Birth control today; 11; Abortion and the Law

WB AA presents birth control today. Freedom and responsibility. This is a series of programs about birth control and how it affects us and our society. Today we focus on abortion and the law. Existing abortion laws in the United States have been the object of criticism by both legal and social reformers since the turn of the century. State jurisdictions are generally very restrictive yet the number of illegal operations has assumed fantastic proportions and in all but in significant number of cases go unprosecuted some pioneer states have liberalized their abortion laws with varying results. In the first two months after Hawaii liberalized its abortion law on March 11 1070 more than 600 abortions were performed at an average cost of three hundred dollars. Colorado reports that in 1968 there were four hundred ninety seven abortions performed one in 1969 there were 900 California indicates that in 1968 there were over 5000 legal abortions and in 1969 the

figure doubled the normal cost of abortions in California is between five hundred and seven hundred dollars. Authorities believe that there are 80000 illegal abortions annually in California. Since New York liberalized its abortion law in July 1970 there have been over 20000 abortions since then the New York law has restricted abortion operations to licensed hospitals rather than including clinics. There is a definite need for more extensive research on the effect of more liberalized abortion laws and national groups such as the Association for the Study of abortion and the National Association for repeal of abortion laws are attempting to meet this need. They have published large amounts of relevant material health statisticians say illegal abortions will continue to outnumber legal ones perhaps since they cost less than legal ones and less red tape is involved. Also awareness of provisions of new laws takes time to spread in any discussion of the statistics of birth control and abortion. One name invariably

comes up the name Christopher Tsetse the information center on population problems talk to Dr. Tsetse for the population crisis. Dr. Tsetse is a distinguished biostatistician associate director of the biomedical division of the Population Council and a member of Governor Rockefeller's committee to study abortion in New York State. In an article in Scientific American Dr. Tsetse summed up the worldwide abortion picture abortion he said is still more commonly used than any other method of fertility control or birth control. He estimates that 30 million abortions are performed each year. And he writes in countries where abortion is legal and is done with proper medical safeguards it results in remarkably few deaths. We asked Dr. Tsetse this question in the age of the birth control pill and the intrauterine device.

Why is abortion so common to our area as in the boy live creatures in the world where modern contraceptives are not widely used and they have for their impact on the number of conception I don't the number is relatively small whereas abortion has been used by man the flies since time immemorial and is used in all cultures and some pops up that wealth a percentage off pregnancies and in that portion may be contacted by a number of Frankenfish very great and therefore they rate all abortions but thousands of women is high. This is particularly chilling. Or reach an off Latin America where birth rates and pregnancy rates high high and well even they population rate but a thousand women up a thousand population is believed to be very high. Furthermore there are

areas in the world where abortion is legal where very large numbers of abortions are being done for you count only in Japan about 800000 abortions are reported every year in Eastern Europe probably on the order of one million two hundred thousand. We question Dr. DC about Latin America's high rates of illegal abortion and then we asked him if those high rates are an argument for more widespread family planning services. They had no question in my mind that from they have the House point of view the day development of a strong family planning program based on contraception is the most desirable sort of mission and that is in fact the sort of action that she has chosen. Let us not forget that the motive behind the

program is precisely to reduce the number of illegal abortions which in Chile but it is serious public health. Program and correctly so turning to the United States Dr. Dietz he stated that deaths from illegal abortions are considerably less than 1000 per year. Much fewer than most people realize. I do believe that even a relatively few that I could do you know legal of course that are still much too many. And I speaking personally and not representing any organization I do believe that existing restrictive abortion laws should be repealed. There are four main forces operating together to create a climate for more liberal abortion laws. Again in strength of the feminist movement with its insistence on women's rights to careers and personal fulfillment increased concern over the population

