Abortion '83

On January 22nd, we will be celebrating or at least observing the 10th anniversary of the Supreme Court decision giving women the right to have abortions in the United States. And to examine that decision, we have a panel of guests who include Jan Allen, who is with the National Organization for Women. She is NC now task force on reproductive rights chairwoman. We also have with us Paul Stam, Jr., who is an attorney practicing in APEX. He is president of the Wake County Chapter of North Carolina right to life. Dr. Mary Jane Gray is also with us. She is adjunct professor in the Department of Obstetric Thin Gynecology here at the University of North Carolina at Chapel Hill. And I've asked each one of them to prepare a little opening statement to sort of summarize some of their views and opinions before we go into actual discussion. So I think we'll start with Dr. Gray at the far end of the table. All right. What positions want from the law relative to abortion is the right to treat patients in the way that they think is best for those patients.

This includes the right to discuss abortion, our perform abortion, our refer for abortion depending on their particular specialty and the problem of the patient. All right, Mr. Stam. Say we've had 10 years of a social experiment in privacy that's resulted in the death of about 15 million fetuses, children, tissue, whatever you want to call them. And it's not so unusual that children die, sometimes they die intentionally, not intentionally, but the really amazing thing about row versus weight is now we have a situation in which mothers intentionally kill whatever it is. We believe it's a child. Doctors who at one time took an oath of office, the Hippocratic oath that they would not participate in abortion now regularly violate that oath. And the state which used to be the guarantor of human life, in fact Thomas Jefferson said

the principal function of government is a preservation of human life and not its destruction. The state has now authorized it, permitted it, and in the case of state of North Carolina actually encourages and pays for abortion. I find this amazing and I'd like to change it. Thank you. Jen? Okay, I would like to read a few words and then make a couple of comments. It is the right of every woman to control her own reproductive life. This includes her right to bear children, not to bear children, and whether or not to choose abortion. The right to life people have acted and would have us believe that it's a proven fact that life begins at conception and therefore abortion is murder. In fact there is profound disagreement. The belief in personhood at conception is a belief of some religious groups. In fact most Protestant and Jewish denominations regard the fetus as a potential human being and have statements in favor of supportive legal abortion.

And public opinion polls have consistently shown since the 1973 Supreme Court decision widespread support for reproductive freedom. I believe that the issue here is a woman's right to control her own body. The right to control her own body is basically controlling her life economically socially and spiritually, denial of a woman's right to abortion is a religious philosophical and more importantly a spiritual issue, not a political issue. Okay, we have touched on a number of different aspects of the problem and I guess one of things you said got right to the core of it. Is it the Roman's right or going back to what Paul said? Is it the state's right? Is it the state's interest to protect this life or is it the woman's right to go about her life in the way she thinks best? Now abortions have been around for a long time whether they were legal or not. And this is one of the things that the Supreme Court was attempting to eliminate. Are Paul is really valid to expect that getting rid of or changing the Supreme Court decision

is going to get rid of abortion? No, I believe in dealing with every crime you don't expect making a deal legal will completely prevent it. Abortion roughly tripled after it became legalized and I'd be surprised if it was reduced to zero if it were made illegal again. But of course we have laws against theft and we don't say well people violate that anyway so we'll just repeal the law. Jan, Mary-Dane, who wants for a shot? I resent the word abortion or abortion being called a crime. Get back to my statement about the profound disagreement. Most of the Protestant churches, the Presbyterian church, the United Methodist, the Episcopal, Unitarian Universalists, the Jewish denominations, all of them have statements in support of legal abortion.

They don't believe it's a crime. You know, to say that these people supported is to say that they're all wrong, that there is one belief that seems to hold precedence here. Address a question to Dr. Gray and ask her whether or not in fact there is disagreement about whether this thing which is being aborted is alive. Is there medical disagreement about that? I think there's no medical disagreement about whether the cells that make up a fetus are alive. They obviously are. That's when you get the question, when does life begin as a philosophical question that I wouldn't even begin to get into today. Let's get back to the public health aspects of this. Is there just a frame of whether it's human? It's human tissue, certainly. It's human and it's alive. It's human and it's alive. So are the cells lining your mouth. They're human and they're alive. They don't have the same potential that a fertilized egg has. But all of this really is a philosophical question.

