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.