When safe abortion isn’t a choice

If she is brave enough, she will ask around. Someone will know someone who knows someone. Or something.

Someone’s grandma might know about the old days. Drinking turpentine or Clorox, which is what the poorest women often did. They also took massive doses of quinine. Equally dangerous and, like the household cleaners, not a particularly effective abortifacient. Although as faded memories become urban myths no one seems to remember that these methods don’t work and often kill, and so they remain in the lexicon of “options.”

An Internet search, if she has access and doesn’t have to worry about the prying eyes of parents or an abusive partner, might lead her to misoprostol. A friend from Latin America or Asia might be more familiar with this “option.” Assuming she gets the right dose of the real medication and not some sugar pill or poison passed off as the real thing, she might have a 30-40% chance of inducing her abortion early on. Ironically, it gets more effective as the pregnancy advances. Like most women she’ll take the pills by herself, cramping and bleeding on the toilet or squatting on the ground. No one to hold her hand. No one to wipe her brow. No one to recognize when she has a fever or has lost too much blood.

Many women find their way to people who offer certain “skills.” Procedures, if you can even call them that, offered in back rooms. Rooms that don’t have an autoclave to sterilize tools or even basic resuscitation equipment. Some rooms have the essence of respectability, many do not. Almost none are operated by anyone who has more than a cursory knowledge of the reproductive tract.

On kitchen tables these women lie. Some might be offered a Valium or a Vicodin. For a price. It might ease the pain a little. These medications may also makes them less likely to cry during the sexual assault that can be part of the deal. After all, who is going to complain about getting raped at their illegal abortion?

Maybe their vagina and cervix is cleaned before hand, but maybe not. An instrument is pushed through the cervix by hands that do not know how to atraumatically dilate the opening of the cervix. Too much force is dangerous. The practitioner may not know (or care) that the wall of a pregnant uterus is like butter and any instrument, no matter how soft, is like a knife.

If they can’t navigate the opening of the cervix, or if they haven’t even bothered to look, the instrument is just forced up until there is no more resistance or until the screaming stops. This blind stabbing often leads the instrument to puncture the top of the vagina, weaker than the cervix, traveling alongside the uterus where the major blood vessels are found.

Ultrasound machines are not used. They cost hundreds of thousands of dollars. Even if one were available, the chance that such a provider would know how to use one is slim. Gestational age is therefore a guess. Unfortunately, knowing about the long bones and skull is crucial in the 2nd trimester. An unskilled hand can easily push splinters or larger pieces through the uterus into waiting bowel and blood vessels.

If blood vessels are transgressed, the bleeding is catastrophic and requires emergency intervention. Many women don’t get to the hospital in time. Who is going to call the ambulance?

If fecal material announces a bowel perforation a caring provider might stop and say, “You need to get the hospital.” Most are not that caring. Better she stagger home and call.

Even when the procedure seems to go smoothly, the risk of infection is high. Pretreatment with antibiotics to lower the risk of infection, standard with a safe abortion, doesn’t happen. Products of conception left behind by untrained hands and unsterile equipment take their toll in 2-3 days. If the woman is not too ashamed or afraid to go to the hospital she will need advanced care. She may need her uterus re-evacuated to remove what was missed and is now the nidus of infection. As there are fewer and fewer providers skilled to perform abortions, there are fewer and fewer hands experienced enough to do this without the back wall of the uterus falling apart from the currettage. Many will now get hysterectomies.

A CT scan might show abscesses in the belly and a punctured bowel. In these dire circumstances surgery, a colostomy bag, and a prolonged hospital stay will be the result. Infection and blood loss may also cause the body to attack itself, losing the ability to clot. This is disseminated intravascular coagulation and even with prompt, expert, intensive care it is often fatal.

But if she is so alone, so alone that she can’t fathom asking anyone she might take a stick, or a coat hanger, or a knitting needle and stick it up her vagina. She won’t know about the cervical os, the opening of the cervix, or that she has no hope of finding it blindinly. She’ll push. It will hurt. A lot. But she’s desperate. She might stick it into her uterus, or right through the uterus into bowel. After two or three days of fevers and cramping and vomiting she might go to the hospital and hopefully the damage and infection will be confined to her uterus. She might also slice through blood vessels and bleed to death by herself on her bathroom floor.

