Abortion Reproductive Health Women's Issues

The End of Roe Affects Colorado’s Neighbors

Signe Wilkinson Editorial Cartoon used with permission of Signe Wilkinson
and the Cartoonist Group. All rights reserved.

            Jennifer and Jake are newly-weds. The couple met in graduate school at Texas Tech University in Lubbock, Texas. She is working toward a degree in engineering and he is studying to be a nurse practitioner.

            They were doubly cautious about contraception. Although they want at least one child in the future, first they want to meet their educational goals. In addition to using condoms, they avoided sex when she thought she might be most fertile. Then they had a condom break. Jennifer kept an online menstrual diary “” and the next morning was horrified to find that she might have been fertile at that time. When her period was late and breasts started to be tender, she was sure she was pregnant.

            Since online calendars can be monitored by the “Texas abortion police”, one of the first things she did after she stopped crying was to delete that information. Next, she asked a friend who had had an abortion where she could go. She contacted all the New Mexico clinics, but they were either too busy or the availability of appointments conflicted with their student responsibilities. Finally, she made an appointment at the Durango Planned Parenthood clinic. Jake had an afternoon class on Monday, but if they slept a bit and left Lubbock before midnight, they could reach Durango in time for the 10:30 appointment.

            The couple was greeted by people yelling and waving signs outside Planned Parenthood’s parking lot. The armed guard just inside the door was much more friendly, but said that Jake needed to wait outside in the car, and Jennifer would join him in 2 or 3 hours.

An hour later she woke exhausted Jake to tell him good news. “I fell asleep while filling out the forms, but the first thing they did” she said, “was a pregnancy test. It was negative—I’m not pregnant!” Jennifer was so frightened by the new Texas laws that she was afraid to buy a pregnancy test. Instead, she took the evidence of pregnancy that her body gave her, not realizing that women can have anovulatory cycles which mimic pregnancy.

            This narrative recounts the stories of real patients, but the names and situation are fictional.

            Only 2 of 40 countries that have changed their abortion laws since 2000 are more restrictive; Nicaragua and the USA. The other 38 have increased access to safe abortions services. Ethiopia reformed its abortion laws in 2004 in response to the high death rate of women having illegal abortions. Its maternal mortality rate now is less than half of what it was before the legal reform. Already too many women are dying in the USA from pregnancy complications, but that figure will skyrocket as desperate women seek care where abortions are illegal.

            It took the high-profile death of a woman for the law to be changed in Ireland. This very Catholic country had banned all abortions with an amendment to its constitution. In 2012 Dr. Savita Halappanavar was sick with an infected miscarriage. She requested a D&C, but was told that she couldn’t have it as long as the fetal heart was beating. It was too late when the fetus did die; the mother perished from sepsis shortly after.

            For me, the overthrow of Roe v. Wade by the US Supreme Court wasn’t a surprise. Politicians, in league with churches using abortion as their rallying cry, had been pushing to make abortion illegal for decades. All the articles I’ve read have decried the tragedy to human rights, but none has mentioned that the subsequent increasing human population will have global repercussions.            What can we do? Support people coming for abortion care from antiabortion states. Donate to Planned Parenthood, the National Network of Abortion Funds, Cobalt ProChoice Colorado. Most important, vote for prochoice politicians; we need laws and constitutional amendments to guarantee access to safe abortion care. Please remember, the majority of Americans are prochoice.

©Richard Grossman MD, 2022


Should we send food to Africa?

Drought in northern Kenya

“…the tide of the battle against hunger has changed for the better during the past three years. But tides have a way of flowing and then ebbing again. We may be at high tide now, but ebb tide could soon set in if we become complacent and relax our efforts. For we are dealing with two opposing forces, the scientific power of food production and the biologic power of human reproduction. Man has made amazing progress recently in his potential mastery of these two contending powers.
“But [man] is not yet using adequately his potential for decreasing the rate of human reproduction. The result is that the rate of population increase exceeds the rate of increase in food production in some areas.
“There can be no permanent progress in the battle against hunger until the agencies that fight for increased food production and those that fight for population control unite in a common effort.”
  Norman Borlaug, 1970, Nobel Prize Acceptance Speech

            The North American southwest is experiencing the worst drought in over 1200 years, endangering the livelihood of millions of people. In contrast, in Africa, where many people already live on the edge, the risk is to their lives.
            Here, there is less snow, and it is melting sooner. Rivers are running low and reservoirs are shallow. Ranchers and farmers are suffering from the drought. We know that half of our megadrought is due to climate change. Furthermore, we know climate change is largely due to CO2 from using fossil fuels. 
            In many places, Africans are also experiencing drought. Paradoxically, there is destructive flooding elsewhere in Africa. Drought there is not because Africans are using lots of fossil fuels, of course. The average annual income of a person in Sub-Saharan Africa 1/15th that of the average American; we consume much, much more. People in Africa simply cannot afford the extravagance of fossil fuels we take for granted.
            It seems unfair that our consumptive lifestyle should lead to famine in other parts of the world, but it is difficult to escape that conclusion. 
            However, some of the responsibility for the famine in Africa may rest on the shoulders of a Nobel Prize laureate for peace, although he certainly warned us about growing population in the quote above. Norman Borlaug has been called the father of the Green Revolution because he developed agricultural innovations that increased crop productivity markedly. More food allowed populations to increase—when there was adequate rainfall. However, more productivity has its costs. Expensive non-native seeds must be purchased, and more productive plants required chemical fertilizers, herbicides and other chemicals to grow, yet often depleted the soil.
            Now, with more people and less rain, crops are failing. People have debts that they cannot pay. Animals are dying from thirst and lack of forage. There is an excellent but sad report in the NYTimes on the famine: “’We Buried Him and Kept Walking’: Children Die as Somalis Flee Hunger”. I had to turn away before finishing.
            The African famine reminded me of the great question that faces scholars of Southwestern archeology: why did the Ancestral Puebloans leave the Four Corners region? A series of wet years preceding the departure allowed the population to grow. It is likely that the human population overshot available sustenance during the megadrought of the 1250s. Did the people move because of famine? This theory is supported by evidence of severe strife and bloodshed before the exodus.
            Should we help Africa with food relief? Unfortunately, that would encourage people to congregate near food distribution centers, away from farms. Even though relief will save lives in the short run, it will make people more dependent on foreign aid, and won’t solve the problem of overpopulation. I don’t know what the most humane thing to do is. Perhaps we should follow the advice of a friend who only donates to relief agencies that also provide family planning.

© Richard Grossman MD, 2022