The Way It Was

The Beatles ruled. The mini was in. I was seventeen, and pregnant. What happened next is what could happen again.

The author at 17.The author at 17.In 1959, when I was a precocious smarty-pants still in grade school, I wrote a fake letter to Doris Blake, the New York Daily News advice columnist. I pretended to be a teenage girl "in trouble." I spun a tale of a liquor-soaked prom night and passing out in the back of a car. I included a cast of entirely fictional characters—a worthless boyfriend, a mentally unstable mother, a strict, brutal father. I ended my letter with: "Now I think I am pregnant. Please help me. I am desperate."

I'm not sure what I expected, but my letter was not printed, and no advice was forthcoming. The silence was utter. Possibly Miss Blake, like Nathanael West's Miss Lonelyhearts, had a drawer where such letters were tossed. If so, the other letters in that drawer were no doubt a lot like mine—except that they were not written by wiseass children. They were real. And for the writers of those letters, the silence was real. And I remember thinking: Gee, what if I really were that girl I made up? What would I do?

One summer night some years later, when I was not quite 18, I got knocked up. There was nothing exciting or memorable or even interestingly sordid about the sex. I wasn't raped or coerced, nor was I madly in love or drunk or high. The guy was another kid, actually younger than I, just a friend, and it pretty much happened by default. We were horny teenagers with nothing else to do.

Nature, the ultimate unsentimental pragmatist, has its own notions about what constitutes a quality liaison. What nature wants is for sperm and egg to meet, as often as possible, whenever and wherever possible. Whatever it takes to expedite that meeting is fine with nature. If it's two people with a bassinet and a nursery all decorated and waiting and a shelf full of baby books, fine. If it's a 12-year-old girl who's been married off to a 70-year-old Afghan chieftain, fine. And if it's a couple of healthy young oafs like my friend and me, who knew perfectly well where babies come from but just got stupid for about 15 minutes, that's fine, too.

In the movies, newly pregnant women trip, fall down the stairs, and "lose the baby." Ah. If only it were that easy. In real life, once that egg is fertilized and has glided on down the fallopian tube, selected its nesting place, and settled in, it's notoriously secure, behaves like visiting royalty. Nature doesn't give a fig about the hostess's feelings of hospitality or lack of them. If the zygote's not defective, and the woman is in good health, almost nothing will shake it loose. Anyone who's been pregnant and didn't want to be knows this is so.

 

On November 5, 2003, three decades after Roe v. Wade established a woman's constitutional right to terminate a pregnancy, President George W. Bush signed the Partial Birth Abortion Ban bill into law. We've all seen the photograph: The president sits at a table with a modest little smile on his lips. Nine guys—senators and congressme—stand behind him, watching that signature go onto the paper, giddy grins on their faces. They look almost goofy with joy.

Two of these happy fellows are actually Democrats: Jim Oberstar and Bart Stupak. The rest are Republicans to their marrow: the bill's sponsor, Rick Santorum, as well as Steve Chabot, Orrin Hatch, Henry Hyde, Tom DeLay, Mike DeWine, and Dennis Hastert.

Be assured that it's not just "partial-birth" abortion they're so happy about passing a law against. It's all the law heralds. Like some ugly old wall-to-wall carpeting they've been yearning to get rid of, they finally, finally loosened a little corner of Roe. Now they can start to rip the whole thing up, roll it back completely, and toss it in the Dumpster.

For with the PBAB, Bush and Co. have achieved the first federal legal erosion of Roe v. Wade since its adoption in 1973. Roe states that a woman may terminate a pregnancy up to the point of "viability," approximately 24 weeks. After that, states may prohibit or restrict abortion, but exceptions must be made to preserve "the life or health of the woman." The PBAB has been around the block before—in 1995, 1997, 1999, and 2000. What stopped it before was always the debate over allowances for women's health. President Clinton vetoed it three times because it disallowed exceptions to prevent serious disabling injury to the woman. But when the bill came up again in 2002, allowances for prevention of disabling injury to the mother were left out, as were those for rape and incest. A "partial-birth" abortion would be permitted only as a last resort to save the mother's life, or if the fetus was already dead. In other words, the risk of permanent injury to the woman if she proceeds with the pregnancy is not a good enough reason to perform one—not in Santorum's book. She has to be literally on death's doorstep. A couple of Democrats tried to offer an amendment that brought up that pesky women's health issue again. The bill's authors objected. Women and their doctors will just use the amendment as a loophole! Chabot worried it would create "a phony ban" and Santorum predicted it would be defeated. It was.

