Abortion in Texas
One year after the Supreme Court decision we survey how hospitals and private citizens are responding to legalized abortion.
There are other options to an unwanted pregnancy, but none is so controversial. How available are abortions today, where are they done, and what has legalizing them meant?
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Elizabeth is married to an attorney who practices law in a small town and they have two sons in college. When she found herself pregnant, Elizabeth and her husband decided on an abortion.
“I’m 42. If I had a baby now, I’d be 60 when it would be 18. It’s hard enough trying to understand my teenage kids now and I’d hate to think what it would be like in 20 years.
“Our boys are almost grown now, you know? I mean Bill and I had planned to do some traveling, and I wanted to start teaching again—I had to quit when John (the oldest child) was born. Well, anyhow, we had planned all these things and then I got pregnant. I think I knew right away, but I didn’t tell anyone, not even Bill. All these things were going through my head. We’d have to convert the guest room back into a nursery. I’d have to give up my idea about going back to work, it might mean Bill would have to put off retiring and then I’d read that children born to older parents had a bigger chance of being deformed or sick or something and I didn’t even want to think about that.
“It all sounds so selfish when I say it now, and I admit I still feel guilty, but I just didn’t want another baby. Instead of being happy about it, it just seemed like my whole world was crashing down. What kind of mother would I be feeling like that?
“I really hadn’t ever thought of abortion—not for myself at least. It’s o.k. for a 16-year-old girl who gets in trouble or something, but for me? I couldn’t talk to our doctor. We live in a small town and I know his wife—it’sjust not like living in Houston or somewhere where nobody knows you.
“So I finally told Bill that I thought I was pregnant. He wasn’t happy about it. Oh, he tried, but I knew what he was thinking. At first I didn’t mention what I’d been thinking—about an abortion, I mean. But one night—he could tell something was bothering me—and I guess I just let it all out. We talked for a long time and decided we’d try to find somewhere. We were both relieved I think when the decision was finally made.
“So one weekend, we went to Austin. Bill had asked around and found a place where they could help us. We talked with a minister, both of us, and he was really sympathetic. He didn’t try to make me change my mind or anything and he really made us both feel better about what we were doing. So he set up an appointment for me in San Antonio. Bill went with me and it was allover in no time. Right at first, I was almost euphoric, it was such a relief. Then, when we went home and I was by myself, I began to think about it and believe me, it wasn’t easy for awhile there.
But I still feel like I did the right thing. I can talk about it now and Bill has just been great. We never did tell the kids. Maybe someday we will, but not now. It’s changed me some, I guess. I’m more determined about going back to work and really making something of myself. I feel like I have a responsibility to do that now. I know some people would really look down on us for what we did, but it doesn’t bother me anymore. For us, it was the right thing to do.”
Jennifer is a student at the University of Texas. She transferred there from a small West Texas college after she had an out-of-state abortion. Many women from smaller Texas towns still go out of state for abortions because there are no facilities nearby, or because they just don’t want to take the chance of meeting someone they know.
“I never even considered having a baby. The guy I was going with sure as hell wasn’t any help —when I told him, he made tracks right out of town. I had a friend who’d gone to New York and she helped me get it arranged. Some of the girls in the dorm put up money—it was really great, and I didn’t have to tell my parents. So, anyhow, there wasn’t a money problem.
“In New York, they had it all set up, but I really felt herded through. Like when I was there, there were 26 other girls. They had appointments scheduled for 7 a.m. and for 11 and they took about 15 of us at a time. And this was like an everyday thing and I had no idea it would be like that. I was just floored. The whole time I was in the office, the phone was ringing and they were making appointments.
“When I got back, I told my parents I wanted to switch schools and I came down here. I take the pill now all the time, but I don’t see myself as somebody who just sleeps around. I think a lot of people won’t take the pill because it’s like admitting to yourself that you might go to bed with anyone you go out with or something. You know, like one-night stands. Well the truth is that it can happen and it’s a whole lot better to risk the side effects of the pill than to get pregnant. I’m just making sure that it never happens to me again, until I get married, I mean. I just wish more girls would face up to this kind of thing. Then, maybe we wouldn’t have to have abortions at all.”
