Chapter Eight: Analyzing the Antis
THE ANTIABORTIONISTS like to proclaim that theirs is an ecumenical movement, and not predominantly Catholic. Although statistics on the composition of their various groups are not public information, anyone who reads their literature, subscribes to their national newspaper, or attends one of their state or national gatherings cannot avoid the impression that Catholics are running the show. At one meeting of a Wisconsin group, the members spent an hour discussing whether they should identify themselves as Catholics in the letters they wrote to newspapers. Opinion was sharply divided on divulgence of this important information, not because there were non-Catholics present but because one faction thought it bad P.R. to be identified as Catholics, while the other argued that being Catholic is "nothing to be ashamed of."
Whether or not the Catholic composition of the antiabortion movement is in doubt, one fact is not, and that is that the resistance to giving women the right to choose abortion is religious. When you scan lists of groups opposing abortion, you find all of them are religious in nature.
Organized religion has done great harm to women. The pervading put-down of women detectable throughout the Bible, the myth of Eve's sin, the ludicrousness of a virgin birth (as though there really were something wrong with ordinary sex)--all this has damaged women. Elizabeth Cady Stanton, who fought for women's equality in, the nineteenth century, said forthrightly: "The Bible and the Church have been the greatest stumbling blocks in the way of women's emancipation." Another of her statements that has been widely quoted strikes a responsive chord with those exposed as children to dogmatic religions: "The memory of my own suffering has prevented me from ever shadowing one young soul with the superstitions of the Christian religion."
The desire of so many clergymen to keep women subservient, dependent, voiceless, is in itself an appalling commentary on both religion and male supremacy. Man has stood for so long with one foot on woman's neck that he finds he cannot stand up any other way. The posture is crippling.
Ostensibly we are a country devoted to the principle of separation of church and state, a principle that is germane to any discussion of abortion, because the conflict surrounding abortion is a conflict of the various beliefs on the beginning of life. There are obviously many beliefs about when life begins. Some people believe life starts at conception, others that life is present before conception and exists in the sperm and the egg. Some people believe life starts with movement of the fetus; the dictionary defines "quickening" as "to come alive." Others believe life starts with viability (capability of the fetus for independent survival). Still others think it starts with birth. One of the reasons abortion was so readily accepted by the Japanese was because the Shinto religion defines life as starting at birth.
Now, in a country which says church and state are separate, there should be room for all religious beliefs, particularly in areas of private concern where the public interest is not in question. The woman who believes life starts with conception should be free to carry through her prenancy, just as the woman who believes life starts with quickening should be free to terminate her pregnancy.
But with no abortion laws, say opponents, women will be asking for abortions at eight and a half months. Not so. A woman who does not want to be pregnant does not want to stay pregnant a day longer than she has to. Women who want abortions want them early, the earlier the better. Many choose menstrual extraction when it is available, opting for the procedure even before a urine test to confirm their pregnancy is valid. Fewer and fewer women are seeking abortions after three months, as early abortion becomes more readily available to them. The longer the antiabortionists continue to fight legal abortion, the longer there will continue to be late abortions, because it is lack of access to abortion that results in late abortion in many cases . Almost the only women asking for second trimester (four to six month inclusive) abortions, in areas where abortion can be found easily, are teen-agers who have been afraid to tell anyone they are pregnant, women with highly irregular periods who have no way of knowing they are pregnant, or women who think they are in menopause and discover it is pregnancy. A surprising number of women have periods after becoming pregnant and find, to their dismay, that they are four or five months pregnant rather than the two or three months they had calculated. Women who suspect they are carrying damaged fetuses cannot receive confirmation of this through amniocentesis until the fourth month of pregnancy, and do not have the option of choosing early abortion.
* * * *
In Wisconsin the shrill insistence of the Catholic Church that all Wisconsin must live by Catholic doctrine is particularly ironic, when one realizes that Catholic women are the major group seeking abortions in Wisconsin. In 1971 in a survey of 200 consecutive women referred by Madison ZPG, 54 per cent were Catholic. Edith Rein, formerly of Milwaukee and the founder of the Wisconsin Committee to Legalize Abortion, the first referral group in the state, reports 75 percent Catholic women referred over a four year period. Rev. Elinor Yeo of the Clergy Consultation Service in Milwaukee reports approximately 80 percent Catholic women referred in 1972 and 70 percent in 1973. The Catholic Church obviously cannot sell its ideas to its own people; what arrogance that it should attempt to impose these beliefs by law on others.
Instead of frantically attempting to bolster its fractured church by the same old pronouncements on the evils of contraception, sterilization, and abortion, the Catholic Church would be far more profitably and relevantly employed in asking itself: What have we done to our women? Why do so many Catholic women seek abortions?
The answers are obvious, of course. A woman brought up to regard contraception as sinful is far less apt to protect herself from an unwanted pregnancy than a woman who has been taught that contraception is intelligent. A Catholic woman is more apt to experiment with rhythm, one of the least effective methods of birth control. A Catholic woman is more apt to have been denied a tubal ligation by her Catholic physician in her Catholic hospital. She is more apt to seek abortion because she is worn out from childbearing, because she has had a baby every year until she is about to die from it.
Whenever I hear a Catholic priest condemning abortion, I remember the young woman whom I counseled extensively both before and after her abortion, who needed far more support than most of the women I refer. She had been impregnated by her priest.
The most unsuccessful birth control and abortion reform groups in this country have been led by those who say, "But what will people think if we criticize religion? We don't want to alienate our Catholic friends." It's a cop-out and a very serious one. When I first heard that the proabortion forces working to win the referendum in Michigan were not planning to utilize religious arguments in their battle, and were going to refrain scrupulously from any criticism of the Catholic Church, I shuddered. This is what the battle is all about. When the Catholic Church is trying to ram its doctrine down the throats of everyone in sight, you are not going to beat them off if you tiptoe around saying how nice they are.
