The Brave Doctors for Choice
by Li Onesto
Revolutionary Worker #947, March 8, 1998
They must summon courage just to go to work each day. But they know that without the right to choose, many women's lives are ruined. They know enforced motherhood is a recipe for crushed dreams.
Some of them remember when abortion was illegal. Desperate and alone, women ended up at the mercy of back-alley butchers. Many ended up maimed. Many ended up dead. An unforgettable image--a woman, clutching herself in pain, bleeding to death--keeps the commitment strong and they vow: "Never again."
When a poor woman takes a six-hour bus ride to see them, they know they are needed. When a desperate teenager comes through their doors, they know their work is important. When a woman with nowhere else to turn asks for help, they know they must continue.
These are doctors on the front lines, risking their lives so that women have the right to choose. Every day, they face vicious threats and harassment. Forced to wear bullet-proof vests. Subjected to death threats. Vilified and isolated by a reactionary climate.
These brave heroes too often go unrecognized. They don't get the appreciation they deserve. They don't get the support they need. But without access, without providers, the legal right to abortion is nothing but a cruel joke. This is why the people must stand in solidarity with abortion providers, put an end to their isolation and defend them by any means necessary.
***** Their stories tell a lot: Decades of experience. Hands with memory worth a thousand medical books. Compassion from years of listening. Commitment nurtured in the face of death threats.
Before 1973, why did doctors do illegal abortions? When they risked being arrested. When they could have their medical license taken away. Since Roe legalized abortion, what has kept doctors' commitment strong in the face of antiabortion harassment, violence and murder?
Carole Joffe's book, Doctors of Conscience, offers valuable interviews with providers before and after Roe v. Wade. Today, many of the doctors who did illegal abortions are still doing abortions. And they have a vivid and strong memory of why they felt compelled to defy the law.
Re-educated by Her Patients
Dr. Jane Hodgson started her private practice in 1945 and says this marked the beginning of her real medical education: "As an obstetrician/gynecologist I began to listen to thousands of stories from patients, many of whom were poor, handicapped, or nonwhite. I heard tales of sexual abuse and of physical and financial hardship. I learned about the many tragedies associated with unplanned pregnancies, sexual discrimination and harassment, child abuse, incest, the inequities of the divorce laws. I was reeducated by the pregnant teenager, the single welfare mother, the cancer patient, the drug addict, the menopausal mother."
Then in the '50s and '60s Hodgson worked in a number of poor, Third World countries where she says she came to realize how women are disproportionately represented among the poor, illiterate, and unemployed and how their status is directly related to their ability to control their reproduction.
Back in the U.S., she witnessed the deadly results of botched abortions, fumed as hospital administrators remained aloof and uncaring, and saw the tremendous demand for safe abortions. In 1971, Hodgson explained in an editorial for a medical magazine why she supported legalizing abortion: "I am personally not concerned as to whether life begins with the two-cell, four-cell or eight-cell division but I am extremely concerned with the quality of life that will result from the teenagers and women than with the future of a few embryonal cells."
Hodgson says it was very wearing to turn women down who came to her for an abortion. And she went from being someone only mildly concerned with abortion to an abortion activist. She told Joffe: "I had been taught that abortion was immoral. I gradually came to change. I came to feel that the law was immoral. There were all these young women whose health was being ruined, whose lives were being ruined, whose plans had to be changed. From my point of view, it was poor medicine, it was poor public health policy."
Rejecting the Status Quo
Dr. Henry Morgantaler had haunting memories that contributed to his decision to start doing illegal abortions in Canada in 1968. He was born in 1923 in Lodz, Poland into a highly political, secular Jewish family. As a child, he was subjected to anti-Semitism from his Polish neighbors. His father was arrested and killed by the Nazis. The rest of his family was sent to concentration camps. Henry and his younger brother survived six years in Dachau and Auschwitz but his mother and sister died.
After the war, Morgentaler studied medicine in Germany and Belgium and then moved to Canada. He recalls how his decision to do illegal abortions was a direct outgrowth of his militantly secular upbringing: "I was brought up in a an anti-religious atmosphere. Religion was a dead weight...the acceptance of the status quo, the acceptance of injustice, the acceptance of inferior status, the acceptance of all kinds of indignities. I was brought up in a family which had broken away from all that... The Jewish socialist movement was a complete break with the past--it affirmed human dignity. We don't accept the status quo just because religion says God wills it. But we have to do something to make society more just."