explosion the apparent success of the new abortion laws in Britain and Japan in cutting the cost of the operation and reducing the death rate among women who have a performance and a rising death toll from the illegal abortions performed by the unskilled usually not physicians and under unsanitary conditions. In different parts of the world there have been a variety of attitudes and experimental solutions to the abortion problem. Dr. Daniel Callahan director of the Institute of society ethics and the Life Sciences in New York and author of abortion law choice and morality recently gave a public lecture at Purdue on abortion and the law. How the effect of different legal solutions one might ask what in essence is the legal problem that legal problem seems to me essentially this society to allow women who want or need abortions to have those abortions without legal hindrance. My own conclusion. With some qualifications which I'll spell

it is that yes society should make this right available to women. But I think one can't simply state a position here without explaining how all of one got there and some of the problems and even trying to come out with that of the syce of sort of position. I think there are at least three general kinds of legal solutions to abortion throughout the world. Are those solutions which by and large prohibit abortion or allow abortion. Only in a situation of a life or death conflict between the mother and the fetus. There are those solutions which try to find a middle way which allow abortion under number of circumstances but require that a woman prove that she meets the conditions of the law. That and also that she present herself and in one way or another before a committee which

decides upon her case. A third set of laws which I will term permissive laws are those which basically leave the decision up to the woman setting forth no special indications or requirements that she must meet in order to have an abortion. I'd like to say something about each of these three solutions since it seems to me that each of them presents some attractions and some difficulties. Let me begin with restrictive laws laws which state via and large the woman may have an abortion only if there is a direct threat to her life. Restrictive laws are found in most of the states in this country. In all the Latin American nations in a number of the Asian nations and in particular in India and in most of the Southern and middle European nations. The main results of those

laws seem to me fairly clear from the data which has been collected namely that in countries or areas which have very restrictive laws the result is at a very high illegal abortion rate. One evidence of the large number are. Are the number of women who are the victims of bungled abortions and who turn up in hospitals to be repaired. If they can be repaired in Latin America in a in a city like Santiago the illegal abortions. Which result in hospitalization run close to fifty thousand a year. In this country it's estimated that there are anywhere from 200000 to a million and a half of illegal abortions and a year. It's quite clear that then that restrictive laws do lead to illegal abortions simply out of the obvious fact that some women are determined not

to have a child and they will risk their very life in order to have an abortion. However illegal however dangerous. Are some of the results of very restrictive codes. What again seem to be world wide patterns is that most of these codes do seem to bear the impact of de facto discrimination of one sort or another that is to say in countries which have very tight laws against abortion. The main people that suffer from these laws are the very poor of the well-to-do and the rich are able to find reasonably safe illegal abortions are able even in this country to get abortions performed by physicians in hospital settings. I have one advantage of being affluent and well educated is that one knows the successfully how to beat the law and that has been the case in this country with with the abortion laws.

When one looks at the statistics of the abortion legal abortions carried out in private hospitals versus those carried out in welfare hospitals the the difference of range is a 20 to one up to a thousand to one against that the well welfare hospital. Which seems to indicate that in private hospitals the law has been stretched for years but this is new and a stretch for the sake of the affluent but not stretch for the poor. Now if restrictive laws then have some very serious side effects one has to say finally that one thing which is also common about these laws throughout the world is that they are never enforced or they are enforced very sporadically and only in cases very often where there isn't. If a woman has died as a result of illegal abortions. Now if there are some drawbacks one might

also say that there are some strings to these laws. They have certainly symbolized the high valuation society places on pre natal life in this respect even if the law has not been honored the very fact that there is such a law has been one way of saying that we think the unborn child both has rights for and at the same time is entitled to the respect of society. So too with restrictive laws the number of legal abortions has been very small even if the number of illegal abortions have been very large. Not when one looks at a very different kind of legal solution namely what I will call here moderate laws. Namely those laws which provide for abortion under any number of circumstances

provided the woman present herself argue her case to show that she meets the conditions. The last of this kind really pioneered in the Scandinavian countries most notably in Denmark and Sweden and in this country the closest parallel would be would be the laws in California Colorado and Maryland. The aim of these moderate laws has been to steer a middle course to try on the one hand to alleviate some of the drawbacks of a very restrictive legal codes and the high number of illegal abortions. And on the other to at least go half way to meeting the demands of those women who feel that abortion should be much more easily available or available on request. What I think can be safely said that the general experience or at the world has been that these modern laws don't work. Nowhere have they succeeded in cutting

