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Roe v. Wade: The unintended consequences of abortion restrictions


By C. Richard Gulick, M.D., Richmond Heights, Mo.

Before 1973, when the Supreme Court legalized abortion in the landmark case of Roe v. Wade, the procedure was illegal in most states. That meant desperate women without means had to undergo illegal “back alley” procedures to end an untenable pregnancy. The consequences of illegal abortions were awful. I know because I was there. As a resident in OBGYN at Barnes Hospital form 1971 to 1974, I saw the difference before and after that ruling. Until Roe v. Wade, at least two patients were admitted every week for septic (severely infected) abortions.

As residents we were instructed to perform the following for any woman who came to the Emergency Department with vaginal bleeding: pregnancy test, white blood cell count if the patient had a fever (to find out if there was an infection), and an x-ray of the abdomen to determine of there was evidence of uterine perforation.

Those patients who were clinically very ill with an elevated white blood cell count and a positive pregnancy test, without evidence of a viable pregnancy, were admitted to the hospital after an emergency D&C (dilatation of the cervix and scraping infected tissue from the uterus). Those patients who continued a downhill course despite IV antibiotics often had to have hysterectomies. Many of those patients were rendered infertile. Some died.

Young women came to the Emergency Department very frightened with shaking chills, at times with a foreign object protracting from the cervix, bleeding and ill. We could not write “induced abortion” in the patients’ charts, or the patient would be subject to arrest. Added to that was often fear of reprisal from the person performing the illegal abortion, or fear of arrest if the abortion was discovered.

Roe v. Wade changed things. Admissions to the hospital for septic abortions became extremely rare after Roe. Women no longer were made to risk their lives and their families.

I do not pass moral judgement on those who have had an abortion, nor on those who believe abortions are wrong. Should that be the woman’s difficult choice, however, I believe every woman has the legal right to a safe procedure.

Research at the Guttmacher Institute, a public policy institute dedicated to reproductive health, gives evidence of the horrible outcomes of illegal abortions. Before abortion became legal, they found nearly 18% of maternal deaths were due to abortions, although fear of reporting means this percentage was likely much higher. The Institute then states, “by making abortions legal nationwide Roe v. Wade has had a dramatic impact on the health and wellbeing of American women. Deaths from abortion have plummeted, and are now a rarity.”

Nevertheless, state and federal lawmakers continue to use the legislative and regulatory process to reduce access to abortion. Caught up in the crossfire is Planned Parenthood, whose broad scope of work is primarily educational and medical care to prevent unintended pregnancies and STDs, breast exams and PAP smears to detect cancer, and even vasectomies for men. Despite the federal Hyde amendment preventing federal dollars from being used to provide abortion, I am concerned that our state and federal governments are attempting to withhold funding for preventive care – care that could go far to prevent unintended pregnancies and, in turn, abortions.

Although Roe v. Wade has prevented many maternal deaths, pregnancy prevention, i.e. planning parenthood is, of course, much preferred. On behalf of patients and doctors alike, I urge elected officials to increase support for preventive and prenatal care for those most in need.