Governor Jerry Brown’s decision to sign a bill allowing non-physicians to perform a class of surgical abortions is being hailed by pro-choice forces as an advance for women’s health. Despite resistance from pro-life physicians and, for a time, the California Nurses Assocation, the law will allow nurses, midwives, and physician assistants with ad hoc training to perform first-trimester aspiration procedures.
“De-medicalizing” abortion has long been an objective of many elements of radical feminism. Today, as they struggle to find physicians willing to perform abortions in many areas of the country, groups like Planned Parenthood are welcoming the new California law and urging similar proposals in a handful of other states. California has long been an outlier for abortion extremism. It already has one of the highest abortion rates in the country, funds it routinely through state programs, has no public abortion-reporting regime, and has voted down parental notice and consent policies. It is hard to imagine a state where abortion could become less medically and socially accountable.
In his insightful new book, Abuse of Discretion, veteran right-to-life attorney Clarke Forsythe notes the activist’s catchphrase that polled well in the 1970s: “Abortion should be between a woman and her physician.” This, he notes, was never a reflection of medical reality. An abortion today is almost never between a woman and her doctor. “Fewer than 5 percent of abortions are performed by a woman’s regular obstetrician-gynecologist. Almost all are performed by a stranger, whom the woman does not meet until she is gowned and in stirrups.”
Now, thanks to AB 154, many California women will have a form of surgical abortion performed by practitioners who perform no other kinds of surgery, and, as Dr. Mary Davenport notes, who likely are not versed in treating complications such as “hemorrhage, uterine perforation, sepsis, damage to pelvic organs” and other problems that occur in 5 percent of surgical abortions.
Maternal safety, of course, is not the only issue in the abortion debate. From a pure physical-health-and-safety standpoint, tossing 100 newborns off a cliff could be accomplished without a single medical injury to their mothers. A generation ago the nation’s foremost champions of reproductive freedom promised the nation massive benefits from the births of fewer unwanted children. They insisted child abuse, child poverty, fetal anomalies, and future criminal behavior perpetrated by unloved children would wither away and disappear. The Rockefeller Commission on Population Growth and the American Future was particularly vocal on the topic.
These benefits, suffice it to say, have been, well, unevenly realized. The demand for ever simpler, ever more “accessible” abortion has been answered with less responsible decisions about sex, commitment, and marriage. Casual sex may now meet more casual abortion methods.
On the same day Governor Brown signed the “no doctor needed” bill, he signed another, less discussed measure that lowered the health and safety standards required for operation of an abortion facility. Provisions for a larger recovery room than required in a primary care setting and for a separate counseling room were among those lifted. Physically and symbolically, this second law represents the diminution of concern about the moral, human, and personal dimensions of abortion. A California abortion facility may come to resemble the average car-repair shop. Welcome to the disassembly line.
We live in extraordinary times. Bearing a child has never been safer; never have its processes been more dramatically presented to the human eye than they are now through advanced ultrasound; and medical miracles are happening on the frontiers of perinatology with dazzling regularity. In the midst of all this, our governing overseers offer women and girls less time and less care with less-accomplished medical professionals, no public health tracking, and precious little follow-up.
By what standard of civilization does this make sense – or constitute justice?