The first time I ever heard anything about abortion was also the first time I watched Dirty Dancing. I was ten, maybe. My best friend’s older sister was baby-sitting for us, and had plugged it into the VCR. She allowed us to stay, in our pyjamas, wide-eyed.
After the infamous the guy had a dirty knife and a folding table line, I asked what was happening. I don’t remember what I was told, but I do remember being horrified at poor Penny’s suffering.
Dirty Dancing was set in 1963, a decade before the historic decision of the U.S. Supreme Court to legalise abortion through the famous “Roe v. Wade” case. The film itself was released in 1987, only fourteen years after. But even by then it was hard to imagine quite what the past had felt like; abortion had already become an accepted right for most American women, as the film’s screenwriter and co-producer Eleanor Bergstein explains in a recent interview:
When I made the movie in 1987, about 1963, I put in the illegal abortion and everyone said, ‘Why? There was Roe v. Wade ― what are you doing this for?’ I said, ‘Well, I don’t know that we will always have Roe v. Wade.’
Roe v. Wade revolved around the US Constitution’s 14th amendment (the right to individual liberty). The case is back in the headlines now, as a landmark decision under threat from President Trump’s appointment of Brett Kavanaugh to the Supreme Court (nomination subject to US Senate approval, as this article explains).
Many women’s health and rights organisations have decried Kavanaugh’s nomination, arguing that his previous track record as a federal Judge implies a possible reversal of Roe v. Wade with a swing of the Supreme Court to the right (see the #SaveRoe campaign). There is already evidence of states increasing restrictions to the federal policy, with 214 limitations on the right to abortion voted between 2011-2014 (more than for all three previous decades).
Analysis by the Center for Reproductive Rights predicts 22 states in America would use a Supreme Court reversal to enact their own abortion laws. So if Roe v. Wade is struck down, what would that mean for American women? Was “the Penny situation” typical, and would it still be, in 2018?
There are obviously no official statistics about how many American women underwent illegal abortions before 1973. Some argue that Roe v. Wade did not change much: in five states (Washington, New York, Alaska, Hawaii and California) abortion was already legal. Others obtained terminations quietly from sympathetic doctors.
The same would probably occur today, with women travelling interstate or abroad, or procuring drugs such as mifepristone and misoprostol to avoid some of the most awful home-alone methods of yesterday. But regardless: self-administration of any medical or non-medical procedure is not without risks, and seeking a legal abortion elsewhere would still require time off work, and a budget for the operation, travel or accommodation.
This point is particularly relevant. Of the 926,000 abortions performed in the US in 2014, half were for women of low income, according to an article by the BBC. Illegalising abortion would create a double burden of discrimination in terms of need and access, but could also threaten disproportionate criminality for poor women, as described by Michelle Oberman writing in the New York Times:
In Chile, the small number of abortion prosecutions annually typically target doctors. El Salvador prosecutes women. Government officials there have toured the country’s hospitals to inform doctors of their duty to report women suspected of having induced their miscarriages. Not only does this policy violate near-universal norms of patient confidentiality, but because doctors have no reliable way to tell a natural miscarriage from an abortion, reports are made on the basis of suspicion. Whom do doctors tend to suspect most readily? Poor women.
It is difficult to have an exact figure for illegal abortions, but it is estimated that 25million terminations (of a total of 56million annually worldwide) are unsafe, defined as lacking either trained medical staff to conduct the termination, or the use of unsafe/incorrect methods. And again, since accessing drugs online such as misoprostol still requires knowledge, money, and supply, it is not surprising that the majority of unsafe terminations happen in developing countries (where there is also the greatest unmet need for contraception, and where the laws tend to be the most restrictive).
So banning abortion does not stop it from happening; it simply makes it more dangerous. Unsafe terminations result in around 22,800 deaths annually (likely a conservative estimate), and some 6.9m ‘complications’, detailed below by the IPPF (and which cost an estimated $553m a year to treat according to the WHO).
So what are the risks? Immediately: severe bleeding, uterine perforation, tearing of the cervix, severe damage to the genitals and abdomen, internal infection of the abdomen and blood poisoning.
In the medium to long-term possible repercussions of unsafe abortion include reproductive tract infections (RTI – a 20 to 30% chance), pelvic inflammatory disease (PID), chronic pain and infertility (20 to 40%). Then there’s the risk of ectopic pregnancy, miscarriage or premature delivery in subsequent pregnancies.
But the picture is not stagnant. Whether for these ethical, economic, or human rights reasons, 27 countries have relaxed laws on abortion since 2000. This is also in line with international treaties signed by the majority of the world’s countries which establish rights to dignity, health, equal treatment, and health – all fundamentally linked to contraception and abortion.
However, legislation, though a pre-condition, is insufficient alone. Rights can only become reality when women have freedom to enact them. Laws are always at the behest of public opinion, or a politician’s pen: Poland has progressively and aggressively narrowed grounds for abortion in recent years.
Where does that leave us? With a fairly linear conclusion, it seems to me. There will never be a happy compromise between the viscerally-opposed pro-life and pro-choice camps. And abortion will always be the most visible and controversial element of a broader taboo surrounding women’s sexual and reproductive health; rights which appear as a challenge to sacred tenets such as the family, the community, religion, virility, or fertility.
Well, so be it. Those rights are inherent to existing first and foremost as a human being, and not just as a mother, wife, or child-bearing instrument. An abortion is already a very difficult and intimate decision. It shouldn’t also be a source of persecution, prosecution, injury, or death. Save (Jane) Roe, indeed.