Morgentaler came to look at abortion in the larger context of two issues about which he felt very deeply--social injustice and religious intolerance. He said, "Here was a situation where women were discriminated against, exploited, were subjected to the danger of losing their lives, losing their fertility, and nobody was doing anything about it. A situation of tremendous injustice, and I said to myself, `Well, doctors usually go into medicine for humanitarian motives.' I went into medicine with very idealistic motives. Many doctors would go to countries in Africa and South America and subject themselves to the dangers of yellow fever, cholera, and what not. Some of them would even die, and they were taking enormous risks for humanity. Here in our own society, nobody was willing to take risks to help women with this kind of problem. It didn't make sense. And I researched it, and it seemed like it was religious prejudice...The image I had was that if you had a person drowning in the lake, and you were there, able to help that person just by extending your arm, everyone would do that, right? And in this particular case, would you do it, if it was, say, forbidden?... I told myself, 'Well, it would be a normal human gesture on my part to help.' "
Defying the Law
It is estimated that from 1,000 to 5,000 women a year died from illegal abortions before Roe and many thousands more were injured.
For some doctors, going along with laws against abortion was like being complicit in a system that, as one doctor put it, "was full of death and injury--all of it so utterly unnecessary." Louise Thomas, a resident in a New York City hospital in the late 1960s, talked about the "Monday morning abortion line-up": "What would happen is that the women would get their paychecks on Friday, Friday night they would go to their abortionist and spend their money on the abortion. Saturday they would start being sick and they would drift in on Sunday or Sunday evening, either hemorrhaging or septic, and they would be lined up outside the operating room to be cleaned out Monday morning. There was a line-up of women on stretchers outside the operating room."
And Dr. David Bennett will always remember the day a woman from somewhere in Latin America showed up at his office: "Now I don't speak any Spanish at that time. Through sign language I finally realized...she wanted an abortion. I asked her how she was getting back. So she pulled out a bus ticket. She also pulled out her purse, and she had a dirty crumpled wallet, and dropped it in my hand, and it had a five-dollar bill in it...And I'm just so moved that she has got herself here, it seemed incredible to me. She came with no money, just faith. I mean she's come all this way with just a dirty crumpled five-dollar bill to pay for an abortion. I wanted to give her the money back. At that time, I didn't want to offend her sense of dignity. I know she stayed at the hospital rest room, this is all the money she's got. I looked in her purse, she's got these tortillas in her purse, that's what she's living on--these tortillas. So I somehow managed to say to her that I would like to provide the service free, that she so honored me by making the great effort to get here, that I would like to provide the abortion for her free, if that was all right with her. I knew everything was all right, because a big smile came on her face, she reached out and took the five-dollar bill and put it back in her purse."
Doctors like Bennett broke the law by providing women like this with abortions. But even doctors who were not doing abortions sometimes time found themselves in a situation where they felt the only right thing to do was to defy the law.
In N.Y. state in the '50s and '60s, doctors in hospitals were required to report "all illegal abortions or suspected illegal ones" to the District Attorney. Dr. Rosalind Greene, who did her residency in a N.Y. hospital during this time found this requirement unacceptable: "Women would never admit to having an induced abortion. But that was the law; you were supposed to inform them of anyone you suspected of having an induced abortion. When we saw how they hassled the women, we never called them unless we thought the woman was going to die."
And Ed Lever, a resident at University Hospital in the Midwest in 1960, remembers how in the case of one woman, he was ordered to find out the name of the abortionists for a police report. "This young woman was in the process of dying of sepsis and I asked her if she would tell me who did this, and she said no, and she died. And that was the thing that sort of solidified it for me [commitment to legal abortions]... It was starting to impress me that women felt that strongly about an unwanted pregnancy, that they would go to that length, knowing the risks involved--these people must have been awfully frightened and they must have felt very strongly about what they wanted to do...I had always been taught in medical school that physicians were always to be the advocates of the patient and all of a sudden I was no longer an advocate, I was an adversary. That got me terribly upset."
