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Saturday, October 03, 2009

Rhetoric and the macabre trophy: The death of Rosie Jimenez

In 1976, the Hyde Amendment went into effect, banning the use of Federal funds to pay for abortions except to save the mother from an immediate threat to her life. The measure was named for its author, Congressman Henry Hyde. Abortion advocates had been keening from the moment the Hyde Amendment was up for vote. They painted a ghastly picture of coathanger-impaled women littering the streets as poor women were driven to desperation by lack of "access" -- much the way they were keening last year about the upcoming vote in South Dakota.

When the Hyde Amendment went into effect, abortion advocates ramped up the hysteria and waited for a death, any death, they could hang around Henry Hyde's neck.

On October 3, 1977, the abortion advocacy vultures got what they'd been waiting for: a dead woman they could use as leverage in the fight to once again force taxpayers to fund elective abortions.

On September 26, 1977, 27-year-old Rosie Jiminez had shown up at the emergency room of McAllen General Hospital in the Texas border town of McAllen, with septic shock. She was put in intensive care, but died on October 3 from renal and cardiac failure caused by disseminated intravascular coagulopathy (failure of the blood to clot properly) triggered by gas gangrene from a criminal abortion. She left behind one child.

The initial response of the abortion lobby to news of Rosie's death was little short of euphoric. They had their trophy, their dead woman whose story they could leverage, they hoped, into the restoration of tax money flowing into abortion clinics.

One voice stood out from the crowd: Ellen Frankfort, author of Rosie: the investigation of a wrongful death. Frankfort was disgusted with the bulk of the prochoice movement, who seemed content to make note of the death and then milk it for political gain. She began an investigation into what had led Rosie to her death, and she found a lot that neither the Centers for Disease Control nor abortion advocacy organizations had been willing to look for, since all they'd wanted was political leverage. They weren't looking for the real culprit behind Rosie's death: they'd had a bogeyman in mind even before she'd died, in the form of Henry Hyde.

Off to McAllen Frankfort went, to learn all she could.

Rosie had already undergone two abortions at taxpayer expense. The first time, she had not been using contraception, and a private ob/gyn in McAllen aborted her 9-week fetus on July 15, 1975. She went on birth control pills after this abortion, but quit using them when a physician told her they might impair future fertility. She quickly became pregnant again and had a second tax-funded abortion, this one done at a facility Rosie had been referred to by a local Planned Parenthood, at 11 weeks of pregnancy.

The CDC's investigation after Rosie's death could not determine if she used any form of birth control after this second abortion. She became pregnant yet again. In September of 1977, she suspected that she was again pregnant, and consulted with a cousin and a friend, who told her that Medicaid would no longer pay for elective abortions.

Rosie had also gone to her family physician, Dr. Homer, in McAllen for treatment of pain in her sternum. She mentioned that she might be pregnant. The physician did not arrange for a pregnancy test or discuss her options with her in any way. He simply informed her that Medicaid would no longer pay for abortions, and let it rest at that.

It is interesting to note that in all the finger-pointing following Rosie's death, no prochoicer thought to place any blame on this physician. Evidently he knew about the two previous Medicaid abortions. Why did he consent himself with telling Rosie that there would be no more free abortions? A referral seemed to have been in order, either to a prolife center that would help her with the expenses of continuing the pregnancy, or to the local Planned Parenthood, that could arrange an abortion on a sliding scale and could possibly help her tap into private funds for elective abortions. Dr. Homer, in fact, was very much in favor of abortions and was aware the Dr. C performed them and that Planned Parenthood referred for them on a sliding scale.

Regardless, Rosie's physician just dropped the news -- no more tax-funded abortions -- and effectively abandoned his patient.

The week of September 19, Rosie went to Mexico for some sort of injection to cause an abortion. She had the shots at a pharmacy, at $5 each. The second injection made her ill, and she abandoned this means of attempting to get rid of the unwanted fetus.

