DOCTORS AND ABORTION
Nearly thirty years ago, I published a book, Abortion and the Private Practice of Medicine, in which I sought to understand what then was already emerging as the settled pattern of access to abortion services around the country. By the 1980s, the present pattern in which abortions are performed in specialized clinics rather than in hospitals or doctors’ offices had been established. Several writers in that decade, the sociologist Kristin Luker and the anthropologist Faye Ginsburg among them, described the politics of abortion clearly dependent on how physicians were delivering those services.
The question I wanted to answer in my book was why obstetrician/gynecologists were reluctant to perform abortions, even though such a medical procedure was directly in their purview of training. Surveys of physicians’ attitudes toward abortion done in the 1970s revealed that psychiatrists were most liberal in their acceptance of a broad range of justifiable reasons to permit abortion and ob/gyn doctors were among the most conservative. I described what I called “obstetrical conservatism” as the principal explanation for the way abortion services have come to be provided. But it is the politics of abortion that arose out of the Supreme Court’s supreme blunder in 1973 that has assured that such obstetrical conservatism is encased, as it were, in the larger reluctance of the vast majority of physicians to participate in the highly charged debates about abortion. I learned this years ago when I was invited to speak to Harvard medical students about abortion and explained why, if they chose to practice obstetrics and gynecology, they would by and large be able to avoid most requests for abortion by referring patients to clinics. This, I told them, would shield them from the fierce politics that defined such work and allow them to avoid the controversy that would put them at some risk of being publically targeted. For that piece of empirically verifiable advice, I was not asked to talk to Harvard medical students again. I imagine I was expected to suggest that they lead the way in changing how the practice of abortion was organized. A physician’s reluctance to engage this contentious terrain seemed at the time, and still does, to reflect common sense.
The rejection of such common sense has long been typical of abortion’s advocates among physicians. The New Republic on July 23rd published a response by Dr. Jen Gunter about the ongoing controversy that has embroiled Planned Parenthood about undercover videos that show top executives of the organization discussing the acquisition and disposition of aborted fetal parts. Although the political debate will be about the funding of Planned Parenthood, the medical and moral debates are really quite different, and they entail an understanding of how so few proponents of Planned Parenthood’s present policies regarding the uses of aborted fetuses can have such a disproportionate impact on both left-wing political and feminist sensibilities that mock a common sense about what such policies mean to the vast majority of Americans.
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