Abortion Public Health Reproductive Health

The Truth about Abortion

          Dr. C. Everett Koop was President Ronald Reagan’s Surgeon General for most of his 2 terms. An excellent pediatric surgeon, Dr. Koop had very strong anti-abortion beliefs, consistent with Reagan’s.

            Reagan asked Koop to research the psychological and physical harm that abortion does to women. When Koop did not find the substantiation he had expected, he refused to publish his findings. He is reported to have commented about the value of studies done by antiabortion people, mentioning ”… the poor quality of their research evidence….”

            When the report was made public, Koop stated: ”There is no doubt about the fact that some people have severe psychological effects after abortion, but anecdotes do not make good scientific material.”

            The world needed to wait more than 30 years to get good scientific evidence about abortion’s lack of psychological damage to women. Dr. Diana Greene Foster and a team of social scientists at the University of California, San Francisco, have finally done the research that was needed to determine the sociological and psychological safety of abortion. Their findings are good news for women.

            The physical safety of abortion had already been determined. Despite what some people think, having an abortion is much, much safer than giving birth. It was only the psychological and economic effects that were in question in Koop’s era. 

            The work of Dr. Foster and her group is outlined in a short TED talk, “What Happens When We Deny People Abortions?” In addition, her book The Turnaway Study (2020) is very readable; it intermixes their findings with short case histories of study women.

            What is the best way to investigate the effect of abortion on women? You need to compare two sets of women. One group would be women with unintended pregnancies who had abortion care. The other group would also want to abort their pregnancies, but not be able to do so. Foster and her group found these two groups, and carefully followed each woman for 5 years. They recruited women from abortion clinics all over the USA. Each clinic has a gestational limit. Members of the first group were just under that limit; women had their desired abortions. Women in the control group were less fortunate. They were just over the limit, so could not have an abortion, and the nearest clinic where the abortion could be performed was too far away for them to travel. They were turned away and later delivered.

            The findings were conclusive:

  • Most women who have an abortion do not regret having had it.
  • Having an abortion did not tend to cause psychological harm.
  • Women who wanted an abortion, but did not receive it, had an increase in poverty.
  • Being denied an abortion makes it more likely that a woman will stay with an abusive partner, and more likely that a woman will be a single parent without family support.
  • Children born as a result of abortion denial are more likely to live below the federal poverty level and experience poor maternal bonding.
  • More than half of women who seek abortions are already parenting children. This study found that the financial wellbeing and development of these older children are negatively impacted when their mothers are denied abortion.

          Let’s hope that there will be no more deceit about abortion. Not only does abortion help women, but it also helps the children who preexisted the aborted pregnancy, or who were born after. The saddest finding of the Turnaway Study is that two of the women who were forced to carry unintended pregnancies died as a result of those pregnancies.

©Richard Grossman MD, 2024

Abortion Action Public Health

How to Laugh at a Senator

            Have you ever wanted to slap an elected official with whom you disagree—or do something more than just slap them? Well, some AIDS activists made a big splash when they rebelled against a legislator.

            Jesse Helms was a conservative US senator from North Carolina who opposed gay rights and access to abortion care. His stance against HIV research angered campaigners to take an extreme and humorous action. In 1991 they inflated a huge condom over Helms’ house! On the side of Helms’ condom was this writing: A CONDOM TO STOP UNSAFE POLITICS: HELMS IS DEADLIER THAN A VIRUS.

            Helms was no friend of reproductive rights. In 1973 he wrote an amendment to the Foreign Assistance Act; it prohibits the use of foreign assistance funds to pay for abortions. This amendment was in response to the Roe v. Wade decision that same year, that made abortion legal throughout the USA. Unfortunately, his Amendment forced many people to seek dangerous “back alley” abortions. By limiting access to safe abortion care, Helms caused thousands of maternal deaths. 

            There is another even worse policy that limits access to reproductive health. It amplifies the Helm’s Amendment, and then extended limitations to the U.S.! The Mexico City Policy, also known as the “Global Gag Rule” (GGR), was passed in 1984 and goes a step further than the Helms Amendment. The GGR bans foreign aid to any nonprofit that provides any aspect of abortion care. It prohibits informing women about abortion or making referrals to abortion providers. The GGR even prohibits advocating for decriminalization of abortion or working to expand safe abortion services.

            Ronald Reagan initiated the GGR in 1984 by means of a presidential memorandum. Since it was established by executive order, it can also be undone in the same way. Indeed, every Democratic president since then has rescinded the GGR, which then was reestablished by the next Republican president. Fortunately, the GGR is not in effect now since our president is a Democrat.

            Two brave Democrats, Cory Booker (New Jersey) in the Senate and Jan Schakowsky (Illinois) in the House introduced bills named “Abortion is Health Care Everywhere Act”. They started in 2020 and then reintroduced the same bills every Congress since then. These Acts could repeal the Helms Amendment and substitute language stating that U.S. foreign assistance can be used to provide abortion as part of comprehensive reproductive health care.

            Although these bills seem to be lost in committee, it would be wonderful to see them passed and eventually become law. I realize that this is very unlikely in today’s political climate, but I have hope that people will rise up and once more safe abortion care will be legal in every state.

Although not all obstetricians and gynecologists are prochoice, the large majority of my specialty is. Our professional organization, the American College of Obstetricians and Gynecologists (ACOG) has a policy which supports access to abortion care. I would like to end this essay with the words at the end of the ACOG policy:

“ACOG supports every person’s right to decide whether to have children, the number and spacing of children, and to have the information, education, and access to health services to make these decisions. Individuals seeking abortion must be afforded privacy, dignity, respect, and support, and should be able to make their medical decisions without undue interference by outside parties. ACOG advocates to improve access to full-spectrum reproductive services, to integrate abortion as a component of mainstream medical care, and to oppose and overturn efforts restricting access to abortion.”

© Richard Grossman MD, 2023