June 12, 1970: "Maternal Indications" Abortion Proves Fatal for Philadelphia Mother

Arlene Francis Hull was an unmarried 24-year-old black woman living in Philadelphia. She discovered she was pregnant in the spring or early summer of 1970.

There is no record of whether Arlene sought out an abortion on her own initiative or whether her doctor recommended it because she has multiple sclerosis (MS) and epilepsy causing grand mal seizures. Whatever the reason for the abortion, due to her health issues her doctor was able to admit her to Jefferson Hospital for an abortion at 15 weeks. 

Though Pennsylvania abortion law didn't specify a "life of the mother" exception, Arlene's doctors felt confident about the legality of their decision. 

Grok indicates that MS symptoms can either improve or improve during pregnancy. In 1970 it was treated primarily for corticosteroids for flare-ups. At that time doctors recommended that women with MS avoid pregnancy. Common antiepileptic drugs in 1970 could harm the fetus, leaving doctors to have to balance the risk of seizures and the risks of causing fetal injury. 

The technique chosen was hysterotomy (pictured), which is just a C-section with the intention that the baby not survive. Jefferson Hospital was a major academic medical center, appropriate for any kind of surgery for a high-risk patient. Grok could only theorize as to why such an invasive procedure was chosen. However, in 1970, abortion at 15 weeks was unusual because the fetus was too big to be aborted with a dilation and curettage but the uterus was too small for most doctors to attempt an amniocenteses abortion, which usually wasn't attempted prior to 18 weeks. Saline amniocenteses would also have been an extremely risky procedure even for a healthy woman.

Arlene's abortion was performed at 9:15 am on June 12. By 4:30 pm, Arlene was dead from complications of the thiopental, nitrous oxide, succinyl choline and curare administered for anesthesia. According to Grok, this drug combination was standard for general anesthesia, but might have been a risky choice for a patient with neurological conditions. 

Grok offers the following possible mechanisms of complication leading to Arlene's death:

• Respiratory Depression or Arrest: Thiopental and nitrous oxide can suppress breathing, particularly if dosing is not carefully titrated. Succinylcholine and curare, which paralyze respiratory muscles, require mechanical ventilation; any delay or failure in intubation could lead to hypoxia.

• Anaphylaxis or Adverse Reaction: Succinylcholine or curare can trigger allergic reactions or malignant hyperthermia, a rare but fatal condition causing muscle rigidity and fever.

• Neurological Interaction: Arlene’s epilepsy and MS may have altered her response to anesthesia. For example, succinylcholine can cause prolonged paralysis in patients with neurological disorders, and AEDs may interact with anesthetics, increasing sedation or toxicity.

• Cardiovascular Collapse: Anesthesia-induced hypotension, combined with Arlene’s compromised health, could have led to shock or cardiac arrest.

Grok did not share my confidence that Pennsylvania doctors would have had no fear of prosecution for performing a hospital abortion on a high-risk patient. 

Sources: 

• Medical Examiner's Certificate of Death File No. 061692 70
• Genealogy records