Like some ugly old wall-to-wall carpeting they've been yearning to get rid of, they finally, finally  loosened a little corner of Roe. Now they can start to rip the whole thing up, roll it back completely, and toss it in the Dumpster.

One Democratic senator proposed a nonbinding resolution, expressing "…the sense of the Senate that…Roe v. Wade was appropriate and secures an important constitutional right and should not be overturned." This amendment passed in the Senate by a 52-46 vote. The House version of the PBAB lacked any such amendment.

In conference, the Republicans quickly took care of that feeble bleat on behalf of Roe: They simply deleted it. When the bill landed on Bush's desk, the resolution to reaffirm Roe was gone.

What, you might ask, is "partial-birth" abortion? Most of us know that the term is not a medical one. Invented by the pro-life folks in the last decade or so, it's a vague reference to "intact dilation and extraction," or D&X. Introduced in 1992, D&X is a variation on a similar, well-established second- (and sometimes third-) term procedure—"dilation and evacuation," or D&E—used after the fetus has grown too large to be vacuumed or scraped out in a simple D&C, or "dilation and curettage."

In a D&E, the fetus is usually dismembered inside the uterus and extracted in pieces. Old obstetrics books from as far back as the 1700s have disquieting illustrations of the various tools of yore used for fetal dismemberment. Nowadays, powerful gripping forceps are used, making the procedure much less dangerous for the woman.

The D&X was developed with the same objective. An inherent hazard of D&E—aside from potential damage by the instruments themselves and the risk of leaving tissue behind, increasing the chances of infection—is that fetal bones begin to calcify at about 13 weeks. As they are broken up, the sharp bone ends can puncture, scrape, and perforate. Hence the "intact" dilation and extraction. The fetus is brought out whole instead of being pulled apart bit by bit. The head is punctured and then collapsed by suction or compression so that it will fit through the partially dilated cervix. The fetus is dead, but in one piece. This, specifically, is the procedure the PBAB has sought to criminalize—when the fetus is killed while its body is outside the uterus, therefore "partially born."

Under the PBAB of 2003, a D&X would be permitted only to save the woman's life or if the fetus is dead. It would require a girl who'd been impregnated by her uncle, father, or brother, and who, out of shame, ignorance, and fear had hidden her condition until it was obvious to the world, to carry the fetus to term and give birth. If a woman discovers, late in her pregnancy, that the fetus has, say, anencephaly—a brain stem but no actual brain—then she must carry it to term, give birth, and let it die on its own.

Since lurid descriptions of partial-birth abortion have been so effective in rallying support for the bill, perhaps some balance is needed. I've read and heard hundreds of accounts of pre-Roe abortion, and there was a wide range of danger, squalor, sanitary conditions, provider skill, follow-up care. The well-heeled and well-connected often flew to Puerto Rico or Sweden and checked into clinics. Of the ones who couldn't do that, some were lucky enough to find competent, compassionate doctors. Some were treated kindly and recovered without incident. The other extreme was pain, terror, and death worthy of the Inquisition. A typical picture emerges, though, and it matches up just about perfectly with a story told to me by a woman I know.

A doctor friend there said he couldn't help her himself, but sent her to a local prostitute who did abortions. The prostitute had her own speculum. The procedure was done on the prostitute's bed: The catheter was inserted through the cervix and left there.

After a date rape (by a "poet") during a trip to Paris in 1967 when she was 23, she found herself pregnant. She tried the usual "remedies"—scalding hot baths, violent jumping, having someone walk on her belly. When she got home to Minnesota, she was two months along. A doctor friend there said he couldn't help her himself, but sent her to a local prostitute who did abortions.

The prostitute had her own speculum. The procedure was done on the prostitute's bed: The catheter was inserted through the cervix and left there. After four days of high fever, chills, bleeding, and passing big chunks of tissue, she landed in the hospital. They said her uterus was perforated, that she had acute peritonitis and an "incomplete" abortion. She was given a huge dose of penicillin and treated as if she were some sort of contemptible lower life form. The emergency-room doctor snarled, "What have you done to yourself?" Later, she realized that the first doctor—her friend—had known all along that she'd probably get desperately ill. Only then could a hospital legally give her a D&C.

