licensing these facilities, frequently lack the funds and manpower to do an adequate job. Until something is done to change this, the nation will continue to have what Senate investigators call "commercially operated jails." Toledo, Ohio, August 3, 1975. SENATOR BIRCH BAYH, Chairman, Senate Subcommitee on Constitutional Amendments, Washington, D.C. DEAR SENATOR BAYH: I would like to thank you very much for having given me the opportunity to testify before your subcommittee in favor of the passage by Congress of a total human life amendment to the United States Constitution. I would like to commend you on conducting what I felt were very fair hearings. And, too, I would like to commend you on the sensitivity with which you are approaching the issue of abortion. I realize that you conducted the hearings in such a way that essentially prohibited any rebuttal from those who testified first. I am not critical of that policy, but do feel that I should make some comments regarding the testimony against the amendment which on July 24, 1974, followed my own testimony. If these comments could be included within my official testimony, I would be deeply appreciative, if not, I will understand. Nonetheless, I do hope that you have the opportunity to read some of what I have to say. When I testified, I testified solely on the given subject of "What Impact 'Liberal' Abortion Policies have Had on My Practice of Medicine". As you know from my testimony, I had a good deal to say in that regard. However, I have done considerable research on the Medical Hazards of Legally Induced Abortion and did not have a great deal to say on that day in regard to my own research. I would like to refer you specifically to my papers on that subject: and Medical Hazards of Legally Induced Abortion ABORTION AND SOCIAL JUSTICE, Sheed and Ward, Inc. Medical Complication of Legal Abortion, in INDUCED ABORTION: A DOCUMENTED REPORT. You have both of these books since I included them as part of my testimony. I would like to make comment. Those who advocate abortion focus only on mortality rates of legal abortion in the first three months of pregnancy. They then compare these with maternal mortality rates and state hat aborion is X-times as safe as going through childbirth. This is a narrow view of the complications of abortion. There is a good data to show that at least in some countries the first trimester abortion mortality rate is higher than the maternal mortality rate. Nonetheless, in some countries and some states in the U.S., these figures are lower. When discussing first trimester mortality rates, the pro-abortionists may have a statistical advantage. However, one must remember that maternal mortality includes deaths in women who are pregnant up until the time they deliver and up to 3 months after delivery. In New York City it is even a longer period of time. . . up to six months after delivery. Therefore, the comparisons are skewed toward the advantage of abortion. In addition, maternal mortality rates are expessed per 10,000 or 100,000 live births while abortion mortality rates are expressed per 10,000 or 100,000 abortions. There is no common denominator. Therefore, they cannot legitimately be compared. Nonetheless, left as they are, there is absolutely no question that legal abortions done in the second trimester are often fatal than childbirth. As you can see, to look at mortality rates as the sole criteria of safety is complex. In fact, it does not tell the whole story. In my book, I have well documented the increased incidence of stillbirths, miscarriages and prematurity in subsequent pregnancies after having an early abortion (first trimester). Prematurity is the leading cause of mental and motor retardation in the United States. There is also an increase in the incidence of ectopic pregnancy and sterility following legal abortion. There are others that are listed in my paper. The important point is that there are long term physical complications which women suffer after legal abortion. These are for the most part irreversible. 57-676 O-76-45 The documentation that I have appended to my papers can be consulted first hand. I am enclosing under separate cover a copy of the Wynn Report which was written for the Lane Committee on the Study of the Abortion Law in Great Britain. They have come to the same conclusions as I while studying independently of me. I would also like to refer you to the chapter in my book entitled ABORT'ON, POVERTY AND BLACK GENOCIDE Gifts To The Poor? Written by a black woman social worker, it contains strong evidence on the genicidal implications of legal abortion. Nearly 47% of all abortions done on New York City residents are done on black people while the black population of New York City is only 18%. The black population in New York is the only population which is so heavily skewed in favor of abortion in spite of the strong evidence that blacks in general do not favor abortion. I am told that similar data can be seen in the District of Columbia and the State of Maryland although, I do not have the documentation for that. I would like to point out to you also the testimony of the anti-amendment doctor from Indiana who testified to the fact that he puts IUD's in 13 year old black girls without their knowledge or permission. I urge you to find his statement in this regard in the transcripts of his testimony and question and answer session. I personally feel that this is a terrible abridgement of individual freedom and privacy. Nonetheless, I have come across similar situations in inner city hospitals I have been associated with. I have always attempted to fight it, but usually without success. Much was said regarding the numbers of criminal abortion deaths in the United States. I feel confident that you understand that this is no longer a major problem in the U.S. and that what was testified to wah a gross exaggeration. In fact, more people die from penicillin allergy every year in the USA than of criminal abortion. I would like to refer you to my study on criminal abortion in INDUCED ABORTION: A DOCUMENTED REPORT. I should point out to you that it is extremely difficult