Don Sloan

In the following viewpoint, Don Sloan bemoans the fact that women are finding it increasingly difficult to obtain legal abortions. Although the Supreme Court’s 1973 Roe v. Wade decision supposedly protects a woman’s right to a safe abortion, the majority of counties in the United States have no abortion facilities, and women often face restrictive measures such as mandatory counseling sessions, twenty-fourhour waiting periods, or parental notification laws. Sloan maintains that such restrictions impinge upon a woman’s legal right to choose. The decision to abort a fetus may be an unpleasant option, but reproductive choice is ultimately about rights and freedoms, not morals and ethics, the author asserts. Sloan is a physician and an assistant editor of Political Affairs, a monthly periodical.

As you read, consider the following questions:

1. According to Sloan, what percentage of abortions occur in the first trimester of pregnancy"
2. What are some of the inflammatory terms anti-choice activists use to chastise those who support the right to choose, according to the author"
3. In Sloan’s view, what are the four basic truths about the abortion debate"

She’s young, unmarried, working at a marginal job, barely making ends meet—and very much pregnant. She doesn’t have the vacation and sick-time perks that would allow for time off. Family leave doesn’t apply in her case. Queasy every morning, she is worried how long her boss will tolerate her tardiness. Single and nearly jobless, she’s at wit’s end.

Her local hospital doesn’t do abortions. If she had the bucks, she could go off to the big city somewhere, a clinic, or even a private doctor. No, it has to be here and it has to be now—time is running out. So she gets a name—a nurse, a pharmacist, maybe a retired health care worker. That’s if she’s in luck. If her luck has run out, she ends up without any name at all and finds herself in some hospital emergency room, bleeding, in shock, in a coma—dead.

A cautionary tale from the ’50s? Hardly. Unless living in a major city, women today face the de facto prohibition of abortion entitled by law. The right to a clean, safe procedure is theoretically protected by that law, at least for the time being. In practice, however, it is a right that is becoming more and more difficult to exercise.

Anti-Abortion Maneuvering

Although both the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) seem to have sidestepped the real issues of the abortion question, they are on the public record as being officially pro-choice. Early abortion is still ten times safer than childbirth, so from a purely medical standpoint, choice is the position that gives the doctor the greatest latitude to do what is best for the patient—if that is what the patient chooses. But when it gets down to individual cases, there’s nothing to stop doctors or hospital administrations from playing politics and branding physicians who do abortions.

Infighting, controversy, and political maneuvering go on within the sterile walls of the medical world perhaps as much as on the floors of the legislature or on the sidewalks in front of abortion clinics. The term “abortionist” still carries with it a heavy weight. We’ve made it legal, but we haven’t yet made it respectable—not quite.

First-trimester abortion, making up almost 90 percent of all procedures, is “minor” surgery in the lexicon of the gynecologist. Despite its nominal status it is still subjected to disproportionately close scrutiny. Several years ago a research study exposed the way various health-care professionals, from doctors to hospital clerks, viewed the procedure. The study compared how intake emergency room services handled women who sought help for what were allegedly complaints or complications following either an abortion or a dilatation and curettage (D&C) (a carbon- copy procedure done for reasons other than to end pregnancy). The results were startling.

With rare exceptions, abortion patients came under greater surveillance than D&C patients. The former underwent more extensive evaluations, including lab testing, x-rays, and (usually unnecessary) additional surgery, often of a major type involving abdominal incisions and even hysterectomy.

The researchers concluded there was an obvious prejudice against abortion patients and the procedure itself, partly due to ignorance on the part of the staff or out of a regressive attitude which looks down upon patients and their doctors.

A Time Bomb

In the abortion equation, it is the doctors, still mostly male, who are being stigmatized as the culprits more so than the patients. In states that are waiting for the next test of Roe v. Wade, the criminal penalties are aimed at the physicians, with an added wrist-slapping for the patients. As a result, anger against them has led to the brutal killing of a physician in Florida and his colleague and the shooting of another in Kansas. Most recently is the sniper murder of a highly respected practitioner in Buffalo, New York. . . . These are the inevitable outcomes of the policies of past administrations in Washington which, turning a blind eye to the attitudes and escalating violence of anti-choice forces, inadvertently triggered what was a time bomb waiting to explode.

The seeds of violence have been sown in the semantics of those who purport to oppose killing. But in this case, the pen is as mighty as the sword, as anti-choice rhetoric only serves to further obfuscate the issues. To irresponsibly label an accepted procedure a “murder” of a “child” in defiance of law and medicine is to castigate those who perform this task as “murderers.” In this twisted revision of the terms of debate, pro-choice has become pro-abortion. Pro-abortion, anti-life. Anti-choice then becomes pro-life and it filters down to an option between life or abortion, now synonymous for death. And abortion, “a murder by murderers,” is performed not for a woman to remove an unwanted pregnancy or embryo but instead on a “kid,” an “unborn,” “your baby.” Names have even been assigned to these entities.

The revaluation of terms goes even further: the procedure is not being done in a hospital or outpatient unit, center, or clinic, but in a “killing chamber,” “crematorium,” or “vacuum station.” Specially-made videos have been produced depicting the movement of the embryo as that of a playful tot, seemingly communicating with its future parents, family, and friends.

