1971: Legalization Triggers Maternal Death and Mass Nursing Crisis in the Aloha State

Hawaii was one of the first states to legalize abortion essentially on demand. While a handful of medical safeguards prevented it from becoming a destination for “abortion tourism” like New York or California, they weren’t enough to save an unidentified woman in 1971.

“Coral” was a resident of Hawaii. State regulations required that prospective abortion clients live in Hawaii for at least 90 days before. This would ensure that the client would be able to return to facility or hospital to receive care in the event of complications. (If other states such as New York or California had implemented a similar policy, it could have saved the lives of many, including but not limited to Lisa Marie Hoefener, Denise Holmes and Kathryn Strong.) In addition, abortions past “viability” were still banned except for health exemptions, minors required the knowledge and consent of a guardian, and hospitals were free to set their own regulations to further protect the health of their clients.

Unfortunately, these protective regulations were not enough to save Coral. She underwent a “safe and legal” hypertonic saline abortion. This method was highly dangerous; one hospital reported a 32.7% rate of serious complications among their saline abortion clients. (It is not specified if it was the same hospital where Coral underwent her fatal abortion.)

In addition to mortality and morbidity of abortion clients, another negative effect of legalization was documented: the psychological effects on hospital staff, particularly nurses, amounted to “an unexpected crisis in patient care.” A study compiled interviews with nurses involved in abortions or in the care of post-abortive women and found that every single one of them “suffered from strong emotional reactions” such as anxiety, depression and even identity crisis— including those who had initially supported the legalization before it was actually implemented. It was concluded that conscience protections for these workers were crucial; "The option of not working on abortion cases must be kept open."

Abortion in Hawaii: 1970–1971

A Preliminary Report: Abortion in Hawaii—— Present and Future Trends

Hawaii Med J. 1973, A Midterm Procedure Not Without Risks

Fam Plann Perspectives 1973