What constitutes life? Whether it began three, three billion years ago, whether, you know, that's all something that the experts debate, debate, debate, it depends on how you define life and how you define a human being. I think we shouldn't spend too much time on that issue, except to say that is one of the core issues that there's disagreement on. But on whether it's human life, that isn't disagreed about. I mean, whether it should be protected in law, whether it's a person, there's disagreement itself. But whether it's human life, in the sense that I'm human life or you're human life, is there really scientific disagreement about that? No, those are human cells. Living human cells. Living human cells. That's from a human life, yes, from whether they are constitute a human being or a potential human being. There is a great deal of disagreement about. I don't worry about all the sperm that get lost every time a couple has intercourse and only

one sperm fertilizes an egg or maybe no sperm fertilizes an egg. You can get all of my own kinds of extraneous issues. For example, the developing human is a clinical embryology book, I'm sure you're aware of. And it says the fertilize of them, that's the beginning of human life, and it's a definition of a... Sure, but that's one book. Well, does anybody say to the contrary? The question of what constitutes a human being has a lot of... A human being is philosophical. Right. What constitutes an individual human life in that not philosophical, not religious, that's just a purely scientific one. There are several thousand eggs in every woman's ovary. There are many million sperm in every male's testes. But how many of these... Each of these... Fertilized. Fertilized O-Side and because of the individual human beings. We have...

We have... ...until it dies 70 years later. We probably know ways that we could make those cells divide and start developing without even usual fertilization. We're seeing things where eggs are fertilized and then put into the uterus. I think that there are so many different scientific developments coming from so many different directions that we need to be very careful about definitions and very careful about trying to make theological assumptions about scientific things in vice versa. I have a different religious belief. I don't recall. I don't recall stating a religious belief. I have a... You don't have to say that you're one denomination or another to state a religious belief. There's a wide, wide area of disagreement. Public opinion polls show that the vast majority of people are against banning abortions. That isn't it. Isn't it the case that about 25% of the people are opposed to abortion except where the

mother's life's in danger, about 25% support the now position when it just like it is and the great 50% in the middle don't know what they want. They want to preserve the child's right to live and they also want to put them to the mother. Let me quote two polls. There was an NBC News Associated Press poll last January 82. Do you favor or oppose an amendment to the Constitution which would give Congress the authority to prohibit abortions, 75% of these people opposed prohibiting abortions. A similar poll, a Harris survey in February 1982, came out with 61 opposed to a similar type banning of abortions. And are you familiar that the introduction to the Harris poll told the people that the current law allowed abortion only during the first three months of pregnancy? What difference would that make in opposition to banning abortions? I think people are strange. They don't know what really goes on. And the actual fact is abortion throughout pregnancy.

Abortion does not take place through. We call it something else after six months. After six months we keep that baby alive and take it to the nursery. That's not an abortion. Obviously there are times when a mother's life is threatened before she goes clear to term and cesarean sections may have to be performed at an early time. That really has nothing to do with abortion. I think, as a matter of fact, the Supreme Court decision was a little confused on that point and shouldn't have talked about third trimester abortions at all because that makes no medical sense. We didn't turn the wonder away from something else that we had tested on early, which were the public health indications of illegalizing abortions. Yes, Paul said that there were at least three times as many abortions now as there were before abortion was made legal. It all depends on what figures you base this on.

I was surprised at how nearly the number of abortions done the first year after the Supreme Court decision corresponded to the number of abortions that we postulated were being done illegally in the country before the Supreme Court decision. So one of the big things we've done is to take that group of abortions, which were illegal in which were accompanied by a great many medical problems, and make the legal so that they could be done sterling and the results would be much better. I think it's safe to say we don't know how many illegal abortions there were. We don't know how many deaths there were fairly accurately because the year before, how many were there the year before we legalized abortions? I don't have that figure with me, but there was something like a thousand in the country at large, and the figures if you look at them show a remarkable drop in the mortality rates due to abortion with the legalization of the operation.

