Footnotes for "Amicus Brief in Webster v. Reproductive Health Services" by Christine Torre, et al.

1. Roe, 410 U.S. 148-152, 163.
2. W.M. Hern, M.D., Abortion Practice, 101 (1984) (emphasis supplied.)
3. Thornburgh v. American College of Obstetricians and Gynecologists, 476 U.S. 747 (1986) and Akron v. Akron Center for Reproductive Health, Inc. 462 U.S. 416 (1983).
4. A small sampling of these testimonies is included in this Brief. For the Court's convenience, Amici have compiled hundreds of additional testimonies of abortion victims in the volume lodged with this Brief entitled "Rachel Weeping." Testimonies of members of Women Exploited by Abortion are included in D. Reardon, Aborted Women, Silent No More (1987), copies of which have also been lodged with this Brief. Additional testimonies of aborted women are contained in Appendix D to the Brief Amicus Curiae of Focus on the Family and the Family Research Council.
5. Documentation of legal abortion deaths has been included in the volume lodged with the Court under the caption "When Legal Means Lethal." Amici have documented only a small number of the legal abortion deaths which have occurred throughout the Nation, and have focused on a study of the abortion industry in one urban area, Los Angeles, California, which is thought to be representative of the manner in which abortions are performed in most other urban areas in the United States.
6. Thornburgh, 476 U.S. at 833 (O'Connor, J., dissenting).
7. D. Horan & T. Balch, "Roe v. Wade, No Justification in History, Law or Logic," in Abortion and the Constitution 58 (1987) (hereinafter "Abortion and the Constitution").
8. Id. (citations omitted).
9. Akron, 462 U.S. at 456 (O'Connor, J., dissenting) (citation omitted).
10. Cox, The Role of the Supreme Court in American Government, 114 (1976).
11. There was by no means unanimity of opinion in the medical community regarding this "fact" in 1973. Ely, "The Wages of Crying Wolf: A Comment on Roe v. Wade," 82 Yale L.J. 920, 942, n. 117.
12. As Justice O'Connor's powerful dissents in Akron and Thornburgh point out, even the types of regulation supposedly permitted in Roe failed to pass constitutional muster as new medical "findings" by the Court invalidated regulations previously thought to have been constitutional. Thornburgh, 476 U.S. at 828-33 and Akron, 462 U.S. at 452-72.
13. Hilgers & O'Hare, "Abortion Related Maternal Mortality: An In-Depth Analysis," in New Perspectives on Human Abortion 69-91 (1981).
14. While there are certain medical risks associated with pregnancy and childbirth, studies examining maternal mortality and morbidity "arise primarily from a small group of high risk patients." A. Saltenberger, Abortion Choice or Chance? 62 (1987) citing "Most Mother Child Mortality Seen in Small High-Risk Group," 16 Ob. Gyn. News, 13, May 15, 1981. Yet, the vast majority of abortions are performed on young women who are not aborting due to medical risks. Thus the women and young girls who are most likely to obtain an abortion are those less likely as a group to be at risk for medical complications associated with pregnancy and childbirth. See Appendix C "Abortion in America" in Brief Amicus Curiae of Focus on the Family and the Family Research Council.
15. Abortion and the Constitution, supra at 77 quoting Comment, "Technological Advances and Roe v. Wade: The Need to Rethink Abortion Law," 29 UCLA Law Review 1194, 1199, n. 41 (1982).
16. Kaunitz, "Causes of Maternal Mortality in the United States," 65 Obstetrics and Gynecology (May 1985); see, e.g., Manaskie v. Rosenblume, No. 15028-83 (N.Y. 1983) in 4, No. 2 Medical Malpractice Verdicts, Settlements and Experts (Feb. 1988) ($75,000 verdict for 24-year-old woman who suffered a vaginal tear and a ruptured cervix during a first trimester abortion and suffered two miscarriages thereafter) and testimonies of women included in this Brief.
