A national report on THE ABORTION MILLS AND THE LAW
This year, 75,000 Canadian women will undergo bloody and dangerous “kitchen” abortions. In many cases, their own doctors will agree the women need abortions for medical reasons, but will refuse to operate from fear of the law
FROM EARLY SPRING TO LATE SUMMER and into the fall, Canadians watched with increasing horror and sympathy while the toll of thalidomide-deformed babies mounted and then mercifully stopped short of seventy births. The dilemma of the babies’ parents has made it impossible for the same Canadians any longer to avoid thinking and talking about abortion, a social and medical subject most people have shunned until now. Before abortion again becomes an unmentionable underworld practice, there are some facts that doctors, jurists, legislators and the rest of us should face about the 75,000 Canadian women who each year turn themselves over to hundreds of criminal abortionists.
• Hardly a social agency in the country will counsel or help a pregnant woman who needs, or thinks she needs, an abortion.
• Most doctors will refuse a woman an abortion when medical indications are that one is necessary.
• Police in Vancouver, Winnipeg, Toronto and Montreal try to track down and arrest criminal abortionists. Most of the country's other local forces don't bother to go after abortionists unless somebody makes a complaint and provides evidence.
• There is therefore a criminal abortionist available to almost any Canadian woman who wants the services of one, and in almost every case the abortionist's procedures arc dangerous when they're not barbaric.
• Consequently, thousands of women who submit to criminal abortions hemorrhage, and some bleed to death; others develop uterus infection severe enough to sterilize or kill them; a few die instantly when the hack inadvertently allows air into their wombs where the bloodstream picks it up and carries it to the heart, causing it to stop.
Repeatedly in the past few weeks doctors
who've seen bungled abortions have told me that most women are profoundly ignorant of the risks they take in making an appointment with a criminal abortionist. The same doctors privately admit that they sometimes turn over their own patients to these hacks even when the patient clearly needs an abortion for medical reasons. Under the vague law governing abortion in Canada almost no doctor can be confident that he will not be accused and convicted of carrying out an illegal operation if he performs an abortion, even in cases where the medical justification is clear.
THE PENALTY: LIFE IMPRISONMENT
Section 209 of the Canadian Criminal Code defines a legal, therapeutic abortion. It says that such an operation can be done only “to preserve the life of the mother . . .” Doctors frankly admit they can't decide how to interpret the word “preserve," and since Section 209 stipulates that any one found guilty of performing an illegal abortion is liable to life imprisonment, they’re wary of doing the operation at all. Their hospitals are equally cautious of authorizing any of their physicians to perform an abortion in their operating theatres. The medical profession’s fear is natural enough. Medico-legal experts disagree sharply on what the Code means, and some of them, like J. J. Lederman, a B. C. doctorlawyer, say abortion — any kind of abortion— is illegal under the present law. In a recent issue of the Canadian Medical Journal, Lederman warned his colleagues, in an article called The Doctor, Abortion and the Law. that any doctor who performs the operation is leaving himself open to prosecution. A second authority, Dr. Kenneth Gray, a Toronto psychiatrist and lecturer in medical jurisprudence at the University of Toronto, disagrees. He has authorized abortion on psychiatric grounds and
he says: “Abortion is legal. I teach my students it’s legal."
Both Lederman and Gray are in firm agreement that the abortion law should be clarified. A little over a year ago the Canadian Bar Association admitted the law wasn't “facing the facts of life" on abortion and that it needs changing. A couple of months afterwards Dr. Jack Walters, then chairman of the Ontario Medical Association’s obstetrics and gynecology section, said his group was going to come up with recommendations for a new act in the spring of 1962. (Neither group has so far done any tangible follow-up work.) A year ago Dr. Walter's contention was that the law should reflect the present view of many doctors, which is that they should perform an abortion when it will preserve the physical and mental health of the mother. Catholic doctors say this type of abortion is unthinkable; that a mother must be under the threat of imminent death before the operation can be done. (A Catholic doctor would never abort a mother who had taken thalidomide but, on the other hand, he wouldn’t hesitate to destroy a living fetus while he worked to remove a malignant tumor from a mother’s womb.) A few other doctors say the Criminal Code adequately covers them to perform an abortion, not only to protect life and health hut also to insure a mother’s well-being. These doctors would abort thalidomide mothers and rape victims. Many other doctors might agree to do an abortion for these reasons once in a lifetime of practice. More likely they'd refuse for fear of being prosecuted.
