Dr. SHOUP. Yes.

Senator BAYH. I don't recall any Purdue faculty meeting your description when I was going there.

Dr. SHOUP. Times have changed.

In a year and a half since the Supreme Court decisions reaffirming the right of women to choose pregnancy termination, a highly publicized, well-financed campaign has been launched by so-called rightto-life groups across the country, their purpose being to enact legislation to limit access to and ultimately ban abortion altogether in the United States. Interestingly, these efforts come at a time when abortions are increasing worldwide.

In recent months, citizens across the country concerned about the far-reaching implications of such restrictive legislation have recognized the need to organize and present an opposing viewpoint. Some of these groups have united their efforts by forming as affiliates of NARAL, and one such group is the Indiana Freedom of Choice Coalition, which has chapters in each of the congressional districts in the State of Indiana. Our purpose is to educate and inform the public about the importance issues involved and to urge our elected representatives in Congress to support the Supreme Court decision of January 22, 1973.

There are a number of important reasons why abortion must be available as an option to women with problem pregnancies. Some lawmakers, while opposed to complete liberalization of abortion laws, concede that abortion should be available when necessary to preserve the life of the woman or in cases of rape or incest.

I believe that is the position taken by your opponent in Indiana. Senator BAYH. I am not too sure what his position is. I am not too sure that is of concern for us here. Perhaps that is pertinent to you back in Indiana, but not for us here.

Dr. SHOUP. I would like to discuss three other reasons in some detail, with reference to a few statistics for the State of Indiana, especially the Calumet Region and the metropolitan Chicago area in which I reside. I will then discuss the question of when life begins from a biological perspective.

(1) CONTRACEPTIVE FAILURE

As we all know, perfect contraception-100 percent safe and 100 percent effective-is not yet available. The oral contraceptive the most efficient method, has a small, but significant failure rate and moreover, thousands of women cannot for medical reasons use it safely. Other devices are less successful in preventing unwanted pregnancies. Added to this are the thousands of pregnancies which result from ignorance of biological facts and/or legal or procedural restrictions to access to contraceptive devices. A 1970 national fertility study found that 26 percent of couples who use contraception fail to delay a pregnancy which they do not intend to have at all. More than onethird of couples who use birth control because they want no more children have a pregnancy within 5 years.

Similar results are found in an Indiana survey: among 35 women interviewed by Planned Parenthood of Northwest Indiana during a 3 month period if 1973, 47 percent had become pregnant because

57-782 76 - 13

1

their methods of contraception has failed or because protection had been discontinued on the advice of a physician.

In sum, unwanted and unplanned pregnancies do occur with starting frequency and for a variety of reasons. We must ask, “Is it morally defensible to force a woman to bear a child against her will?" I would like to insert a personal note. My husband and I are the parents of two very much loved and wanted children. I became pregnant 411⁄2 years ago with a third as a result of a contraceptive failure. We chose an illegal abortion. This was prior to the availability of legal abortions in this country. Our reasons were primarily a matter of social conscience. We already had two children, as many as we felt we could justifiably to the population. We were concerned with the bell-being of society. We felt that any additional children we desired we ought to adopt.

(2) BIRTH DEFECTS

The second item is birth defects. Some 250,000 children with serious birth defects are born in the United States each year. Serious fetal anomalies occur in 15-40 percent of cases in which the pregnant woman contracted rubella during the first trimester, which means to that individual that her chances of giving birth to a normal, healthy baby are significantly diminished. A number of genetic and developmental defects-such as Mongolism, Tay-sachs disease, Hurler's syndrome, and may other crippling or fatal diseases can now be detected in utero by the procedure known as amniocentesis, in which a sample of amniotic fluid is extracted from the uterus of the pregnant woman, usually at about the 16th to 18th week, i.e. during the second trimester. With such medical procedures available it is now possible to give a woman a choice whether or not to give birth to a child for whom life may be an unmitigated misery and for whose family severe psychological and economic hardships are inevitable. Which of us would presume to preclude options for a woman who finds herself in this tragic situation? The proposed Constitutional amendments would deny that woman the right to terminate her pregnancy if she so desired.