The progress that has been brought about in women's rights, and birth control and abortion law reform, has been brought about despite the Catholic Church, not because of it. There is no point in our pretending that official Catholic views are enlightened and humane, or that Catholics are not different from anyone else. Catholics are different from others--they are quite willing to associate themselves with an organization that has done and continues to do an immense amount of damage to women, to families, to countries, and to the world. If the Catholic doctrines on sex (no contraception, no sterilization, no abortion) could prevail, all the world would be miserable instead of just some of it. All the world would be hungry. The world would end.
Repeatedly in my conversations with Catholics around the state of Wisconsin, I have urged those who have expressed sympathy with the contraception and abortion causes to start a "Catholics for the Right to Choose Abortion" or "Fond du Lac Catholics for Contraceptive Law Repeal." To a woman (or man), they have shuffled their feet, looked uncomfortable, and said, "Oh, I couldn't do that." When I say, "Well, at least quit giving money to your church and tell your priest why--no more money until these positions are changed," they reply, "Oh, but our priest is quite liberal." People like this are part of the problem; they are not part of the solution. They are totally unwilling to accept responsibility for the monstrous actions of their church.
If people had chosen to tiptoe around other harmful organizations, for example the Ku Klux Klan, and say, "Oh, they mean well; they're really nice people," the Klan would prosper. It is social disapproval and social pressure, as well as intellectual persuasion, that causes individuals to avoid groups or stop supporting them. If, through politeness, we smile and agree with our Catholic acquaintances that there are indeed many liberal Catholic priests, and, yes, hasn't the Church changed, they are going to keep on forking out the money and support that keeps the Catholic Church going, and buttresses its continued denial to women all over the world their right to practice contraception and have sterilizations and abortions.
Think of the millions of dollars the antiabortionists have already spent attempting to deny American women their right to choose abortion. Financial support for antiabortion candidates, full page ads in the country's most expensive newspapers, demonstrations, radio and television ads, books placed in libraries, films and slide shows, their own antiabortion newspaper--think of the good that money might have done. All over the world there are miserable, starving, needy Catholic children. Why, in the name of morality, aren't they helping children already born, rather than trying to force unwilling women to produce more unwanted children?
Think of the "Birthright" groups, those antiabortion counseling services that follow the lead of their mentors, the so-called "Right-to-Lifers." They, too, like to emphasize that they are not really Catholic groups, but ecumenical groups, and that is is sheer coincidence that so many of their offices are located on the premises of Catholic welfare organizations, such as homes for unwed mothers.
Another coincidence seems to be that Birthright, like the Catholic Church, opposes contraception and sterilization as well as abortion. Article 111, Section 2 of the Birthright Charter Document reads:
The Policy of every Birthright Chapter and everyone of its members and volunteers is all that chapter's efforts shall be to refrain in every instance from offering or giving advice on the subjects of contraception or sterilization, and to refrain from referring any person to another person, place or agency for this type of service.
No contraception, no sterilizations, no abortions--tell us, Birthright, what are women supposed to do?
But the real pity of the Birthright movement lies not in its attempts to conceal its Catholic pedigree, but in its conception as an antiabortion gesture--not out of concern for women, but because of adherence to religious doctrine. Had there been no freedom for women to choose abortion, there would have been no Birthright movement. The frightened pregnant woman who needed someone to turn to was always there. Birthright materialized and took an interest in her only when her right to choose abortion challenged sectarian belief.
Along about my two hundredth abortion referral, I became aware of a sort of refrain among the callers. "I asked my doctor for the pill, but he is Catholic and he won't help me." "I wanted a tubal ligation, but my doctor is Catholic and he wouldn't do it." "The specialist said not to have another baby or I might not live through it, but our hospital here is Catholic, and he couldn't do a ligation." Or, "After my last baby I wanted to go on the pill, but we're Catholic, and my husband wouldn't let me."
There is no way of assembling and evaluating the damage done to women, families, and society by the Catholic Church, but we can talk about it. Not to do so would be the equivalent of the emancipators of 120 years ago saying, "Oh, they own slaves, but they're nice people, so we won't say anything."
Birth control and abortion are our greatest steps forward in social and moral progress since we freed the slaves. A woman's right to control her own reproductive life is a blessing, a blessing for her and a blessing for society. There is no reason to be bashful or apologetic about supporting women's freedom to choose abortion; there is every reason to be ashamed of supporting a religion that opposes that freedom.
Chapter Nine: What can we do about Medicine?
WOMEN, THOSE SECOND-CLASS CITIZENS, have suffered long and silently from an elitist medical profession dominated by males. When a general practitioner or a gynecologist goes out to a small community and will not, as many in Wisconsin still do not, offer birth control, sterilization, or abortions to his patients, the state is allowing the medical profession to place individual religious views above the health and welfare of its citizens. When women with four and five Caesarean sections are denied tubal ligations by their physicians, a familiar story in Wisconsin, we might as well be licensing Jack the Ripper or Richard Speck. Because women are going to suffer and women are going to die.
From 1969 to 1971 in Wisconsin forty-eight women died in pregnancy, thirty-two of whom had serious and compelling medical reasons not to be pregnant at all. (Herbert Sandmire, M.D., "Family Planning Comes of Age?" Wisconsin Medical journal, April, 1972, pp. 71-72.) Unbelievably these victims included a woman whose scar from a classical Caesarean section had ruptured in her last pregnancy. What did these medical boobs think would happen, allowing her to become and remain pregnant again? One woman who had had seven pregnancies, and suffered from hypertension of several years duration, requested an abortion, which was denied. One day prior to her own death, she delivered a stillborn, macerated fetus. No doubt her doctor still is allowed to practice his lethal brand of medicine and her hospital still is receiving public funds!
