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Their Last Choice

Frequently Asked Questions

Some of these deaths are before Roe v. Wade. Wasn't abortion illegal then?
Abortion was always permitted, even under the most stringent laws, if the doctor thought that ending the pregnancy was necessary to preserve the mother's life. Beginning in 1968, some states began allowing abortion for women who were ill, who were pregnant through rape or incest, or who believed that they might be carrying a handicapped child. In 1970, California and New York legalized abortion on demand for the first two trimesters of pregnancy. This is why almost all pre-1973 deaths are in California and New York.

Why are deaths from a ruptured ectopic pregnancy blamed on the abortion? Wouldn't the woman have died anyway?
It would seem that if a woman had an ectopic pregnancy, she would be less likely to die if she sought an abortion. After all, the examination should reveal the location of the fetus. Also, a pathology report on the contents of the uterus should show that no fetus was extracted. Also, the woman is supposed to be provided with follow-up care that would diagnose why her period still hadn't started and why she still felt pregnant. However, in practice, women who elect abortion are more likely to die from ectopic pregnancy than women who intend to carry to term. In practice, many abortion facilities are not thorough as they should be during the physical examination. Many fail to order a pathology report on the abortion specimin, or may file the report without reviewing it or advising the woman. Finally, the symptoms of ectopic pregnancy are abdominal pain, nausea, and sometimes fever. These are also normal symptoms a woman might experience after an abortion. Therefore, the post-abortion woman is more likely to try to treat the symptoms at home. Even clinics often fail to suspect ectopic pregnancy, and instruct the woman to treat the symptoms without performing tests that would reveal the ectopic pregnancy. Reassured that her symptoms are just aftereffects of the abortion, the post-abortion woman is less likely to seek medical care and more likely to die. It is also interesting to note that abortion providers consider it inexcusable to fail to detect and treat an ectopic pregnancy in an abortion patient.

Why are so many women transferred to hospitals when their abortions take place in hospitals to begin with?
In some areas, particularly California, when abortion was legalized on demand, hospitals were opened that specialized in abortion. These hospitals lacked many of the supplies and staff necessary to treat life-threatening complications.

Some of these abortions were performed in very shady facilities that seem to be operating outside the law. Aren't these illegal abortions?
There is no uniform definition of "legal" or "illegal" abortions. The Centers for Disease Control define a legal abortion as one performed by a licensed physician, or by other qualified persons as allowed by law in areas that allow abortions by non-physicians. All other abortions they classify as illegal. The International Classification of Diseases - 9th Edition (ICD-9) leaves it up to the coder's individual judgment to declare an abortion legal or illegal. Decisions to classify abortions as illegal seem to be based on negligence or lawlessness on the part of the facility. I consider these distinctions to be useless. My distinction is based on the woman's perception of the legal status of her abortion. Therefore, any abortion performed in a jurisdiction where abortion is known to be legal, in an openly operating facility, I classify as a leagl abortion because the woman made her decision to trust the facility based on her perceptions. The uselessness of the CDC definitions can be illustrated by the deaths of four women at one Florida abortion facility. The facility was licensed at the time of all four abortions. All four women died as a result of negligent practice at the facility. However, one woman's abortion was performed during a brief period where the abortionist's medical license was suspended, and therefore the CDC counts this woman's abortion as illegal, and the other abortions as legal. An example of the meaninglessness of ICD-9 judgement calls is the classification of Jennifer Suddeth's death as an illegal abortion, even though it was performed in a licensed facility by a licensed facility, because the physician was charged with manslaughter in her death.

Weren't thousands of women dying from abortions every year before legalization?
This claim was a bald-faced lie. Many sincere people still believe it because they trusted prochoice organizations to give them accurate information.

Haven't the number of abortion deaths fallen steadily since legalization?
Quite the contrary. When abortion first became legalized, the Centers for Disease Control noted a rise in the number of abortion deaths. The rise in the number of reported deaths continued unitl 1976, when the CDC abandoned many of the practices that were most helpful in gathering information about abortion deaths. When they stopped actively seeking cases, they found fewer. So the falling numbers are a measure of the CDC's efforts to learn about abortion deaths, not a measure of the actual number of women dying. We don't know how many women are killed by legal abortion because nobody is counting.

