What Will 79% of OB/GYNs Do in Response to Supreme Court Abortion Decision?
Expect a backlash when <i>Roe</i> ends
Robert A. Hatcher, MD, MPH, chairman of the Contraceptive Technology Update editorial board, discusses the history of Roe v. Wade and what could happen once the U.S. Supreme Court overturns it.
CTU: What is your history with abortion and Roe v. Wade?
Hatcher: I was a co-plaintiff in the Doe v. Bolton court case. Roe v. Wade and Doe v. Bolton were two cases about abortion that the U.S. Supreme Court heard together in 1973. The court decided in 1973 the laws regulating abortion in Texas and in Georgia were unconstitutional.1
I am a pediatrician. In the late 1960s, I went to the Centers for Disease Control and Prevention and said, “I want to work in family planning.” They assigned me as an Epidemic Intelligence Service officer to the health department family planning program in Columbus, GA. When I got done with those two years, I’d put in many IUDs [intrauterine devices] and had seen people for a wide range of contraceptives. My next step was to join the department of gynecology and obstetrics at Emory University. My experience has been primarily in contraception.
I was never opposed to abortion, but I did not have strong feelings in favor of abortion until I started seeing patients in family planning who were using contraceptives and who became pregnant.
I’ll give you one example from 1969 that altered my opinion about abortion. This woman came to me through our family planning program. She was the mother of five children. She had an IUD in place and was late for her period. I had to tell her that she was pregnant. Her life was looking up for her before this pregnancy. She had been living in an apartment that had rats in it, and they bit her children. This is what she awakened to find many times in the morning. She had found different public housing in Atlanta where rats were not a problem. But she could not move in if she had six children. I had to tell her that she was pregnant with what would be her sixth child. She was absolutely desperate.
I told her there was no law favoring abortion at this point. I didn’t know how it would happen, but I told her I would help her obtain an abortion. There was group at Emory called the Emory Clergymen’s Counseling Service. I knew that what they would require of her was about $300 to fly to Mexico to get the abortion in a place where they knew of doctors doing safe abortions. I asked two individuals if they would contribute $100 to this process, and decided I would do the same. That’s how we came up with the $300. She flew down to Mexico, obtained a safe abortion, and from then on, I had put my foot into the water in terms of being a proponent of safe, legal abortions.
Then, in the summer of 1969, I was called by a woman who pulled together all the co-plaintiffs in the Supreme Court case in Georgia that would be argued with Roe v. Wade, the Texas case. Doe v. Bolton was the Georgia case. They asked if I would be a co-plaintiff in this case. Five years after the Supreme Court handed down their momentous decision, I found out that I was the first person called in Georgia because they wanted a doctor to sign up as the first co-plaintiff. I don’t know what would have happened if there hadn’t been four or five summer students sitting in the room with me when I got the call asking me to be a co-plaintiff. I said, “Of course, I’ll do it.” However, I was very nervous at that point because the chairman of the department for which I worked was listed as one of the co-defendants in Doe v. Bolton. I was a young, recently hired member of his GYN/OB faculty.
Ultimately, three people from our department became co-plaintiffs. The department chair was one of the people whom the case was filed against because his department had turned down Doe for an abortion. Eventually, his name was taken off the case.
I’d only been in the department for a year and a few months. Fortunately, most of the department wanted abortion to be available to people in Georgia. Later on, Dr. John D. Thompson’s name was taken off, and the case went to the Supreme Court. The case was filed against the attorney general of Georgia, the police chief of Atlanta, and the head of the hospital authority.
CTU: Did you ever think Roe would be overturned in your lifetime?
Hatcher: Most Americans wanted abortion available for women. That was the case in 1973 and it’s still the case in 2022. I didn’t think Roe v. Wade would be reversed, but I always thought it could be because it’s such an emotional subject.
This raises the question: “How are women going to be able to get abortions in the United States?” It’s going to be much more difficult for young women, unmarried women, poor women, economically disadvantaged women, and women of color to obtain abortions. Women who have money and who can go elsewhere will have safe abortions because there will be abortions available in many other places.
The mother of five I talked about is an example of what could happen again. Politically, the health concerns of poor, unmarried women of color are of less concern to many Americans although those are the very people who will not be able to get an abortion.
There are lots of people who know what their options are, but to have access to an abortion now in the face of the Supreme Court overturning Roe, safe access to abortion is going to be unlikely for a large segment of society. Abortions will cost a lot of money, and lack of access will hurt many people and their families.
CTU: If these bans occur, will doctors turn away women whose health depends on an abortion?
Hatcher: In many cases, the answer clearly will be yes. That’s what happened in the past when hospitals turned away women for abortion even when pregnancy was dangerous.
This is a profound women’s rights issue, and most physicians in obstetrics and gynecology now are women [79%].2
CTU: What will be the long-term repercussions of abortion bans?
Hatcher: Some physicians who are practicing in a state where abortions have been dramatically curtailed are going to fight and do things they’re not supposed to do, and if they can hide it, they will do so. You just know that’s going to happen. It’s pretty straightforward how to do these procedures and how to do them safely. But you will also have back alley abortions, and they will sometimes be done incompetently. There are thousands of nurses and doctors in each state who know how to [perform] an abortion safely. It’s not at all beyond the pale that some abortions will be available. It will be scary because the punishments are so ridiculous, but people will do them. I predict that some physicians in Texas, Florida, Mississippi, and Georgia will assist women desperate to end a pregnancy. I doubt that such physicians will go to jail or pay $10,000 fines. But we will see.
Imagine the young woman, who is raped, finding herself pregnant. She may know people who know someone who can perform abortions safely. She will put all sorts of pressure on her friends or family members to help her.
There will be a lot of tragic consequences from all these changes. I think it’s safe to predict that eventually there will be a change back toward more availability of abortions in response to those tragedies.
- The Embryo Project Encyclopedia. Doe v. Bolton (1973). Nov. 29, 2017.
- Zippia. OB/GYN statistics and facts in the US. Updated Sept. 9, 2021.
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