Category Archives: Abortion

Abortion Politics and Mini-Storage – Strange Bedfellows?

That’s a real billboard up there, one that’s creating a lot of controversy here in Manhattan. I happen to like it, although I wonder how I’d feel if the other side started putting up similar ads.

Manhattan Mini-storage ad’s have been raising eyebrows for some time now. Previous billboards have had such slogans as:

“Your closet’s so narrow it makes Cheney look liberal”

“Your closet’s scarier than Bush’s agenda.”

And my personal favorite –

“Your closet’s so shallow, it makes Paris look deep.”

What do you think? Should Manhattan Mini-Storage be allowed to mix politics and advertising?
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(Photo from Gothamist)

The Next Generation of Abortion Providers

An insighful article by Stephanie Simon in the LA times explores the reasons why some young doctors are gravitating to the field of family planning. It’s a career choice driven by passion, politics and a committment to choice.

I found that the sentiments of one young doctor interviewed in the article echo those that I felt years ago when I first decided to enter the field of Ob-Gyn….

…young doctors-in-training have found their own motivation to enter a field that they know will put them at risk of isolation, harassment and hatred. For them, doing abortions is an act of defiance — a way of pushing back against mounting restrictions on a right they’ve taken for granted all their lives.”It’s like when your big brother says you can’t do something,” Lederer said. “That just makes you want to do it even more.”

Most of these students are members of Medical Students For Choice, a group who’s motto is “Without providers, there is no choice”. How true.

Simon states in her article that there is no straight path to becoming an abortion provider. Actually, there is – a family planning fellowship. These comprehensive programs are at some of the best medical schools in the country, and combine family planning and abortion training with clinical and epidemiologic research and a master’s degree in public health. The fellowships are an important bridge between the provision of family planning services and the public health aspects of the field.

The intimidation of physicians being perpetrated by this government appears to be serving as a catalyst for some young men and women to enter a field that can only get tougher. They deserve our gratitude and support.

Today’s Health News from TBTAM

These news stories came my way today via my list servs and friends (thanks, Susan!).

Texas Legislators vote down mandatory HPV vaccine.

In a 135-to-2 vote that appeared veto-proof, the Texas House gave final passage on Wednesday to a Senate bill that bars the state from ordering the shots until at least 2011. Even many supporters of the governor resented Mr. Perry’s proposal as an abuse of executive authority.

It was the right thing to do. The push for mandating the vaccine was coming from Big Pharma, and not the healthcare community.

BTW, Did you notice the Gardasil ad aimed at teenage girls on American Idol this week? Direct marketing to teens! I had a patient who says her daughter is wondering if she should get the vaccine because her friends “are all getting it”. Who would have predicted that a vaccine would be the new teen trend? Maybe they could combine it with a tatoo….
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New York Governor Elliot Spitzer proposes legislation to strengthen abortion rights in my home state.

Mr. Spitzer’s proposal would remove abortion from criminal statutes and make it a matter of professional and medical discretion. It would also repeal an old statute “that criminalizes, among other things, providing nonprescription contraception to minors,” according to the governor’s office..

While the proposed legislation will not change the new laws, it will create an environment in New York where doctors can feel freer to practice medicine that does not place their patient’s health in conflict with their own fear of recrimination .
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We’re all on the take from Big Pharma.

Nearly 95 percent of physicians in the United States receive free food,beverages, drug samples, sports tickets or other benefits from drug company sales representatives eager to influence their prescribing habits, according to a report today in the New England Journal of Medicine.

I stopped seeing reps this past year, and haven’t missed ’em. I admit, I still take lunch when they show up to see the docs who practice down the hall. I think I’ll stop that now.

Abortion and Breast Cancer – Once Again, There is No Link

Once again, a well-done study, this time a prospective cohort study from the Nurse’s Health Study, has failed to reveal a link between abortion and breast cancer. The findings were published in the Archives of Internal Medicine this week.

This study joins the ranks of a myriad of other well-done studies showing the same thing. To top it off, a large workshop convened at the National Cancer Institute in 2003 found no causal link between abortion and breast cancer.

And yet, if you were to google “abortion and breast cancer” or “breast cancer and abortion”, almost every result in the first 10 pages of the search results are links to non-medical sites stating that there is a causal link between abortion and breast cancer. The only exception is the NCI’s fact sheet on the topic, and occasional news articles about the “controversy”, which give equal voice to the facts and those who would distort the data for political reasons.

This is where the web’s power breaks down as far as I’m concerned. Those who know how to can manipulate the web so that a search for real medical data becomes akin to finding a needle in a haystack.

Here are just two links to information on this topic from reputable medical organizations:

National Cancer Institute Fact Sheet on Breast Cancer Risks

American Cancer Society Information on Breast Cancer Risks

and a good article by CNN:

Harvard Study Latest to Discount Abortion -Breast Cancer Link

I challenge those of you who value scientific opinion and review over politics to blog about this topic and to provide your readers a link to one of the above information sites on your blog. Let’s give these sites the hits they deserve and get them their well-deserved place on a google search.

Women deserve nothing less.

Making Choices

I was in my third year of medical school working on the abortion service.

In those days, women were admitted to the hospital the night before their abortions in order for laminaria to be inserted. Overnight, these dried seaweed rods would moisten and swell, slowly stretching the cervical opening so that the procedure could be performed the next day without the need for dilating the cervix manually, thus decreasing the risks of tearing and bleeding.

