"Like a Car Wash"

While updating information on the death of Carole Wingo for my latest installment of the Lime 5 review, I came across a series done by the Detroit Free Press that deserves praise and careful attention.

"Going through an abortion clinic in Detroit is like going through a car wash," said Delores Katz, medical writer, in "Abortions, Assembly Line Style" in the September 10, 1974 Detroit Free Press.

In both cases [abortion and car wash], the procedure has been made routine and standardized with an eye to processing the maximum number of customers in the shortest time at the greatest profit.

The entire abortion procedure takes from two to five hours. The actual abortion takes five minutes, counseling 10 minutes, and recovery an hour. The rest of the time is spent waiting, usually in a room packed with other patients.

The only time the patient sees the doctor is during the operation. The only examination the doctor performs is a brief pelvic examination before the abortion. Many doctors never see their patients' faces.

And just as car washes function whether the cars going through them are dirty or not, most of Detroit's abortion clinics don't bother to determine whether their patients actually need abortions.

And by "need abortions," Ms. Katz means that the women are actually pregnant. The issue of whether abortion is the solution to the woman's problems if she actually is pregnant is another matter entirely.

Ms. Katz investigated Detroit's clinics and fully half of them told them that she was pregnant even though she wasn't.

Midwest Family Planning Clinic and Dr. Gilberto Higuera

Ms. Katz visited Midwest Family Planning Clinic where Dr. Gilberto Higuera (who later got in trouble for an illegal third-trimester abortion, reusing disposable equipment, and altering a medical record -- ed.) performed about 20 abortions every weekday. The receptionist and counselor treat her kindly and don't use any high pressure sales tactics. They leave her to wait in a hallway with eight other women and girls all clad in paper gowns and slippers. As the hours go by, Dr. Higuera doesn't even look at the patients when he comes out into the hall for coffee then resumes his work. Ms. Katz is brought into the procedure room. Higuera examines her and asks when her last period was and prepares to inject anesthetic.

"I look up, terrified. Higuera sees my face. 'Maybe we better wait,' he says."

He offers her more tranquilizers. She says she needs more time to think. He says she can come back any time in the next four weeks and he'll do the abortion.

Later, I call the clinic and ask whether my pregnancy test was positive. The woman gets my chart, and says there is no notation on it.

"Sometimes they don't do the tests," she says.

Family Planning Clinic

Family Planning Clinic was part of a network of clinics owned by Len Sands of Dallas. Ms. Katz doesn't describe much of her experience there, but what she has to say is vivid:

The procedure room I am put in has a wastebasket at the foot of the examining table, right under the stirrups. The continuous strip of paper that runs the length of the table ends in the basket, which is filled with blood-specked paper.

One of the two clear glass suction jars standing next to the table is filled with blood from an abortion. ...

Dr. Duane Larkin walks in. He doesn't look at me.

"You have a negative (pregnancy) test," he says, staring at my chart.

He goes to the foot of the examining table.

"Tell her to lie down," he says to the nurse.

"Lie down, dear," the nurse says to me.

"Tell her to relax," says Larkin.

"Relax, dear."

He performs the examination, staring at the far wall of the room.

"She could be three or four weeks," he says to the nurse. "Have her come back in two weeks." He turns around and walks out.

At least he told her the test was negative and didn't insist on going through with an abortion.

Physicians Medical Center

This vignette starts with a phone call. Ms. Katz calls to say she thinks she's pregnant. She tells the date of her last period. "You're almost nine weeks gone -- the sooner the better," the woman on the phone says.

Dr. Stephen S. Friedman, an osteopath in Pontiac, Michigan, would come down to Physicians Medical Center on alternate Saturdays. He'd do about 20 abortions.

Ms. Katz's description of her intake seems brusque. When her fake name is called, she and the receptionist sits down with her at a table and collects the $212 abortion fee. "She gives me three packets of medicine, a printed sheet of instructions on aftercare, and asks if I have any questions." Ms. Katz asks if it will hurt. She is told, "No, just cramps for 5 or 10 minutes." She's asked to sign a paper certifying that she is no more than 12 weeks pregnant. There's no mention that anybody has done an examination of any kind.

Ms. Katz is brought to a tiny room that barely accommodates two beds. The woman on the other bed explains that she's going through a divorce.  She hasn't had a pregnancy test or an examination. She hasn't spoken to a doctor, a counselor, a friend, a family member other than her husband, who found the clinic in the phone book and drove her down. The woman is called out of the room and comes back about ten minutes later, crying. 

Ms. Katz is brought to the procedure room.

"You are doing this of your own free will," Dr. Freidman says in a monotone. "Nobody is forcing you."

Ms. Katz nods. Friedman examines her and explains the procedure. Ms. Katz says she wants to think about it some more and asks how long she has to make up her mind. Friedman tells her two weeks.

When Ms. Katz returns to the room with the beds, the other woman is still crying. She wanted the baby. She just didn't think that it was the right time.

Ms. Katz dresses and gets her $212 back.

Again, I have to give them credit for not pressuring her.