Gynecology: More Abortions: The Reasons Why

The growing use of more reliable methods of birth control, notably "the pills," might be expected to cut down the number of U.S. abortions. But abortions are on the rise. Many doctors agree with the estimate made by Johns Hopkins' Dr. Harold Rosen,* an expert on the subject. His estimate is that frankly illegal abortions, ranging from $50 back-room jobs to $1,500 opera tions performed by skilled surgeons, will rise some 10% this year to a total well over 1,500,000. Also increasing, by at least 10%, is the much smaller but significant number of medically acceptable "therapeutic abortions," performed in good hospitals, to protect the pregnant woman. Doctors expect them to exceed 18,000 this year.

Abortion is illegal everywhere in the U.S., but 45 states make an exception if physicians are convinced that it is necessary to save a woman's life. Some medical men interpret the laws liberally to protect not only the woman's life but also her health — and the health of her expected child. If the laws are narrowly construed, many of the therapeutic abortions now being performed in first-rate hospitals by reputable doctors are technically illegal.

Two Disasters. After a decline in therapeutic abortions for almost two decades, thanks to medical progress, two disasters spurred the current increase. First was the thalidomide tragedy, which left some 10,000 European babies deformed or crippled, and in the U.S. led to the publicized case of Sherry Finkbine, who went to Sweden to be aborted. The other was an even worse disaster: the German measles (rubella) epidemic that began late in 1963 in New England. It moved slowly across the U.S., is still claiming victims in the Pacific states, and is expected to leave more than 30,000 U.S. babies stillborn or crippled. Doctors widely disagree as to what proportion of women who get the infection early in pregnancy will bear blind or deformed babies. The most authoritative estimate, from Johns Hopkins' Dr. Alexander J. Schaffer, places it at 40% if the mother catches the infection in the first month of pregnancy, declining to 10% in the third month.

A number of doctors argue that German measles is no valid reason for abortion. Says Tulane's Dr. Isadore Dyer, a chief of obstetrics at New Orleans' vast Charity Hospital: "If between 10% and 20% of the women who contract the disease in those first three months are going to have babies with anomalies, it seems rather drastic to destroy the other 80% or 90% to guard against this." Other physicians take precisely the opposite view. Dr. Daniel G. Morton, obstetrics chief at the University of California Medical Center in Los Angeles, states frankly: "Therapeutic abortions have been done here for German measles and other reasons." Among the "other reasons" accepted at many medical centers are rape and incest.