January 21 is the anniversary of the landmark 1973 Supreme Court decision Roe v Wade, striking down restrictive abortion laws across the US. At the time I was the Medical Director of the International Planned Parenthood Federation in London. I still remember a surprised phone call from New York. My friends and mentors, such as Alan Guttmacher then the president of Planned Parenthood, were pleased with the decision but afraid that a medical professional, with no experience of safe abortion, might make many mistakes. Happily that was not the case. All that happened was that women stopped dying of unsafe abortions.
A careful study of abortion statistics after New York State reformed its law, (because family planning was becoming more available) found that there were fewer safe abortions after a law was changed than there had been unsafe abortions before the reform.
I practiced obstetrics in England when abortion was illegal. Virtually every night I was on duty I had to get up to treat a woman with what doctors called an ‘incomplete abortion’. Clinically, it is often difficult to distinguish between a spontaneous miscarriage and a deliberately induced abortion. I used to wonder how many of the incomplete abortions I treated had been illegally induced and how many were genuine spontaneous miscarriages. I learned the answer after you change the law. The incomplete abortions virtually disappeared.
All the evidence from around the world is that restrictive abortion laws have little or no significant impact on the number of abortions that take place. What restrictive laws do is to kill women by preventing their access to safe abortions. In Africa there are 6 million unsafe abortions each year, and 26,000 women die.
There happen to be 26,000 male and female students on the Berkeley campus. Now every day when I walk across the campus and I see the vibrant young people I have the privilege of teaching, I think of those 26,000 people – all women – who we kill each year because we cannot think objectively about abortion. Even in a low-resource setting, I can teach people to do a safe surgical abortion or permit women to induce a medical abortion, both of which have a death rate of about one in 100,000. In parts of Africa where I work, women who have an unsafe abortion have a one in 100 chance of dying. A thousand-fold difference in death rates is a stunning difference.
I recognize and respect that fact that abortion is a topic where sincere people have differences of opinion. But once you realize the restrictive abortion laws do not stop women having abortions, but merely drive women to have unsafe abortions, then the issue is not whether abortion is right or wrong, but whether you want to save women from dying a painful death, or suffering life-long injury.