(3) MATERNAL HEALTH

In previous testimony, you have heard of the public health benefits of legal abortion in the States of New York and California. I would like to share with you information from other parts of the country. Prior to 1973, Cook County Hospital in Chicago admitted an average of more than 330 women per month for complications resulting from illegal abortions. Since abortion has been declared legal, an average of 5 women per month are treated for consequences of abortion.

In the first year of the liberalized New York abortion law-July 1. 1970 through June 30, 1971-2,800 Indiana women traveled to New York to terminate unwanted pregnancies. An estimated 2,500 legal abortions were carried out in Indiana in 1973. In the first 5 months of this year 2,906 legal abortions have been reported. In a 6-month 1973 study of 523 Lake County Indiana women who sought counseling for problem pregnancies, 74 percent chose abortion; among 54 women studied in Porter County, 89 percent opted to terminate their pregnancies.

Statistics show that two-thirds of three-fourths of all legal abortions are replacements of illegal ones.

The study of Tietze has been reaffirmed by June Sklar and Beth Berkob in a report which came out this week in the September issue of Science.

Clearly, women will terminate pregnancies whether abortion is legal or not; the question is, will all women, regardless of social and economic status, have access when needed to medically safe abortions? A human being can scarcely be more desperate than a woman pregnant against her will. To deny her the right to reproductive selfdetermination is to violate her fundamental right to privacy.

In the context of an over-populated world facing rising costs for food, goods, and services, and the grim reality of shortages even in our own country, who can seriously propose that more unplanned children are needed, especially children for whom adequate provision cannot be made? It is quite clear that we don't satisfactorily care for many of the children we already have. Limitation of family size is often an economic necessity. In more than a few cases, women choose abortion in order to provide better opportunities for the practical necessities of life for living children.

Most people support the right to free choice of abortion because they love children and are concerned for the welfare of potential children and those already born. This concern is a highly moral and practical one. Often, if a woman is forced to have a child before she is ready to care for it, she may never know the joy of having a wanted child.

For these reasons and others, safe, legal abortion must be available as a subsidiary method of birth control. Rather than "How can we justify abortion?" We must ask the question, "How can we justify compulsory pregnancy?" Because of contraceptive failure, serious fetal defects, and for maternal health, abortion must remain a legal alternative. We must remember that amendments to the Constitution which establish personhood for the fertilized egg deny a woman's right to control her reproductive life. Potentially, it can mean compulsory pregnancy for any woman.

The controversy surrounding abortion often centers on widely divergent response to the question, "When does life begin?" At what point in a 9-month pregnancy can we call the fetus a human being, or person at the moment of conception? at implantation? at the moment of birth? With present medical techniques it is impossible even to detect conception and implantation; only some days after the conceptus has embedded itself in the uterine wall can a pregnancy be confirmed. From a biological point of view it is impossible to state categorically that life begins at any one particular moment. The unfertilized egg is just as much "alive" as the fertilized one, in that it possesses the properties we recognize as characteristic of life. Yet biologically, embryos and fetuses are distinguished from the more completely formed stages. As human ecologist Dr. Garrett Hardin has pointed out, "An acorn is not an oak tree, an egg is not a hen, a human fetus is not a human being or person. Smashing acorns is not deforestation, scrambling eggs is not gallicide."

Most biologists think of life as a continuum, a series of stages or events from conception to death. Individual cells are born and die

throughout this continuum from the earliest prenatal stages to death of the organism. To impose arbitrary distinctions as to which moment marks the beginning of life is intellectually dishonest, not justifiable on the basis of our current knowledge. What remains of this debate are honest differences of opinion among people of good will as to the commencement of life, the acquisition of soul or personhood by the fetus at some particular stage of development or by the newborn baby. This is a judgment or definition made by individuals based on religious, moral, and/or philosophical grounds-a perfectly valid expression of opinion, but not a scientific fact.

The proponents of constitutional amendments prohibiting abortion by bestowing personhood on the fertilized egg from the moment of conception would deny the rights of those whose opinion or definition, also based upon moral, religious, and/or philosophical convictions differs from their own. Because no definitive scientific statement on this complex issue is possible, it seems to me inappropriate for the government to pass legislation reflecting one narrow religious and/or ethical position. Fr. Robert Drinan-D. Mass.-himself morally and philosophically opposed to abortion, has reminded us that "* ** the Constitution is made for people of fundamentally differing views. It is seldom appropriate for one group within society to seek to insert their moral benefits, however profoundly held, into a document designed for people of fundamentally differing views."

