More on Abortions
To the Editor:
The title of the article by Magda Denes, “Performing Abortions” [October 1976], is somewhat misleading since the article focuses primarily on saline abortions induced during the sixteenth to twenty-third week of gestation. The proportion of saline abortions has been gradually reduced to less than 10 per cent of all abortions in the United States (with only 2 per cent of all abortions performed at the twentieth week or later). The greatest frequency of such late abortions is among very young and economically disadvantaged adolescent women. Dr. Denes notes that thirteen of the eighteen women in the abortion hospital were eighteen years old or younger; she writes poignantly about a twelve-year-old and the turmoil engendered by the disposal of a twenty-four-week-old fetus. Very late abortions usually reflect personal conflict and distress; no one advocates such procedures as a primary method of birth control.
It is seldom realized that the United States ranks fifth in the world (just below Nigeria, Senegal, Sudan, and Trinidad) in the proportion of total births to teenage women. Still to be answered is the question of whether delayed abortion indicates the inexperience of disadvantaged teenagers in recognizing the signs of pregnancy, an unwillingness to accept the reality of a given situation, ignorance about where to seek advice and help, and a hesitation to confide in adults or, rather, negative attitudes of the medical establishment and delays inherent in an overburdened bureaucracy ill-prepared to provide abortion services to teenagers. It would have been welcome if Dr. Denes’s justified concern over late abortions had been matched with suggestions for mechanisms designed to make effective contraceptives and early abortion (if needed) easily and sensitively available to . . . teenagers.
Henry P. David
Transnational Family Research Institute
To the Editor:
. . . Magda Denes seems to be genuinely convinced that women who have abortions suffer serious emotional problems. . . .
When I first did abortion counseling in Boston, before abortions were legally available in this country, we were only able to make referrals to England for those who could afford it or to a few Boston hospitals which performed a few “therapeutic” abortions weekly. We had more than 100 women a week ask us for help, and I wondered what happened to the hundreds of women we could not help. After New York legalized abortion we were able to make referrals for most women who chose to terminate their pregnancies. I was concerned then about the women who returned and felt we should offer them more follow-up counseling. At that time, I felt these women would have emotional problems after their abortions and we should be there to help. After establishing post-abortion counseling with professional and lay counselors, we found the overwhelming reaction was one of relief. Very occasionally, I would see a woman who was mildly distressed, but that was usually because she had had to go through the experience alone. More often we saw women expressing relief and concern only that maybe something was wrong to feel so very positive about having had an abortion.
In the years since then, every major study of the psychological effects of abortion substantiates what I learned six years ago with the women I counseled. This is best summarized by Dr. Zigmond M. Lebensohn in a 1973 article in Comprehensive Psychiatry:
Recent experience in the United States indicates clearly that well-motivated women with no previous history of psychiatric disorder will emerge from a legal abortion performed under medical conditions with no psychiatric sequelae. On the contrary, most women report only a feeling of unalloyed relief.
. . . I am confident that the millions of women who in desperation had illegal abortions and the millions who are grateful for their legal abortions would be distressed and insulted to read Dr. Denes’s generalizations about attitudes toward abortion.
National Abortion Rights Action League
To the Editor:
. . . Why didn’t Magda Denes do her research in an abortion hospital where only first-trimester abortions are performed? . . . The aspiration technique used in first-trimester abortions has nothing about it to remind one of giving birth, and had Dr. Denes studied such cases, she might have felt differently and concluded that these early procedures are giving many too-young girls a chance to live their own lives. . . .
To the Editor:
“Performing Abortions” by Magda Denes was commendable for the variety of perspectives which it provided. Relatively few people have the opportunity to witness the personal interactions occurring on the saline wards of our hospitals. Dr. Denes takes us there in her lucid, slice-of-life description. . . .
The article inexorably leads to the author’s affirmation of her original conviction, only to be frustrated by her need to integrate a particularly difficult case, involving incest, into her thinking.
But a moral principle is not negated by one unique exception. . . . Dr. Denes has not denied, through her difficult exception, either the correctness of her basic moral conviction or the general entitlement of the unborn to human status. . . .
James P. Downey
To the Editor:
Magda Denes has written a powerful and compelling anti-abortion statement. This calm and factual account of trauma and death in the saline unit . . . is a masterpiece of understatement and “evenhanded” reporting. . . .
Was it an accident or a deliberate statement to follow Dr. Denes’s account with Dorothy Rabinowitz’s “Portrait of a Survivor” of the Nazi death camps? The parallels are obvious, and ironic. Otherwise viable human beings are legally placed in a non-human category, and then efficiently, rationally, and scientifically exterminated. . . .
We were sold abortion as a humane solution to rape, incest, and other social tragedies. We were not told that the fetus was a real human body, we were led to believe it was a formless lump of protoplasm, with no feelings, no reactions. Now, having read Dr. Denes’s vivid account, we know about the violent death trauma, hours of pain, agony, and unheard screams from our own sons and daughters drowning in a caustic salt solution. If we are human, we will hear their cries. . . .
Apalachin, New York
Magda Denes writes:
I did my research in a hospital in which abortions from six to twenty-four weeks of gestation were performed. Suction, D & C (or, more exactly speaking, a combination of the two), and saline methods were employed appropriate to the length of the pregnancy. It is clear, as Henry P. David points out, that saline patients on the whole are the youngest, most disadvantaged, most emotionally and/or mentally disturbed segment of the pregnant female population. And though I discussed only saline abortions in my article, I also observed non-saline abortions, which are not pleasant to witness either. Beyond eleven or twelve weeks the fetus is too large to be simply suctioned. The large bones must be broken up by the surgeon with an instrument and they must be removed by hand. This includes the head of the fetus which, if left in the uterus, tends to act like a ball-valve clogging up the suction route. The advantage of early abortion resides in the mother’s subjective experience. She is usually unconscious by way of general anesthesia or she is heavily sedated. From the standpoint of the fetus, all three procedures are fatal.
These facts notwithstanding, I believe that abortions of any sort should be legal all over the world.
But more than that. I am firmly committed to the notion that the value in humanity is awareness of self, the conscious affirmation and choice of our beings. The fetus lacks this realization. The mother does not. Her choice is in the service of enhancing the quality of being and of life. Her choice is also a choice made in mourning. For no one who values life can dispose of a segment of it with ease. And that is as it should be.
Karen Mulhauser’s comment that women often express “concern only that maybe something was wrong to feel so very positive about having had an abortion” is quite revealing. Aside from individual psychodynamics which involve dissociation, denial, reaction-formation, and other mechanisms of defense in the wake of psychic trauma, I think that these women are unknowingly addressing themselves to a highly detrimental cultural phenomenon in American life. I am referring to our predilection to disown the tragic, insoluble, paradox-filled aspects of our daily existence. A corollary consequence of this stance is to regard guilt as the crime, remorse as the transgression, sorrow as the embodiment of sin.
But in fact guilt and remorse and sorrow are appropriate emotions to actions which injure a higher order in the interest of affirming one’s individual life. They are the only appropriate emotions. And acknowledged, they make for an attitude of responsibility and restitution through which the quality of humanity is affirmed once more.
We do our lives endless harm when we deny this truth and when, through propaganda, we force our aborting women to feel guilty about feeling guilty, induce them to look falsely cheerful, and (lest they prove wanting as women) to report rapture at the act of having in necessity stilled their own blood and flesh.