down on the number of illegal abortions to any great extent. Nowhere have they succeeded in doing away with the problem of discrimination for the countries which did the pioneering Sweden and Denmark have themselves decided that these laws don't work. They say they have found that most women still are unsatisfied that most women who want to portions get them and are primarily still getting through illegal abortions. The conclusion one would have to draw on in fact the conclusion of the people themselves who fashion these laws is that. Middle Way is in the very nature of the case cannot be successful. They they will certainly leave unhappy those who want freer laws and they will leave unhappy. Those who think abortion under any circumstances and wrong is wrong and that even a moderate law is a. An unacceptable compromise with morality. Now if

third type of legal solution very permissive laws has been tried in a number of nations most notably and with the longer the longest historical record. A number of the East European nations particularly Rumania Bulgaria Hungary Czechoslovakia and most recently East Germany the other nation with with a long history of permissive abortion laws in Japan are the results of those laws have been fairly striking. They have succeeded in reducing very sharply the number of illegal abortions there has been a very sharp drop in the number of deaths and injuries from illegal abortions. The very great drop obviously in the complaints of those who found abortions unavailable before. In one sense then very permissive laws

have solved the problem for many they have their personally unhappy those who think abortion should not be legalized but in most of these countries that is not the common view. The permissive laws have been reasonably accepted in this country in the state of New York which has enacted an abortion request law up to the 24th week of pregnancy and in the states of Alaska and Hawaii where the laws have been repealed altogether. One sees a situation analogous to that in Eastern Europe and Japan. In the big American states however that there is no history yet on what the results of these laws will be. And yet at the same time even in the countries which have no particular religious scruples about abortion. Even in those countries which have had very permissive laws one discovers on closer examination a great number of dissatisfactions with these laws. The main dissatisfaction on the part of

many people in the medical profession is that there are just too many abortions under these laws. Roumania. Which actually changed its law from a very permissive to a very restrictive law in 1965 calculated that in the year one thousand nine hundred five there were one million one hundred fifteen thousand recorded legal abortions. That is a very large figure but it's. It's all the more striking when one realizes that in Rumania that there were no more than perhaps six million women in the fertile age category. What one finds in these countries and this includes Japan. But the medical profession is unhappy about the very large number of abortions. A Because they have found that an awful lot of women in these countries use abortion as the primary method of birth control that they are lax about using contraceptives

simply because abortion is so easily available and in one sense a good deal less trouble than a regular use of contraceptives. The physicians have also complained in many of these countries because of a terrific drain on the hospital bed space and on the time of hospital personnel both physicians and nurses. Many of these countries have been considered a changing of their laws back into a to a more moderate and in some cases even restricted direction. The curious thing though it seems to me when one looks at the whole world scene is that one sees a terrific flux. My own conclusion is that no country is very happy with the law it has regardless of what that law happens to be. All of the countries have one complaint or another against their solution and it's not surprising that within the past five years any number of countries have changed their laws some as in the case of

Roumania and Bulgaria going to much more restrictive direction. Others as in the case of some of as in the case of Great Britain some of the states here and East Germany growing in the direction of much more permissive laws. The only point I can conclude from this is that as a that there exist at present nowhere in the world a happy solution a solution which will satisfy both the people in general the medical profession and those who are concerned abet the ethical problem of abortion. My own conclusion is that. One can see what happens under a variety of different kinds of legal systems. It seems to me the experience right the world that when a Russian or surveyed made very permissive. Women are less prone to use contraceptives very effectively.

Moreover one finds that whenever a countries begin very strong family planning programs programs which concentrate on the use of contraceptives it will not be very long before they are likely to go toward a much more permissive abortion law. In those countries which have had a very permissive abortion laws with perhaps the exception of those of the Soviet Union. These laws have seen a very sharp drop in the birth rate. Japan is the most spectacular instance of this with a very high birth rate prior to one thousand forty eight and with in a decade a drop to one of the lowest birth rates in the world. Hungary and other nations had a very low birth rate and as I mentioned in the case of both Rumania and Vogue area they changed their abortion laws because of the low birth rate which was primarily attributed to the easy access to abortion.