It’s going to be challenged, of course, in the Supreme Court and all — but literally, we stopped abortion in the state of Mississippi, legally, without having to– Roe vs. Wade. So we’ve done that. I was proud of it. The governor signed it into law. And of course, there you have the other side. They’re like, ‘Well, the poor pitiful women that can’t afford to go out of state are just going to start doing them at home with a coat hanger.’ That’s what we’ve heard over and over and over.

“But hey, you have to have moral values. You have to start somewhere, and that’s what we’ve decided to do. This became law and the governor signed it, and I think for one time, we were first in the nation in the state of Mississippi.”

– Mississippi GOP state Rep. Bubba Carpenter

Join the Conversation


    1. there is only one way it could be more brutal: photographs of the conditions mentioned…

  1. Can this governor be sued for the assault on women who are injured because of his actions?

    1. I hope so. I flagged that repulsive YouTube video of his speech under “hateful and abusive content”. I posted a scathing comment, but of course they’re screening and will only approve glowing christian praise.

  2. My father, now a retired physician, did his residency in San Bernardino CA. Abortion at that time was illegal. He once told me that every Wednesday the ER was filled with women dying of septic shock after undergoing an abortion in Mexico or an illegal one here in California over the weekend. He also regularly treated women who had mutilated themselves with knitting needles, boiling hot baths and, yes, coat hangers. He is a deeply conservative man, but that experience made him pro-choice. Because when abortion is illegal, women die.

      1. When abortion is illegal, women (living breathing women, women already born, women living OUTSIDE of the womb, in other words, women already IN THIS WORLD) die. No problem to you?

        You can never outlaw abortion. You can only ensure that women will suffer and die, needlessly. Do you really want that? Do you really want enforced childbirth? Enforce how? Put women in jail? Chain them to their beds? Force feed them? Desperate women will always do desperate things to abort.

  3. Horribly sad, but true. I worry especially about young teenage girls who have no one to turn to. Abortions are going to happen, whether legal or not. We might as well have safe options available for those who are going to have one regardless of the government’s opinion on whether it’s ‘moral’ or not.

  4. Your description is not to far from what has occurred in in the last two years in PA, AL, MD and NJ. No matter one’s opinion, the OB-GYN community has been negligent in policing these docs, often referring them patients because they are known to be a bit “loose” with dates.

    The problem with the abortion business, like certain sectors of the elective plastics business, is that there is a disproportionate number of indicted felons and frequent flyers to medical board discipline committees involved. This seems to be related to the type of person who is attracted exclusively to this practice and the cash in advance payment method. The documented actions of these physicians makes people of reason who honestly subscribe to the safe, legal and rare process call for increased controls on the procedure to the point of closing clinics. Many clinics are objectively not safe and women continue to die and women in extremis are dumped. People of reason quickly determine that a closed clinic is safer than one that actually kills and injures women in their midst.

    The Gosnell Indictment http://tiny.cc/6jylew is a horrific telling of how things were in Philadelphia in for decades. Last month, there were 76 pages of violations in Alabama http://tiny.cc/uizlew before that was an insane scheme of inducing an abortion in NJ and driving the patient to MD for completion – utterly reckless. Most women in crisis lack the ability to discern a safe clinic from one “reeking of cat urine” and staffed by high school students. So, who best determines what is safe? If the OB-GYN community or the local community? If it is the latter, they are reactive, and tend to use a big stick – leading to the scenarios you describe.One tires quickly of ER dumps of women which continue nearly 40 years after Roe.

    Who is to blame for this? I suggest it is the Ob-Gyn community who abandoned a procedure particular to their specialty and failed to develop and demand appropriate standards legislatively. At this juncture, one ER dump in a year will eliminate abortion in an entire state and exhibit A is Alabama.

  5. Many, many anti-choice advocates will be entirely unmoved by this description. In their world view, one real death is worth it to bring N hypothetical babies to term. The “fact” that these women are sluts and deserve punishment for not being godly just makes it go down all that much easier.

