CHAPTER ONE
THE WELL-KEPT SECRET

Throughout history, wars have been fought, and many people have fancied themselves to have won. But preventing wars, or stopping them, has vast advantages over merely winning them. As those of us in the peace movement have worked hard to show, achieving peace involves taking everyone's thoughts and feelings and well-being seriously, especially those of the opponents.

Having gone through the exercise of listening to the real-life experience of doctors and nurses involved in providing abortion in the United States, I have come to the conclusion that the abortion business is too fragile to last. In this book, I take a preliminary look at the psychology and social dynamics of performing abortions.

Though more study and the passage of time will tell whether this is right, I will risk making the following prediction: the abortion business is weakening, this downturn can't be stopped, and the American public for the most part will not be sad to see it go.

Politics won't settle the issue. Achieving peace doesn't mean scoring a victory over opponents. Only when everybody's well-being is realized will we get peace. And peace is coming.

THE PLUNGE

Is the abortion business in a state of decline? Time ran a cover story on this very point as early as May 4, 1992: "While there are about 2,500 places around the country that provide abortions -- down from a high of 2,908 ten years ago -- they are mostly clustered around cities, leaving broad areas of the country unserved . . . for a glimpse of the future, look at Mississippi. Three of the state's four clinics are clustered around the capital and largest city, Jackson. But their survival is threatened . . ."

Indeed, their survival was threatened. One of the major doctors who performed abortions, Thomas Tucker, had his license suspended and later revoked. The reasons for this become obvious in light of the remarks of Joy Davis, a former employee of Dr. Tucker's, which will be used throughout this book. A New York Times report (April 24, 1994) cited that "he was found to have kept signed prescription forms, and to have allowed workers who were not doctors to perform preliminary abortion procedures while he was absent. The eight-member State Board of Medical Licensure, whose members harshly criticized the doctor before the vote, took little more than an hour to reach its decision."

The report attributes the problems to the fact that he "travels between his clinics here and two in Alabama, performing as many as 150 abortions a week himself. The members of the board suggested that the doctor's work had suffered because of this strenuous pace."

Avoiding a strenuous pace, of course, would require more doctors performing abortions to spread the load.

At the time of the 25th anniversary of Roe v. Wade, it was widely reported in the media that 60% of doctors who do abortion are 65 or older. More abortion doctors are closing in on time to retire, and the new doctors to take their place are coming in very low numbers. Without an infusion of new providers, attrition alone will deal a deathly blow to the sustaining of the abortion business.

A 1993 survey of abortion doctors done by "Project Choice" showed 71% of those practicing abortion claim to have witnessed an illegal abortion tragedy, and two thirds of those claim that as a major motivating factor in continuing to provide abortions. That motivation is almost entirely absent now. Young doctors are much more likely to have witnessed negative medical or psychological after-effects from legal abortion. That might serve as a motivator to those who think they can be better and more professional than the ones who caused the problem they witnessed, but it's more likely to dampen enthusiasm for going into the field.

The New York Times even suggested in an editorial on October 13, 1994, that as abortion providers get more scarce, they also tend to be seedier. Young doctors see that doctors who do abortions get little respect. Nor is it terribly comforting to be one of only a very few people, as the numbers dwindle. The Times dealt with the subject of dwindling abortion doctors in a lead article of 13 pages on January 18, 1998; only 12% of OB-GYN programs routinely teach abortion and all indications are it is "trending down."

How have things gotten to this state? This was not how legalized abortion was supposed to work.

ODDITIES

The Washington, DC Yellow Pages has carried a one third page ad for an abortion clinic, Prince George's & Germantown Reproductive Health Services, that said, "We treat all our patients with kindness, courtesy, justice, love and respect." That had to be stated? What other kind of clinic feels it necessary to assure potential clients of this? Wouldn't it ordinarily be assumed?

In addition to the fact that it's a surgery that people attack or defend, abortion is distinguished from ordinary medical care by many oddities. It's remarkably centralized, since most of it occurs in clinics devoted to abortion as their major function. Patients ordinarily know their doctors before surgery and get follow-up care from those same doctors, yet this is unusual in abortion practice.

Health safeguards are fewer. For example, 60 Minutes did a piece called "Suzanne Logan's Story," about health hazards at a Maryland clinic. Ms. Logan was brain-damaged and would spend the rest of her short life in a nursing home due to anesthesia complications. She died there on December 1, 1992, after the story ran. The report showed her attorney, Patrick Malone, saying:

"The anesthesia was given without any monitoring whatsoever, without an anesthesiologist present, without a nurse anesthetist present, without the normal safeguards that are part of standard modern American medical care. I've seen a lot of cases, and met a lot of doctors, and reviewed a lot of records, and I've never seen anything like this."

