For most of my career, I have been able to care for women without fear of major complications or death from abortion. However, I have not forgotten those days when safe abortion was generally unavailable. I was delighted when I delivered my first baby in 1968. But at that time in our history, the exciting events of bringing babies into this world were often countered by the tragedies of illegal abortion.
Enough time has passed since the legalization of abortion in the US that it appears much of our society has forgotten the dangers of unsafe pregnancy termination and the desperation of women encountering an unplanned, unwanted pregnancy. It is estimated that approximately 13% of maternal deaths worldwide are due to unsafe abortion. The death rates are even higher in some countries where abortion has been totally banned.
No one has a greater appreciation for the value of human life than those of us who dedicate our lives to the wellbeing of mothers and the delivery of their babies. No other profession has a better knowledge of the complexity of the reproductive process, the potential complications, and the tragic circumstances that can sometimes accompany pregnancy than obstetrics and gynecology. We understand the current science of embryology and factors associated with both normal and abnormal human development. We know and deeply appreciate when a human embryo reaches a stage of fetal development where survivability outside the mother becomes a possibility. We know that a safely performed outpatient pregnancy termination in the first trimester has a complication rate of approximately 0.3%, of which most are minor.
We also know that in many cases, pregnancy termination any time prior to fetal viability is far safer than proceeding with the pregnancy. We respect the ethnic, cultural, religious, social, and moral differences that might factor into a decision to end a pregnancy. Termination of any pregnancy is difficult, but under many circumstances, it is the best alternative for a woman. She has that freedom of choice.
During one of my many trips to Washington, DC, my wife and I took a walk to the Jefferson Memorial. After you enter the memorial, you can read Thomas Jefferson’s passionate words on religious freedom. His words prompt questions that may be answered differently according to the reader’s perspective. Was Jefferson’s expression of separation of church and state intended to entitle persons to make their own religious choices and beliefs within the moral framework of society? Should government interfere in such a personal choice as whether or not to bear a child? A birth certificate legally records our day of birth, but should the government even attempt to arbitrate the debate of scientific versus religious interpretation of the beginning of life?
Somehow, I believe Jefferson would be greatly offended by the current legislative and judicial interference into the highly personal patient-physician relationship. Our specialty of obstetrics and gynecology ardently supports the dignity, rights, and autonomy of all women. I also believe all of us who deliver babies have an intense reverence for life. However, we must not ignore or misinterpret our country’s history of personal freedom and the history of tragic consequences of illegal, unsafe abortion. Those who ignore history are doomed to repeat it.