Other women in this Wisconsin study, who died from pregnancy, had diabetes, breast cancer, heart disease or disorders, histories of toxemia and hypertension, four and five previous Caesarean sections. They might as well have lived in remotest Upper Slobovia, for in far too many communities in Wisconsin a woman's life and health still do not matter--what matters is the religion of her physician and of those who control the local hospital.
In Wisconsin there are 145 hospitals for short-term patient care in the state. Of these 133 are classed as "private." In many communities the only obstetrical services available are from Catholic-owned or dominated hospitals. What are women to do under this sort of medical dictatorship? And is there such a thing any more as a "private" hospital? All hospitals receive huge infusions of the public's money, and they should be operated by medical, not religious standards. A state government does not license doctors or hospitals for their benefit, but for the public's benefit. When will the idea of service penetrate that armor of insensitivity surrounding the medical community?
A new wrinkle in hospital practice in cities having two or three hospitals is the channeling of maternity patients to one facility. All too often the facility chosen is a Catholic hospital, and women needing sterilizations at the time of delivery find their medical needs ignored because of religious prejudice. Neonatal units (for high risk newborns), serving wide geographic areas, are occasionally located in Catholic hospitals, and the pregnant woman again is in a captive situation. Sterilizations are sought more often by women after high-risk pregnancies, and these patients' serious medical needs again are shunted aside. Catholic hospitals delight in proclaiming their moral objections to abortion, yet every time they deny a woman a sterilization they have created a candidate for abortion.
In the backlash of the United States Supreme Court decision on abortion, Congress and many states have passed laws specifying that any hospital, public or private, may turn away any woman for sterilization or abortion, no matter what her physical condition, even if she has a doctor willing to help her. These laws have been challenged successfully insofar as public hospitals are concerned, but, unbelievably, the private hospital exemption has been allowed to stand. While such laws have limited effect in large, urban communities with a choice of hospitals for women and doctors, they seriously jeopardize freedom of choice and humane health care for women who have one local hospital.
These laws, of course, discriminate against women, since men do not need abortions and can have their sterilizations performed in doctor's offices. Women need a hospital for a second trimester abortion and for a sterilization. Such laws discriminate against the poor. If a well-to-do woman is denied an abortion or tubal ligation in her own community, she has the money and resources to seek these services elsewhere. But if the poor woman is not served by her local community, she is rarely served at all.
No hospital should be allowed to deny emergency treatment to women. When a woman is having a fourth or fifth Caesarean section, she needs a tubal ligation; this is an emergency situation. When a woman becomes pregnant, who has diabetes or hypertension or a heart disorder or any of a dozen other serious conditions, she needs an abortion; these are emergency situations. Too many women suffer and die because hospital policy ranks higher with male physicians, male legislators, and male judges than women's lives and health.
In 1974, 5,000 applicants, many of them women, applied for 121 medical school openings at the Wisconsin Medical College in Milwaukee.(Milwaukee Journal, Sept. 8,1974) While some of these applicants were accepted at other schools, and many did not have the necessary academic qualifications, there were still large numbers of qualified would-be physicians who were turned away. Here we are, the richest country in the world, and qualified women and men who wish to become doctors may not do so because we do not have the capacity to train them. The most important single thing we can do to improve health care in our country is to train more doctors, and to be sure that at least half of them are 'women, and that blacks and other minorities are represented fairly. Who knows--with enough doctors to help, maybe house calls might be fashionable again? (In 1955 I had had twin babies via Caesarean section, my third Caesarean, with my medical history further embellished by a ruptured appendix earlier in that pregnancy. I was nursing the babies, having an abundance of milk, but developed a breast infection when they were about a month old. I was really very sick, with chills and raging fever. The doctor diagnosed and prescribed over the phone. When a couple of days passed and my fever still raged, the doctor suggested that I come in for an office visit. I explained what he must have known--that I was too weak to do that, that my fever edged up a notch or two just getting up to go to the bathroom. When I recovered and went in a week or so later to be checked, he said, "Well, we got through that one all right, didn't we?" I would agree that the patient going to the doctor makes sense most of the time, but there are occasions when house calls are warranted, even for obstetricians.)
In addition to training more doctors we must check the screening procedures used in acceptance of applicants. Medical schools must not look just for academic excellence, but for social concern, some evidence of social commitment, some awareness in the applicant of the dignity and worth of all people. Too often a physician comes across not as a patient advocate, but as a patient adversary. The qualities of consideration and warmth are ignored. One cannot avoid the impression that most medical schools in the past have screened for political conservatives.
Since a medical education is the most expensive education we offer, and since the medical student pays for only a small portion of that education (15 percent at the University of Wisconsin, Madison), it is fair and proper that we expect certain things of these privileged persons. If a student wishes to become a gynecologist or obstetrician, the student should understand that she/he will be expected to help women with birth control and do tubal ligations and abortions. Medical students must be screened, and if they possess convictions that prevent their delivering certain medical care, then they should either specialize in an area where they cannot damage their patients with their personal beliefs, or perhaps they should consider the church, not medicine.
In addition, since this is such an expensive education that we provide, there is no reason why we should not ask these women and men, who have been chosen for this coveted training, to serve in areas without doctors for two years, or perhaps a period equivalent to their academic training? Who knows-they might like the communities that need them, and when they wished to leave, new graduates would be coming along. This is a practical, feasible answer to the distribution problem.
If we had a shortage of persons wanting and qualified to be physicians, we would have some excuse for being in the bind we are in. We do not have that shortage. Our problem is one of priorities, and our priorities can be changed!
