In 1914, Yale School of Medicine accepted its first female student. I arrived there 80 years later in the first class that was majority female. As part of a masterslevel thesis, I surveyed every female graduate from Yale. Some of those written surveys developed into oral histories recorded on a handheld microrecorder.
The stories that continue to shape my practice of medicine included the stories of several obstetriciangynecologists. They told me that they were experts in sepsis, intensive care medicine, and the early use of medicine to maintain blood pressure in dying patients. That made little sense to me because their job should have been delivering babies and performing gynecologic surgery. Instead, for nearly 60 years, they cared for women dying of infection or hemorrhage from illegally obtained or selfinduced abortion.
To be clear, Roe v. Wade, in 1972, did not bring us abortions. Roe v. Wade brought us safe abortions. It allowed women to be seen by a doctor who had the skills and the equipment to provide them a safe passage through a difficult decision. Abortions had been occurring for hundreds of years, sometimes with tragic outcomes. In my opinion, women who decide to have an abortion are never excited about this decision. They are sad, overwhelmed, ambivalent, and, often, selfloathing. If they could go back in time, they would do everything in their power to have not become pregnant in the first place. But, in the absence of timeturners, they are left to make the best decision possible for themselves and their family. And they are often desperate to do so.
Our nation’s abortion rates are the lowest they have been since data has been collected. There has been a 14 percent drop in abortions since 2011 and most of us see this as a victory for women’s health. Abortion rates are low because access to longacting, reversible, and incredibly effective birth control has increased. A key component of the Affordable Care Act (ACA) is full insurance coverage of birth control for all women. No longer do women have to scrimp to save $700 for an IUD or forego food to pay $30 a month for the birth control pill. It is now the standard of every medical specialty with a focus on women’s health to offer firstline longacting reversible contraception like the implant, the intrauterine device or an injectable birth control.
Although some may argue that the drop in the abortion rate is due to increased restriction on abortion access, the states where there is no restriction have seen a great decline in abortions and unintended pregnancies. The closure of twothirds of the women’s health clinics in Texas did little to reduce unintended pregnancy. Instead, rural and poor women have lost access to preventive cancer screenings, STD testing, and family planning. And maternal mortality increased substantially.
If you oppose abortion and you want to see its continued decline, fight for women’s access to excellent and inexpensive birth control. The birth control pill should be over the counter (OTC) and purchased without a prescription. The pill is OTC in the majority of the world and this move is supported by the leading medical societies in our country, including gynecologists and family physicians. IUDs, which cost pennies to manufacture and have been around for decades, should cost less than $100. If drug manufacturers in the US are unwilling to reduce their profit margin, women’s health clinics should be able to purchase IUDs from Canada or Mexico for use in this country.
The most broadreaching effort to support family planning is to continue federal funding for Planned Parenthood. That organization provides the fastest, least expensive, and most evidencebased healthcare to women who need it most. Finally, maintaining the federal mandate that insurance companies cover birth control for women is critical in reducing unintended pregnancy.
Stories of women dying in intensive care units because of lack of access to safe abortions must remain reminders of a shameful past. They have no place in our present or future.
Ruth A. Potee, MD, ABAM, is a family physician with Valley Medical Group in Greenfield.