Doens't anybody have an estimate of the number of maternal deaths in the US every year from abortion?
In 1970, Carl Tyler of the CDC testified before Congress in favor of legislation allowing abortion on demand throughtout the United States. He estimated at that time, based on the number of projected abortions and the anticipated death rate, that if abortion were legalized on demand in the US, between 200 and 800 women would die annually. This means that Tyler anticipated a huge leap in the number of maternal deaths, since fewer than 50 women had been dying from combined legal and illegal abortions at the time. Based on the medical journal articles I've reviewed, I think that Tyler's estimates were realistic. Since the number of abortions reported annually is at the low end of Tyler's estimate of how many abortions would indeed be performed, I think that the number of deaths is likely to be at the low end of his estimation as well -- roughly 200 women per year in the United States.

Wouldn't these women have been more likely to die if they'd continued the pregnancy to term?
Studies claiming that abortion is safer than childbirth are based on the CDC mortality numbers, which are known to be seriously flawed. Even with the CDC's gross under-reporting, it is known that by 16 weeks, abortion is definately riskier than carrying to term, and the risks of death double each week after the 16th week of pregnancy.

Aren't legal abortions still safer than illegal abortions?
We can't know for sure, because nobody has ever made a concerted effort to determine the true risks of legal abortion as practiced in the United States. All things considered, however, the risks are probably similar for any individual woman. First, most criminal abortions (roughly 80%) were performed by licensed physicians. The term "back alley" referred not to the place the abortion was performed, but to the entrance the woman used to get into the doctor's office. When abortion was legalized, these same doctors continued to practice abortion, but openly and without fear of legal repurcussions. Two criminal abortions with clean records -- Milan Vuitch and Jesse Ketchum -- went on to become careless and kill two patients each in their legal abortion practices. It could be argued that taking away the fear of prison for botching an abortion may lead abortionists to take unnecessary risks and actually increase the chances that the woman will die. It is also a little-known fact that despite the widespread availability of legal abortion, amateur and self-induced abortions persist, for several reasons. Some feminists consider abortion "natural" and a purely feminine concern, and for ideological reasons perform abortions on each other or themselves. Other women are mentally ill, and their abortions can be considered a form of self-mutilation. Other women seek self-induced or amateur abortions for ideosyncratic reasons, such as cultural tradition, mistrust of doctors, desire to control the process, and so on. So really, the situation after legalization is similar to the situation before legalization: the vast majority of abortions performed by doctors, and a small percentage performed by laypersons without medical training. The biggest difference is the woman's perception of the safety of abortion. Women seeking criminal abortion are aware of the risks and accept them. Women seeking legal abortion believe that no harm can befall them, and assume the risks blindly.

Didn't C. Everett Koop, during his tenure as Surgeon General, do a study that proved that risks from legal abortion were negligible?
When then-President Reagan asked Koop to prepare a report on maternal risks from abortion, Koop declined. He said that he felt it was morally wrong to dilute the arguement that abortion was wrong because it kills fetuses with arguements about the mothers. Reagan insisted, so Koop palmed the project off on George Walter, an underling. Walter then sought help from the Alan Guttmacher Institute, the Centers for Disease Control, and other organizations that were not merely prochoice but avidly pro-abortion. Very few medical people and organizations who opposed abortion were invited to participate, and their input was ignored. The studies Walter reviewed consisted entirely of articles compiled by the Centers for Disease Control, and were mostly CDC work, with a few contributions from the AGI and other pro-abortion sources. Walter presented the report to Koop, who glanced over it and instructed Walter to trash it. Instead, Walter sent it to Reagan and to Congress with a cover letter from Koop's office. Koop backpeddled to try to cover up his lack of control of his underlings, with the end result being that the Alan Guttmacher Institute's writers were able to put out a report with C. Everett Koop's name on it. In other words, it was a political coup and has no more scientific validity than an R. J. Reynolds' report on the health benefits of smoking.

Some of the women and girls who made the terminal choice
How Many Women Die?
Recommended Reading
From Back-Alley Butcher to Abortion Provider: The Adventures of Jesse Ketchum
Post a message at Their Last Choice Forum
Abortion Mortality Chat
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