The letter that follows is just an "every day" letter that illustrates the problems caused by doctors imposing religious views on their patients. This young couple had decided to opt for permanent birth control but could find no doctor to help them.
Dear ZPG: I wrote to you about eight months ago. My husband wanted a vasectomy and you were very good to give us a list of doctors from this area who perform this surgery. We contacted the doctors but no one would do it because my husband is only twenty-four. At that time I had tried the pill and had very bad reactions, and the doctor did not want to give it to me. So they put in an IUD that worked for one year, and now I am pregnant. We have prepared ourselves for a baby, knowing we will try to make good parents. But the point is that after four years of marriage and two years of going together, we had definitely decided we did not want children. Now with one baby coming we are already worrying about what method of birth control we can use next. We can't understand why this decision should not be ours. We are old enough to vote and pay taxes and run a business of our own, but we aren't old enough to decide if we want a family or not. We have discussed all the angles many times and this is still our choice. So if there is anything you can do to help us now we would appreciate it. Thank you. R.S.
The medical community could do so many painless things to improve its image and its services. Boards of Medical Examiners, for instance, should not all be physicians; they should have consumer representation. Medical societies should offer referrals. There should be a place to call and find out where one can get, for example, a safe tonsillectomy at the lowest cost. There should be simple procedures for registering complaints about treatment and charges.
Recently I referred a woman for abortion, who had a three-year-old child and an eleven-week-old baby. She said her doctor, a specialist, had told her as long as she was nursing and used foam, she would not get pregnant. She believed him, and she got pregnant. Now, you could forgive a doctor like that if he were some old, overworked, country GP, but a specialist! Doesn't he read the literature? She could have got advice as sound from any occult. And here she is-she doesn't want to have an abortion, but what is she to do?
Besides giving out a great deal of misinformation and incomplete information on contraception, many doctors will not tell women of the risks involved in closely spaced pregnancies, or the risks of childbirth. Some of them love to represent abortion as involving risk, but they will not tell women that delivery involves greater risk. A careful specialist will see that his patient goes off the pill every two to three years for a few months time, to let her ovaries work on their own, but there are specialists who will never let on to their patients that four, five or even seven straight years on the pill is a risk they should not take.
Personal action is certainly in order for every woman in this country concerned with women's medical care. First of all, quiz your doctor. If he is opposed to contraception, sterilization, or abortion, dump him. Even if it means the inconvenience of going to another community, don't patronize him. If you are lucky and he is not a sexist, that is still no reason to be in awe of him. If he goofs, let him know. If his charges are excessive, complain. He has had a privileged education, tax-supported for the most part. He should be serving patients, not running his own private dictatorship.
Over the past few years my own attitude toward the medical profession has undergone a rather painful metamorphosis. I summed it up in a speech before a medical group in the spring of 1971, the chapter that follows.
Chapter Ten: Why are you all so angry?
MOST OF MY LIFE I have been somewhat in awe of doctors. I have shared the general view that the profession was noble and the practitioners worthy of respect. My deference was so pronounced that my husband used to tease me, saying I failed to get my money's worth out of trips to the doctor. I was habitually reluctant to discuss my aches and pains to any degree when I actually was in the doctors' offices, because my symptoms seemed so trivial in light of the serious cases I knew they had to treat. And I appreciated that they must frequently be tired, probably overworked, at least pressed for time. I was pleased to have doctors as business friends and acquaintances, and I shared the traditional admiring attitude elicited by a physician's presence in any gathering.
But now all that has changed. I am a pronounced critic of the medical profession. I am on speaking terms only with two or three of my former medical friends and acquaintances. I no longer read or respect the AMA News. We even boo at our house when Marcus Welby comes on TV.
The reason? In my work for abortion reform I have learned that most doctors care more for their bank balances, their colleagues' opinions, their comfortable, unjeopardized way of life than they do for the health and welfare of their women patients.
When a federal court declared last March that the Wisconsin abortion law was unconstitutional and that the state of Wisconsin could no longer deprive a woman of her right to terminate an early, unwanted pregnancy, I was elated. Now, I thought, the doctors will help these women. Yet in the whole state of Wisconsin with its thousands of doctors, only one acted--Dr. Alfred Kennan of the University of Wisconsin Medical School. Calls came pouring into University Hospital from all over the country--as many as seventy in a day, with special-delivery letters and wires adding to that count. The hospital administration very quickly adopted a quota, understandable since they are a training hospital, but totally unrealistic in that only about five to eight abortions weekly were to be performed.
Because of my work with the Wisconsin Committee to Legalize Abortion my own phone started to ring, and I was able to get a few of these patients requesting abortions into University Hospital. But what to do with the others? I phoned every gynecologist in Madison asking for his help. Few were even polite to me. Only one showed any compunction about turning down my request. At the time I phoned one of the patients I specifically was trying to help was a fifteen-year-old girl from a broken home, whose very young age and tragic family situation I thought would surely elicit sympathy. Not a chance! I turned next on behalf of this girl to Milwaukee specialists. One doctor made an appointment and on the day of the appointment cancelled it. Another saw her after a ten-day wait and then refused to do the abortion. The search had been time consuming and by this time the girl had passed the deadline for the D & C. Since my only other safe source at this time was in Mexico City and because it seemed impossible to have a fifteen-year-old go that far away alone, I kept phoning Milwaukee doctors and finally found a crusader who did accept her. However, the salting out did not progress well, there were complications and she was in serious condition for two days before recovery. My relief to have her well and happy again was somewhat tempered by the fact that her hospital bill was in excess of $1,000, and by my knowledge that if there had been one Madison doctor who cared about a teen-aged girl's right not to become a mother, she could have had a safe, simple, inexpensive abortion in early pregnancy.
