One Woman's Abortion

Each year for hundreds of thousands of American women there is a wide gulf between what the law forbids and what they feel they must do. The author of this article, whose credentials are trusted by the Atlantic, is a college graduate in her forty-sixth year, the mother of three children, living with her husband and family in one of the many commuter communities in the East

My first call was made to the doctor whose credentials seemed to me best. When I asked for an appointment at his early convenience, he replied—somewhat nervously, I thought—that he was considering taking a trip and asked that I call back next week. Number two on my list proved able to see me the following day. My visit did a good deal to quell the panic which had been building steadily in spite of my efforts at self-control. The office seemed orderly, the tools of the trade were neatly arrayed in the glass cases dear to the hearts of the medical fraternity; the doctor's examination was brief and businesslike, and as far as I could tell identical with those performed on me over the years by obstetricians and gynecologists under different circumstances. He explained in simple and understandable terms exactly how he would perform the operation, how long it would take, that it would be painful, but not intolerably so, for a few minutes. (I gather that except for abortions done in hospitals, anesthetics are almost never used. For obvious reasons, these physicians work without assistance of any kind. They are thus not equipped to deal with the possible ill effects of anesthesia; nor can they keep patients in their offices for any great length of time without arousing suspicion about their practices.) The doctor I was consulting described precisely the minimal aftereffects I might expect. We fixed a date at mutual convenience a couple of days off for the operation.

This particular M.D. was able to strike a nice balance between willingness to help and lack of overeagerness to collect his $500, payable in advance. He stated frankly that he felt the element of physical risk was negligible but that the myths and exaggerations about abortion and the hard fact that it was an illegal procedure created prior apprehensions of sometimes damaging proportions. He urged me to call him and cancel the appointment if my husband and I felt there was any reason to reconsider our decision. Short of physical and fiscal miracles we had no right to expect, I didn't see what could alter our circumstances and told him so, but I agreed wholeheartedly about the apprehensions.

The operation was successfully concluded as scheduled. Forty-five minutes after I entered the doctor's office for the second time, I walked out, flagged a passing cab, and went home. Admirably relaxed for the first time in two weeks, I dozed over dinner, left the children to wash the dishes, and dove into bed to sleep for twelve hours. The operation and its aftereffects were exactly as described by the physician. For some five minutes I suffered "discomfort" closely approximating the contractions of advanced labor. Within ten minutes this pain subsided, and returned in the next four or five days only as the sort of mild twinge which sometimes accompanies a normal menstrual period. Bleeding was minimal.

Post hoc, my conclusions are these:

1. If five people, of my limited acquaintance, knew five different abortionists in active practice within a few square miles of each other, I find myself wondering if the abortion rate must not parallel the live birth rate in the United States.

2. Four of the five abortionists recommended to me were duly licensed physicians. Is this extraordinary, or are the dark tales about all abortions being performed in filthy surroundings by unskilled practitioners using knitting needles exaggerated?

3. My operation at least was performed with what seemed to me incredible proficiency, speed, and deftness, with sterile instruments designed for the purpose for which they were used. The Kinsey Institute is welcome to add me to its conclusions, which are that though they have been able to interview few abortionists, they are much impressed with the skill, humanity, and understanding these few showed for their patients.

I am sure that my experience is not unique. There must be hundreds like me from coast to coast who for sober and considered reasons daily undergo the same fears, search for the same kinds of operative sources, and find the money necessary to terminate unwanted pregnancy.

Some states are less rigid in enforcing antiabortion statutes than others. The low nationwide rate of convictions obtained against abortionists perhaps points not only to the difficulty of obtaining evidence against them but also to the acknowledgment by law enforcement agencies of the real necessity of such practices. As the Kinsey group says, "In our own sample we find that the great percentage of the women who had an illegal abortion stated that it had been the best solution to their immediate problem. This widespread difference between our overt culture as expressed in our laws and public pronouncements and our covert culture as expressed in what people actually do and secretly think is as true with abortion as with most types of sexual behavior."

Is the time coming when we can rid ourselves of one more hypocrisy, closing the gap between what we do and what we say we do? Therapeutic abortion practices will have to lead the way. There is some evidence that the first steps have been taken. Grounds for therapeutic abortion vary widely from state to state and from city to city. Unfavorable Rh factors, for instance, are considered reason to terminate pregnancy by some physicians in some areas, as is a case of German measles suffered in the early stages of pregnancy. Social grounds for abortion could follow, under the surveillance of abortion boards composed of M.D.'s and psychiatrists. (Such boards exist in many areas but are generally rubber-stamp groups who are notified by a physician that he will be performing a therapeutic abortion on date fixed by him in the hospital of his choice.)

I believe that dilation and curettage is the only method of abortion used, legally or illegally by most physicians in this country. Though the operation is a relatively simple one, it remains an operative procedure with some attendant risk of infection, however small, whether performed without anesthesia, in a hospital or in a doctor's office. Again citing the Kinsey group: "It is already evident that it would not be difficult to develop effective and safe abortifacients, including some to be taken orally. The fact that such a development has not been made is largely a moral matter."

The italics are mine. Is it moral anguish, fear of fine or imprisonment, and terror about illicit practices on families who have sound social reasons for terminating an unwanted pregnancy? If it is moral to prevent conception, is it immoral to interrupt an ill-advised one?

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