In practice, therefore, a woman may be allowed a medical abortion — or she may be denied one, depending on her choice of doctor and his attitude towards the law. The majority of the women who took thalidomide found out about its tragic effects after the twelfth week of their pregnancies when it was too late to safely abort them. If some of the mothers found out early enough and did get abortions, both they and their doctors are telling no one.
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“Don’t tell me your town has no criminal abortionist. You’re just too naïve to know who he is”
Outside the spotlight of thalidomide. hundreds of other mothers have what is tor them dire reasons for wanting to rid themselves of unborn children. Mothers who contract rubella (German measles) during the first two months of pregnancy are almost certain to bear a deformed child and a mother who gets the disease during the third month has very little chance of producing a healthy normal child. In recent years some non-Catholic doctors and hospitals have aborted rubella mothers, while others continue to refuse.
For whatever reason, only a very tew' therapeutic abortions are performed in any Canadian hospital. Women can enter hospitals for critical cancer, heart and kidney diseases and have an operation performed on the say-so of one doctor, but to get an abortion a woman needs two, three and four signatures before a hospital will allow her the operation. Dr. John F. Ffarkins, an obstetrician-gynecologist at the Toronto General Hospital, estimated recently that there are between four and eight hundred therapeutic abortions performed in Canadian hospitals every year.
Ontario doctors seem to authorize abortions more freely than their western counterparts w'ho, they say, are more under the thumb of the legal profession and listen closely to lawyers who say abortion is, or may be, a crime. Dr. E. C. McCoy, acting director of the B. C. division of the Canadian Medical Association, said not long ago, “There are many cases w'hcre doctors are convinced women should be aborted but they arc powerless to act because of the law.” His remark could apply right across the country, and even though Ontario doctors say the law' allows them to perform a medically necessary abortion, Ontario women still find many doctors fearful of actually doing it.
Last winter a Toronto woman, frustrated by a dozen medical turndowns in her owm province, went as far as Cleveland and back to Montreal before she got a legal abortion. She's forty-three and the mother of two nearly grown children. For the past few years she's lived cautiously, protecting a single kidney that’s done her double-duty since the other was removed during a cancer operation three years ago. At that time doctors told her not to strain the remaining kidney and warned her emphatically not to get pregnant. When she did, her doctors admitted privately she needed an abortion — but they wouldn't do it. "They wouldn’t stick their necks out,” she says, "but when I became determined they took me into hospital for a w'eek and tested my kidney to see how it was standing up. Luckily for my health it seems to be all right. Unluckily, they said they couldn't abort me unless my kidney was diseased. They still admitted it was dangerous for me to be pregnant and finally they suggested I see a psychiatrist; that perhaps he'd find emotional reasons for aborting me. He turned me down, and I'm glad he did. I had perfectly good physical reasons for needing the operation.” Time was running short when a relative in Montreal told the woman about a general practitioner who
might help her. When she arrived in Montreal the doctor examined her, listened to her story and the two of them plotted to get the necessary operation. By moving into her relative's house she was able to join the Quebec hospital-insurance plan. Next the doctor referred her to an obstetrician who assumed she was a Montrealer. The rest happened quickly. The second doctor examined her and passed her along to a third doctor. He examined her, agreed the operation
should be done—and did it. A dilation and curettage, the surgical operation for abortion which can only be done during the early weeks of pregnanev, was out of the question. She was four months pregnant and a more complicated operation that amounts to a miniature Caesarean section was performed instead. Today the woman says. “I think the laws are brutal. Thank God I found a humanitarian.”
If she had been eligible for a D and C' the operation would have been, as
one doctor describes it. “routine but tricky.” Under the best hands women have been known to lose up to three pints of blood during a D and C. The pregnant uterus is soft, susceptible to the least intrusion of toxic material, and hemorrhages easily. One doctor says, “doing a D and C is worrisome. It's rough being the mechanic. I'd liken it to running a sharp knife across an inflated balloon with your eyes closed."
The 75.000 women who annually look outside a hospital for their abortions don't get the conscientious care of an antiseptic hospital or concerned doctors. These women get their abortions on kitchen tables, bathroom floors and beds laid out with plastic sheets. They usually don't know who their abortionists are, or even if they are skilled enough to avoid killing a client.
Actual statistics of women who get illegal abortions are impossible to tally, but 75,000 is a minimum annual estimate for Canada. In 1955 a group of American doctors, meeting for the Arden House conference on abortion, made an authoritative guess that there could be one abortion for every four live births and as much as twenty percent of the total abortion figure would be absorbed by women w'ho had spontaneous abortions or miscarriages. Relating their estimates to the Canadian birth rate w'hich is slightly less than half a million a year. 75,000 becomes a low figure for illegal abortions. Even allowing for more conservative Canadian mores, the figure is probably close to ninety thousand.