About this time two or three Madison organizations interested in abortion reform arranged a meeting with Madison General Hospital, a community-supported facility. Women's Liberation people spoke on the side of abortion; a pediatrician, a psychologist and a Unitarian clergyman from my committee urged the hospital to perform abortions. But the doctors from the hospital and its administrators told us they had no intention of doing abortions. It was one of the low points of my life as I listened to male after male speak against having the hospital offer this service. The final straw was the chief of staff who took the podium and talked about his "reverence for life." The meeting broke up into informal arguments and as I left the room I heard one doctor dramatically exclaim, "Why are you all so angry?"
I had not been asked to speak that night and the doctor's rhetorical question went unanswered, but I have often thought of what that answer should have been.
We are angry because for the first time we have seen the need for abortion that you must have seen throughout your careers and would do nothing about. We are angry because the court has given you the opportunity to help women who do not want to be pregnant, yet you will not take that opportunity, even though it brings you much money and much gratitude.
We are angry because we have seen and heard so much tragedy, so much avoidable tragedy. We cannot understand why you would want a fifteen-year-old girl who is physically immature, mentally immature, desperately unhappy, her education incomplete, to become a mother, when you possess the skill and have the legal right to help her.
We are angry because we think of the women throughout human history who have had to endure unwanted pregnancies. We know, now, at this time, women who are too poor to have another baby, who have too many children already. We know women who have begged their doctors for contraceptives or for tubal ligations, and who are now pregnant because they were refused. How, we wonder, do you have the audacity to turn away the woman who wants an abortion when you would not help her prevent that pregnancy?
We know, as we are sure you know too, how many victims of incest and rape there really are in Wisconsin. How, we ask, can you be so inhumane as to turn away a thirteen year-old girl and her eleven- year-old sister, who have been impregnated by their mother's "boy friend"?
And what about those pregnant girls who cry throughout conversations with you because their boy friends have gone--gone to California, or gone to Florida, or "We were to be married, but I don't know where he is now"?
What about the mother who has had a baby every year? Can't you recognize that a pregnant woman with five little children, the youngest three months, has a legitimate claim to any doctor's help and sympathy?
You ask why we are all so angry. We answer with a question. How can you be so cruel?
Chapter Eleven: Every five days there are one million more of us?
THE STARVING CHILDREN have come into our living rooms now. There they are on the network evening news lining up for a cup of milk, or bony hands outstretched, jostling for a bit of food. We were told this would happen. Back in 1950 scholars were predicting this. But ours was the country of surpluses and it was not a problem of scarcity, most said, but a problem of distribution. In 1950 poor India appealed to the World Health Organization (WHO) for help with contraception, but the Catholic member nations of WHO made their usual outcry, and what India got in 1950, when the problem still might have been alleviated, was a team of experts to teach--you guessed it: rhythm!
Now the signs of disaster are everywhere. Food shortages, fuel shortages, fertilizer shortages, unemployment, pollution, dust bowls, encroaching deserts, disease. For it is a truth that population is going to be controlled. If it is not controlled by women's and men's intellect, it will be controlled by famine, disease, and war.
Sharing the American continent are countries so poor that most of their people are malnourished, yet these countries will double their populations in the next twenty years. The question is inescapable: when these governments cannot take care of the people they have now, how can they be expected to keep up with the demands of ever-burgeoning populations?
How long will our neighbors to the south allow each other to live in peace? How long will the United States and Canada remain islands of affluence while the rest of the hemisphere suffers? What would you do if it were your kids that were hungry?
Food is only one problem--health and education are critical problems, too. In all the six central American countries there are fewer physicians than we have in the state of Tennessee, and Tennessee is not known for its advanced health care. In El Salvador for every one hundred students in the first grade in 1967, eighty failed to graduate from the sixth grade, and untold numbers never find their way to school at all. (C. Capa, and J. M. Stycos, Margin of Life. New York: Grossman Publishers, 1974, p. 6.) Health care should be the right of every child in the world and how do you break the poverty cycle without education, without some preparation for jobs?
We live today on a crowded and polluted planet where population control has become our single most important problem. Every five days there are one million more persons on earth. Even with the much- heralded dip in the United States birthrate, our own country added almost 1.5 million persons to its numbers last year, some through immigration, but most through added births. The reality of overpopulation confronts almost every country, yet in much of the world contraception remains limited, sterilization unavailable, and abortion illegal.
Chapter Twelve: Do we belong in the Kitchen?
PREGNANCY IS NOT something you do; it is something that happens to you.
Far too often pregnancy has been compulsory, and its limited emergence as an elective already is shaking society. That the women's liberation movement in America coexists with a drop in the birthrate is not coincidence. True equality for all women will have as its immediate by-product a drop in the number of births. Real freedom to control reproduction will change the world because women never wanted all those babies-they had them because they couldn't help it.
When most cultures regard women as breeding machines, and most of the world does just that, of course populations will grow. When you are brought up not to please yourself, but to please men, naturally you are going to breed. Left to be free you might use your creativity to be a composer or inventor or architect, but if the role that is forced on you is that of wife and mother, you must be very strong indeed to overthrow tradition. When in school you are steered toward home economics or typing, and to become a cheerleader is the begin-all, end-all of existence, of course you are going to turn out to be a breeder. If cheering on the men rather than achieving things yourself is what you are judged by, then quite naturally you will fall into the pregnancy trap.
In the United States we are taking the first steps toward a society that will see women as persons, not sex objects. We are moving toward a society that will give women equal opportunities in the professions and trades, where the criterion for employment will be ability, not sex. Such a society will produce happier women and men. Such a society will produce fewer children, but such children will be treasured because they will not be accidents, or duties, or someone else's expectations--they will be wanted children.