On September 25, she consulted with her cousin, saying that she wanted to find a cheap abortionist quickly. Rosie's cousin brought her to a lay midwife in McAllen, who charged $120 to insert a catheter into Rosie's uterus. Fifteen minutes later, she sent Rosie home.

Rosie had pain and cramping upon returning home. Over the next 12 hours, she developed an increasing fever, and had nausea, vomiting, chills, dizziness, and increasing vaginal bleeding. The next afternoon, Rosie was unable to get out of bed. She asked a friend to take her to the hospital. She was admitted at 5 p.m., roughly 22 hours after the abortion.

Rosie lied to the doctors when she was admitted, telling them that she was suffering from leg cramps and abdominal pain, saying that her period had just started and denying an abortion. She had a fever of 100.8, a rapid pulse of 108, respiration of 24, and a blood pressure of 110/80. These vital signs are an indication that something is wrong, but are not in and of themselves alarming.

The physical examination, however, revealed cause for concern. Her abdomen was tender and guarded -- meaning that she tensed up when touched. Her uterus was enlarged and tender, and her cervix was soft and dilated wide enough for doctors to pass a ring forceps inside. She had dark bloody vaginal discharge. These are all signs of a recent terminated pregnancy -- whether by miscarriage or by induced abortion -- with infection and possible retained tissue.

So despite Rosie's insistence that nobody had done anything to terminate her pregnancy, McAllen General's doctors accurately diagnosed a septic incomplete abortion. They did a blood culture and found clostridium perfringens bacteria -- gas gangrene.

The doctors immediately put Rosie on intravenous antibiotics and fluids. They also performed a D&C to remove retained tissue from Rosie's uterus. These tissues, also, showed clostridium perfringens infection. Doctors also found placental tissue, confirming their belief that Rosie had indeed been pregnant.

Despite the aggressive treatment, Rosie's condition deteriorated over the next twelve hours. She developed severe jaundice. Her pulse was a racing 160 beats per minute. She developed a rash over her torso and thighs. Her urine output fell, causing the doctors to suspect kidney failure.

More laboratory tests were performed, which led the doctors to believe Rosie was developing disseminated intravascular coagulopahty. They performed a hysterectomy to get rid of the source of the infection. After surgery, her blood pressure was a low 90/60, her pulse a still-rapid 120, and her respirations a panting 30 breaths per minute.

Within six hours of surgery, Rosie's heart failed. A consulting physician recommended intense measures to support Rosie's failing body. Over the next three days, her respiratory problems grew worse, and she was put on a ventilator. Doctors administered medications to correct the clotting failure, antibiotics to attack the infection, and intensive supportive therapy to support her failing organ systems, to no avail. Rosie died on October 3.

The doctors reported the death to the CDC, the CDC notified their allies in the abortion lobby, and Rosie's death was quickly trumpeted nationwide as proof that Henry Hyde was a murderer and taxpayers should immediately resume funding elective abortions to prevent another such death.

What is particularly telling in Rosie's death is that prochoice groups had been very successful in spreading the word that public funding for abortion had been cut -- Rosie's friend and cousin, as well as her physician, were well aware of this fact -- but they had pointedly failed to also pass out the word that Planned Parenthood referred for abortions on a sliding scale, and that private funds were available. It's almost as if the public-relations departments of Planned Parenthood and other abortion-advocacy groups had deliberately increased the odds of a tragedy like Rosie's death in order to provide the corpses needed in order to prop up a drive to restore tax monies to abortion facilities.

Frankfort was particularly disgusted with the response of public health officials, who likewise simply announced Rosie's death and began a call to restore abortion funding, but made no effort to close down the illegal abortion practice where Rosie had undergone her fatal abortion.

Frankfort took it upon herself to orchestrate a sting, with local law enforcement. She coordinated a dramatic raid that put the lay abortionist out of business.

And what of the hysteria? Had it been justified?