Amateurs are easier to find
Criminal abortionists aren't difficult for these unknown thousands of women to find. Dr. Alan Guttmacher chief of obstetrics and gynecology in a large New York hospital and easily the most outspoken authority on abortion in North America, told a group of American and Canadian protestant ministers recently, “Don't tell me your town doesn’t have a criminal abortionist. You're just too naïve to know w'ho he is ... ”
In large cities, half a dozen telephone calls will almost alw'ays track down a criminal abortionist who for $75, $100, $200 or $300 will “Jo something” to get rid of an unwanted pregnancy. Criminal abortionists seldom vary their treatment, but their prices slide up and down to accommodate their clients’ budgets; women from prominent families are known to have paid thousands. An abortionist's greed can extend to deliberately risking his patient’s life. An expectant mother, four-and-a-half months pregnant with twins, was recently killed by a criminal abortionist. Some incredibly irresponsible criminals have attempted to abort women six months pregnant. Ethical doctors don't like doing a D and C after the eighth week and won't attempt it after the twelfth.
A woman's best security lies with an abortionist-doctor who has a reputable practice as a sideline, enough conscience to examine her before he attempts a D and C. and the medical discipline to know what he does is dangerous. But amateur abortionists are much easier to find. According to the late Dr. Alfred Kinsey, director of Indiana University’s Institute for Sex Research, men and women with no medical training comprise about eighty-five percent of criminal abortionists. Because desperate women clutch the first name or phone number that comes their way, their chances of being mangled, as one doctor says, “are excellent.”
Who are the women who'll risk injury and death for an abortion, and take the chance of losing their reputations in a public scandal if they're caught? A police detective says they're “rich, poor, married, single, student, careerist, but the great majority of them are married women who've already had at least one child.”
An unmarried Toronto career woman whose lover ditched her before she learned she .was expecting a baby, got an abortion last July. Sitting in a Toronto restaurant two months later, she was composed and chic. Her job precluded any possibility that the woman wasn't efficient and responsible.
“It was rotten,” she said. “I tried to think my way out of it. but there was no other way. First I went to a G.P., but he wouldn't help me. 1 tried a few obstetricians — went to them cold. They didn't know me and they wouldn't suggest anything.
"I had to protect my job but I had to chance telling someone. I picked friends outside the office that I intuitively felt might know of an abortionist. Three or four days later a woman called me and said she'd heard I was in trouble, that she'd help me. I asked who had said such a thing and who was she.
"She just said, ‘I'll hang up if you're not going to be reasonable. How pregnant are you?' I gave in and told her eight weeks. That was fine. She told me not to eat dinner and to have $200 in cash ready the next night. 1 pleaded with her for the name of the person who'd told her, but it was no use. She hung up and the next evening I was ready. She called again, about ten-thirty and said to be ready after the eleven o’clock news. A cab driver took me in a roundabout way to an apartment house.” (The abortionist often sends a middleman to make initial contact and if he suspects the woman is a police decoy, he ditches her. By cutting out the middleman, abortionists can make more money, but they then protect themselves by doing business only through trusted referrals.)
The woman continued, “The driver gave me an apartment number and the woman I'd talked to on the phone
was inside. She asked for the money and then told me to lie down on a metal drop-leaf table in her kitchen. While I was getting arranged, she stirred a milky solution in a dishpan. She brought it over with a syringe and tube and said it might hurt and not to scream. I didn't look after that. I kept thinking. ‘Lord, she didn't wash her hands after she took the money.' and then she was hurting me so much I just hung onto the leaves and prayed they wouldn't fall down."
Sitting at the restaurant table, oblivious of a handsome man at a neighboring table who was eyeing her appreciatively, the woman shivered and was silent. She stretched her tense legs and said. "When she was through the woman told me it would be over in about ten hours and I probably wouldn't feel like going to work the next day. How right she was. 1 didn't work for three days and I'll never forget it.” She looked up from her coffee and saw the man watching her. In one motion she was on her feet—walking attractively toward the door.
