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deaths per 100,000 live births. In New York City, only four maternal deaths from abortion were reported in 1972-73, while 22 had been reported in 1970.
Although abortion has been a major cause of maternal mortality, many women, who in the past did not have the alternative of legal abortion, were actually endangered because of their pregnancies. Young teenage girls, women nearing menopause, women who have had many or problematic pregnancies, and women with medical handicaps all are at risk during pregnancy and childbirth. The number of women who die from all of these causes has also dropped since the liberalization of abortion laws. The New York City Department of Health reports a 51 percent decline in maternal deaths from 1969 to 1972, and in California, a 15 percent decline has been reported in the four years following abortion reform,
The rate of infant mortality has also decreased markedly. The New York City Department of Health reports a drop of approximately 20 percent in this figure from 1969 to 1972.
The number of babies born out of wedlock has dropped. In the first year of neir abortion laws in California and New York, the out-of-wedlock birthrate declined 16 percent and 12 percent respectively, completely reversing the trend of earlier years of ever-increasing numbers of illegitimate births.
Fewer babies have been abandoned or given up for adoption. In one New York institution, there was a 56 percent decline in such cases the year following abortion reform. And the number of New York children placed in foster homes dropped 41 percent in two years after the law was changed.
The Supreme Court decision has increased equality of opportunity between the rich and the poor. It has long been an alternative of those women who can afford to travel to countries or States (or the Nation's Capital in Washington, D.C., for that matter) with less restrictive laws. Legal abortion was thus available to the wealthy although it was a financial impossibility for the poor. The Supreme Court ruling has to a great extent eliminated this discrimination based on economic status,
Millions of tax dollars have been saved by providing availability of abortion to women on welfare. In 1971 in California, the state medical welfare program paid $17.9 million for abortions for women on welfare. If none of those abortions had been performed, the cost to taxpayers would have been $59 million for health care during pregnancy and immediately after birth alone, beyond which would have been the continuing payments for the additional children on welfare rolls that could have run into hundreds of millions of dollars.
From 1970 to 1972, the national fertility rate for welfare mothers declined by 2.1 percent. In New York City, however, where abortion reform had taken effect. the fertility rate for welfare mothers declined by more than three times as much.
I bring these statistics to the attention of the Subcommittee because they are worthy of careful consideration. The abortion issue is a controversial and highly charged one: I believe it is imperative for us to be as fully aware of available data as possible and to keep our minds open to the moral, physiological, psychological and economic issues involved, in that order. Only in this manner, will we be able to view the abortion issue rationally and responsibly. As we debate what is "right" and what is "wrong" we must also be understanding and respectful of opposing views earnestly held by others.
STATEMENT OF SENATOR EDWARD W. BROOKE Last year, in perhaps its most controversial decision of the past decade, the United States Supreme Court ruled that a woman has a constitutional right to terminate her pregnancy under certain circumstances.
The decision, instead of resolving the abortion issue, has percipitated an intensification of an already heated debate. Opponents and proponents of the decision have flooded Capitol Hill with hundreds of thousands of letters. This attention has focused primarily on the various proposed amendments to the Constitution, designed to overturn the Supreme Court decision.
Because I have many reservations concerning these amendments, I cannot in good conscience support the efforts to enact them.
In order to discuss the constitutional amendments, it is first necessary to understand precisely what the Supreme Court decided. In the companion cases, Roe v. Wade, and Doe v. Bolton, the Supreme Court held: (1) that during the first trimester (usually meaning the first 13 weeks of gestation), the decision to have an abortion must be left solely to the woman and her doctor; (2) that during the second trimester, government regulations "reasonably related to maternal health", such as licensing of the facility and its personnel, are permis
sible; and (3) that after the 26th or 27th week of pregnancy (when the fetus is potentially capable of life outside the mother's womb) anti-abortion laws may be passed to protect the state's “interest in the potentiality of human life", but that abortion prohibitions must make exception for the preservation of the woman's life and health.
Regrettably, confusion still exists as to what the Supreme Court actually allowed. For example, some contend that the decision authorizes "abortion on demand". This is not so. The Court held that based on her right to privacy, a woman has a qualified right to have an abortion. But, this right, as outlined above in the summary of the Court's holdings, is dependent on a number of factors.
Secondly, the Supreme Court decision does not force anyone to do anything that would be inconsistent with one's religious or personal beliefs. In fact, the essence of the Supreme Court decision is freedom of choice. The government assumes a neutral position. It forces no one to have an abortion, nor does it compel anyone to perform an abortion.
On the other hand, I fear that the proposed constitutional amendments might preclude individuals from acting in accordance with the dictates of their consciences. In these amendments the federal government assumes an affirmative role. It can be argued that the religious or personal beliefs of some would be imposed upon others. If so, I believe that these amendments might endanger a central Judeo-Christian tenet-freedom of conscience. Such a result might also be violative of the spirit of the First Amendment's Freedom of Religion Clause. I am apprehensive about endorsing any measure that might threaten one of our most precious heritages.