for a woman to die of obstetrically related causes and not have it reported. Every state in the union has maternal mortality committees whose job it is to investigate in depth the cause of death of any woman in the childbearing age group. Finally, I would like to address myself to the problem of how to detect ovulation and therefore conception. This was brought out in regard to the use of abortifacients. Women do vary considerably in their menstrual patterns. Ideally, the normal woman has a period every 28 days, however, few women follow the ideal. Some are very short cycles, others long and still others very irregular. What we do know is that ovulation occurs (if it is to occur at all) 141 days before the onset of the next menses. This is, of course of little help in definion when ovulation occurs before the actual fact. In the use of abortifacient drugs or devices, it is only important that we know how they work. If used when in fact a woman is not pregnant, then they will be used needlessly. The purpose of them is to avoid 'pregnancy' and they will be used only for that purpose. Therefore, if the purpose is to abort and that is how they in fact effect their action. then they would be destructive to new life and that is the prime consideration here. If per chance there were drugs on the market that were used for other purposes and had an abortifacient action as a side effect, then there are sophisticated ways of predicting when ovulation occurs and their use could be limited only to pre-ovulation days. I hope that some of this may be of help in your deliberations. I would recommend that you look carefully at Abortion and Social Justice since it is a book written by scholars who are experts in their field. In fact, it is the only book on abortion that has been written by experts in the field of which they are writing. Too often, theologians write about science and scientists write about theology. There is none of that in ABORTION AND SOCIAL JUSTICE. Again, I thank you very much. IN LIFE AND PEACE, THOMAS W. HILGERS, M.D. Chief Resident, Obstetrics and Gynecology, THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER, DEPARTMENT CF PEDIATRICS, Hon. BIRCH BAYH, DEAR SENATOR BAYH: I am writing to support the legislation that allows freedom of choice of physicians by women seeking therapeutic abortion. The need for support of this legislation has been adequately documented. I would also request that my letter be made part of the record. Sincerely, HARRIS D. RILEY, Jr., M.D., Professor of Pediatrics, Pediatrician-in-Chief. LAS ARENAS, P. A., Las Cruces, N. Mex., June 10, 1974. Re Hogan & Buckley Amendments. Senator BIRCH BAYH, Senate Office Building Washington, D.C. DEAR SENATOR BAYH: I would like to request that this letter be read before the subcommittee hearing in order that it become part of the record. For 16 years I have been practicing psychiatry. Four years prior to that I was in general practice. During this span of 20 years, I have had an opportunity to see many young women who have been pregnant because they did not want to be, those who have been pregnant because they did want to be, those who have children that they want, and those who have children that they do not want. I have also seen mothers who have given up children under stress and have worked with children who have been given up by the mothers. I have paid special attention to the psychological reaction of pregnant women who have come to me requesting an abortion on a psychological basis. In the past three years, this would probably number approximately 100 women. In the follow-up interviews following abortion, I can remember only one woman who regretted the abortion, and the reason for this was that she began to have marital problems and she thought that if she had the baby the marriage might ga better. The reason that I paid special attention to these psychological reactions following abortions is that it had been stated by various authorities that there might possibly be psychological damage following an abortion. I have yet to see this in a woman who sincerely wanted an abortion. Anyone who has seen and worked with mothers who do not want children but have had them anyway, and children who are unwanted, is likely to be impressed with the misery and severe psychological damage that can sometimes result. The Supreme Court ruling makes sense to me, and to have it any other way makes no sense. The woman who is pregnant usually knows whether or not she wants the child. For someone, or some group, to arbitararily decide without some knowledge of each woman's individual case seems irrational to me. It would be equivalent to someone whom you did not know deciding how many children each of you should have based upon their belief with no knowledge of your individual situation and relationships. Abortions have been performed for centuries as all of you know. A law made in this land that abortions are illegal will only force those who want them to have it done illegally. Many of us have seen the complications, sometimes fatal, as a result of illegal abortions. Certainly there are complications or fatal results with legal abortions, but this is much less likely to be the case than those performed illegally. We are all acquainted with this, and I will not belabor the point. Those opposed to abortion often times state that it is murder. Sometimes in the subconscious (unconscious) of women, this is true. A woman will sometimes consciously think of her abortion as murder, and I have talked to some of these women. I have been struck by the fact that they seem to accept this and go on about their daily living without undue guilt or remorse. When questioned about this, the answer often times is that it seems more merciful to have the abortion than to bring an unwanted child into the world. My thoughts regarding abortions are the result of 20 years experience working with people. It has become obvious to me that permitting a woman to have an abortion when she truly wants one is the rational and sensible thing to do. To do otherwise, under those circumstances, is to do both the woman and the as yet unborn