Busted and Jailed
In 1970 Jane Hodgson openly challenged Minnesota's abortion law by doing an abortion on a young woman who had been diagnosed with German measles. She went to federal court in Minnesota and asked that the current abortion law be overturned. When this was turned down, she went ahead and did the abortion at the hospital. Shortly after this, the police came and arrested her, setting off an intense three year legal battle. Hodgson was initially found guilty--making her the first physician in U.S. history to be convicted for performing an abortion in a hospital. She appealed to the Minnesota Supreme Court and, while this was still in progress, the U.S. Supreme Court handed down its Roe v. Wade decision, automatically overturning Hodgson's conviction.
Hodgson risked jail time and having her medical license being taken away. But she considers herself "lucky" to be a part of the fight to legalize abortion and says, "I was in the right spot at the right time. It was just something I couldn't avoid. It just seemed like a role that had been created for me and it was sort of inevitable, kind of a role you feel you have to play."
In 1970, Morgentaler's clinic in Montreal was raided and he went to trial before a French Canadian jury in 1973. He recalls, "They had nothing in common with me except our common humanity. I was a Jew, I was an atheist, I didn't swear on the Bible [in court], and the foreman of the jury asked the judge about that..." Morgentaler convincingly testified about his sense of "moral duty" to help those seeking his services and was acquitted. But the government immediately appealed this decision and Morgentaler was found guilty and sentenced to 18 months. He spent 10 months in prison and says, "I knew I was there unjustly; they had overturned my jury acquittal. It was outrageous. I had the firm conviction that I had done a unique service and should be given a medal, instead of going to jail!"
Being in prison brought back memories of the Nazi concentration camps and Morgentaler decided he had no choice but to become a rebellious prisoner: "I had to keep my dignity...In order to get away from the humiliation, I needed to fight the Administration. There were lots of things to fight about." He organized prisoners to protest restrictive visiting policies and fight for better health care. And he became a kind of "father confessor and medical advisor" to many inmates. For this, prison authorities considered him a troublemaker and at one point put him in solitary confinement.
After getting out of prison in 1976 Morgentaler resumed his work. In 1983, he opened clinics in Winnipeg and Toronto--which were both promptly raided by the police. In 1988 Canada's abortion law was declared invalid but to this day, there is no national abortion law in Canada and the right to abortion is still being fought over in individual provinces. After 1988 Morgentaler opened additional clinics in Newfoundland, Nova Scotia, and Alberta, and in each case has faced legal harassment by authorities, as well as arson attempts, blockades, and the bombing of one of his clinics.
Providers Under Siege
Since the 1973 Roe v. Wade decision, abortion has been legal in the United States. But the brave doctors who provide abortions have worked in a continuous state of siege.
1993: Dr. David Gunn killed outside a clinic in Pensacola, Florida. Dr. George Tiller, shot outside his clinic in Wichita, Kansas. Dr. Wayne Patterson, killed in Mobile, Alabama.
1994: Dr. John Bayard Britton and his escort James Barrett, killed in Pensacola, Florida. June Barrett, James Barrett's wife survives gunshot wounds. Dr. Garson Romalis, shot in his home in Vancouver Canada. Shannon Lowney and Leanne Nichols, staff members at two clinics in Brookline, MA, shot and killed.
1995: Dr. Hugh Short, shot while inside his home in Ancaster, Ontario, Canada.
***** In 1993 Dr. Pablo Rodriguez testified as the Medical Director of Planned Parenthood in Rhode Island: "In the beginning, the harassment was the usual nasty letter and graphic pictures of dismembered fetuses: but slowly it became more aggressive. I began receiving strange packages with dolls inside, as well as subscriptions to gun magazines and hunting lodges, showing pictures of dead animals hanging by their extremities. Then the `Wanted' posters began to appear, the first one taped to the front door of the clinic for patients to see. Copies of this hideous poster were also sent to my wife at home and to my office. then the doors and locks to our clinic were glued on multiple occasions, culminating with three episodes of forceful blockading of our clinic. During the invasions, the police failed to arrest anyone and when arrests were finally made, the fines were minimal and there were no jail sentences given. The day Dr. Gunn was shot. I knew that my life would irrevocably change."
