Abstract: INTRODUCTION She lay there shivering, black, but pale nonetheless. Her skin contrasted against white sheets with the wrong hospital name printed in blue. The intravenous bottles were glass back then. Three hung from cross-like poles, draining colorless solution into separate cutdown sites. She had been taking the most potent antibiotics the medical world had ever known for three days; still neither her fever nor her delirium broke. I pulled the curtain closed and hustled to my four o'clock seminar. When I returned at seven the next morning, I found the bed made, the window open to the breeze and the traffic on First Avenue, and a housekeeper emptying a wastebasket. She was humming something, and didn't speak to me, her baleful brown eyes looked away quickly. I didn't say anything to her either. She was somebody's daughter, undergoing a postmortem examination on that morning in 1972. She was one of an estimated two million women (including fetuses) that died in 1972 as a result of abortion procedures, typically performed in haste and often under conditions marked by squalor and filth.(1) The Roe v. Wade decision has prompted many changes in the field of obstetrics and gynecology, ranging from differences in education and training to the resultant effects on women's health. Part I of this Article offers a snapshot from the viewpoint of the practitioner in the early 1970s.(2) Part II of this Article confronts the impact that Roe has had on the landscape of women's health.(3) In Part III, the Article examines the trends concerning abortion services education in the medical community.(4) Finally, Part IV of this Article discusses the effects of Roe on health care providers.(5) I. HISTORICAL PERSPECTIVE For obstetrician-gynecologists and their patients, the 1973 U.S. Supreme Court decision in Roe v. Wade(6) had a wide range of downstream effects. Certainly women's health care would change, and some of these changes were easy enough to anticipate. Other changes were surprises that prompted the rethinking of some firmly held principles in medical, educational, and ethical arenas. Physicians who were previously adept at avoiding political briar patches inevitably found themselves dealing with the thorns. Most medical students in the early 1970s had no concept of the sociology and history of abortion. It was a seventies issue, larger than leisure suits, but smaller than the turmoil in Southeast Asia. We were ignorant of the fact that abortion is not unique to any point in time or level of societal organization, unaware of a history that dates back to hunting and gathering tribes.(7) Sociologists tell us that not only has abortion been openly practiced in primitive societies, but also similarities to current attitudes have persisted. Few societal groups have given the concept unqualified approval.(8) The same conditions that influenced primitive societies to approve or impose abortion continue to be influential factors today: unmarried status of the mother, ambiguous paternity, adultery, poor maternal health, rape, and incest.(9) Though these conditions were prevalent in the pre-Roe era, many women had to negotiate various health hazards typically associated with an illegal abortion. II. IMPACT OF ROE ON WOMEN'S HEALTH A. Magnitude of the Issue During the 1960s, New York municipal hospitals found that complications from illegal abortions contributed to nearly twenty percent of all pregnancy-related admissions as well as twenty percent of the deaths.(10) Infection and hemorrhage, combined with delay in medical intervention, represented frequent causes of these cases, for there was great reluctance to seek medical care.(11) Today, a small number of abortions continue to be done clandestinely by untrained or unlicensed operators.(12) Occasionally, in situations of desperation arising from poverty, the mother will perform the abortion herself. …
Publication Year: 1999
Publication Date: 1999-01-01
Language: en
Type: article
Indexed In: ['pubmed']
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