Feminist and author Elizabeth Janeway, who always has something thoughtful to say, addressed the annual meeting of the National Abortion Rights Action League (NARAL) in Washington D.C. in October, 1973. Commenting on the possibility of the United States Supreme Court decision on abortion being overthrown, Ms Janeway concluded: "If we lose this one, we belong in the kitchen."
But we're not going to lose this one. Male supremacists, fundamentalists, and the Catholic Church finally have met their match. Feminists will work until the freedom to choose abortion is extended to women everywhere. Women no longer belong in the kitchen. They belong, as equal persons, in the world.
Chapter Thirteen: "Why Don't they just use birth control?"
WHENEVER I SPEAK ON ABORTION an inevitable question is: "Why don't women just use birth control?"
It is my own experience in referring women for abortions that about 38 percent of them are practicing birth control at the time they become pregnant. Some of the methods being used are most unreliable-- foam, rhythm, withdrawal, but people are trying. Out of each hundred women I refer, I can count on three or four of them having IUD's in place. Although most IUD failures seem to occur in the first year of use, I have referred a woman for abortion whose IUD had worked for her for nine years. Women getting pregnant with them after two or three years of successful use is not at all unusual. The Dalkon shield, the crab-shaped IUD so popular with physicians, is the most unreliable of the well-known IUD's. Recently it was withdrawn from the market, since it apparently was the cause of serious uterine infections, some fatal, in women who became pregnant while it was in place.
The pill, of course, is an effective method of birth control, but even with its good record of reliability some women still get pregnant on it--they do not forget to take it--there are occasional legitimate pill failures. One woman I referred for abortion became pregnant twice on the pill. The first time she carried her pregnancy to term, and then her doctor prescribed a stronger pill. She took it faithfully and she took it at the same time every day just to be very sure. And she conceived a second time, even on a high estrogen-content pill.
Although pill failures are relatively rare, serious reactions to the pill are common. Many women who have family histories of blood-clotting diseases should not take it at all. Women subject to migraine headaches, asthma, varicose veins or high blood pressure may worsen their conditions on it. Liver disease, kidney disease, diabetes, epilepsy, heart disease or defect, and cancer usually preclude use of the pill.
For many women the decision to take the pill is out of their hands because it makes them so sick--there is no question of their continuing on it. Unhappily many women stay on the pill despite side effects because their contraception options are so limited.
In addition to being so imperfect, contraception is still unavailable, especially to young people and to poor people. Many states still have laws restricting the visibility and accessibility of contraceptives. For instance in Wisconsin condoms legally may not be sold in machines, and crusader Bill Baird was arrested in 1971 for displaying "indecent articles" in a public lecture. Until a federal court ruling in November, 1974, unmarried persons in Wisconsin legally could not use contraceptives. As long as contraception remains as imperfect as it is and as unavailable as it is, we can expect women to resort to abortion.
Those who ask, "Why don't they just use birth control?" must be reminded that sex education is trivial or nonexistent in many schools. The student learns in the typical biology or health class that sex may result in pregnancy, but she/he is not told how to avoid that pregnancy. In addition, many Catholic women and men are brought up to believe that contraception is sinful, and consequently they take chances they would not take had this particular indoctrination not befallen them.
Getting pregnant is very easy. Educating people how not to get pregnant is a gargantuan task, especially in a state like Wisconsin, which has an anticontraceptive law uniquely constructed to make dissemination of information as difficult as possible.
Two very common causes of birth-control failure are dependence on a so-called "safe period," and using condoms for ejaculation only.
I am not a fan of billboards, but I would like to see a few on every major highway across the country saying, "There is no such thing as a safe period." Although most women are apt to conceive midway between periods, I have referred women for abortions whose only intercourse was just before a menstrual period, just after a menstrual period, even during a menstrual period. It is a fact that ovaries can release eggs any old time. The only way for someone to be reasonably sure she does not conceive is to use an effective method of birth control all the time.
Packages of condoms should carry instructions in big, bold print that this product must be used throughout intercourse if it is to be an effective method of birth control. Too often men do not use condoms throughout sex, but only for ejaculation. Sperms escape prior to ejaculation, and pregnancy results.
All of our present methods of birth control are very poor; all have serious shortcomings. The pill's chief liability is its unpleasant, sometimes dangerous side effects; the IUD its pain in insertion, the cramping and heavy menstrual flow it frequently causes, and its unreliability for many women. Foam, of course, is grossly unreliable, and despite what the ads say should never be used alone, only with condoms or a diaphragm. Condoms interfere with touch; many women have aesthetic objections to diaphragms or worry that they may slip out of position. So there you are. It's too bad some of the money we have spent on munitions could not have been spent on research for contraceptives.
When someone says to me, "Why don't women just use birth control?" I am reminded of the member of Birthright who called me long distance for abortion referral information. She was very distraught, half-crying and said, "I always thought of myself as helping these young girls. I never thought of women like me getting pregnant." Her method of birth control had always worked for her, and she was devastated when it failed.
When some woman shakes her head and says, "I could never have an abortion," through my mind pass the dozens and dozens of conversations I have had that started out with the caller saying, "I never dreamed I would be calling a service like yours ... I never believed in abortion ... I never thought I would want an abortion, but..."
Never is a long, long time.
Chapter Fourteen: Late Abortion and the Edelin Case
WHEN DR. KENNETH EDELIN was found guilty of manslaughter by a Boston jury in February, 1975, in the alleged death of a fetus following a legal abortion, the story broke on a Saturday afternoon, and we in Madison braced ourselves for the interpretive reporting of the Wisconsin State Journal, Madison's conservative morning newspaper. Sure enough! There in a type size appropriate for the announcement of World War III was the antiabortion version of what had happened. "ABORTION RULED A KILLING" exulted Sunday morning's banner headline.
