DR. DAVID M. PRIVER, MD, FACOG
From the years 1971 through 1974, I had the privilege to serve as a resident in the specialty of obstetrics and gynecology at the prestigious Sinai Hospital, Detroit, Mich. As any resident knows only too well, a monumental amount of time is spent responding to calls from the emergency room, especially at night, when many people utilize ERs as stand-ins for their private physicians. The vast majority of ER calls dealt with minor issues which could have and should have waited until the next day. But, of course, people have other things to do during the day, such as going to work or school.
So, when ERs got crowded, the issue of “triage” had to be addressed. That meant that someone in the ER had to divide patients into three categories. 1. Those whose situations were of a minor nature and could wait; 2. Those for whom immediate attention was most likely to result in a good outcome, and finally, 3. Those whose situations, although possibly quite severe, could not be helped by immediate attention.
A fairly frequent issue confronted in the ER had to do with women being seen for suspected abortion complications. As the current generation may not realize, prior to the Jan. 22, 1973 Supreme Court Roe v. Wade decision basically legalizing abortion, this procedure was totally illegal, thanks to the never-ending political vigilance of anti-abortion crusaders, mostly promoted by the Catholic Church. Of course, this outfit was just as opposed to any form of birth control as it was to abortion, and woe be unto any legislator who dared to oppose this oppressive dictatorship.
My three years of residency were chronologically divided, almost to the day, between before and after the Roe v. Wade decision. That meant that I spent the first half of that period often being called to the ER to deal with complications of abortion. Most of these were things like infection, hemorrhage or physical injury such as lacerations or, the most dreaded, uterine perforation which was often accompanied by bowel injuries. While I did not witness deaths, I frequently dealt with complications that rendered women subsequently unable to have future pregnancies.
During my early residency, I “moonlighted,” which meant that I earned badly needed extra money by working surreptitiously in various outpatient clinics. This violated our hospital employment contracts, but, essentially everyone did it. (I earned $9,000 in my internship). During this time, the state of New York broke the deadlock by legalizing abortion in that state against tremendous opposition. A major force in this battle was the Clergy Consultation Service, to whom we quite often referred pregnant patients and which has never gotten the attention for achieving ultimate national legalization which it deserved.
Rather than have OBGYN residents serve the common, but absurd 36 hour on-call shifts (which resulted in many extremely bad outcomes), my very enlightened department chair, Dr. Alfred Sherman, assigned all residents to two week rotations on either days or nights. When on nights, sleep occurred during the day. It was on one such stretch that my wife woke me, to my initial displeasure, to tell me that the Supreme Court had issued the Roe v. Wade decision. Although this was monumentally good news, it was actually overshadowed on the evening news by the report that former President Lyndon Johnson had died that same day.
So, after a few weeks during which physicians learned how to do abortions safely, the conditions involving ER visits changed dramatically. Although I still went down to the ER on most on-call nights, there were no more abortion complications. On one night, I brought a junior resident with me and heard him ask the question: “What has happened to all those interesting abortion complications we used to see.” I bit my lip and told him that these no longer exist and never will again.
So, as our country confronts the misogynistic Republican Party (which used to pound its chest promoting “small government” and “individual liberty”), what happens next? As Roe v. Wade becomes “old news,” I am fearful that my prediction that safe abortion rights are with us forever, may prove to be incorrect. I am hoping that my message, as one of the dwindling few who recalls the “bad old days,” will be disseminated to the current generation of young and endangered women. I am counting on the media to get this critical message out to the public so as to make abortion complications a thing of the distant past.