Categories
Action Public Health

We Lost a Superb Activist for Women’s Health

I attended an international family planning meeting in Santo Domingo, the Dominican Republic, in 1984. At that time we were living just a short plane ride away in Puerto Rico.

The meeting was full of people from different countries speaking different languages and was an excellent opportunity to make connections in the family planning world. One person was outstanding.

I was chatting with someone one afternoon and mentioned that I was tired and was headed back to our hotel to take a nap. “You should stay and listen to the next speaker, Malcolm Potts. He is amazing, mixing a lot of knowledge with a bunch of British humor”.

I took their advice, and was not disappointed. Dr. Potts was a world leader in family planning. He died this spring at age 90.

Potts was an innovator. He helped to start the first clinic in Cambridge, England, that offered birth control to young people. He was also the first director of the International Planned Parenthood Federation. He collaborated with Dr. Karman, a psychologist, to develop a simple technique for treating miscarriages and performing early abortions. It uses a flexible cannula with vacuum created by a syringe, thus it is especially useful in places where there is no electricity. Although I learned the Karman method long ago, only by reading it in an obituary of Malcolm’s did I realize that he had aided in its invention.

Potts told me how he had helped with another innovation. The work of Henry David, a psychologist, is often quoted to help justify abortion. David studied children born to women twice denied abortion for the same pregnancy. He followed these kids for 20 or more years. The studies unequivocally showed that the children of unwanted pregnancies did not do as well as matched controls. Potts told me that it was he who suggested David study unintended pregnancies in Prague, Czech Republic, because they had stringent laws limiting who could have an abortion at that time.

In 1984 I interviewed for a job where Potts was the director. It had been called the “International Fertility Research Program”. Potts had realized that the name was long and might prejudice some people against the organization, so had it changed to the more copacetic “Family Health International”.

More recently Potts was the inaugural director of the Bixby Center for Population, Health, and Sustainability, and held an endowed chair at the Berkeley School of Public Health. He was an admired professor and used his imagination to innovate: his nonprofit, OASIS, advances education and choice for women and girls in the African Sahel. He also cofounded a company that is trying to bring birth control pills to the marketplace without the need for a prescription.

My favorite saying of Potts dates from the era when tobacco was sold in vending machines: “Birth control pills should be available in vending machines and cigarets only by prescription.” His wish has come partly true—now cigaret sales are much more restricted and reproductive health materials are available in vending machines. Many college campuses have machines that dispense condoms, pregnancy tests, emergency contraceptive pills and now, even Opill, the new over-the-counter birth control pill without estrogen (see photo above).

Potts was a pioneer in lowering barriers to reproductive health care. For instance, he set up a clinic at a central train station in India to perform vasectomies because people feared hospitals. He was known for this sort of imaginative, out-of-the-box thinking.

One of his coworkers, Alisha Graves, stated that Potts believed “We really have to trust that women are doing the best things for themselves and their families.” It took me years to come to the same conclusion.

© Richard Grossman MD, 2025

Categories
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