What if Abortion Became Illegal?

NYT
By The Editorial Board

A lot of elected officials say they want to see Roe v. Wade repealed, clearing the way for abortion to be made illegal. But few of them go the extra step and say what they would like to see done to women who have abortions. Throw a scared 17-year-old woman in jail? For how long?

Since a couple more Supreme Court nominations could doom Roe, the National Institute for Reproductive Health, an offshoot of Naral Pro-Choice New York, is trying to inject this question into the presidential campaign. They’re doing it in a TV commercial aimed at John McCain, who –unlike Barack Obama and Hillary Clinton — is strongly anti-choice.

The ad aims to focus voter attention on the harsh real-world consequences if Roe were overturned and abortion became a criminal act.

Here’s the ad:

Women die after Nicaragua's ban on abortions

Women die after Nicaragua's ban on abortions
Law won't allow the procedure even when mother's life is at stake
The Associated Press
updated 6:53 p.m. ET, Tues., Nov. 6, 2007

MANAGUA, Nicaragua - Two weeks after Olga Reyes danced at her wedding, her bloated and disfigured body was laid to rest in an open coffin — the victim, her husband and some experts say, of Nicaragua’s new no-exceptions ban on abortion.

Reyes, a 22-year-old law student, suffered an ectopic pregnancy. The fetus develops outside the uterus, cannot survive and causes bleeding that endangers the mother. But doctors seemed afraid to treat her because of the anti-abortion law, said husband Agustin Perez. By the time they took action, it was too late.

Nicaragua last year became one of 35 countries that ban all abortions, even to save the life of the mother, according to the Center for Reproductive Rights in New York. The ban has been strictly followed, leaving the country torn between a strong tradition of women’s rights and a growing religious conservatism. Abortion rights groups have stormed Congress in recent weeks demanding change, but President Daniel Ortega, a former leftist revolutionary and a Roman Catholic, has refused to oppose the church-supported ban.

Evangelical groups and the church say abortion is never needed now because medical advances solve the complications that might otherwise put a pregnant mother’s life at risk.

But at least three women have died because of the ban, and another 12 reported cases will be examined, said gynecologist and university researcher Eliette Valladares, who is working with the Pan American Health Organization to analyze deaths of pregnant women recorded by Nicaragua’s Health Ministry.

Before the ban took effect on Nov. 18, 2006, fewer than a dozen legal abortions were recorded per year in Nicaragua. They were performed only when three doctors agreed a woman’s life was in danger. However, the Roman Catholic Church estimates that doctors and other medical staff carried out about 36,000 “secret” abortions a year, because under the old law they had little fear of government reprisals.

Hemorrhaging most common cause of death
This year the Health Ministry has recorded 84 deaths of pregnant women between January and October, compared with 89 for all of last year and 88 the year before. It listed hemorrhaging as the most common cause, with 27 cases reported. The ministry refused to comment further on the ban.

Abortion rights groups have disrupted Congress several times, demanding that lawmakers lift the ban. On Oct. 25, unable to get past increased security, they held up signs at Congress’ front door that read: “Women assassins” and “They want to keep us quiet and dead.” A minority of lawmakers are still trying to lift the ban, but don’t have enough votes.

The Roman Catholic Church mobilized nearly 300,000 people to march and sign petitions in support of the ban.

“A child is not a sickness,” said Henry Romero, a priest who helped lead the campaign. “When two lives are in danger, you must try to save both the woman and the child. It’s difficult to say now that it isn’t possible to save both.”

Law student Reyes was one of the three confirmed fatalities. She knew something was horribly wrong, and went with her husband to their small town’s medical center. They were sent to Bertha Calderon maternity hospital, more than an hour away in Managua. There, Perez said, Reyes was given a cursory exam, sent home and told to return the next day.

By that time, the bleeding and cramping were worse. Perez said he rushed her to a hospital in nearby Leon, but after she had an ultrasound that confirmed her condition, they left her bent over and in agony for hours in a waiting room. When a doctor at a shift change saw her condition, she was rushed into surgery. She suffered three heart attacks and an exploratory surgery.

Valladares said doctors should have acted quicker.

“They knew she had a limited amount of time before she bled out. The whole world knows that with an ectopic pregnancy,” Valladares said. “They didn’t treat her, out of fear.”

The hospital director, Olga Maria de Chavez, said Reyes arrived late at night, and was told to return the next morning when specialists were available. The doctors who handled her case in Leon refused to talk to The Associated Press.

Walter Mendiata, president of Nicaragua’s Association of Gynecologists and a supporter of the abortion ban, said doctors are taking the new law too far. He argues that surgery for an ectopic pregnancy isn’t the same as carrying out an abortion.

“There’s no discussion in a case like that,” he said. “It’s urgent, and you operate.”

But he acknowledged that many doctors fear they will be accused of performing an abortion, which could mean a license suspension and several years in prison, even though no one has yet been prosecuted.

Some doctors privately admit to carrying out what they believe are illegal procedures, while others say they won’t jeopardize their careers.

“Many are thinking that instead of taking the risk, it is better to let a woman die,” said Dr. Leonel Arguello, president of the Nicaraguan Society of General Medicine.

Infections from illegal abortions
Doctors frequently see women coming in with infections, many likely brought on by illegal abortions that they refuse to disclose for fear they might be punished, said Dr. Carla Cerrato. Because the people with some medical training who used to do illegal abortions have disappeared, Cerrato said, women more frequently take drugs or pull the fetus out on their own using wires or other crude objects.