And Dr. James Armstrong has also testified about the constant harassment, vandalism and death threats: "Violence comes not only in arson and murder, it also comes in the form of threats. These threats, even if they are not carried out, are still a weight which must be borne. Less than three weeks ago, for example, we received a letter threatening us with a bomb on May 5th... We also receive threats via rhetoric in letters-to-the-editor and in ugly placards carried by picketers. We have had picketers at home and at church as well as at our office. In my opinion, all of these contain rhetoric which incites more real violence."
In the face of such attacks, brave doctors have remained committed to giving their patients, safe, affordable and compassionate abortions. Dr. Paul Temple says, "It comes down to who is the patient. Is the woman the patient, or is the fetus the patient? One or the other is the patient. I've never heard a fetus talk to me. I've heard thousands and thousands of women share their pain, their desperation, and their hopelessness...especially with the younger patients that come to us, 12 or 14 years old--their life expectancy may be 84 years!...We're not talking about five- or ten-year survival rates, or remission of cancer...we're talking about the opportunity to help them change the rest of their lives for 70 years."
And Elizabeth Karlin says it would not have occurred to her to do abortions if violent demonstrations had not been increasing. When she was asked to fill in for another doctor, she knew the few trained abortion specialists were already over-committed, and so she accepted the job. And she has learned to confront the dangers with both courage and humor. She says: "When we are frightened, receive death threats, have loud scary protests, or have patients who are so fragile we are afraid for them, what do we do? We know that the potential for complications during the procedure is higher, because both the patient and the physician are more nervous. First, we admit our rage and fear. Second, we take more time, talking and laughing together. We are all very good at laughter. If the patients have been affected, we do this together. Third, we eat a lot of chocolate."
Karlin says many people have asked her, "How can you do this in the face of so much hatred?" To which she answers, "It's easy. Patients stop for a hug on the way home. Women stop me in the supermarket and, with tears in their eyes, thank me for what I do. Last week in the beauty parlor a woman jumped up from her chair, cut hair flying from the plastic smock, to thank me. Many patients chose to come to me as their regular physician, since they feel most comfortable in our office."
The Challenge for a New Generation
Today almost 60 percent of the doctors performing abortions are at least 65 years old. Nearly two-thirds are beyond legal retirement age.
Most doctors doing abortions specialize in obstetrics and gynecology and ob-gyn's learn to do abortions during their hospital residency programs. But a 1991 study showed that only 12 percent of these programs now routinely teach abortion. And the percentage of ob/gyn's willing to do abortions has dropped from 42 percent in 1983 to 33 percent in 1995.
The challenge today is insuring there will be a new generation of doctors committed to giving women the right to choose.
Before Roe doctors saw women killed and maimed because abortions were illegal. And some of them summoned courage, defied laws, and risked careers, to save women's lives.
Today, there must be a new generation of young doctors who see the harassment, violence and murder of providers--and in the face of this, step forward, even more committed to making sure women have the right to choose.
There are already some good beginnings. After Dr. Gunn's death in 1993, a new organization, "Medical Students for Choice," was formed with contacts in over 100 medical schools. One of its first activities was gathering over 3,000 signatures from medical students all over the country on a petition demanding that abortion training be a required component in ob/gyn residency programs.
***** Some doctors and clinic workers have quit because of the vicious campaigns by the antiabortion movement. But the attacks have made others stronger and more committed. Dr. James Armstrong speaks of this courageous stand and also issues a real, life-and-death challenge to medical students, young doctors, health care workers, and all those who support the right to choose.
"We are committed to our work. Satisfaction comes from the enormous gratitude of our patients... The rhetoric and violence will not deter me and my staff because we are so committed to our patients. But perhaps the real question on access to health care...is who will follow when I and my colleagues retire. Will there be other providers willing to take on the harassment, threats of violence, and aggravations to provide these necessary services for women."
Sources for this article:
Doctors of Conscience--The Struggle to Provide Abortion Before and After Roe v. Wade by Carole Joffe, Beacon Press, 1995.
Abortion Wars--A Half Century of Struggle, 1950-2000 edited by Rickie Solinger, University of California Press, 1998.
This article is posted in English and Spanish on Revolutionary Worker Online
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