As a senior medical student in 1973, the year the Supreme Court Roe v. Wade case made abortion legal in America and a political issue, I decided to specialize in Obstetrics and Gynecology. My choice began forty-three years of conflict. After counseling hundreds of patients as they made and lived with decisions about unplanned pregnancies, attending seminary, writing a novel, and listening year after year to political argument on the issue, I have decided that both the pro-choice and pro-life movements are right in some ways and missing the point in others. A woman has a right to choose what happens with her body. A baby has a right to life. Two people are involved in this decision. The legal question becomes at what point does the state have the right and responsibility to intervene when two people's rights conflict?
A brief look at the history of abortion is helpful. Abortion has been a part of every known human culture. The medicine women of hunter-gatherer communities knew which herbs would end a pregnancy and used them before people were even sure what caused pregnancy. Economics have always entered into the decision. One of the highest abortion rates in America happened during the Great Depression in the 1930's. When children were going hungry already, women did not want to bring more into the world. History's point: making abortion illegal does not prevent it.
What making abortion illegal does do is select poor women to suffer disproportionately. Women of means still find safe ways to accomplish it, where poor woman are reduced to unsafe efforts to abort themselves or back alley butchers. Making abortion legal did increase the abortion rate, initially. In 1973, according to the Guttmacher Institute, the abortion rate per 1000 women was 16.3. Over the next seven years it increased to 29.3. After two years at that rate, even though abortion remained legal, the rate has fallen back to 16.9 in 2011. The reasons for the decline are not known for certain, but better birth control is one reason, a reason to support Planned Parenthood.
After reading the Roe v. Wade majority opinion, I believe the Supreme Court got it right. In the first 14 weeks of pregnancy risk to a woman's health aborting a pregnancy is less than carrying the pregnancy to term, and the fetus is totally dependent on its mother's womb. The Court considered these two medical facts in reaching its 7-2 decision that abortion should be unrestricted until 14 weeks.
After 14 weeks the woman's risk of abortion increases and is equal to the risk of carrying a pregnancy to term. This medical fact was the basis of the Court's decision to allow restrictions on abortion that protected the life of the mother between 14 and 28 weeks.
At 28 weeks, the Court determined that the fetus was viable outside the womb and ruled that abortion could be banned except to save the mother's life. Since 1973 with improved medical care the age of viability has been reduced. Twenty percent of fetuses survive at 22-23 weeks; fifty percent survive at 25-26 weeks, and ninety percent survive at 27-28 weeks. The intent of the Roe v. Wade decision was that abortion should be banned at viability, and this change in the age of viability needs to be addressed. This discrepancy in age of viability is the basis of partial-birth abortion which I believe the Court intended to ban. In 2016, a more appropriate age of viability when considering elective abortion is 22 weeks.
Why does all this matter? Since 1973 over 55 million abortions have occurred in America. Three in ten women have had at least one abortion by the age of 45 years. While many of these women are comfortable with their decision, millions suffer regret, shame, guilt, and sadness. A visit to the National Memorial to the Unborn website will confirm this truth. Fifty-five million children have died before birth leaving only a question as to how their lives would have changed the world. Family members also suffer. For these millions abortion is personal not political.
In 1992 the Lexington Herald published a Sunday supplement on the abortion issue. A reporter asked every OB/GYN doctor in town if they did abortions and if not, why not. I agonized over what I would say. I didn't perform abortions, mostly because I thought it was taking human life that I was committed to save, but I still believed abortion should be legal and said so. My conflict became public, and I got dozens of letters from people who agreed with my conflicted position.
I have read that conflict is the basis of every good novel. After receiving those letters, I decided to try writing a novel. I hoped that the writing would help solve my conflict. I hoped that by telling a good story people who were closed-minded on the issue might see that dealing with unplanned pregnancy is complicated, that abortion is not an easy way out, that preventing unplanned pregnancy is best. The novel, Saving Jane Doe, is published and available everywhere and I have peace with my pro-life choice position. I believe that I am right, but what I know for certain is that I would rather be compassionate than right.
[You can find more information about me and the novel at www.carolynpurcellmd.com.]