That gentle Dr. Edelin ever should have found himself a defendant against a charge of manslaughter beggars belief. Reared in a black district of Washington D.C., he attended segregated schools there. One of four children, three of whom went to college, he graduated from Columbia University in New York in 196 1, taught math and science for awhile, and then decided to take up medicine, graduating from Meharry Medical College in Nashville.
He became the first black chief resident of obstetricsgynecology in the history of Boston City Hospital, a hospital which serves a largely black clientele. After the historic Supreme Court decision legalizing abortion in 1973, he performed abortions at the hospital for the women who requested them.
In October, 1973, a black woman brought her seventeen-year-old unmarried daughter to Dr. Edelin for an abortion. Estimating her pregnancy at approximately twenty-one to twenty-two weeks, Dr. Edelin proceeded with the saline-injection method of abortion, which usually causes uterine contractions and expulsion of the fetus. When attempts at repeated saline injections were unsuccessful, he performed the abortion surgically by a procedure called hysterotomy, a miniature Caesarean section. His patient had a normal recovery.
Prior to this time in Boston, four scientists, all medical doctors, were trying to find alternate drugs to prescribe for pregnant women allergic to penicillin. They had studied, with the consent of the patients involved, thirty-three women who were having abortions. Two antibiotic drugs, clindamycin and erythromycin, were given the women prior to their abortions, and the aborted fetuses were then studied, to see which drug more readily passed the placental barrier. Their findings, that clindamycin passes through more easily than erythromycin, and that either drug is a reasonable alternative to penicillin in the treatment of intrauterine infections, were published in the New England Journal of Medicine. (Agneta Philipson, M.D., L.D. Sabath, M.D., and David Charles, M.D., "Transplacental Passage of Erythromycin and Clindamycin," New England Journal of Medicine, June 7, 1973). Antiabortionists, to whom fetal research is anathema even though it is conducted to help women retain pregnancies, called this article to the attention of Massachusetts State Representative Raymond Flynn, who took the issue to a Boston City Council member, Albert O'Neill, who in turn called it to the attention of Boston District Attorney Garrett Byrne. (Boston Globe, Jan. 5, 1975. Subsequent direct quotations in this chapter, unless otherwise attributed, come from the Boston Globe, Jan. 5,12,19, Feb. 16,17,1975.) In Byrne's ensuing investigation, the twenty-one to twenty-two week fetus Dr. Edelin had aborted was discovered at the mortuary by the antiabortionists. Grand jury proceedings followed. Eventually, unbelievably, the four doctors engaged in fetal experimentation were charged under a nineteenth century "grave-robbing" statute (case pending), and Dr. Edelin was charged with manslaughter. Alice- in-Wonderland never knew what she missed by not visiting Boston.
The six-weeks trial of Dr. Edelin, a trial that never should have taken place, attracted nationwide attention. The prosecutor, forty-four-year-old Assistant District Attorney Newman A. Flanagan, was described repeatedly by the Boston Globe in flattering terms. "His reputation for wit and flair matches his record as a tough prosecutor," trilled the Globe. Examples of his wit were recorded: he explained his gray hair as a result of "early piety" and "he might pick up a dead phone and say for the amusement of his fellow prosecutors 'Tell Cronkite I'm too busy ... No, no, I haven't got time to be interviewed by Newsweek."'
That he was the father of seven children was duly reported by the Boston paper, along with his eldest son's athletic prowess. The full roster of prosecutors' names--Flanagan, Mulligan, Brennan and Dunn-- sounded like roll call at an Irish wake.
Judge for the trial in Suffolk's Superior Court was James McGuire, a graduate of Catholic University and Boston University School of Law. The Boston Globe cited his "reputation for competency" and for "keeping lawyers from straying off the central issue."
This "reputation for competency" was put to an early test. William Homans, the attorney for Dr. Edelin, asked to have the case thrown out of court on the basis of the jury pool. In Boston, a "sexist" computer chooses names of prospective jurors; it is programmed to put out two men's names for every one woman's name. In addition, the registrar is instructed to mail out the summons for jury duty on a two- to-one, male-preferred basis. This blatant discrimination against women did not move Judge McGuire, who denied Homans' request. The all-white jury that was selected was predominantly male; only three women were chosen. Ten of the twelve persons finally deciding Dr. Edelin's fate were Catholic.
That card-carrying, dues-paying Catholics ever should have been allowed to serve on a jury deciding a charge of abortion-related manslaughter is a travesty of justice. They support the institution that is the major enemy of abortion in the world--yet they were allowed to bring their religious bias to this legal setting.
Examination of jurors is extremely restrictive in Massachusetts. It is all done by the judge alone. Although the defense attorneys and the prosecution may submit questions for the judge to ask, there is no delving permitted and a very limited number of challenges allowed. In a case as serious as Edelin's, lawyers for the defendant are understandably reluctant to use up all their challenges early in the jury screening, since far more biased potential jurors could be expected to be coming down the pike.
The prosecution stumbled early in its case, when one of its major witnesses against Dr. Edelin testified that she had not been in the operating room at all at the time the hysterotomy took place. In essence, the only witness against Dr. Edelin turned out to be Dr. Enrique Gimenez-Jimeno, who testified that Dr. Edelin, after detaching the placenta from the uterine wall, held the fetus within the woman's uterus for three minutes while looking at a clock on the operating room wall. Such an action would deprive a fetus of oxygen. Gimenez-Jimeno's testimony was refuted by all other eye-witnesses, who stated that the hysterotomy took place with no unusual delays and that the clock Dr. Gimenez referred to was not there at all, as it had been taken out for repairs.
