Eugenia de Altura is a female graduate student conducting research on issues of women and gender in the cities of La Paz and El Alto, Bolivia. Bolivia is the poorest country in Latin America with the exception of Haiti, and over 60% of the country’s population is of indigenous descent. Eugenia’s postings explore women’s rights, sexuality, and reproductive health in Bolivia and in Latin America as a whole.
A couple of weeks ago, the New York Times Magazine published a piece entitled, “The New Abortion Providers” that centers on the medical professionals that are currently providing elective abortions in the U.S.A. Although my own work, and most of my blog writing, focuses on Latin America, I’ve chosen to write about this issue because it strikes me as an extremely important one. I will warn you now—the NYT article is long, but it is more than worth reading. In fact, I think that anyone who considers herself pro-choice—and everyone who opposes abortion, too—should read it.
The article, by Emily Bazelon, stresses the difficulties that abortion doctors face in the U.S., and the dwindling pool of doctors willing to provide the procedure because of these difficulties. Doctors who provide abortions not only get harassed and murdered in the U.S., they also pay between $10,000-$15,000 more for malpractice insurance than doctors who do not. Many older abortion providers had to go out of their way to learn to perform abortions, since medical schools often opted out of providing training. Some of these doctors traveled out of state a couple of times a week to provide abortions. During the years that I worked in abortion care, I knew at least two doctors who commuted across state lines to do abortions.
The challenges that abortion doctors face in the U.S. are not coincidental; anti-abortion activists and a conservative medical establishment have fabricated or contributed to many of these. As Bazelon points out, following the 1993 speech of a radical anti-abortion activist, eight doctors were murdered across the U.S. The hesitancy of doctors to perform abortions sometimes stems from where these doctors must do procedures—as hospitals and private doctors have turned away from providing abortions, more and more abortion doctors have had to work in free-standing clinics, ie., the kind that are constantly plagued by protestors and violence.
As of 1992, it became apparent that the population of U.S. abortion providers was aging—one survey reported that “59 percent of those age 65 and older said that they performed abortions, compared with 28 percent of those age 50 and younger.” One of the clinics where I worked—a small, feminist, non-profit—joined the efforts of other clinics to train younger and less experienced providers in abortion care. This training process, albeit incredibly important, ended up increasing patients’ wait times and stressing the clinic’s already limited resources. The clinic—like many others in recent years—was forced to close a few years ago.
The numbers of doctors providing abortions has not decreased due to decreased demand for the procedure. As Bazelon notes, “abortion remains the most common surgical procedure for American women; one-third of them will have one by the age of 45.” The author also points out that the numbers of abortions performed annually has remained the same since 1977. And yet, even the doctors interviewed in this article report disruptions in their careers and in their everyday lives due to their decision to perform abortions. Most of them gave pseudonyms rather than their real names. And many of them may soon retire.
Fortunately, pro-choice doctors have not met these trends lying down. Since the mid-1990s, doctors and their allies have built training programs, hoping to increase the procedure’s availability and to support providers who perform it. Increasing the availability of abortion and the number of doctors providing it is not only a matter of improving women’s access to abortion—it also would help normalize the procedure as an integral part of women’s healthcare. Although the pro-choice movement is working hard on these issues, Bazelon believes that, “there’s a long way to go from here to there.”
I am unwilling to fault medical providers for their hesitancy to perform abortions. I have worked with dozens of abortion doctors, and I have seen the challenges they face. But perhaps because of that, I also recognize the special dedication, selflessness, and heroism of doctors that do perform these procedures. So, I’d like to think of this posting as a call to arms: if you are a doctor and you work with women, step up to the plate. 1 in 3 American women need you. And the rest will value your commitment, too.