Didn't the doctors use to consider the child a patient also? We still do consider the child. If the mother wants it, you consider the child a patient. If the mother doesn't want it, you consider the goal of the operation. With all the battered children and all the problems that our society has, if the mother has no interest and no desire to continue a pregnancy, I think as a society, we should support her in her working out the best decision that she can come to regarding a pregnancy. Say this is what concerns me the most about row versus weight, part of it's advertisement in the decision was that we had to have this legalized abortion to prevent unwanted children, battered children, and now we've had about 15 million since then, and you would expect the rate of child abuse to somehow have decreased. In my roles in attorney, I've seen child abuse reported cases skyrocketed. Maybe they just increased a little bit, but we should have put an end to the problem

of child abuse with a boarding 15 million of it. Of course, that's not the only reason for child abuse, and of course, our methods of reporting child abuse are a lot better than they used to be. That's a great thing. Women and men are a lot freer to do this sort of thing, and I really don't think you can link the two issues. This improvement in maternal death rates, I mean, it was improving even before abortion was legalized. Yes, not all of that can be accredited to abortion. There are certainly women with problems like heart disease and high blood pressure who are alive today because they had abortions who would have died, had they not had those. Before 1973, for instance, the legal abortions were leading cause of maternal death and mutilation. After that, the death rate dropped down a great deal, and of course, now the death rate from abortion is way, way below the death rate from childbirth. Just exactly what is the position? We know that right to life is opposed to abortion. Are there any circumstances at all which your organization would favor or condone? Certainly, in the case, for example, of a tubal pregnancy, we don't really consider that an abortion.

If you want to call that an abortion, then I support that because the reason we're opposed to abortion is because we're in favor of life, human life. The woman's life is obviously just as important as the child's. So often abortion is justified on this ground. We need it to save women's lives. And out of every thousand abortions, how many would you say are done to save the physical life of the mother? Well, perhaps ten. I think the question is though, if you say that this is not an absolute, then who decides? I, as a physician, have gone through the time when I made these decisions together with my colleagues and told women whether they could or couldn't have an abortion. But the more I watched the women and listened to the reasons that they wanted their abortions and the more I studied this, the more convinced I was that as long as someone had to make that decision, it had best be the woman herself.

Jane, what is the now position on the laws and the abortion laws? Are you trying to have them changed even more liberally or you're just trying to protect what it is? I believe that the Roe versus Way Decision said it best and what we're trying to do is protect that. There have been many, many restrictions, as you know, since 1973, that have said that women who can't afford it anymore can't get abortions. I believe it's a basic right. I would have to disagree with that. I believe it's a basic right of every woman regardless of her ability to pay. There are other things that you're paying for that you probably don't agree with either. My taxes go for a lot of things I don't like. Are you aware of the situation? In this country where women can't get an abortion? There are places where Medicaid will not pay for it. Now we're one of the very few states that will help poor women pay for abortions. I believe it's a basic health issue and the woman herself is the only one who can make that decision. So in right life, you're saying the entire organization is going to gather its arms and go to the general assembly at the next opportunity to oppose state funding for abortions for

the indigent. That's one of our goals, not because we're particularly opposed to abortions for indigents. We're just as opposed to abortions for the rich. But unfortunately, the Supreme Court doesn't allow us to attack the abortion institution except at the issue of justice. Of course, this is one of the other problems. The rich can pick up and fly to any part in the world as they did before the abortion law was changed. I'll concede before we need to protect. I'll concede one gross inconsistency, and that is the federal government does pay for abortions for its own employees, which isn't inconsistency, and that they're a lot more able to afford it than the poor folks. But if abortion is a medical procedure, it ought to be one of those medical procedures that is funded under any hospital policy or any kind of health insurance. Isn't it different though? What other procedures can you think of in which the patient, 99 times out of 100, isn't sick?

A tubal ligation? A tubal ligation? The psychedomy? No, things like that. Now, you're saying that medical reasons don't include psychological reasons, that you're taking a very narrow view of medicine, and I certainly... Well, 98 times. Our psychiatric colleagues would take great issue, and indeed they have been much more willing to go out on an limb to support abortion than the average practitioner. My question, whether it's 99 times out of 100 or 95 times out of 100, it's different in that at least in that huge majority of cases, you're doing a medical procedure, but the patient doesn't have a germ that you're trying to get rid of, doesn't have a laceration, you're trying to fix, doesn't have missing organs. Has a major problem that she's trying to solve? I would like to take issue with the tack you're taking. What you're doing is trivializing women in their decisions. Women, I believe, take abortion and motherhood very seriously, and what you're basically saying is that women really don't have the common sense or the intelligence or whatever