She recovered—sterile, violently allergic to penicillin, and so "paralyzed and ashamed" by the experience that she stayed away from men for four years. Who says deterrence doesn't work?

Originally taken by a police officer in Norwich, Connecticut in June 1964 and published by Ms. magazine in April 1973.Originally taken by a police officer in Norwich, Connecticut in June 1964 and published by Ms. magazine in April 1973. WikimediaThen there's the famous 1964 police photograph of a woman's corpse on a motel-room floor in Connecticut. She's kneeling naked, face down as if to Mecca, legs bent to her chest, bloody towels bunched under her. The case had made local headlines, but the picture wasn't seen by the general public until Ms. Magazine ran it in a 1973 article lauding the ruling of Roe v. Wade. Details emerged about the woman's life and death: She was 27, married with two young daughters, but estranged from her violent husband. Her lover had performed the abortion, using borrowed instruments and a textbook. When she started hemorrhaging, he panicked, fled the motel, and left her there.

 

Compared to those two women, I got off easy. By the middle of September, I'd missed two periods and my cigarettes were tasting peculiar. I was bound for freshman year at college in Boston, though, so I just ignored the facts and went off to school. It took a third missed period and almost throwing up in the backseat of a car packed with kids to penetrate my adolescent thick headedness.

I had a savvy friend in New York, Kat, who only dated rich older men. I figured she'd be the one to call. Soon a long ride on buses and trains took me out to a house in a Boston suburb. The doctor's wife answered the door. There was no waiting room, no magazines, no other patients. The house was completely ordinary, perhaps a touch run-down. She showed me into a room off the front hall and vanished.

Except for a small sink, the office was just a regular room, a parlor, with green walls and venetian blinds and a worn rug on the floor. A tall, battered, glass-doored porcelain cabinet stood in a corner. Through the glass, I could see on the shelves a dusty disorderly jumble of stethoscopes, hypodermics, bottles, little rubber hammers, basins, forceps, clamps, speculums, wads of cotton. There were rust stains in the sink and a tired old examining table.

The doctor, a little nervous man with glasses and a bald head, came in. I explained my problem. I have to examine you, he said. And he said: Everything has to be clean, very clean. He went to the sink and washed and washed his hands.

He finished and stood there without saying anything. His eyes were sort of glittering behind his glasses, and he acted as if I was supposed to know what to do next. I glanced around for a gown, but he was looking impatient, so I just took off my underwear and climbed onto the table.

He didn't bother with a glove. He poked around a while, then told me that I'd waited too long, I was too far gone, it would be too risky for him, and that would be $25.

He didn't bother with a glove. He poked around a while, then told me that I'd waited too long, I was too far gone, it would be too risky for him, and that would be $25.

And I was back out on the suburban street, the door shut firmly behind me.

Kat told me to come to New York and bring $500. I slept on the couch in her apartment. Kat's roommate, Elaine, gave me the address of a doctor over in Jersey City. I took a train and walked 10 blocks to a street of old brownstones, some of them with their windows boarded up. There had been no calling ahead for an "appointment"; you were supposed to just show up.

This doctor had a waiting room, with dark walls and a very high ceiling, the front room of the brownstone. It was full of people, facing each other along opposite walls, sitting in old, cracked, brown leather parlor chairs with stand-up ashtrays here and there, like in a bus station. A set of tall sliding wooden doors stood closed between that room and the next. Everyone was smoking, including me. The air was blue.

Several Puerto Rican-looking women chattered away in Spanish and seemed perfectly cheerful. There were a few men, who looked as if they might be accompanying somebody, and some more women who sat silent and staring.

And there was a couple who stood out like a pair of borzoi among street mutts: a man and woman, tall, slim, expensively dressed WASPs, faces grim, looking like people who'd taken a seriously wrong turn off the highway. I remember feeling sorry for them.

The tall wooden doors separated. A potbellied man in shirtsleeves who resembled Harpo Marx minus the fun stood there. His eyes moved around the room. He looked at the Puerto Rican women, the tall WASP woman, then at me, then the WASP woman again, considered for a moment, turned back to me, and pointed.