    In the same way, you can show them the stats that comprehensive sex ed prevents unwanted births and abortions, a win-win if there ever was one, they plug their fingers in their ears and won’t settle for anything but abstinence-only education and purity pledges.

    1. My thoughts exactly. I also have a sickening feeling that someday we’ll find out that “Bubba” (a.k.a. “Proudly reinforcing Southern redneck stereotypes by name and game”) has a daughter who took a little trip to visit Aunt Flo in a distant state when she was 14 or so, right after Bubba’s wife caught him paying a little too much attention to her. These self-appointed “moral champions” always seem to have some twisted skeleton in their closets.

    2. Jim, you are unfortunately correct. While the uninformed who are on the fence might be swayed by the facts, the anti-choice philosophy is about enforcing a social hierarchy that oppresses women. That many women will be harmed, even killed, by it is not a bug but a feature.

  6. I’m afraid Jim B is right. They don’t care. They only care about making whores and sluts suffer for being whores and sluts.

    It’s time to stop trying to reason with them. They can’t be. It’s time to call them what they are: Woman hating scumbags. We have to say it often, we have to say it loudly.

    Shame might be the only thing that makes these scumbags go back under the rock they came from.

  7. There’s a lot of talk about “not going back” to pre-Roe V. Wade days lately, but I got to thinking the other day and wondered how many unsafe, illegal, self-induced abortions are performed today? Because even though Roe is in place, there are some states, counties, etc. where abortion is hard, if not impossible to come by. So, even though Roe supposedly protects the right to abortion, Roe doesn’t protect or provide for access to it. Are ER docs seeing casualties from self-induced or illegal abortions today? And if so, why aren’t we talking about it? Or does that just lead to discussion of providers like the one in PA? Who is an outlier, but a nice anti-choice sound byte.

  8. We might find safer ways to practice child prostitution if the Supreme Court made it legal. But they won’t, for the simple reason that child prostitution is wrong. Such is the case with abortion, which amounts to prenatal homicide, even when performed “safely.”

    1. You are the only adult in front of a burning building which houses a preschool and a in vitro fertilization clinic. If you run towards the preschool you will be able to save five children, but if you run towards the in vitro clinic you will be able to save thousands of embryos. Which way do you run? No one else will be able to reach them in time.

    2. No. Abortion is not “prenatal homicide” – a zygote or a non-viable fetus is not a person. And even if a fetus were a person, that _would not matter_. Forcing a woman to continue a pregnancy she does not want to continue would be approximately equivalent to forcing me to repeatedly donate bone marrow for several months. Both are wrong.

    3. “True Feminist”? False equivalence, more like.

      PS. I came here from Libby Anne’s blog Love Joy Feminism – thank you, Dr Gunter, for writing this article.

  9. I, personally, don’t believe in abortions, BUT that is my choice and EVERYONE has a CHOICE.

    1. I, personally, don’t believe in slavery. BUT, that is my choice and EVERYONE has a CHOICE

      1. To compare the abortion of an unfeeling, unsentient first-trimester embryo or fetus to the systematic oppression, rape, torture, and forced labor that enslaved people endure is sickeningly callous and illustrates exactly how little you think of those who are/were enslaved.

        An adult or juvenile human does not have the right to use my organs, tissues, fluids, or entire body without my permission. Therefore, a fetal human does not have that right. It is my choice whether or not to donate my body to any fetal humans dependent on it for survival.

  10. I’m learning so much here today, up until about 6 or 7 comments ago. This is a very complicated issue. I am a person of faith, and was raised that abortion is “wrong”. As a nurse and a mother and a human being, I am learning that there are many ways we harm one another that are “more wrong”. If we were a society that could care for one another in many ways much earlier, abortion would not be the thing we so often end up talking about. It doesn’t matter if you “believe” in abortion. They are being done this second. Do we “believe” in caring for hurting women? Do we value them enough to ensure their safety, in all areas of life?
    That said, Sunshine, please reconsider your last comment. You’re not “donating your body” to a fetal human; you donated it to a sperm producing human and thus created another human. Blocking that sperm would seem pragmatic.
    Thanks, Dr.Jen, for the information. It makes my pro-life/pro-choice journey a better informed one.