In considering whether one should support one of the proposed amendments, it is also important to ask a practical, realistic question : will this amendment stop abortions? Available evidence suggests that passage of an amendment would merely restore the practice of millions of illegal abortions—many under backalley conditions that have prevailed until recently. This would mean a reutrn to high maternal death rates, uneqal treatment of poor women, and an increase in abandoned, abused and unwanted children. In addition, severe laws would again be permitted with criminal penalties for women who feel they must prevent childbirth. We must ask ourselves whether approval of such a constitutional amendment would create greater problems than it would solve.
Another consideration is my reluctance to use the constitutional amendment process to solve the social problems that beset our country. In recent times there seems to be a disturbing trend to resort to a constitutional amendment as a panacea. In addition to threatening the independence of the Judiciary, I believe that this tendency distorts the concept of our Constitution. It was not meant to be the repository of every proposed solution to every social ill.
In addition to the aforementioned factors, one other major reason contributes to my disinclination to endorse a constitutional amendment. Too many important and relevant questions remain unresolved. As the recent abortion hearings before the Senate Subcommittee on Constitutional Amendments amply demonstrated, many issues deserve to be thoroughly studied. Included would be consideration of the legal status of the unborn child, the intention of the framers of the Fourteenth Amendment regarding the meaning of a “person", the origins and limitations of the "right to privacy", the rights of the father of the unborn child, the medical and psychological consequences of abortion, etc. If the subject of abortion is to be fully and fairly treated, all these issues must be comprehensively examined.
The cumulative effect of all these reservations is to make me quite dubious about the merits of these constitutional amendments. The available evidence appears to indicate that passage of such an amendment would only exacerbate an already difficult situation.
The abortion question is truly agonizing. I am fully sympathetic to the views expressed by individuals on both sides of the issue. I do hope that all involved in the debate will remain tolerant of one another's beliefs. Unfortunately, on occasion, the debate has been marked by uncommon bitterness.
Although we may believe our causes to be right and just, we must still respect differences of opinion-especially on an issue that embodies so many legal, moral, medical, religious, and sociological factors.
Senator BAYH. Our next witness is the Honorable Lawrence J. Hogan, a Congressman from the State of Maryland.
STATEMENT OF HON. LAWRENCE J. HOGAN, A U.S. REPRESENTA
TIVE FROM THE FIFTH DISTRICT OF THE STATE OF MARYLAND, ACCOMPANIED BY WILLIAM J. HOGAN, M.D., OBSTETRICIAN/ GYNECOLOGIST
Mr. Hogan. Thank you, Mr. Chairman. My name is Lawrence J. Hogan and I am a Member of Congress representing the Fifth District of Maryland.
I have introduced a human life amendment in the House of Representatives. I introduced H.J. Res. 261 on January 30, 1973. Senator Helms' proposed amendment is identical to mine.
It seems to me, Mr. Chairman, that these hearings should address themselves to two questions: When does life begin?; and once it has begun, what legal rights does it have?
Mr. Chairman, if you would forgive me, I have with me my brother, Dr. William J. Hogan, who is an obstetrician and gynecologist, and my medical counsel. Senator BAYII. Glad to have both of the Hogans present.
Mr. HOGAN. As I said, Mr. Chairman, it seems to me that these hearings should address themselves to two questions: First, when does life begin?; and once it has begun, what legal rights does it have?
It is my position that human life begins at conception and destroying that life through abortion is killing a baby. That is the basis and crux of my opposition to it and, I believe, the ultimate basis of all opposition to abortion.
An argument often raised to support legal abortion is that restrictive laws are broken. This argument is inconsistent and is not based on logic or jurisprudence. Virtually all of our laws are broken, and that is hardly a legitimate reason for repealing them.
Twenty years ago few would have questioned that abortion is killing a baly. Now one is called upon to defend that statement. When there is a doubt-as the public has been led to believe--whether or not human life exists, the moral course, it seems to me, should be to err on the side of protecting that life.
Assuming for the purposes of argument that there is some doubt, the moral course, it seems to me, should be to err on the side of protecting that life.
If you are a hunter and you see something move behind a bush, and you think that there is a 50 percent chance of its being a wild boar, and a 50 percent chance of its being a child, should you not refrain from shooting? If society, buttressed by law, upholds the right of the child behind the bush to be safe from the assault of a hunter, why does not the law give a similar benefit of the doubt to the child in the womb?
Until 15 years ago our laws did, in fact, give this benefit of the doubt. And there was less medical proof then than there is now that the unborn child is a human being. If it is not a human being, what is it?
The woman seeks an abortion because she does not want to have a baby. So, if what is in her body is not a baby, then what could it possibly be?
So let us take a look at what it is. Physicians tell me that in the first month of life, growth and development are rapid and dynamic
with the central nervous system, the brain, seeing its most important growth spurt, and the rhythmic contractions of the heart beginning. The primitive skeletal system has completely developed by the end of the eighth week, and the electroencephalogram has detected brain waves as early as 43 days.