17. One study has indicated that the medical risks of abortion taken together produce an immediate complication rate of ten percent--that is, physical complications of abortion in 300,000 women annually. Frank, "Induced Abortion Operations and Their Early Sequelae," 35 J. Royal College of General Practitioners 175-180 (April 1985).
18. See, e.g., McNair v. Rubin, No. 4492-81 (N.Y. 1988) reported in 4, No. 2 Medical Malpractice Verdicts, Settlements & Experts (Feb. 1988) ($701,500 verdict for estate of 24-year-old mother of two who died of amniotic fluid embolism after a second dose of saline solution to induce abortion).
19. A. Saltenberger, What Every Woman Should Know About Legal Abortion 28-32 (1982) (hereinafter "Legal Abortion"). See R. Castadot, M.D., M.H. P., "Pregnancy Termination: Techniques, Risks, and Complications and Their Management," in Fertility and Sterility 5 (1986) (hereinafter "Castadot"); G. Wulff, Jr., M.D. FACOG and S. Freiman, M.D., "Elective Abortion Complications Seen In a Free-Standing Clinic," 49, No. 3 Obstetrics and Gynecology 351 (1976); A. M. Kimball "Deaths Caused by Pulmonary Thromboembolism After Legally Induced Abortion," 132(2) Am. J. Ob. & Gyn., 169-74 (Sept. 15, 1978).
20. Castadot, supra at 13.
21. Castadot, supra at 10, citing C. Tyler, Jr., "Epidemiology of Abortion," 26 J. Reprod. Med. 459 (1981).
22. Some critics of non-hospital abortions maintain that because a free-standing clinic may lack blood banks, a staff skilled in resuscitation, and surgical facilities to deal with emergencies that the risk of death and morbidity may be higher in non-hospital abortion. Legal Abortion, supra at 39. Lack of adequate resuscitation equipment may contribute to a greater number of anesthesia and analgesia deaths outside a hospital setting. Id. citing D.A. Grimes, "Comparative Risk of Death from Legally Induced Abortion in Hospitals and Non-Hospital Facilities," 51 Ob. & Gyn. 323-326 (March 1978). Query whether some of the legal abortion deaths at the Inglewood Abortion Clinic and Hers Medical Clinic in Los Angeles discussed below might have been prevented if they occurred in a fully equipped medical center?
23. Doe v. Bolton, 410 U.S. 179, 193-95 (1973) (striking down a Georgia statute requiring hospitalization for all abortions).
24. Doe v. Bolton, 410 U.S. at 91-92 (citation omitted, emphasis supplied).
25. See D. Reardon, Aborted Women, Silent No More (1987) (the culmination of three years of research and interviews with aborted women).
26. Adapted from A. Saltenberger, The Threat of Abortion: When Legal Means Lethal (1978).
27. The Center for Disease Control has made some sweeping claims for the "safety" of legal abortion. One spokesman for the CDC was quoted as saying that "[i]t is one of the safest surgeries performed." The Abortion Dilemma, Press-Telegram (Special Reprint of Articles appearing July 14-22, 1985) at 10, col. 1.
28. Other legal abortion deaths are also described herein and in the volume entitled "Rachel Weeping" which has been lodged with this Brief. The inherent dangers of death from legal abortion are also demonstrated by the death of Diane Boyd in October 1981 after an abortion performed at Reproductive Health Services, one of the named plaintiffs in the instant case. Diane Boyd, a 19-year-old retarded black woman who underwent a court ordered abortion at the plaintiff clinic died of cardiac arrest after the administration of the drugs Sublimaze and Valium. "Clinic Didn't Study Records Before Abortion, State Says," St. Louis Globe Journal, Nov. 10, 1981, at 3A; "Clinic Declines Comment on Abortion Death Report," St. Louis Globe Democrat, Nov. 11, 1981, at 6A.
29. These included the dispensing of medication not ordered by physicians, failure to sanitize reusable items between uses, not following proper infection control techniques, failure to keep an operation register that would detail complications suffered by patients, and overcrowding in the recovery room which allegedly often held four patients when there was only enough equipment to monitor two patients. "State Again Finds Violations at Inglewood Abortion Clinic," Daily Breeze, May 14, 1985, at 1B, col. 1
30. "'Battlefield Conditions' Reported at Hospital in Inglewood," Los Angeles Times, Dec. 3, 1987, at pt. II, 8, col. 4.