by your comment that you just made that it was sort of all while they're doing it on a limb type thing. No, no. I am really not attacking women. I really see the culprits here in addition to the judges as being the doctors, most of whom are male, who do it? Well, actually, you know, in this country, it was the clergyman and the lawyers who led the fight to change abortion law. I am ashamed of the fact that many of my colleagues were so slow to join in this crusade. That's correct. American Bar Association had a lot to do with it. Just as the American Medical Association had a lot to do with the criminalization of abortion in the mid-1800s, the question is, the strong division there is not how many clergymen we can line up on either side. That's true. But what the inherent justice of the situation is? I think with a situation where clergymen disagree, lawyers disagree, doctors disagree, women

disagree. There is a very deep division. In a pluralistic society, we should allow people to have these different civil opinion and act according to their own conscience. Well, let me ask you this. You would not then have been in favor of any of the civil rights laws in 1964 since the people of North Carolina were generally opposed to them. So you would have said, we can't have those laws because we're in a pluralistic society and we can't impose our morality on these people. I reject that notion of a pluralistic society. I believe that law has a didactic or a teaching function. When people are doing wrong, killing their own children, law can encourage them. But where one of the things that has been touched on recently looks at abortion as it is being used for young girls, seems teenage birth rate, that single group is experiencing the greatest increase, often that these are girls who would have to leave school, who

may already be in a situation of poverty and where you will continue to generate a dependency on the state for maidens. And in the case of funding these abortions, it becomes either funding that or continue to funding what it's been called the welfare cycle. Is that something that you address Paul in the right to life movement or Jan or you are looking at that issue, particularly? And all of our chapters have affiliated groups, there's one here in Chapel Hill Pregnancy Support Services which attempt to help young women who want to keep their child and nurture it. And we're in favor of all the support possible to women in difficult circumstances who are able to keep their children. I believe in support for girls and women, whichever decision they want to make. But when they do want to have an abortion, I believe that for those who can't afford it,

things like the State Abortion Fund helps them along. Some of the women, for instance, who received aid from the State Abortion Fund were not women at all. They were children. They were 111 in the year 1981 to 1982 or 14 years of age or younger. No one can argue that a girl who is 12 or 13 if she wants to have the abortion should continue to that pregnancy. I've heard that reason so often, as a reason for the State Abortion Fund, are you aware how many they, quote, helped? I have a total of three or four thousand. It's about 111 out of about 6,000 are to what you call fuel. That's right. And I think that's a very important figure because that means that's 111 girls who aren't even old enough really in terms of their body age to have a baby. It's damaging to a girl that young to continue a pregnancy. This report, quote, will be looking at the issue again, probably we saw in the last session the human life amendment which the Senate was looking at, which Senator Helms here from

North Carolina did introduce and which was not passed. Are there movements to continue introducing legislation like that and are there counter movements to oppose it, should that come up again? That's why we're here is opposing that. I'd like to point out a couple of the aspects of the human life amendment, otherwise known as the HLA. I don't know that a lot of people understand that when you say life begins at conception, for instance, that also outlaws the IUD. It outlaws the pill that a lot of women take called the mini-pill because in fact the way they work is that they work on a fertilized egg and therefore they would be illegal. The morning after pill, which is used for victims of rape and if there's any suspicion of pregnancy, none of these things would be allowed after something like the HLA passed. The HLA, as National Rights of Life has endorsed it, has a specific exception for the cases where the mother's life is in danger.

I think you're probably referring to the paramount human life amendment that Senator Helms talked about three years ago and in commentary that he wrote in human life review, he specifically stated that it was not intended to change the common law defense that this was necessary to save the life of the mother. I've heard that so many times and we have to oppose the HLA because of ectoptic pregnancies and it's just a non-issue, it's a scare tactic, nobody, nobody, nobody wants to prohibit abortion in case of ectoptic pregnancies. You may not want to but from a technical point of view, if you say that human life begins at fertilization, then I think that physicians will be frightened when they get into this area because how do we know how you lawyers will interpret this? Specifically because of that concern, the current version of the human life amendment has an exception in it that should L.A. completely that concern, and the-

Does your exception accept a common methods of contraception? There are so many issues that are medical issues that- Contreception would not be affected at all. A Board of Facients would. But that includes the IUD and the mini-pill. I think the debate has served the useful purpose at least of helping women to understand that so often their doctors are telling about these contraceptives, the IUD, which weren't in fact contraceptives at all. Again, it's a matter of definition. I think the IUD is a very good method of contraception. There are- Who knows how many methods of contraception we may develop in the future that may be safer for women that may depend on a lack of implantation rather than a lack of fertilization so that we may with such laws be cutting off all kinds of research and future developments because of the very narrow wording of such a law.

