Gynecology: More Abortions: The Reasons Why

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Psychological Hangover. By far the commonest reason, wherever the law is liberally construed, is not the physical condition of the mother-to-be but her mental state. Many pregnant women insist that if they are forced to carry and bear an unwanted child, they will go mad or commit suicide. The majority who claim this are married women who have had as many children as they want. Few of those who see their pregnancies through ever suffer from mental breakdowns; similarly, few who get legal abortions are left with a severe psychological scar. But psychiatrists and other doctors tend to agree that women who desperately seek illegal abortions almost inevitably suffer from a "postabortion hangover." Says Manhattan Psychoanalyst Leah Schaefer: "Sometimes a woman feels so guilty that she blames everything, especially a subsequent difficult birth, on her having had an illegal abortion."

Most hospitals have committees of three to seven physicians to pass on staff members' recommendations for therapeutic abortions. But the boards have vastly different standards. Says Dr. Rosen: "The definitions of valid reason for abortion vary from physician to physician, from hospital to hospital, and from day to day within the same hospital. The board of one hospital may refuse to accept a recommendation, yet the same application may be almost immediately submitted to the board of an adjacent hospital—with, at times, almost the same staff—and be approved."

If a woman is turned down on all sides but has enough money, she can go to Scandinavia, Switzerland or Japan, where a legal abortion is easier to obtain, or to Mexico or Puerto Rico, where abortions are technically illegal but relatively easy to arrange, under medical auspices, for $150 to $300.

Changing the Law. Because U.S. laws are confusing and frequently disregarded, the American Law Institute has recommended a model abortion code. It would legalize abortions performed in licensed hospitals if at least two physicians agree that there is substantial risk of grave damage to the mother's physical or mental health, or of the child's being born with a grave physical or mental defect, or when the pregnancy results from rape or incest. This would legalize abortions in the German-measles cases. Bills to amend the law along these lines were introduced, but failed, in New York and California.

With the moral and philosophical issues of legal abortion still in hot debate, few legislators are willing to campaign openly for changes in the law. Perhaps, says Columbia University's Dr. Robert E. Hall, it is up to obstetricians to do so—because they are the people who are stretching or breaking the law. To that end, many prominent physicians, sociologists and clergymen have formed the Association for the Study of Abortion. Its first president, appropriately, is Obstetrician Hall.