Senator Cook. Congressman, my copy says 6 weeks. Does your's
Mr. HOGAN. I understand that there is a dispute on that, so I decided to take the latter figure to prevent any possible confusion or an overstating of my case.
I might say, Mr. Chairman, that I submitted for the committee a comprehensive statement, and what I am doing now is summarizing it.
Senator Cook. All right.
Mr. Hogan. During the sixth and seventh weeks, the nerves and muscles begin working together for the first time, and the lips become sensitive to touch. And when gently stroked, the child responds.
By the seventh week of life, the child's shape and form are unmistakably human. He now has all of the internal organs of the adult; the stomach produces digestive juices, the liver manufactures red blood cells and the kidney is eliminating uric acid from the blood. His arms are still very short but hands with fingers and thumbs are recognizable, and the legs have knees and ankles and toes.
From this point in development, until age 25 to 27 years old, when full growth and development is complete, the only major changes will be in the size and sophistication of the functioning parts.
Fingerprints, which will never change throughout his life, develop at 8 weeks. The eyelids and palms of the hand become sensitive to touch about 812 weeks. At this point if the eyelids are touched, the child squints. If the palms are touched, the fingers close into a small fist.
The sex hormones have been identified as early as 9 weeks. At 10 weeks, hormone growth is detectable. At 12 weeks the thyroid and adrenal glands have begun to function. Also at 10 weeks the obstetrician can detect the child's heartbeat.
By the end of the third month, or the first trimester, the unborn child has become very active. He can now kick his legs, turn his feet, curl and fan his toes, make a fist, move his thumb, bend his wrist, turn his head, squint, frown, open his mouth and press his lips tightly together. He can swallow and drink the amniotic fluid that surrounds him. Inhaling and exhaling respiratory movements begin to move fluid in and out of his lungs. And thumb sucking is first noted at this age.
He has vocal cords, but cannot cry because he is not strong enough. The fingernails appear and he starts to urinate. By this time, every child shows a distinct individuality in his behavior and the words of noted behaviorial psychologist Dr. Arnold Gesell I think are significant on this point.
He says, and I quote: "By the end of the first trimester, the fetus is a sentient moving being. We need not pause to speculate as to the nature of his psychic attributes but we may assume that the organization of psycho-somatic self is now well underway.”
The child grows very rapidly during the fourth month of life. His weight increases six times and he grows 8 to 10 inches in length.
In the fifth month, 16 to 20 weeks, the unborn child will become one foot tall, and weigh approximately one pound. Hair begins to grow on his head and eyebrows, and a fringe of eyelashes appear. The child sleeps and wakes just as he will after birth and he may even be aroused from sleep by external vibrations. The skeleton hardens and the muscles become stronger. Finally, his mother perceives his many activities.
Now, Mr. Chairman and Senator Cook, I would like to call your attention to a photograph which appeared in this morning's Washington Post. It is a photograph of a mother and father bringing home a three month old Sherri Lynn Scorse, born four months premature. In other words, in the second, early in the second trimester, and the picture shows her leaving the hospital with parents. She had been left in a crib to die after premature birth. This is in the second trimester, when she was born. This beautiful picture is in this morning's Post.
Now, quoting Dr. Gesell on this point again.
Our own repeated observation of fetal infants-an individual born and living at any time prior to 40 weeks gestation-left us with no doubt that psychologically they were individuals. Just as no two looked alike, no two behaved alike. One was passive, when another was alert. Even among the youngest, there were discernable differences in vividness, reactivity and responsiveness. These were genuinely individual differences, already prophetic of the diversity which distinguishes the human family.
The reason that I went into this detail, Mr. Chairman, and I beg your forgiveness for doing so, is because it is important to know what unmistakably human characteristics that a child has even at early stages of pregnancy.
Now, I am not asserting that it is the function of law to proclaim medical truths. That should be done by the medical profession, acting responsibly and in consideration of its tradition.
The law, however, acts improperly when it pretends to assert medical fact or ignores medical fact. This the Supreme Court did on January 22, 1973. It pretended to assert as fact a lack of sufficient knowledge of the unborn condition as a basis for its later pronouncements, one of which was a new definition of a meaningful life.
Mr. Chairman, and Senator, who is competent to say that one life is meaningful and another is not? The law is supposed to portion out justice, to mediate differences, to protect those unable to protect themselves, to defend the interests of the weak, and to limit the force of the strong. The law is not supposed to decide that ones life is not meaningful
The one thing that all human beings have in common is the existence of our life, along with the consensus that we are human. Philosophies may differ as to what attributes of this universal human life the lar is bound to protect, but when there is serious disagreement whether or not life itself should be protected, the existence of all humanity is in peril.
Until a few years ago in America we gave the benefit of every doubt to the existence and continuation of human life. For example comment on a 1941 case before the New York Supreme Court summarized the legal tradition in these words:
It has been the uniform and invarying decision of all common law courts in respect of estate matters for at least the past 200 years that a child en ventre sa mere is “born" and "alive" for all purposes for his benefit.