GWEN IS 20 NOW. She and her husband both work and their 3-year-old son is doing well. Although she could have had an abortion, she chose to have the child. She sees marriage as a valid choice for a woman with a problem pregnancy, but doesn’t advocate it in all cases.
“My parents were really great when I got pregnant. I told them we had decided to get married and Dad just said ‘welcome to the family’ to Mike.
“I really wanted to get married and have the baby. Not everyone wanted me to. My doctor even said, ‘Are you sure that this is what you want to do?’ He talked to me about abortion, but I just wanted the baby. While I was pregnant, I was really happy, but when the baby came, I realized I really had two babies on my hands.
“For a while, I think I even hated both of them. The first time I tried to dress Shawn, he screamed and screamed. Then Mike picked him up and he stopped. I just cried my eyes out.
“This went on for about two years. I don’t think I was really happy for any of that time. I finally realized I needed help when it began to show up in Shawn. He’d say, ‘Mommy, you sure do cry a lot.’ That’s when I went to get counseling.
“I have a job now and Mike is working too. I think I’d like to be a social worker. Having a baby just isn’t for everyone. We’d like to have more children someday. I wish there were a reversible vasectomy, because I don’t think I’d be happy if I got pregnant right now. But maybe in a few years when Shawn is in school, we’d like to have another baby.
“I don’t know what would have happened if I hadn’t come for counseling. Maybe Mike and I would have gotten divorced, I don’t know. But everything’s o.k. now. Shawn’s getting to be lots of fun. I’m glad he’s here.”
THE PROCEDURE
If abortion is chosen as an alternative to pregnancy, the procedure should be done as soon as possible—ideally, during the first 12 weeks. During this period, vacuum aspiration is the usual method. Statisticians report that this procedure is three times safer than a tonsillectomy and five times safer than normal childbirth. While pregnancies can be legally terminated up to the 24th week, procedures used become increasingly dangerous for the woman; they are also more expensive and more difficult to obtain. Procedures most commonly used are:
ENDOMETRIAL ASPIRATION.
Sometimes called “menstrual extraction,” endometrial aspiration is a relatively new procedure for women who have missed a menstrual period by no more than 12 days, calculated from the first day the period should have begun. Doctors generally prefer to wait until the eighth day to do the procedure.
Similar to the vacuum aspiration method, endometrial aspiration is accomplished by inserting a flexible plastic tube called a cannula into the uterus. Using suction, the contents of the uterus are gently removed. Anesthesia is optional and the cervix is usually not dilated. Endometrial aspiration is done on an outpatient basis; costs range from $50 to $125.
VACUUM ASPIRATION
Vacuum aspiration is the most common method of ending a pregnancy up to 12 weeks. It is safe and relatively painless—a woman may have some pain which feels like menstrual cramps; for some women, it will hurt a bit more, but this is unusual.
With this procedure, a cannula slightly larger than the one used for endometrial aspiration is used. A local anesthetic (paracervical block) is injected around the uterine cervix, and a gradual enlargement, or dilation, of the cervical opening is done using metal dilators. A newer and safer method of dilating the cervix is done by the insertion of sterile seaweed into the cervix. These small blocks of seaweed look like matchsticks. After insertion, the material absorbs fluid and expands, gradually dilating the cervix over a period of about six hours. This method of dilation is preferable because metal dilators may sometimes damage cervical tissues.
After the cervix is dilated, the cannula is inserted into the uterine cavity. Vacuum suction removes the fetal material from the wall of the uterus and out into a collection bottle. Then the uterine lining is checked with a curette (a long metal instrument with a spoon- shaped end) to make sure that all fetal tissue has been removed. The suction procedure lasts from 5 to 10 minutes.
Afterwards, the woman will probably feel well within an hour or two. Normally, she can return to work or school the next day, but she should avoid strenuous exercise for a couple of days.
Vacuum aspiration is usually done on an outpatient basis. The cost is about $150.
DILATION AND CURETTAGE (D&C)
Until the recent development of vacuum aspiration technique, this was the standard abortion procedure up to 12 weeks. It is also standard gynecological practice for other reasons, such as clearing the womb after miscarriage or attempting to remedy certain causes of infertility. D&C is still fairly commonly used as an abortion method by physicians who do not have access to vacuum equipment.
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