Medicine: Risky Abortions

Chicago clinics are exposed

She is in her early 20s, single and seeking her first abortion. Not knowing where to turn, it is very likely that she will consult the classified-ads section of a newspaper, where abortion counseling and clinic services are listed. If she lives in the Chicago area, she will probably be directed to a clinic in the city's Magnificent Mile area. There, nestled among the posh Michigan Avenue stores, she will find a luxurious office filled with glass-and-chrome modular furniture. A receptionist tells her that for $150 to $250, payable in advance in cash or by Medicaid or credit cards, she can have an abortion. But what the typical Chicago-area young woman seeking an abortion is not told is that within the next few hours, she may be rushed through an operation that is not only excruciatingly painful but also life endangering.

That is what investigators from the Better Government Association and a team of Chicago Sun-Times reporters headed by Pamela Zekman and Pamela Warrick discovered after a five-month undercover probe of six of the city's 13 legal abortion clinics. Two of the clinics performed admirably, the investigators say, but four others, which together do one out of every three abortions in the Chicago area, are assembly-line outfits concerned only with making money.

Among the alarming conditions reported in the Sun-Times:

> Doctors perform abortion procedures on women who are not pregnant.

> Operations are performed by inexperienced or unqualified people, including moonlighting hospital residents and at least one doctor who lost his license to practice in another state, and is appealing a similar decision by Illinois.

> Clinics are run under unsanitary conditions, and use haphazard procedures. This has sometimes led to severe infections and internal damage that later requires the patient to have a hysterectomy. In one clinic the staff cleaned procedure rooms between patients by wiping up blood with wet tissues. One doctor, Arnold Bickham of the Water Tower Reproductive Center, went from one abortion to the next without washing his hands or donning sterile gloves. Another doctor, Carlos Baldoceda of Biogenetics Ltd., performed an abortion while a nurse gave him what the Sun-Times described as a "sensual massage," and on another occasion did several procedures after drinking champagne at a clinic party.

> Some clinics use an assembly-line system in which doctors perform operations within three minutes (a safe abortion usually takes about 15), do not administer anesthetics or do not wait for them to take effect, and race each other to see who can perform the most operations in a day. According to the investigators, Dr. Ming K. Hah of the Chicago Loop Mediclinic and Michigan Avenue Medical Center may provide the fastest and most painful abortions in Chicago. He makes a pencil mark on the leg of his scrub suit for each abortion and tallies them up at the end of the day. In their haste, doctors often fail to remove all the necessary tissue. Sometimes they perforate the uterus or vagina.

> Clinics are also guilty of shoddy record keeping; falsifying records of patients' vital signs; failing to order postoperative pathology reports; and ignoring, scrambling or losing results of lab tests.