31. At least two other young black women died after abortions at Inglewood--23-year-old Cora Mae Lewis in 1983 and 22-year-old Yvonne Tanner in 1984.
32. "'Battlefield Conditions' Reported at Hospital in Inglewood," Los Angeles Times, Dec. 3, 1987, at pt. II, 8, col. 4. A complaint was made by County-USC Medical Center that the abortion clinic had transferred its patients in unstable condition and without notice to the Medical Center's emergency room, in violation of a federal law against "dumping" patients in emergency rooms.
33. See When Legal Means Lethal in the volume lodged with this Brief.
34. Ibid. It is common practice for abortionists to "rush" through abortions in two to five minutes, despite the increased risk of cervical trauma and uterine lacerations resulting from such practices. See note 43 infra.
35. See, "When Legal Means Lethal" in the volume lodged with the Court. The highly inflammatory remarks attributed by several newspapers to Dr. Edward Allred, owner of the largest chain of abortion clinics in California, had caused some to attribute the abortion deaths of several Black and Hispanic women to racial prejudice. "On the Edge of the Racist Pit," The Daily Californian, October 14, 1980, at 4B, col. 1. "Doctor Labeled 'Racist' in Abortion Suit," at B-1, col. 1 (describing a $14 million lawsuit filed against Dr. Allred in connection with the abortion death of 16-year-old Patricia Chacon in which it was alleged that Chacon had "received substandard medical treatment as a result of her race and ancestry, rather than medical treatment based on her . . . condition and needs," id. at col. 2, quoting Jack Schuler, attorney for Patricia Chacon's parents). The following remarks upon which the allegation was made had been attributed to Dr. Allred in a story which appeared in the San Diego Union: "Population control is too important to be stopped by some right-wing pro-life types. Take the new influx of Hispanic immigrants. Their lack of respect of democracy and social order is frightening. I hope I can do something to stem that tide; I'd set up a clinic in Mexico for free if I could. Maybe one in Calexico would help. The survival of our society could be at stake. . . . The Aid to Families With Dependent Children program is the worst boondoggle ever created. When a sullen black woman can decide to have a baby and get welfare and food stamps and become a burden to all of us it's time to stop. In parts of South Los Angeles having babies for welfare is the only industry the people have."
    - "Doctor's Abortion Business is Lucrative," San Diego Union, B-1, col. 1 (Oct. 12, 1980). Dr. Allred's aversion to government subsidies did not prevent him from collecting approximately $3 million in public subsidies in 1980 for performing abortions. Dr. Allred's statements reflect the same philosophy as demonstrated by Margaret Sanger, the founder and heroine of Planned Parenthood when she said "[t]he most successful educational approach to the Negro is through a religious appeal. We do not want the word to go out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members." E. Drogin, Margaret Sanger, Father of Modern Society 33 (1986), citing Gordon, Woman's Body, Woman's Right: A Social History of Birth Control in America 33 (1976).
36. "Hospital Shut Down As Health Risk Will Reopen For Abortions Tomorrow," Los Angeles Herald Examiner, Feb. 12, 1988, at A-1, col. 1 and A-15, col. 1 (quoting Los Angeles County's supervisor of hospital inspections as saying "It does seem sort of silly though doesn't it? If they're so unsafe they can't keep their [hospital] license, why should they be able to operate as a clinic?").
37. "For Three Women A Safe Medical Procedure Turned Deadly," Los Angeles Herald Examiner, Feb. 22, 1988, at 1, col. 3.
38. Id. at A-7, cols. 2-3.
39. Id., at A-7, cols. 4-6.
40. Thornburgh, 476 U.S. at 765-68 (refusing to recognize that the information which the Pennsylvania legislature required be reported to Pennsylvania public health officials concerning physical complications of abortion serves the legitimate goal of advancing the state of medical knowledge concerning maternal and fetal health).