child a grave injustice. Sincerely, JAMES E. WELCH, M.D. REPORT TO THE LEGISLATURE STATE OF HAWAN ABORTION IN HAWAII: THE FIRST YEAR Submitted by: Pregnancy, Birth Control, and Abortion Study (Roy G. Smith, M.D., M.P.H., Professor, Maternal and Child Health School of Public Health; Milton Diamond, Ph. D., Professor, Anatomy and Reproductive Biology School of Medicine; Patricia G. Steinhoff, Ph. D., Associate Professor, Department of Sociology, College of Arts and Sciences; James A. Palmore, Jr., Ph. D., Assistant Director for Institutional Cooperation, East-West Population Institute. INTRODUCTION On March 13, 1970, Hawaii became the first state in the nation to allow abortion essentially at the request of the woman. An abortion may be performed legally by a licensed physician in the accredited hospital before the fetus is viable outside the uterus, if the woman has been a resident for a minimum of 90 days immediately prior to the abortion. Other restrictions imposed are those that normally apply to any medical-surgical procedure. This is a second report to the legislature on the operation and effect of the law. It is an analysis of data from all cases of induced abortion performed in hospitals in the first year. In the first year following the enactment of the law, from March 13, 1970 through March 12, 1971, 3,643 induced abortions were performed in fifteen hospitals. Prior to the passage of the law, many legislators, individuals, and organizations in Hawaii expressed concern about the effects of the new law. The state legislature allocated funds to the University of Hawaii, School of Public Health, to initiate a study of the operation and effects of the law. The study was multidisciplinary from its inception, and now involves a research team composed of representatives from the School of Public Health, the School of Medicine, the Department of Sociology and the East-West Population Institute. The research team would like to express its gratitude to the legislature for its assistance. Additional funding has been received from the Population Council, the National Institute of Child Health and Human Development, the EastWest Population Institute, and the Health and Community Services Council of Hawaii. During the first year of the new law there were changes in characteristics of women receiving induced abortion and also in medical and social factors related to the operation of the law. However, it was still too early to assess the full effects of the new abortion law on birth rates, illegitimacy, adoptions, or sexual and reproductive behavior. Yearly iluctuations in such factors have occurred even before the abortion law was changed, and a time period longer than one or two years is necessary before we can assess these effects of the law change. METHODS Data on abortion patients were collected from hospital charts, self-adminis tered questionnaires, and in-depth interviews1. Information from hospital charts on all abortion patients has been made available to the study by every hospital in the State of Hawaii performing abortions. Information from the charts includes limited demographic, medical, and socio-economic data. A self-administered questionnaire was given to abortion patients when they were admitted to the hospital and was filled out by each patient prior to abortion. Tabulation of demographic data from hospital charts for those who refuse the questionnaire reveals no major differences between respondents and non 1 Data from maternity patients were also collected but are not included in this report. respondents in the abortion population. Those who were inadvertently missed in the questionnaire administration likewise appear to be a random selection. Questionnaire and interview participation by all patients was socio-economic and attitudinal factors, aspirations of family size, contraceptive practices, reasons for use and non-use of contraceptives, and reasons for having the abortion. Information was also obtained by interviews and correspondence with hospital administrators, physicians, and other medical personnel. To determine whether changes had occurred during the first year, the data were divided into four periods: March 13, 1970 through June 30, 1970; July 01, 1970 through September 30, 1970; October 01, 1970 through December 31, 1970; and January 01, 1971 through March 12, 1971. These periods are slightly unequal because the law took effect in the middle of a month. Where changes were observed, the data are reported by period. Where no change was observed, data are reported for the full year, March 13, 1970 through March 12, 1971. Geographic Distribution FINDINGS AND DISCUSSION The geographic distribution of the 3,643 induced abortions did not follow the population distribution in the state (Figure 1). A total of 3,428 abortions were performed on Oahu. This was 94.1% of the abortions, while only 83.4% of the women aged 13-49 in the state live on Oahu. However, 4.4% of the Oahu abortions were performed on neighbor island women. FIGURE 1.-Distribution of 3,643 induced abortions compared with distribution of women aged 13-49 by county,' Hawaii: Mar. 13, 1970 to Mar. 12, 1971 1 Modification of table 35, U.S. Department of Commerce, "General Population Characteristics, 1970," PC(1)-B 13 Hawaii. During the first three months after the change in the law, only 3.3% of the abortions were performed on the neighbor islands. By the last period of the first year, this had increased to 7.5%. The average for the year was 5.9%. Three major hospitals on Oahu performed 92.3% of the state's abortions during the first period compared to 88.3% for the entire year. This represents a general trend for increased percentages of abortions to be performed outside of Honolulu. TABLE 1.-INDUCED ABORTIONS BY HOSPITAL, HAWAII: MAR. 13, 1970 TO MAR. 12, 1971 There has been an increase in the number of physicians performing abortions both on Oahu and the neighbor islands. Although some neighbor island hospitals preferred not to report names of physicians performing abortions, the number on Oahu is known. A conservative estimate for the State would be a total of 90 physicians. |