One can ask of course see why many people insist on the population problem would like to see far more abortions available. Abortion plus contraceptive or that's to say contraceptives with abortion as easily available as a backup would seem to be the most effective way to very rapidly reduce a nation's birth rate. It's also evident that in countries with very permissive laws that that once these laws the laws have been in operation for a few years the average age of women making use of the laws begins to drop a decade ago in Eastern Europe and two decades ago in Japan that the average woman who had an abortion was a woman a married woman with three or four children. The general trend. As the years went on was for younger and younger more and more unmarried women to make use of abortion and also

for those who were married for women to begin having abortions with their first or second child rather than after the fourth child. All of this has been summed up in the expression of one person as a shift in clientele that is to say with very permissive abortion laws you get a very different kind of person making use of abortion namely younger people people with fewer children. More on married people. Now. Let me try and sketch my own legal solution to the problem. And here I'm guided very much by the conclusions of some study groups in Sweden and Denmark. They came to the following conclusions all of which seem to me to make considerable sense. First Robert there should be abortion on request up to the 12th week but no later than the 12th week.

There should be abortion request simply because unless the state can show compelling reasons why a woman should be denied an abortion that a woman therefore ought to have a legal right to an abortion and in their case it seems to me in the case of most nations it simply can't be shown that there is a decisive right on the part of the state to interfere with the woman's choice here. At the same time the use of Swedish and Danish solution. I said that after 12 weeks abortion decisions should be subject to mixed medical and psychiatric. Decision making processes that after that point primarily because of the medical hazards and primarily also because of the of the what they felt increasing ethical issues given given the greater age of the fetus at that

point society should have to feel has a very real stake in the kind of decisions made at the same time though the Swedish and Danish experts decided that a society ought to steal to attempt to respect the life of the unborn child. And it should do so by simultaneously doing a number of things one making abortion available on request and yet at the same time stepping up in a very strong way a great deal of propaganda against abortion. That is to say. Two messages would be put across at the same time. One that a woman has a right to abortion but at the same time that the she should not have an abortion if at all possible. They also concluded that any kind of an abortion law ought to be part of a full maternal welfare program.

The point it seems to me is to try. In a very different kind of difficult kind of balance to on the one hand accord women the right to make their own choice. Asking only that as they make the choice they try to make a very sensitive choice. And on the other trying to instill in women and in the society at large a very real respect for life both born and unborn in our country. We have a very curious situation that. It is very much easier to get people fanatically opposed to abortion laws and fanatically opposed to any kind of liberalization laws than it is to get the same people to support greater care for expectant mothers. Better medical services for children better educational services for children. It often seems to me that those who are most opposed to reforming abortion laws are much more concerned about unborn life than their born life

on the other side though those who feel that abortion is no moral issue at all and who feel that abortion for any reason at all is a perfectly good reason. Themselves seem to me to have allowed themselves to become insensitive to rot in the act of abortion is for it seems to me that whatever one thinks about the beginning of human life. One has to recognize that abortion is not as some like to put it in a very euphemistic manner. Just a therapeutic procedure. Abortion is not just an emptying of the uterus contents as some put it. Abortion is in fact the healing of a life. Whether we want to call this life a human life in the full sense of the word or potential life only doesn't change the fact of the matter. It is the taking of a life and if one is going to engage in that act one had better have very good and very

serious reasons and one had better do everything possible to see that the society does not allow that act to be relegated to the trivial to the dimension of the non-moral and particularly seen only as as a matter of a legal solution and nothing more. This is been birth control today freedom and responsibility. The next programme in this series will discuss the new morality today's guests were Dr Christopher Tsetse biostatistician and member of the Population Council and Dr. Daniel Callahan director of the Institute of society ethics and the Life Sciences in New York. The series was written and produced by Colleen Gary and narrated by David Bundy recording engineers Morris Moggridge announcer Roger priest. This is the national educational radio network.