There was indeed a small spike in reported illegal abortion deaths after the Hyde Amendment (from 2 in 1976 to 4 in 1977 to 7 in 1978). But there was likewise a spike in reported legal abortion deaths as well -- a far larger spike, from 11 in 1976 to 17 in 1977. (I don't believe that the CDC's reported death numbers are accurate, but they're all we have to work with, and more to the point, abortion supporters place great faith in them.)

Lest prochoicers attribute this jump to women having later abortions because they need time to get funds, we'll note that reported legal abortion deaths fall to 9 in 1978, then leap to 22 in 1979. And although the Hyde Amendment remained in effect, reported illegal abortion deaths fell to 0 in 1979, and remained at 0, 1, or 2 per year. Since this is fewer than the 19 in 1973, 6 in 1974, and 4 in 1975, when federal funds were available for elective abortions, it's hard to say that the Hyde Amendment was causing more illegal abortion deaths.

The most likely explanation lies in Atlanta, not in Washington. When the Hyde Amendment was passed, the CDC launched a study designed to prove that cutting funds for elective abortions would hurt women. They intensified surveillance of hospital admissions for complications of all abortions -- legal, illegal, and spontaneous (miscarriages). Such intense, sudden increase in interest in abortion complications is likely to uncover abortion deaths that would otherwise go unreported.

While it likely triggered the reporting of more deaths than would have otherwise been reported, the study did not find a higher rate of abortion-related hospitalizations for Medicaid-eligible women. To the contrary, the study, "The Effect of Restricting Public Funds for Legal Abortion," found "no evidence of a statistically significant increase in the number of complications from illegal abortions." In fact, they found that while there was no change in the illegal abortion complications, there was a significant decrease in publicly funded hospitalizations for legal abortion complications in cities where funding was restricted, compared to cities in areas where state or local government picked up the tab for elective abortions.

In other words, cutting funds for elective abortions actually had a measurable positive impact on abortion complication rates for Medicaid-eligible women.

So was Rosie's death a fluke? Probably not. The heavy publicity put out by the prochoice movement about how poor women would be "forced" to resort to dangerous criminal abortions probably left Rosie, and some others like her, with the mistaken impression that criminal abortion (rather than birth or even sliding-scale legal abortion) was their only option.

So I'd place the blame for the death of Rosie Jiminez not on the Hyde Amendment, but on several factors:

  • Readily available public funds for abortion had taught her that she need not be careful about her sexual activity and/or birth control.
  • Public relations efforts by prochoice groups left women like Rosie with the belief that criminal abortion was their only option.
  • Rosie's doctor abandoned her, instead of referring her for appropriate counseling and care.
  • The McAllen midwife was willing to play Russian roulette with women's lives instead of referring them for either prenatal care or low-cost sanitary abortions.
  • Since she'd never had to pay for her own abortion before, Rosie was apparently unaware that a legal abortion was available for only a few dollars more than what the dirty local midwife was charging.

    I agree with abortion advocates that the death of Rosie Jiminez was avoidable. But I disagree with them that lack of public funding was to blame. Prochoice organizations had ample opportunity to tout other resources. Prochoice people all around Rosie had opportunities to steer her toward a "safe and legal" abortion, had they chosen to do so. Not a one of them did. And the bigger problem was that nobody ever seemed to entertain the notion that abortion might not be the answer in the first place.

    What's additionally puzzling about this whole turn of events is that the facility to which Planned Parenthood referred abortion patients charged only $130 for an abortion for poor women, just $10 more than Rosie paid for the amateur abortion that took her life. It's difficult to believe that a $10 price difference put the legal abortion out of Rosies's reach, especially since the day before her abortion she'd spent $8 on a cake for a friend's baby shower, and when she died she had a $800 scholarship check in her purse.

    Rosie remains a poster child of the abortion lobby. Their own role in her death is never acknowledged. Henry Hyde is blamed instead -- in spite of his key role in passing a law that reduced abortion injuries among women like Rosie, and in reducing complications, surely also reduced abortion deaths -- in spite of the abortion lobby's best efforts.




    For more abortion deaths, visit the Cemetery of Choice:



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