I would like to point out that there are other reasons, you know, besides the life of the mother, I mean victims of rape and incest after all, who become pregnant. There is no reason in the world why a woman or a girl should have to continue her pregnancy pregnancy. I see nothing for an exception for victims of rape and incest in the- And the whole area of genetic disease, we've made so many strides in these last 10 years in being able now to detect infants with down syndrome, being able to detect- Well, let me ask you this because since that's an improvement, do you believe that infants with down syndrome should be awarded, and to me the function of a state, a political, any political system, is not in providing the means for the stronger group of people to impose its will on the weak and helpless, but rather the function of a state is to support, protect and defend the helpless against- From a perfectly practical point of view in this modern

day and age, couples decide how many children they want, and if you force them to raise a child with down syndrome, that child is replacing a normal, healthy baby that they would otherwise have. Well, isn't that true once a child is born? Well, for example, there are many, you know, genetic diseases that all you can tell the child- All the tell the parents is, well, we know that one chance in four of the child will be deformed. Okay, so if the parent aborts only one chance in four and three out of four healthy, but if you wait till after birth and see, can't you tell them this is- We made a great deal- We made a great deal of progress in VA- So, every force of the abortion? In being able to pick out the ones now that are abnormal, that's the area that we've made so much progress in- But is that ground for a death warrant? I think that the parents are the ones who make this decision about whether or not a mother is forced to continue a pregnancy knowing that she is carrying a baby that will be abnormal.

I believe we're back to the issue here of somebody saying to a woman, I know better than you do, I know better that you should continue your pregnancy, and I know better than you do whether or not you can do this. What I'm here to say is that it is a woman's decision, and I believe we have to take her seriously and her decision seriously because it's she who takes the risk and carries that pregnancy. I believe if the woman determines that she cannot for any of these reasons, we've cited continue that pregnancy, then that is her decision. And women choose abortion for very, very serious reasons, and I believe wholeheartedly that it is their very serious decision to do that. It is not for me to decide what's best for them. It is not right for you to decide or anyone else in the law that is saying that government can intrude and make a very private decision on behalf of someone that is wrong. But is it likely that the country will be able to reach a consensus on what to do about abortion?

It is made the decision in 73, and it seems to have been, as you mentioned, going back and hedging it a little more as time goes back, what do you see ahead? I don't think we will ever, ever come to a consensus on when life begins. That's really not what we should be doing. I believe we have the law. I believe that protecting that law is becoming a very difficult thing. I believe also that everybody was very complacent after the row versus weight and said, oh, well, now we're okay. Now we have safe legal abortions. We're okay. And there has been a very strong, small, but strong religious group trying to impose their religious views on the rest of us. And I think a lot of people are becoming more aware, look at the public opinion polls. 75 and 61% opposing banning abortions. I don't think that we're going to reach consensus on this point for a long, long time. But I would like to see the day come when we respect each other's position on this and allow individuals to live their lives according to their own conscience. Paul?

I would have to agree with the ladies that it's unlikely that there will be a consensus anytime soon. I settled cases for a living. You can settle cases where there's money involved, but this isn't the kind of case you can settle. It's either a child or it's a tissue. If it's a child, you shouldn't kill it. If it's tissue, who cares? Nothing wrong with it. I unfortunately would predict this 30, 40, 50 years of struggle going to go on on this problem. I wish it weren't so. I wish I had it. I agree with you on that. Well, I would like to thank all of you for coming and rehashing some of the issues, possibly stinging people to think a little more about it as we approach the 10th anniversary of the decision. And again, our guests have been Jan Allen, who is with the National Organization of Women and Chairwoman of the North Carolina, now task force and reproductive rights. All-Stam, Jr., attorney from APEX, who was president of Wake County Chapter of Rights to Life, National Organization, and Dr. Mary Jane Gray, who is the adjunct professor

in the Department of Obstetrics and Gynecology here at the University of North Carolina, Chapel Hill. And for W.U.N.C., I'm Femmental Henderson.