“What we are seeing are complications that before we never saw,” Cerrato said, sitting in the dingy pre-labor room at a crowded public hospital in Managua.


She added that she sees hysterectomies and severe infections that leave women sterile or dead because obstetricians can’t take any action that might harm a living fetus.

“We have to wait until the fetus dies,” she said. “But often, for the woman, it’s too late.”

That appears to be what happened with Reyes. Her aunt, Gioconda Reyes, a devoted Catholic dressed in a worn T-shirt in which Jesus promises eternal life, said the sudden death has changed her views.

“I don’t support abortion to get rid of unwanted pregnancies, but in cases like that of Olga’s, it is necessary,” she said, adding: “How could they let four days pass when every minute was precious? They denied her the right to medical care, to a life.”

With Facts on Our Side - by Katha Pollitt

The Nation
Click here for article
[from the November 5, 2007 issue]

For years feminists and prochoicers have pointed out that women have abortions whether or not the procedure is legal.

That was true here before Roe v. Wade, and it is true today in countries where abortion is restricted or banned. The difference is that when abortion is legal it is a remarkably safe procedure; when it is illegal, women are injured, women die, children are left motherless. (True, these are already-existing, sinful children, not embryos or fetuses, but still.) This simple public health argument has gotten lost in a thicket of theology, sexual morality, "family values," politics, spin and outright disinformation. The coat hanger has become a political cliché, a relic of the '60s, like the peace sign. Oh, that old thing.

Now comes an article in The Lancet that shows in cold hard data how right we've been all along. "Induced Abortion: Estimated Rates and Trends Worldwide," a study conducted by the World Health Organization and the Guttmacher Institute, is the first global analysis of abortion incidence since 1995. It finds that rates of abortion (the number of abortions per 1,000 women) are relatively unaffected by whether it is legal. Thus, in South America, where abortion is largely illegal, the rate is 33; in northern America, where it is legal, the rate is 21. "The legal status of abortion doesn't predict whether abortions occur," study co-author Gilda Sedgh told me by phone. "It predicts whether they are safe. South Africa liberalized its abortion laws in l997, and maternal deaths from unsafe abortion have plummeted by 90 percent." Around the world 48 percent of abortions are unsafe--that's more than 20 million. Some 67,000 women die from unsafe abortions--13 percent of maternal deaths, almost all of them in the developing world, where abortion is mostly restricted or banned. Many times that number are injured or maimed.

The good news is that the global trend is toward legalization: as Susan Cohen reports in the upcoming Guttmacher Policy Review, since the Beijing conference on women seventeen countries have liberalized their abortion laws, while three have tightened restrictions (including, most recently, Nicaragua, where abortion is now illegal even to save the woman's life--thank you, Daniel Ortega). The bad news is that, due to population growth, the percentage of abortions that are unsafe has increased since 1995.

The big takeaway from the Lancet article is this: there is basically only one thing that lowers the rate of abortion for more than the minute and a half it takes women to figure out how to evade a new legal restriction: contraception. The countries with the lowest abortion rates, like the Netherlands, have few abortion restrictions and lots of birth control. Consider Eastern Europe. Under communism, abortion was virtually the only family planning method. As contraception has become more available, the abortion rate has plummeted--from 90 in 1995 to 44 in 2003. Indeed, Eastern Europe accounts for almost the entire worldwide decline in abortion in the period covered by the study. Meanwhile, for all our Sturm und Drang, with women in many states having to jump through more hoops than a circus tiger, the decline in the US abortion rate has been small.

I was curious to know how antichoicers would respond to what certainly seems like a devastating refutation of their position. "Anybody can look at data and pick and choose whatever they want," Jim Sedlak, vice president of the American Life League, told me. "The real fact is that abortion is ending life in the womb and should never be legal." I asked him if he accepted the finding that abortion was more dangerous where it was illegal. No, he said. "When something is illegal, people are more careful." So legal abortion is more unsafe? According to Sedlak, it is indeed.

As for contraception lowering the rate of abortion, that's an illusion: contraception is abortion. "Most methods of birth control kill babies in the womb by preventing implantation," said Sedlak, who'd like to see the pill, the IUD and most other methods outlawed. The American Life League, although not an official Catholic organization, explicitly follows Catholic teaching--unlike most Catholics, as Sedlak admitted. But so far as I know (and Sedlak agreed with me here) there is no antichoice organization that endorses contraception. Not one. Even Democrats for Life of America has refused to support Congressional legislation expanding funding for contraception. "Between Title X and Medicaid, the government has made a tremendous investment in contraception," DLA executive director Kristen Day told me. Actually, the government has done the opposite. Title X, which funds contraception for low-income women, has 61 percent less money in real terms than it had in 1980, to serve a much larger population. Had funding merely kept pace with inflation, it would be more than $725 million, instead of $283 million. As for Medicaid, skewed eligibility rules actually deny contraceptive benefits to many poor women who qualify for pregnancy care.

In the past few months, due to a technicality in the 2005 Deficit Reduction Act, the price of contraception in campus clinics has skyrocketed, from around $15 for a pack of pills to more than $50. Some college health centers have simply stopped offering the pill. When you consider that 3 million college women take the pill--38 percent of female students--you can see the disaster in the making. That won't bother the new head of the HHS Office of Family Planning, Susan Orr, a longtime opponent of birth control formerly with the Family Research Council. "We're quite pleased, because fertility is not a disease," Orr told the Washington Post in 2001, praising a Bush proposal to stop mandating contraceptive coverage in federal employees' health plans.

Between facts and theology, antichoicers choose the latter every time.

* * *