Abortion: Precept & Practice

As the sensibly-suited American woman disembarked at Tokyo's International Airport last week, she brushed off the hundred guides who scrambled to show her the sights. She had come to Japan not to wander the shrines and teahouses but, like the friend at home who had tipped her off (and that friend's friend, and so on and so on), for an abortion.

Of the more than 700,000 abortions reported annually in Japan, a small but increasing number--one Tokyo abortionist puts it at something less than 1,000--are performed on American women. Though the trip itself is expensive ($783 for a round-trip tourist ticket from Los Angeles), the operation may cost no more than $15. Last week's traveler was only seeking the same solution that a couple of million American women a year stay home to find.

Laws & Mores. Despite strict anti-abortion legislation in the U.S. and the often exorbitant expense involved in getting to countries with more lenient laws, abortion statistics continue to rise yearly in a striking case of conflict between the mores of a people and their legal code. Of the estimated 1,000,000 abortions performed each year in the U.S.,* only a surprisingly small number fall into the classic category (the girl who has paid the penalty for promiscuity and wants to avoid the consequences before her parents find out).

Even in the case of single girls, many parents feel abortion is preferable to a marriage to the wrong mate. But it is the married women who, for any of a thousand reasons--most often, they already have children and feel emotionally or financially unable to cope with one more--make up more than 50% of the annual abortion figure.

In the U.S., abortion is outlawed in any form except when it may serve to save the life of the woman; in six states it may also be performed "to save the life of the unborn child." All other abortions, no matter how or where performed, or by whom, are classified as "illegal operations." It is illegal to abort a woman suffering from an incurable disease if having the baby would not actually kill her; it is illegal to perform an abortion on a woman who in early pregnancy contracts German measles (in some 20% of such cases, the child will be born blind or mentally retarded). Even a victim of rape cannot be legally aborted.

The Headliners. Since many respectable doctors are terrified of having the label "abortionist" tied to their reputations--no matter what the legality of the case--and since red tape makes arranging for a legal abortion so complex (most large hospitals require consent from a board of staff doctors), it is difficult for a woman to have an abortion performed under operating-room conditions. For this reason, and for reasons of fear and ignorance, nearly 5,000 women die each year at the hands of the nonprofessionals to whom they have turned; these criminal abortionists often do their work on kitchen tables and the back seats of cars, are almost weekly headlined in the tabloids: ABORTIONIST SCARED, LEAVES GIRL TO DIE, Or BODY OF ABORTION VICTIM FOUND IN PARK.

But, unchronicled in the newspapers and often kept secret even from friends and families, abortions are being performed daily on thousands of women. If they act quickly enough (after the eighth week of pregnancy it is, in many cases, too risky), chances for a successful abortion are high. The most desirable procedure is for a physician to refer the patient to a psychiatrist, who may certify that danger of suicide exists if pregnancy is not terminated. Thus armed, the doctor can make arrangements for a therapeutic abortion (known as a dilatation and curettage--or "D. and C."). Under good hospital conditions, a D. and C. on a pregnant woman is considered "minor, but tricky," costs from $75 to $125. The difficulty is that the psychiatrist may find the patient perfectly normal and refuse to certify the need for therapeutic abortion.

Then, if the woman is determined enough, she can usually find a sympathetic doctor. He will not perform the abortion himself, but knows someone (usually nameless, usually located in a nameless suburb) who will. This procedure is inestimably more dangerous and expensive; the criminal abortionist's average price is anywhere from $400 to $2,000. Other women "take a trip" to Finland, Sweden or Norway (where laws provide for abortion on three grounds: medical, humanitarian and eugenic), to Mexico or Puerto Rico (where abortions are as illegal as in the U.S., but much simpler to arrange), or to Japan (where abortion is completely legal on all grounds).

New Leniency. The American Law Institute, which has worked for ten years on the model penal code for the U.S., calls for a drastic revision of present abortion law. The institute's proposed abortion statute would make abortion legal if the doctors are convinced that 1) grave impairment of the physical or mental health of the mother is involved, 2) the child would be born with a serious mental or physical defect, or 3) the pregnancy was the result of rape or incest. Opposition to this new liberalized view of abortion is strong: nearly every religion opposes abortion in one degree or another, and the Roman Catholic Church flatly considers it murder.

The American Medical Association, which has formulated no stand on any proposed abortion legislation nor seems likely to, considers the problem social rather than medical. Says A.M.A. Attorney Bernard Hirsh: "The Association recommends that each doctor protect himself from charges of illegal abortion by following the requirements set up by some states and most hospitals ... In states where it is illegal, it is unethical. In states where it is legal, the doctor must be guided by his own conscience."

* A figure quoted at the recent conference in Manhattan of the Society for the Scientific Study of Sex, and admittedly a guess, since secrecy surrounding abortion is at a premium. Other guesses range as high as 3,000,000.

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