New York State officially ranks its heart surgeons as a consumer service. Yet New York allowed abortion doctor Abu Hayat to maim several women before prosecuting him. According to a May/June 1993 article in Ms. magazine entitled "Back-Alley Abortions Still Here For the Poorest Among Us," they excuse themselves on the grounds that they have inadequate resources to monitor these doctors.

These doctors deal only with women, doing something unique in female biology. Abortion is done mostly by men, exclusively on women. Large numbers of women get abortions, and especially in New York it's one of the most common surgical procedures. Yet monitoring resources go elsewhere. The decision on where those resources go is made on some basis other than frequency or need.

Many abortion clinics have counselors whose pay is incredibly low. They are often given no training, except in telemarketing and sales effectiveness. Group counseling, when done, is one time, and it discourages questioning.

Charlotte Taft, at the time the administrator of Routh Street Clinic in Dallas, said this in a taped telephone conversation: "In most clinics, the doctor is pretty much the technician. We do the counseling, we do the blood testing, we do the sonogram, and then the doctor sees the patient for the abortion. And for many reasons, that's cost effective, and you need to do that in order to keep the cost low. It does mean that the doctor's interaction with the patient is very limited. So they don't get a lot of the goodies that you get when you're in a relationship. They get to go inflict pain on someone for five minutes. That's a tricky piece."

RARELY HEARD: ABORTION BUSINESS MISERY

What explains these conditions? Why are abortion doctors so different?

Can the answer be found in the emotional impact of doing abortions on the people who do them? There is enough written and said by them to show that this is, in fact, no ordinary medical procedure. What they say shows that the peculiar nature of their work goes far beyond the fact that it gets picketed so frequently.

The reaction to the work itself is examined in an article written in the American Medical News, put out by the American Medical Association, which reports on a meeting of the National Abortion Federation. It says that the discussions "illuminate a rarely heard side of the abortion debate: the conflicting feelings that plague many providers . . . The notion that the nurses, doctors, counselors and others who work in the abortion field have qualms about the work they do is a well-kept secret."[1]

In a paper given by Dr. Warren Hern to the Association of Planned Parenthood Physicians, he says of his staff, "Attitudes toward the doctor were those of sympathy, wonder at how he could perform the procedure at all, and a desire to protect him from the trauma. Two felt that it must eventually damage him psychologically."[2]

In this case, he was referring to late-term abortions. But it's not ordinary for medical staff to regard surgery as a trauma. Dr. Hern is still an abortion specialist at this writing, and he gave this paper in front of other abortion specialists.

Another example comes from the article in the American Medical News, which states:

A New Mexico physician said he was sometimes surprised by the anger a late-term abortion can arouse in him. On the one hand, the physician said, he is angry at the woman. "But paradoxically," he added, "I have angry feelings at myself for feeling good about grasping the calvaria, for feeling good about doing a technically good procedure which destroys a fetus, kills a baby.

This doctor is angry at his own patients, and he is angry at himself. Doctors are not ordinarily angry at themselves for doing their work well. The way he worded the problem gives an unmistakable clue as to why this would be, but only hints at the complexity. There seem to be some negative emotions that have not been explored.

Those emotions don't seem to be being dealt with in a normal way. Group support, a sense of accomplishment, and appreciation from the society as a whole aren't lacking entirely, but they seem to be inadequate for the needs of these doctors and nurses and other staff.

Charlotte Taft put it this way: "Physicians are isolated in many levels. They're isolated in their own field, because abortion providers are isolated. We haven't really done a very good job of making the physicians who work with us really feel connected . . . They're isolated in terms of the medical field, because as you well know, it's been marginalized as a sub-specialty of gynecology . . . And then there's the social isolation that happens when someone is scared to tell what they do . . . These guys are pitiful."

Pitiful? That doesn't seem to fit the rhetoric of what abortion defenders say is supposed to happen when abortion is legal and accessible.

LOOKING AT AFTERMATH

Defenders of abortion believe that it's a form of medicine, and should be treated like other medical practice. Opponents of abortion believe it to be killing.

If abortion is the taking of a human life, and therefore is violence, then certain psychological consequences could be expected among those who perform abortions. Human history is tragically full of instances of massive violence, and therefore we have knowledge of what those kinds of reactions might be. We will look at this in the next chapter.

If we find no such aftermath, the case that abortion is not violence at all is strengthened.

If those reactions can be found, what then? Can the United States, with its abundance of abortions, provide evidence for such a problem? Are there other negative emotions that also interfere with the smooth functioning of the practice, and account for its oddities? If so, it could help to explain a decline and predict an eventual fall.

The rest of this book will be making a case for the prediction that this has started to happen, will continue to happen, and probably can't be stopped.

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