You, he said.

I got up and went in. He slid the doors shut. We were alone.

The windows in here had been nailed over with plywood, and the floor was ancient linoleum. There was a smell of insecticide. Boxes and bundles of paper were piled high in the dim corners and on a rolltop desk, and along the walls were shelves crammed messily with stethoscopes, hypodermics, speculums. The examining table was the centerpiece of the room, antique and massive, from the last century, dark green leather, steel and ceramic, designed so that the patient did not lie flat but in a semi-reclining position. Instead of stirrups, there were obstetrical leg supports. A tall old-fashioned floor lamp with a rose silk shade and a fringe, the only light in the room, stood next to the table alongside a cylinder of gas. An unlit crystal chandelier dangled in the overhead shadows.

Be here at seven o'clock in the evening. Give me one hundred dollars now because this will be difficult. You can pay the rest when you come back. Bring cash. Five hundred more.

The doctor had a trace of some sort of European accent. German, I guessed. He was about a foot shorter than I was, and behaved with obsequious deference, as if I had dropped in for an afternoon sherry. He gestured toward the examining table with a courtly flourish. I sat between the leg supports while he stood close and asked questions: Last period, how many times had I had sex, was I married, how many men had I had sex with, did they have large or small penises, were they circumcised, what positions, did I like it?

He moved the floor lamp closer. I put my legs in the apparatus and looked up at the chandelier.

He didn't bother with a glove, either. He thrust several fingers in, hard, so I could feel the scrape of his nails.

Ouch! I said politely.

Ouch, he mocked. Never mind your ouch. He pushed his fingers in harder and pressed down on my belly with his other hand.

You are very far along, he said. It will be a very difficult procedure. Come back tomorrow. Be here at seven o'clock in the evening. Give me one hundred dollars now because this will be difficult. You can pay the rest when you come back. Bring cash. Five hundred more.

I borrowed the extra hundred from Kat, and enlisted someone I knew to ride out to Jersey City with me on the train, a guy who was something of an ex-boyfriend. Even though I was enigmatic about why we were going to Jersey City at night, he guessed what was up, and seemed fairly entertained at the prospect.

This time, there was no one in the waiting room. The doctor looked very annoyed when he saw that I wasn't alone. My friend stayed out there while I went into the office. The doctor locked the door behind us.

The doctor stood next to me, leaned on me heavily, and rubbed his two hands up my thigh, all the way up, so that his fingertips collided with my crotch. I understood then that he'd known perfectly well on my last visit that he wasn't going to go through with it.You are a beautiful girl, a beautiful girl, he breathed moistly onto my face as his hands slid up and down, up and down.

When I was on the table, he stood between my legs and pressed and ground his pelvis against me and then put his fingers in for a while.

Then he said: You are too far gone. I cannot do it.

I put my legs down and sat up. He stood next to me, leaned on me heavily, and rubbed his two hands up my thigh, all the way up, so that his fingertips collided with my crotch. I understood then that he'd known perfectly well on my last visit that he wasn't going to go through with it.

You are a beautiful girl, a beautiful girl, he breathed moistly onto my face as his hands slid up and down, up and down. It is too late. Take my advice. Have the baby. Have the baby.

He unlocked the sliding doors and beckoned my friend in.

Get married, he said. Have the baby.

Hey, I'm not the guy, said my friend.

What about my hundred dollars? I asked.

Get out of here, the doctor said, and turned his back.

When we got to my friend's train stop, he walked off whistling a jaunty tune. Good luck, he said, and was gone.

 

Today, chat rooms and message boards related to abortion show a disturbing trend among some young people: Not only is disinformation rife ("The only reason abortion is still legal," writes one correspondent, "is becuz the babies organs are prossed and some of that money is forwarded to the libral party."), but many young people haven't the remotest notion of pre-Roe reality. Abortion's been legal since before they were born. Some even believe that abortion was invented with Roe v. Wade.

Abortion was not always illegal before Roe. Into the 19th century, what a woman did with her early pregnancy was considered a purely domestic matter. Until "quickening," when the fetus was perceived to be alive and kicking, it wasn't even considered a pregnancy, but a "blocking" or an "imbalance," and women regularly "restored the menses," if they so chose, through plants and potions. Abortifacients became commercially available by the mid-1700s.