41. See the discussion of exploitative practices by the abortion industry in Section 11, infra, J. Wilke, M.D. & B. Wilke, Handbook on Abortion, 78-80, 89 (1979). See also Pamela Zekman and Pamela Warrick, "The Abortion Profiteers," Chicago Sun Times, special reprint Dec. 3, 1978 (original publication Nov. 12, 1978). Zekman and Warrick reveal how undercover investigators in abortion clinics found that clinic employees routinely checked off "no complications" before the surgery was even performed."
42. State of California, Department of Vital Statistics, Death Records, Table A-2, Maternal Deaths By Selected Causes of Death, California, 1960-1984 (By Place of Residence) in California Vital Statistics (1986). It is clear that the Department of Health Services either knew nothing of the deaths which occurred in 1983 and 1984 when it issued its report, or for some other reason simply did not report them as abortion deaths. In either case, this is but one example of the underreporting of deaths from legal abortion which takes place across the Nation, and is illustrative of why conclusions drawn from the current data cannot be relied upon. Failure to report abortion deaths is not limited to California. In an investigation of only four abortion clinics of the twenty operating in Chicago in 1979, the Chicago Sun Times uncovered 12 unreported abortion deaths. Aborted Women at 109 (citation omitted). Even when previously unreported abortion deaths such as those that occurred in Chicago and Los Angeles are uncovered, they are generally not included in the 'official' total since they were not reported as such on the original death certificate. Id. at 109 citing Wilke, Handbook on Abortion 81-92 (1979).
43. Roe, 410 U.S. 163-166 (stating that the abortion decision was to be made "by the physician after consulting with the woman considering an abortion . . . the abortion decision is inherently, and primarily a medical decision and basic responsibility for it must rest with the physician").
44. Doe v. Bolton, 410 U.S. 179, 191-192 (1973), citing United States v. Vuitch, 402 U.S. 62, 71-72 (1971).
45. See statement of former abortion provider appearing in the Appendix at p. 27a.
46. Allred "likes to spend no more than five minutes on each abortion," and "is proud of having eliminated needless patient-physician contact." "Doctor's Abortion Business is Lucrative," The San Diego Union, A-3, col. 6 and A-14, col. 4 (Oct. 12, 1980). See statement of former abortion provider appearing in the Appendix at p. 27a.
47. "Doctor's Abortion Business is Lucrative," The San Diego Union, Oct. 12, 1980, at 3A, col. 5-6 at A-3, col. 5-6.
48. Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 67 (1976).
49. Thornburgh, 476 U.S. 747 (1986) and Akron, 462 U.S. 416 (1983). In Akron, the Court struck down a provision requiring information regarding the status of the pregnancy and fetal development, holding that, although the States might legitimately further an interest in preferring childbirth over abortion, the Akron ordinance, by requiring specified information, restricted access to abortions. 462 U.S. at 444, n. 33.
50. Information regarding fetal development is clearly within the scope of the medical information to which women should have access in order to give their informed consent to an abortion. Logic, as well as attention to the testimony of countless women who have undergone abortions, dictates that severe emotional and psychological trauma may result when a woman undergoes an abortion without a clear understanding of the nature and development of the child to be aborted and discovers this information after the fact. Nonetheless the Thornburgh court obviously feels women have no right to know this information if its effects may be "inflammatory" 476 U.S. at 762, n. 10, if it may cause her "anxiety," 476 U.S. 762, or horror of horrors, if it may "persuade her to withhold [her consent] to the abortion" 476 U.S. at 762. The essence of informed consent is the provision of precisely this kind of information, which has the capacity to influence a patient's decision regarding a proposed medical or surgical procedure. Many of the testimonies of aborted women set forth in this Brief, in the Appendix, in the volume lodged with the Court and in Aborted Women have a recurring theme--if only I had known that my baby was alive, what my baby looked like, I would never have chosen abortion.
51. See autopsy report, along with the follow-up investigation into Baby Arias' mother's abortion in the volume entitled "Rachel Weeping" which has been lodged with this Brief.
52. Id.