Freedom of religion and separation of church and state are among the most significant rights granted by the Constitution. It is important to note that a very large number of religious bodies in the United States support the right of the individuals to make decisions concerning abortions in accordance with their consciences and therefore oppose efforts to deny abortion through constitutional amendment, for example Division of Social Ministries-American Baptist Churches; American Ethical Union; B'nai B'rith Women; Catholics for a Free Choice; General Executive Board-Presbyterian Church in the U.S.; Board of Homeland Ministries-United Church of Christ; National Council of Jewish Women; Union of American Hebrew Congregations; Board of Church and Society-United Methodist Church; and many others. In fact, 23 Protestant, Jewish, and other religious groups are members of a national organization called Religious Coalition for Abortion Rights-RCAR.

In addition to religious groups, various professional associations, feminist organizations, groups concerned with civil liberties and human rights, and the majority of the people in this country want to preserve the option of legal abortion.

Thank you very much.

Senator BAYH. I appreciate the contribution you have made.

The test, of course, is whether one group who may feel very strongly about the rightness or wrongness of abortions should impose that particular standard on the others who may disagree. That is a big step that I struggled with myself.

All three of you, but particularly Mrs. Roudebush, came down awfuly hard on the right of a woman. I have never been a woman, so it is extremely hard for anybody who hasn't, to know how a woman looks at this problem. I don't suppose there has been any other mem

ber of Congress try to insure women's rights more than I have, but that still doesnt change what I said earlier about the inability to perhaps fully appreciate it.

Do you feel that there should be limitations imposed on that right? Mrs. ROUDEBUSH. I believe that limitations were imposed by the Supreme Court decision and those are the ones that I can accept. In the first trimester the woman must have the consultation of the physician, and in the second trimester the State may regulate for maternal health. In other words, it might be that a State would require her after the first trimester to go into the hospital for the procedure. It is also within the decision that after viability she does have abortion rights if her life is imperiled. This is what leads me to say that I consider the decision as a kind of compromise. It is not a wide open option through the 9 months of pregnancy.

Senator BAYH. May I ask you to be more definitive as far as your own thinking is concerned. Would you be comfortable with a greater restriction than the Supreme Court placed on abortion? Suppose the Missouri Legislature were to prohibit any abortion except where the mothers life was involved during the third and/or second trimester; how would you feel about that?

Mrs. ROUDEBUSH. I am not comfortable with that. I would be perfectly comfortable if the Missouri Legislature were to say, in the first trimester it must be done by a doctor, in the second, after the first trimester, the procedure must be done on an outpatient basis or in a hospital or similar facility. I would not be comfortable with an absolute prohibition of the procedure in the last trimester unless there were exceptions that if the woman's life were in danger or her health-good medical judgment decided that she could have safe legal abortion, medically safe abortion.

Senator BAYH. You would be opposed to an outright prohibition? Mrs. ROUDEBUSH. Even with those exceptions? Well, not with those exceptions. If those exceptions were there then I would think that the medical judgment could prevail for the woman who—————

Senator BAYH. The health of the mother.

Mrs. ROUDEBUSH. The health and life of the mother, yes.
Senator BAYH. What about just the life?

Mrs. ROUDEBUSH. No, not just the life of the mother. I prefer health because I know that it has been held to mean mental health as well as physical and a judgment could be made that her mental health would be impaired in such a way by the continuation of the pregnancy that abortion should be justified, even if it is very late in the pregnancy when no woman would choose it unless she were pretty desperate.

Senator BAYH. One of the major concerns that I have here is competing rights, the old cliche about the right that you have to swing your fist until it comes into contact with somebody else's nose. And, Doctor, you talked about eggs and hens. What is an egg that has a baby chicken?

Dr. SHOUP. It is a fertilized egg, no more, no less. Senator BAYH. It is not quite the same egg that you for breakfast.

would scramble