Quality control was not great, and the earliest abortion legislation, in the 1820s and '30s, appears to have been an effort to curtail poisoning rather than abortion itself. According to several historians of the issue, as abortion—both through drugs and direct procedures—became a bigger and bigger commercial venture, "orthodox" physicians, who were competing with midwives, homeopaths, and self-styled practitioners of all stripes, pushed to make abortion illegal. The nascent American Medical Association established its dominance over lay practitioners through abortion laws, and women were kept in their place. Eugenics played a role, too: With "undesirables" breeding prolifically, motherhood was hailed as a white woman's patriotic duty, abortion a form of treason. By the mid-1800s, most of the "folk" knowledge had been lost and abortion became "infanticide." Between 1860 and 1880, antiabortion laws spread city by city, state by state. Now there was a ruthlessly pragmatic aspect: In the aftermath of the slaughter of half a million men during the Civil War, the births were needed. First the men were conscripted, then the women.

Into the 19th century, what a woman did with her early pregnancy was considered a purely domestic matter. Until "quickening," when the fetus was perceived to be alive and kicking, it wasn't even considered a pregnancy.

Demand for abortion continued to grow in spite of the laws. Periods of relative tolerance gave way to periods of stricter enforcement, which inevitably corresponded to periods of women's activism. In the late 19th century, it was when they demanded a voice in politics. After World War II and through the 1960s, it was when they demanded sexual freedom. All kinds of change, rebellion, and upheaval were busting out then, and the reflexive reaction of the authorities was to crack down. For women getting illegal abortions, this era was particularly marked by fear, secrecy, ignorance, shame, and danger. This was the era that put the rusty coat hanger into the collective consciousness.

The day after I returned from Jersey City, there was another doctor in a seedy little basement office in New York, who didn't even touch me. He said the only way to do it at this point would be to perform a miniature caesarean, not something he could do in his office.

Kat and Elaine were plainly getting tired of having me and my problem on their couch. They came up with a phone number in Florida. I called. A male voice said I should fly to Miami. They'd meet me and take me to one of the islands, to a clinic. Give us the telephone number of where you're staying now in New York. We'll call you back and confirm the arrangements.

He called back within an hour. It was set: Fly to Miami next Thursday, between the hours of noon and five. Wear something bright red so we'll know you when you get off the plane. And bring eight hundred dollars, in cash.

One last thing, he said. You must not tell anyone where you're going.

They understand that I'm over three months, right? I said.

Yeah, yeah. They know. It's all set.

I hung up. This didn't feel good at all. Florida, the islands, wads of cash, distant voices.

I thought about doing what I should have done in the first place: calling my mother.

Not calling her in the beginning wasn't because my mother was a prude or religious or anything like that. Hardly. It was because I was naturally secretive, had wanted to take care of things on my own. I just wanted it to go away. But there was a limit to even my pigheadedness. I thought about how sad it would make my mother if I just disappeared. My mother, who was right there in the city, swung into action instantly. She made arrangements with a doctor she knew, and borrowed the $1,500 it would cost because of the added risk.

This doctor had a clean, modern office in Midtown. He drew a diagram showing the difference between a first-trimester D&C and what I'd be having. After three months, he said, the placenta and the blood vessels that feed it grow too complex to simply be scraped out. To do so would be to just about guarantee a hemorrhage. In a normal birth or miscarriage, he said, the uterus contracts, shearing off the placenta and pinching off the connecting blood vessels. We induce a miscarriage, he said, by injecting a saline solution into the amniotic sac. The fetus dies. The uterus rejects it by contracting. That way, no hemorrhage. Then we go in and take it out. If it were done any other way, it could easily kill you.

A date was made for the following week. I was off of Kat and Elaine's couch and on my mother's.

One evening, my mother's phone rang. It was the man in Florida. He'd tracked me down through Kat, and he was angry. What the hell had happened? Where was I? They'd waited all day at the airport in Miami, met every plane. I apologized, told him I'd made other arrangements here at home. He said I was a fucking bitch who owed money to him and a lot of other people, told me to go fuck myself, and hung up.