Some Basic Truths

The time has come to stop this word play demagogy. I offer instead four basic truths:

First, that the “abortion” debate is a misnomer; we are not debating abortion, we are debating rights. Rights, not morals; rights, not ethics. Roe v. Wade, the law of the United States, is in effect. That is why Pennsylvania’s Casey (Casey v. Planned Parenthood) decision requiring a 24-hour delay was nothing more than pure politics. Roe stated that choice is a constitutional right, just like our other basic freedoms. Would any libertarian agree to forcing a day’s delay before exercising the freedom of, say, speech? Or a required session and an overnight consultation with a government-appointed counselor before deciding in which church to worship? Or perhaps a compulsory hour-long discussion with the newsstand proprietor on the relative merits of various publications before making a purchase"

Second, life and its inception are considerations for science to solve, not religion. A most cherished American tenet is the separation of church and state. The class action Doe case (Doe v. Bolton), after much authoritative testimony, has set a 24-week limit as the time when, as has been taught to gynecologists for generations, the embryo becomes a fetus and independent life is plausible. Speaking of potential children is analogous to an acorn being a potential oak tree or a grape being a potential bottle of fine champagne. Roe and Doe have had their rulings bent, not broken.

Infringing on Women’s Rights

Third, that right and that science are being denied to a majority group who have been the victims of male dominance since time immemorial—women. Choice is clearly a battle over male supremacy and class domination and control. To deny that abortion is about women and their rights and freedoms is to behave like the ostrich that keeps its head in the sand.

Fourth, the abortion/choice question is but an extension of what health care in America is for women. The U.S. remains the world’s only industrialized nation without a universal health care program. It has even become a message of our foreign policy.

The conservative coalition’s influence has channeled funding of the United States Agency for International Development (USAID), the agency responsible for health care in developing countries away from abortion even in those areas where it is legal. Bill Clinton’s tacit reversal of that policy has not resulted in substantial changes.

Cumbersome Restrictions

“Permit but discourage” has been proposed as an alternative to choice. Under the Casey and before that the Webster (Webster v. Reproductive Health Services) decision, consent and waiting period restrictions are equal to an outright denial for many women, especially the young and the poor. As of now over 80 percent of the counties in the country have no abortion facilities or staff.

Suggesting that women need an additional waiting period flies in the face of common sense. It is as though this very heart-rending decision to abort were made on a whim by a woman on her way downtown to do a little shopping who just happened to pass by her local abortion emporium and decided to stop in and have one. It furthers the stereotype of a female as being muddleheaded, morally infantile, emotionally unstable, and weak. Does anyone really think women have abortions for the same reasons climbers scale mountains—because they are there? The decision to abort is always a true dilemma—one made between two unpleasant and unwanted alternatives.

No one is pro-abortion. No one is anti-life. No one. I don’t think there is anyone doing abortions who hasn’t wished at some point that the situations creating the demand for them would just go away, including me. There have been plenty of times when I’ve wanted to say, “Enough! This is more human tragedy than I want to deal with.” But that would require a different world—one without poverty, rape, incest, contraceptive failure, genetic defects, maternal illnesses, unprotected moments of passion, or human fallibility.

Restrictions Erode Rights

Each and every restriction on legal abortion further erodes women’s control over their own reproductive life. Women need access to late-term abortion when their health is at stake at least as much as they do to abortions earlier in their pregnancies. No third party should be allowed to interfere with the decision reached between a woman and her doctor as to which abortion procedure is best for her. Passing even one restriction strengthens the idea that women shouldn’t be allowed to make this decision by themselves, even though they must live with the consequences of an unwanted or dangerous pregnancy.

Elizabeth Schulte, International Socialist Review, June/July 2000.

In the deprived nations of Africa, Asia and South America, word has gotten around. In the majority of cases, whenever someone appears at the doors of an emergency room with some sort of infection from a botched abortion done in a back alley shop, she is denied treatment that would be life saving, out of fear that the hospital service will be marked and denied USAID funding. “Don’t touch abortion” becomes the rule of the day. More wooden boxes.

The belief seems to be that in the Third World as well as here, denying proper health care for the poor will “make them more responsible” and “motivate” them to seek out proper birth-control methods. This is just more cruel thinking. We keep trying failed policies over and over again. Statistics speak for themselves. Worldwide, a septic abortion kills a woman every two minutes. That only means more and more wooden boxes.

Choice Is the Issue

Abortion policy from the right is but a microcosm of what is the state of health care services offered to the poor women of the world today. Here in the U.S. the Pentagon spends more in fifteen minutes than is allocated for women’s health care programs in a year. Progressives in the pro-choice movement are trying to get out that message. It is just this year (1999) that research centers in the U.S. have been given the go ahead to evaluate RU-486, the French self-administered oral abortion medication, already widely accepted in Europe [RU-486 was approved in the United States in September 2000 for use in early nonsurgical abortions.]. This should not be looked upon as a panacea and the need for surgical terminations will remain. But RU-486 will be a valuable addition to the methods that will give doctors and their patients those alternatives when needed. Each will have its place. It all filters down to the basics—abortion is not the issue, choice is.

The women of America need support, not only for their choice to end an unwanted pregnancy, but for prenatal care, mammographies, PAP tests, and physicians’ help when needed. Health care is not a privilege. It is a right.

She was young, unmarried, pregnant, alone, and desperate. She ended up in my emergency room, bleeding, in shock, in a coma, and then dead. I’ve seen it before. I don’t want to see it again.

It doesn’t have to be that way. If we can learn to see the abortion issue clearly—not ethics but rights, not religion but science, not sexism but equality for women—we can begin to work on the dilemma.