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Reproductive Rights and Health: Time for New Commitment

In California, reproductive choice has long been considered relatively safe, due in no small part to our elected leadership -- many of whom happen to be women. Is that coincidence? I doubt it.
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"When the Supreme Court voted to legalize abortion and, in my words, bring it out of the backwoods and put it in the hospitals where it belongs, I thought it was a great, great decision." - Betty Ford, R.I.P.

Three decades ago, medical and public health students at UCLA were sometimes taken on a tour of an old hospital ward, previously dedicated to women suffering the aftereffects of illegal abortions. I believe there had been something like 70 beds then and the veteran professor who guided us on the visit said that until 1970, when abortion was legalized in California, the ward was always full of suffering and dying women. "We used to have to mop their blood from the floors here -- it reminded me of serving in World War II," said the old doctor. After the laws changed, the ward quickly emptied out and was no longer needed.

That historical lesson stuck with me as no lecture could -- as the professor likely intended. Whatever other issues I worked on, for many years I tried to make some positive contributions regarding reproductive health and rights. I joined the dedicated people working at Planned Parenthood for years, and reviewed research proposals for the Alan Guttmacher Institute, a superb source on all things concerning reproductive health. With some colleagues, we staged a "smuggling" of the so-called "abortion pill," then called RU486, into the United States, a stunt which landed on the front page of the New York Times and spurred newly-elected President Clinton to vow to legalize the medication -- already available in Europe and favored by the AMA here. Approval for American women took years but was accomplished. After that, we twice mailed brochures describing the importance of legal abortion to all of the over 60,000 American medical students -- for reproductive choice means little if there are not enough accessible services, as is too often the case in many areas of our country.

There was much other "pro-choice" work, but why recount all this here? Because as I survey the current reproductive health arena, I find myself becoming depressed. Did any of these efforts by abortion rights advocates have lasting impact? I am no longer sure -- which is very disheartening. Prospects now can seem grim. Many of the leading Republican presidential candidates are vowing to restrict access to abortion any way they can, including by overturning the landmark Roe v. Wade decision that legalized abortion nationwide. Until that might occur, anti-choice politicians are chipping away at women's rights; the number and variety of new laws aimed at restricting abortion has accelerated in recent years, as detailed by Guttmacher.

What must be stressed is that any "success" of these laws is purely political in both cause and effect -- there is little to no evidence that they will actually decrease abortions, but will only make them harder and more expensive to attain, and also more dangerous to the pregnant women who desire and need them. Even the horrible murder of doctors did not "save" anyone or anything. The increasing restrictions on later-term abortions only impact a small minority of pregnant women, but in potentially tragic ways. Making a safe abortion more difficult and costly to find is simply cruel and counterproductive. Forcing women to give birth to children is not good for anyone, and adoption has never come close to providing enough loving homes and families for every unwanted child.

Here in California, and especially in the Bay Area, reproductive choice has long been considered relatively safe, due in no small part to our elected leadership -- many of whom happen to be women. Is that coincidence? I doubt it, for as renowned lawyer and feminist Florynce Kennedy once quipped, "If men could get pregnant, abortion would be a sacrament."

The numbers of abortions have been declining for some time in many places. There are multiple reasons for that, but researchers do know how to progress towards the ideal of abortion being "safe, legal, and rare." The equation includes good fact-based sex education, accessible contraception, and resources for adoption if that's what an informed pregnant woman chooses -- based on facts, not on biased information from deceptive "clinics" such as have sprung up nationwide, including in San Francisco (and which Supervisor Malia Cohen proposes to hold to more truthful standards). And not only is real family planning effective in health terms, but it's also cost-effective, saving at least triple the amount of funding spent on it, public dollars or otherwise, by preventing the need for more expensive services later. But it seems devout anti-choice advocates don't seem to care much about all that.

Of course, if I really believed that that the embryos or early fetuses that account for the vast majority of abortions were full-fledged "babies," I'd likely be opposed to abortion in most cases too. But such a status is not supported by science, medicine, historical practice, or public opinion -- it largely comes from religious conviction. And that is not a basis for law in our land, especially when it endangers living, breathing women. Pragmatism must rule policy, and history's evidence is that banning abortions results in increased suffering, not less.

The majority of Americans believe that a pregnant women and her physicians should be the ones to decide what is best for them. Most of our relevant laws still reflect that. Perhaps I, and maybe others, had fallen into a bit of complacency that the fundamental battles had been won for good; maybe it was fatigue. But now, when I read of all the ill-advised restrictions noted above, about politicians seeking to "reform" healthcare by gutting services for poorer women and children, and knowingly lying about, say, Planned Parenthood's commitment to reproductive health (and then blithely saying the accusations were "not intended to be a factual" when exposed), and on and on, I can't help but recall the bloody image of that closed women's ward, and vow not to let such a place again become necessary. So, I hope others will join me in re-pledging support for those who provide essential services, and advocacy, on behalf of women. A few good options are below. Join them, and many people, including me, will thank you.

Medical Students for Choice

Physicians for Reproductive Choice and Health

NARAL Pro-Choice America

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