A solution wash is the most common procedure in Canada for a criminal abortion. The theory behind it—and all other methods—is to place some form of irritant in the womb and leave it there for eight to twelve hours, until the uterus, sufficiently aggravated, starts contractions to throw it off. The fetus, embedded in the uterus wall since the end of the first week of pregnancy, is also driven off. Solution washes are usually a mixture of household or personal cleanser and water, and abortionists use their own ingenuity in mixing them. Dangerous and ungentle methods include the use of knitting needles, goose quills, slippery - elm bark and cotton-batting padding. Not fully realizing the hazards, abortionists frequently tear and puncture uteruses; stick toxic materials into them and. in the case of a solution wash, fatally allow air to enter the blood stream through the solution and womb. A Toronto breadman saw his wife die of air embolism—sprawled .across an abortionist's kitchen floor. He'd paid $15 for the operation and at the housewife-abortionist's later trial he testified he'd found her through a friend at work. Later, sentenced to an eight-year term for manslaughter, the woman admitted doing other abortions. Back in court to face fresh charges, the witnesses lined up against her were three nurses who said they'd each paid $75 to the woman, whose name they'd uncovered with the help of a Canton, Ohio, doctor.
There have been several housewives among convicted abortionists and an assortment of clerical workers, an unemployed actor, a salesman, a watchmaker, an ex-prison guard and a sex deviate. Anyone who passes along the name or phone number of an abortionist is risking some woman's life. In Montreal last year one woman led three of her friends to abortionists she'd tapped through a pharmacist. Two of them paid $300 and came through the procedure with no aftereffects. The third paid the same price, but was later admitted to hospital hemorrhaging and when she was released three weeks later doctors told her she was sterile. In Winnipeg wom-
en are whispering about “magic-wand” abortionists. Translated, this means slippery-elm bark and when a Vancouver mother pushed a slab of this wood, wet with Lysol, into her womb a year ago. she died of gas gangrene only a few' days after she was admitted to hospital.
Doctors and hospitals are tending thousands of less-than-fatal cases in silence. Last year Nova Scotia hospitals alone discharged 1.922 women after D and Cs. an operation which is used for legal abortions and, more
frequently to clean out an infected and bleeding uterus after a botched criminal abortion done outside the hospital. Saskatchewan hospitals discharged 2.730 D and C cases, B. C. 5,027 and Ontario coped with more than twenty thousand. A few of these operations were performed on women who started to miscarry, or for conditions that didn't involve pregnancy, but most of them were done to correct the mistakes of criminal abortionists. A young intern at a large Ontario teaching hospital says, "We've got women coming into emergency all the time with messed-up abortions. I don't know how many — maybe two a week.” Actually his hospital's latest statistics show that in 1960, 873 women were discharged after “abortions: threatened and spontaneous.”
Stewart McMorran. Vancouver's city prosecutor, accuses doctors of refusing to help police trap abortionists, by not reporting suspected cases to them. Most police forces, however, ignore abortionists and have certainly never asked for help or laid many charges. Vancouver, Winnipeg, Toronto and Montreal police make most of the country’s abortion arrests; in 1959 not a single local force in Saskatchewan. Alberta, Newfoundland. Nova Scotia or Prince Edward Island laid an abortion charge. New Brunswick handled just one case: Ontario, eighteen; and Quebec, Manitoba and B. C'. split another eighteen between them.
Police laxity, nebulous laws and a public that's never wanted to mention the word “abortion" have all combined to make the problem a serious threat to thousands of Canadian women. In the last two years several groups and individuals — doctors, lawyers and interested laymen—have said they want the law clarified. Many of them want it liberalized. Dr. McCoy, in pointing out that the law restricted doctors from doing even necessary abortions, said he felt the operation should be allowed for broad physical and mental health reasons.
and he included raped women who become pregnant. The Canadian Bar Association has since agreed that rape victims should be allowed to abort, and the lawyers also think mental defectives who become pregnant should be allowed the operation. Other doctors and lawyers have lengthened the list to cover abortion for a wide range of humanitarian and eugenic reasons and some suggest abortions should be allowed for women who have social or economic reasons for wanting the operation. A few have gone so far as to suggest that women in a “tired housewife” category be included.
The unfolding discussion has already split such normally united groups as the Catholic Women's League. In July the League passed an abortion resolution that was anything but bland (“abortion is murder, no matter what the condition of the living fetus”) but, significantly, it did note that, “Many favor terminating pregnancy by abortion in cases in which it is possible the child will come into the world deformed.” A month later, another ladies’ group, The Canadian Federation of Business and Professional Women, came out with the strongest proposal yet made by any group. The women asked the federal government to establish a royal commission on abortion to investigate the situation in Canada. On making the proposal public the federation's president. Elsie Gregory MacGill asked. "If women won’t ask for this, who will?" Who indeed? ★