Maybe everything would have been peachy if I'd gone to the islands. Maybe I'd have come back with a tan and heartwarming stories of kindness and caring that I'd remember fondly through the years. A rather different picture always comes to mind, though, and it involves a morgue in a run-down little hospital with heat and flies, and then a dinghy with an outboard, or maybe a fishing boat with a rumbling, smoky diesel engine, heading out into the Caribbean at night bearing a largish canvas bag weighted with cinder blocks....

That year in the 1960s, several thousand American women were treated in emergency rooms for botched abortions, and there were at least 200 known deaths. Comparing my story with others from the pre-Roe era, what impresses me is how close I veered to mortal danger in spite of not living under most of the usual terrible strictures. Unlike so many of the women I've read about and talked to, especially the teenagers, I was quite unburdened by shame and guilt. I'd never, ever had the "nice girls don't do it" trip laid on me. I came from a religion-free background. I wasn't worried in the least about "sin," was not at all ambivalent about whether abortion was right or wrong. I wasn't sheltered or ignorant. I didn't face parental disapproval or stigmatization of any kind. I had no angry husband. My mother would have leapt in and helped me at any point. There was no need at all to keep my condition secret and to procrastinate, but I did it anyway. What does this say about how it was for other young girls and women who didn't have my incredible luck? I was luckier than most in another department, too—being raped by the abortionist was a major hazard of the era. I merely got diddled by a couple of disgusting old men. It was nasty and squalid, but it certainly didn't kill me. As I said, I got off easy.

That year in the 1960s, several thousand American women were treated in emergency rooms for botched abortions, and there were at least 200 known deaths. I got off easy.

Ironically, it was the medical profession, which had made abortion illegal in the first place, that started to speak out. Doctors treating the desperately sick women who landed in hospitals with raging peritonitis, hemorrhages, perforated uteruses, and septic shock often had to futilely watch them die, because the women had waited too long to get help—because they were confused and terrified, because what they had done was "illegal" and "immoral."

One doctor's "awakening" is vividly described in The Worst of Times, a collection of interviews with women, cops, coroners, and practitioners from the illegal abortion era. In 1948, when this doctor was an intern in a Pittsburgh hospital, a woman was admitted with severe pelvic sepsis after a bad abortion. She was beautiful, married to someone important and wealthy, and already in renal failure. Over the next couple of days, despite heroic efforts to save her, a cascade of systemic catastrophes due to the overwhelming infection culminated with the small blood vessels bursting under her skin, bruises breaking out everywhere as if some invisible fist were punching her over and over, and she died. Being well-to-do didn't always save you.

Her death was so horrible that it made him, he recalls, physically ill. He describes his anger, but says he didn't quite know with whom to be angry. It took him another 20 years to understand that it was not the abortionist who killed her—it was the legal system, the lawmakers who had forced her away from the medical community, who "…killed her just as surely as if they had held the catheter or the coat hanger or whatever. I'm still angry. It was all so unnecessary."

All so unnecessary.

In the same book, a man who assisted in autopsies in a big urban hospital, starting in the mid-1950s, describes the many deaths from botched abortions that he saw. "The deaths stopped overnight in 1973." He never saw another in the 18 years before he retired. "That," he says, "ought to tell people something about keeping abortion legal."

In February 2004, seven abortion doctors in four states sued Attorney General John Ashcroft, claiming that D&X was indeed a medically necessary procedure. Ashcroft retaliated by subpoenaing their hospitals for the records of all patients who'd had late-term abortions in the past five years—most long before the PBAB—to determine, ostensibly, if any D&Xs had actually been prompted by health risks. In June, a federal judge in San Francisco declared the PBAB to be unconstitutional—saying it was vague, placed an "undue burden" on abortion rights, and contained no exception for a woman's health—but she did not, in deference to other cases wending their way through the legal system, completely lift the ban.

"The deaths stopped overnight in 1973." He never saw another in the 18 years before he retired. "That," he says, "ought to tell people something about keeping abortion legal.

One doctor, writing about D&X, said something that particularly struck me—that the actual practice of medicine, the stuff that goes on behind closed doors, is often gruesome, gory, and messy. Saws whine, bones crack, blood spatters. We outside of the profession are mostly shielded from this reality. Our model is white sheets, gleaming linoleum, and Dr. Kildare. Face-lift, hip replacement, bypass, liver transplant—many people would faint dead away at a detailed description of any of these. Doctors roll up their sleeves, plunge in, and do tough, nervy, drastic, and risky things with our very meat-bone-and-gristle bodies, under occasionally harrowing circumstances.