"Experts," whose qualifications included leadership positions in the antiabortion movement, told the jurors that in their opinion the fetus was viable despite its early gestational age. Other witnesses testified that in their judgment the fetus was nonviable, that it not only never breathed, but was incapable of breathing. Dr. Edelin told the jury that he would not perform an abortion if he believed the fetus might live independently from the woman.
"I have never performed an abortion on a woman who was carrying a fetus I considered to be viable," Dr. Edelin testified. "In fact, I have refused to perform such abortions."
At the close of the trial the names of the sixteen jurors were placed in a small metal drum and four slips were removed. These four, who became the alternate jurors and did not participate in the verdict, ironically turned out to be the two youngest and the two most educated members of the panel.
"We polled ourselves," said Michael Ciano, one of the four, "and three of us voted for Dr. Edelin's acquittal."
The other twelve jurors retired to discuss the case, and did not reach a verdict for seven hours. The defense had been hopeful when Judge McGuire charged the jury, because he instructed them that manslaughter required the death of a person, which was defined as an infant born alive and able to exist outside the uterus. Dr. Edelin said later his own optimism dimmed as the first day of deliberation passed and no verdict was reached. When the jury recessed for the night on Friday, he was worried. Shortly after one o'clock on Saturday afternoon, Feb. 15, 1975, the jury brought in its verdict. Foreman Vincent Shea forcefully called out their finding: "Guilty."
Dr. Edelin said he saw the guilty verdict on the faces of the jurors even before the foreman shouted it.
"When the jury came in not one of them would look me in the eye," he said. "I became very apprehensive. As it turned out the die was cast when we picked the jurors.... It was a witch-hunt. I don't think the jury was fair. I don't think it would have been possible to get a fair jury in Suffolk County, no matter how many challenges we might have had."
Later certain jury members were to say that a photograph of the fetus shown to them by Prosecutor Flanagan decided them in their finding of Dr. Edelin's guilt, because "it looked like a baby." Since there was no question of the legality of the abortion procedure, the jurors had to be convinced beyond a reasonable doubt that Dr. Edelin had been guilty of negligence following the abortion. A photograph of a preserved fetus scarcely gives credence to a charge of negligence. It is probably the first time in courtroom history that a defendant was found guilty because his alleged victim looked like a person!
Racial bias may have abetted religious bias, according to alternate juror Michael Ciano, who charged that racial slurs against Dr. Edelin had been made more than once before closing arguments. Although other jurors were to deny this, Ciano quoted one juror as saying, "That black nigger is as guilty as sin."
Dr. Edelin remained outwardly composed after the verdict, but others in the courtroom did not. There were sobs and cries of disbelief as spectators said to each other, "How could they find him guilty?" Several women left the courtroom looking dazed and stunned; some were crying openly. Those who had followed the testimony day after day were especially disbelieving.
"Edelin's attorneys countered the philosophical arguments and they countered the factual arguments," one feminist told me. "The overwhelming weight of evidence was on our side. When the mainstay of the testimony against Dr. Edelin is the word of one man, who reportedly held personal animosity toward him and who based his testimony on a clock that wasn't even there--well, that jury was just dumb."
That Judge McGuire may have shared her opinion seems a likely speculation. According to a report in the Globe, he, too, seemed "stunned" by the verdict, and did not thank the jury as is customary after a long trial. Three days later he sentenced Dr. Edelin to one year's probation.
The Edelin case is being appealed to the Supreme Judicial Court of Massachusetts, with oral arguments probably being heard in the fall of 1975. Although there can be little question that the conviction will be overturned, and that the final fallout from the trial will be favorable, its immediate effect was that many of the doctors and hospitals across the country that had been doing second trimester abortions cut back.
Once again, the victims are women.
* * * *
And who are these women who seek late abortions?
Almost all of them are very young. They are minors who are afraid to tell their parents they are pregnant, until that pregnancy starts to show. Frequently they are children--thirteen, fourteen or fifteen--who refuse to accept the fact that they are pregnant until that fact is obvious to others. They are young people outside the information system, who live in communities where there is no one to turn to for information on early abortion.
If an older woman seeks a late abortion, and this is rare, she is apt to be someone in her forties, who thinks she is in menopause and discovers it is pregnancy. Or she may be someone who does not have regular monthly periods, and does not experience other early symptoms of pregnancy. Or she may be someone whose periods have continued after conception.
She may be a woman with mongolism in her family, or the woman who already has produced an abnormal child and wants to be sure the fetus she carries will result in a normal person. Tests for chromosomal abnormalities can be done, but not until about the fourth month of pregnancy. Then, after the test, a culture must be grown which may take another three to six weeks, and this woman may not know until her fifth month of pregnancy that she is carrying a retarded, deformed fetus.
Not long ago I was contacted for help for a sixteen-year-old girl who was near the end of her second trimester of pregnancy. Her father had a construction business, and a relative, a young man in his twenties, had come to work for her father and had stayed in their home until he found an apartment. He had raped the sixteen-year-old and she became pregnant as a result. She was afraid to tell anyone--she was afraid of the young man and afraid of her father. Finally, she told a teacher, who helped her tell her mother. These are the tragic stories behind the requests for late abortions.
In January, 1975, I spent many hours arranging a late abortion in New York City for a mentally retarded black girl from the Milwaukee ghetto. She was fourteen years old and had no idea of what had happened to her. Some man had taken advantage of her mental deficiency to impregnate her. Despite her tragic circumstances no help was available for her in Wisconsin, where the few hospitals that do a limited number of late abortions cut off at eighteen or twenty weeks.
No woman ever gets pregnant in order to have an abortion. No woman ever says to herself, "Well, I'm six weeks pregnant, but I'm going to wait and have my abortion at six months because it will be so much more fun." Women ask for late abortions for serious and compelling reasons, and the option of late abortion must be kept open for all these tragic cases.