It was a busy service, with upwards of twenty procedures a day, two days a week. We med students were assigned to do the admission histories.

I remember sitting with woman after woman while they told me their stories. A young teenager who had fallen for an older man, a man who had loved her, left her pregnant and was now nowhere to be found. Another, a haggard, tearful woman in her thirties, was adamant that her husband would never know that she had gotten pregnant the night that he came home drunk, beat and then raped her.

There was the newly recovered drug addict just getting her life together, still hoping to get her three children back from foster care. And the mother who had five children at home and was waiting to hear whether her sister would be able to stay with them tonight. Still another teenager, this one accompanied by her mother, who said nothing but never left her side.

Each decision to abort these pregnancies appeared to have been painfully made, and none was casual. Every one of these women had mixed emotions about what she was doing, and yet every one had a conviction that this was her only choice at this point in her life. The teenager seemed a bit less sure of herself, but she reiterated to me that this had been her own choice, and Mom was still hoping she would change her mind. It was her second abortion, and she would not tell me the circumstances of her becoming pregnant.

At one point, all the women were told to undress, put on their hospital gowns and meet in the patient lounge to hear about their procedure from the chief resident, who would then examine them one by one in the small exam room next door and insert their laminaria.

“Tell them to leave their underwear in their hospital rooms”, he told me.

“What?” I cried. “You mean they are all going to sit there completely naked under their gowns while you stand there in your white doctor’s coat and tell them as a group what to expect tomorrow? Can’t they at least wear their underwear?”

“I don’t have time to wait for them to take them off”, was his answer.

“But it demeans them…” I started.

In a tone of voice that told me I had already gone too far, he said simply “Just do it.”

So I did. I was, after all, just a medical student. And he was my chief.

But at that moment, I made my choice as to what I would do when I graduated. If this was how the men who worked in this field treated women, well, then we women needed to become gynecologists and start treating women as something other than cattle.

I also decided that day that I was pro choice. I wasn’t sure if I would do abortions, but I knew that if this was the world that women were living in, then this option had to be available to them until we had something better.

Later on, I would come to realize that the something better is safe and effective contraception, sex education, childcare, family-friendly work environments, healthy male-female relationships, child support and education. Of these, the one that I believe is most within our reach today is safe and effective contraception, and that is where I have concentrated my efforts. I subscribe to the belief that abortion should be safe and available, but rare. Unfortunately, those who most vehemently oppose abortion also oppose contraception, and seem to want to assure that abortion remains anything but rare.

In my career, as it turned out, I would butt heads more than once with the men who supervised me. But I would never again encounter such a blatant misogynistic attitude among any of the ob-gyn’s I was to meet. Sure, there were a few jerks, but also some not-so-nice women. And I will go on record as saying that many of the very best gynecologists I know are men, including those to whom I refer my friends and family.

I don’t know that we women gynecologists have changed this field as much as I thought we would. I think we are too busy just getting the work done. The field has changed most, I believe, in response to our patients and their advocates, who persistently raise the bar for all of us docs, men and women alike. And continue to demand reproductive choice.

So keep up the pressure, Ladies… We need your voice.

Doing the Work that Has To Be Done

I was asked by a colleague the other day if I would be willing to head the medical advisory committee of which I am currently a member. The committee is part of a large organization whose mission includes provision of family planning services. As chair of the committee, I’d have some additional responsibilities, and would have to start attending board meetings for the organization, in addition to the twice yearly advisory committee meetings I already attend.

I don’t like to spending evenings away from family, and try to limit outside responsibilities as much as possible. I never go to drug company dinners, resent my boss for making me join our local medical society (which has monthly dinner meetings), and aside from my voice lesson and choral rehearsal (which I combine on the same night once a week) have no outside evening activities. I told my colleague that I’d think about it and get back to her, because I didn’t think it was nice to say no right away. I promptly forgot our conversation.

A few days later, I was privileged to listen to an esteemed gynecologic oncologist give a lecture about his life’s work. Amidst his tales of the lab, the operating room and the chairman’s office, he told us stories of the old days before abortion was legal. In those days, the hospital wards were packed with septic abortion patients. He told us how many lives they saved by not waiting for cultures to diagnose clostridial sepsis. They used to mix the patient’s secretions with milk right there in the ER, and look for bubble formation (clostridia is a gas forming bacteria). He told of how he stayed up all night long in the ICU with women who had attempted self-abortion with lye, only to have them die in the morning despite all his efforts. And although he had enormous responsibilities in his specialty, he served for years on the board of his local Planned Parenthood. “It was just something I felt I had to do”, he said. “I hope you never live to see the things I saw”.

That same night, I learned that South Dakota has passed a law that outlaws abortion under any circumstance.

Today, I emailed my colleague that I would accept the position.

According to the Alan Guttmacher Institute, in 1962 alone, nearly 1,600 women were admitted to Harlem Hospital Center in New York City for incomplete abortions, which was one abortion-related hospital admission for every 42 deliveries at that hospital that year. In 1968, the University of Southern California Los Angeles County Medical Center, another large public facility serving primarily indigent patients, admitted 701 women with septic abortions, one admission for every 14 deliveries. (AGI also source for graph above)

Category: Second Opinions