The gruesome aspect of D&X has been detailed and emphasized, but as a procedure, it's in line with the purpose of medicine: to get a hard flesh-and-blood job done. What makes it different from other procedures is that it can involve a live fetus. This puts it in a class by itself. But the woman undergoing a D&X knows this. If she's doing it, there will be powerfully compelling reasons, and it's not for anyone else to decide if those reasons are compelling enough.

Women of all kinds seek and have always sought abortion: married, single, in their twenties, thirties, and forties, teenagers. Some have no children, some have several already. Some never want children, some want children later. They are churchgoers, atheists, agnostics. They are morally upright pillars of the community, they are prostitutes. They're promiscuous, they're monogamous, they're recent virgins. They get pregnant under all kinds of circumstances: consensual sex, nonconsensual sex, sex that falls somewhere between consensual and nonconsensual. Some are drunk or using drugs, some never even touch an aspirin. Some use no birth control, some use birth control that fails.

The desperate teenager I invented in my letter to Doris Blake in 1959 surely had hundreds, maybe thousands, of real-life counterparts at the very moment I put the envelope in the mail. All kinds of women are vulnerable and are affected by the particulars of abortion law, but the ones most profoundly affected are the very young, and it's a one-two punch from both nature and society. First, nature itself conspires to make teenagers defenseless—they're lushly fertile, their brains are flooded with sex hormones, and their judgment, practical knowledge, and common sense have been known to be less than perfect.

When a woman does not want to be pregnant, the drive to become unpregnant can turn into a force equal to the nature that wants her to stay pregnant. And then she will look for an abortion, whether it's legal or illegal, clean or filthy, safe or riddled with danger. This is simply a fact, whatever our opinion of it.

Teenagers—especially those who are poor and uneducated—are by far the group having the most elective late-term abortions. If we truly wish to protect the young and vulnerable, promote a "culture of life," as President Bush said so grandly in his signing speech, then we must make teenage girls a top priority. Make sure they don't get pregnant in the first place, and not just by preaching "abstinence only." If they do get pregnant, don't throw a net of fear, confusion, and complication over them that will only cause them to hide their conditions for as long as they can. Because that's exactly what they'll do. You could argue that "partial-birth" abortion is the price a society pays when it calculatedly keeps teenage girls ignorant instead of aggressively arming them with the facts of life and, if necessary, the equipment to protect themselves from pregnancy.

I was hardly one of those tragically vulnerable teenagers. I suppose I was the kind of wanton female the lawmakers and wrath-of-God types look down on. There's no doubt that I was stupid and irresponsible, and I certainly knew better than what you might have surmised from my actions. By some standards, I suppose you could say I was a slut. Those sleazy doctors left no doubt that that's how they saw me. Some would say I got what I deserved, or that I deserved to die.

The arguments would be endless, but they would be irrelevant to the facts: From the moment I started looking for an abortion, not once did I even consider going through with the pregnancy. Not for one second. It simply was not going to happen. Nothing, and I mean nothing, was going to stop me, and it could have cost me my life. And this is what I had in common with millions and millions of women throughout time and history. When a woman does not want to be pregnant, the drive to become unpregnant can turn into a force equal to the nature that wants her to stay pregnant. And then she will look for an abortion, whether it's legal or illegal, clean or filthy, safe or riddled with danger. This is simply a fact, whatever our opinion of it. And whether we like it or not, humans, married and unmarried, will continue to have sex—wisely, foolishly, violently, nicely, hostilely, pleasantly, dangerously, responsibly, carelessly, sordidly, exaltedly—and there will be pregnancies: wanted, unwanted, partly wanted, partly unwanted.

A society that does not accept the facts is a childish society, and a society that makes abortion illegal—and I believe that the PBAB is a calculated step in exactly that direction—is a cruel and backward society that makes being female a crime. It works in partnership with the illegal abortionist. It puts him in business, sends him his customers, and employs him to dispense crude, dirty, barbaric, savage punishment to those who break the law. And the ones who are punished by the illegal abortionist are always women: mothers, sisters, daughters, wives.

It's no way to treat a lady.