural consequences tended to weed out the quacks or at least impose some discipline on them. Jesse Ketchum, for example, wasn't a very good doctor (judging from the lawsuits against him), but he managed not to kill any of his illegal abortion patients. But when New York rolled out the red carpet to abortionists in 1970, Ketchum was in Buffalo the day the new law went into effect, doing abortions out of a hotel suite. As more and more abortionists sent patients home to die, without suffering consequences beyond a scolding by the public health officials, Ketchum grew bold. He began doing hysterotomy abortions in his office and managed to kill two legal abortion patients in a six month period. Milan Vuitch, likewise, had a clean record as a criminal abortionist but went on to kill two patients after legalization. Ketchum and Vuitch exemplify the impact of legalization: it made abortionists cocky. But again, we see dishonesty among the prochoice in presenting the results of legalization.

The favorite study is the California study that found that hospital admissions for abortion complications fell dramatically after legalization. What the study authors failed to mention is that in California, virtually all legal abortions before Roe were done in hospitals. A woman who suffered complications was already an inpaitent, and therefore would not be counted as a new admission. Compare the California study with the mess health officials encountered in New York, where abortionists were given carte-blanc to practice as they pleased. Abortions were done in freestanding clinics and doctors' offices, often with no emergency backup. Extremely dangerous procedures such as saline instillation and hysterotomy abortions were done on an outpatient basis. Family doctors all over the country were suddenly swamped with an influx of abortion-injured women -- many of them moribund -- who had been sent home with no provision for follow-up. It was, in short, a disaster, and should have served as a warning. Instead, abortion enthusiasts focused on the California study and ignored the chaos in New York.

When Roe was handed down, abortionists no longer had to carpetbag -- they could set up New York style freestanding facilities anywhere in the country and thumb their noses at health officials. The consequences were dire. The number of reported abortion deaths began to climb. Something had to be done. Rather than attack the problem of actual abortion mortality, the Abortion Surveillance Branch of the Centers for Disease Control chose to attack the problem of bad publicity. In the years before and immediately after Roe, CDC officials would send out a letter every year to every Ob/Gyn and emergency physician in the country, asking for information on abortion deaths. If a doctor failed to respond to the letter, he was sent a second letter. In this way, abortion deaths that would otherwise have gone unnoted were detected and counted by federal public health officials.

But in 1976 the CDC disbanded the active surveillance and started counting only those abortion deaths voluntarily reported to them through the National Center for Health Statistics or through other public health officials. It is no great surprise, then, that the number of abortion deaths counted by the CDC fell sharply. Not to mention the fact that abortion mortality had already been falling for the previous seventy years. It's a bit unclear how legalization managed to accomplish that.

"Myra" Roe and the others like her are dismissed as abberations, as simply the consequences of all surgery having some risks. But when the cases are looked at closely, clearly they are not cases of unavoidable risk. The bulk of these women were given substandard care, plain and simple. Sadly, they are typical of post-legalization abortion deaths. But abortion enthusiasts choose to ignore these women and others like them, instead continuing to chant their mantra of safe-n-legal. "Abortion must be legal," we are told again, "or women will die."

Myra might well quote Sojourner Truth and ask, "Ain't I a woman?"

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