    1. “That said, Sunshine, please reconsider your last comment. You’re not “donating your body” to a fetal human; you donated it to a sperm producing human”

      Nonsense. She didn’t donate her body to anyone, she used her body to have a mutually enjoyable time with someone else. The sperm-producing human didn’t use any of her internal organs or systems for their own benefit, causing harm to her.

  11. So what I was getting from this was that you should do this the safe legal way. But then followed it with, but safe abortion is illegal here anyways, so go stab yourself in the vagina and hope for the best. Like useful and very important information. But ended in a very “go fuck yourselves” manner

  12. This entry made me cry, and think…. The only reason I never had an abortion is because I was given free non-judgmental access to sex-ed, and contraception; that & sheer luck! Let’s be honest: I do not know ONE woman who’s never had a pregnancy scare…. Late period, thumping heart, did I forget my pill one day? What about that morning I threw up? Or that condom that malfunctioned? I tell my boyfriend I’m 6 days late: wow, he runs off, as if it has nothing to do with him! I’m “privileged” in that I’m educated. I go ask for a “beta HCG” blood test, which I pay cash, for anonymity. A close friend’s holding my hand. The lab tells me to call back in 2-3 days: an ETERNITY. My thoughts race: my life’s over, I want to go to College, I have plans, I’m SO scared, terrified. Will I feel guilty my entire life, after I get an abortion? Will I tell my kids, when I have kids? Will it hurt? What if something goes wrong, and I end up infertile? How am I gonna breathe and function between now and the abortion? How long will I grieve? Will I have regrets? Some decisions can’t be undone & this is one of them. I don’t sleep for 3 days.
    Finally, time to find a phone booth & call the lab. The woman puts me on hold on, and in a very neutral voice, informs me that I’m not pregnant. PHEW. I’m on the sidewalk, shaking. Relieved. Exhausted. Now and only now will I tell my mother & grand-mother. I’ll be more careful, MUCH more careful in the future, especially since this Aids epidemic got my generation to change its sexual habits….. I was 21. That was my first pregnancy scare. And, even if I didn’t need it, knowing that I had a CHOICE made things almost bearable. Since then, abortions are safer, less invasive: RU486 was a miracle!
    Oddly, what stuck 20 years later was that woman’s neutral tone. I could recognize her voice, even if I couldn’t tell you what I had for lunch yesterday. How many times did she have to announce a pregnancy result, not knowing if she was announcing the best news in a young woman’s life, or the worst one?
    I didn’t know all that back then, but today I know that my grand-mother had an abortion (illegal), my great-aunt had an abortion (illegal, she had 2 kids and couldn’t take care of an infant as she was turning 50), my paternal aunt had an abortion (legal, She had 2 kids, and that pregnancy was putting her life at risk, not 100% sure she’d die, but who gets to tell a woman what an “acceptable risk” is?) my mother had an abortion before she had me (1st time she had sex, incredibly unlucky, she traveled abroad to terminate), my best friend had an abortion (IVF, the fetus had a terrible malformation; it broke her heart, bc she’s been wanting a baby SO badly), my grand-mother’s care taker had an abortion (she didn’t know that right after a woman stops taking the birth control pill, her fertility spikes. The only reason I know about this abortion is bc her boyfriend beat the crap out of her for getting pregnant, an then for getting an abortion so I tried to help her). So many women each with a heartbreaking story …. Each abortion leaves a scar, sometimes terrible grief. None of these women speak of it easily. They’re all fantastic loving mothers/grand-mothers.
    The “anti-choice” keyboard warriors anger me, plain and simple: they judge, they call others “baby killers” but they’re the ones killing real adult women. And even when the woman lives, she’s emotionally damaged, sometimes for life by their bully tactics. They’re not interested in listening, or in making unwanted pregnancies less frequent.
    Lowering the # of unwanted pregnancies, you’d think everyone would be on board with that goal…..

Leave a comment

Leave a Reply to Julia Indigo Cancel reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: