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June 3, 2008

First-person: Providing Abortions

Retired gynecologist Waldo Fielding writes an essay for the New York Times on his experiences encountering at-home abortion attempts during his training during 1948-1953 . Needless to say, many of these attempts were failures and resulted in harm to the women themselves. Fielding's memories are quite clear so some might find the reading a bit squeamish.

Complications from surgically induced abortions is minimal; fewer than 0.3% of abortion patients experience a complication that requires hospitalization[1] and abortions performed in the first trimester pose virtually no long-term risk of such problems as infertility, miscarriage or birth defects, and little or no risk of pre-term or low-birth-weight deliveries.[2]

The societal hostility to abortion has also lead to a hostile medical environment. Although some hospitals offered abortion services alongside other reproductive health services, many no longer do so. As of 1998, the percentage of abortions performed in hospitals hovered at 7%, continuing on a downward trend.[3] 91% of abortions were performed at clinics, with 2% unaccounted for. [4]

Fielding writes:

What Roe said was that ending a pregnancy could be carried out by medical personnel, in a medically accepted setting, thus conferring on women, finally, the full rights of first-class citizens — and freeing their doctors to treat them as such.

Personal beliefs and philosophies aside, denying people the right to health care is unethical. Of course, while this occurs indirectly through lack of health insurance or others barriers of access, what we can do at least is to allow people to seek the care they need instead of criticizing their attempts.

1. Henshaw SK, Unintended pregnancy and abortion: a public health perspective, in: Paul M et al., eds., A Clinician’s Guide to Medical and Surgical Abortion, New York: Churchill Livingstone, 1999, pp. 11–22.
2. Boonstra HD et al., Abortion in Women’s Lives, New York: Guttmacher Institute, 2006.
3. Almeling, Rene et al. Abortion Traning in the US Obstretics and Gynecology Residency Programs, Family Planning Perspectives, 2000, 32(6):268-271 & 320
4. Ibid

For another first-person perspective concerning abortion, Susan Wicklund has written "Common Secret: My Journey as an Abortion Doctor." There is also a short NYT article about her as well.