"The Poor Get Poorer"

ELDER DOCTOR: The examination revealed severe burns and lacerations of uterus. Patient admitted using a wire coat hanger in an effort to induce abortion.
WOMAN: Is the baby dead?
ELDER DOCTOR:. Hemorrhaging had taken place for several hours before patient was brought to hospital by ambulance.
WOMAN: I can't, have any more children. I'm sorry. And the welfare people ain't gonna like it I got eight in the house now, Doctor . . . Is it dead?
ELDER DOCTOR: Infection was widespread. All therapeutic measures were instituted. Massive doses of antibiotics and emergency cut down procedures for transfusion. Patient died fourteen hours after admission.
YOUNGER DOCTOR: That was years ago . . . But I remember. Even what she looked like. And her husband . . . when I told him. And the children. Their faces, too.
ELDER DOCTOR: It was a poor neighborhood. A municipal hospital. There were hundreds like her. We couldn't abort them It was against the law. All we could do was sew them up again... or clean them up and send them home.
YOUNGER DOCTOR: To be back within months.
ELDER DOCTOR: Talk to the social agencies, not me. I can't be a missionary about contraception.
YOUNGER DOCTOR: In a way you are. Abortion is the contraception of the poor.
ELDER DOCTOR: At twenty-six he has all the answers. One year a doctor and he can solve the social problems of a century.
YOUNGER DOCTOR: At forty-six he's forgotten himself as he was. Or has he? For his young days are me . . . and I'm never quite still.
MOTHER: When is it due, Doctor?
MOTHER: I ain't gonna have this baby, Doctor. I'll do something -I'll try anything-unless you can help me.
ELDER DOCTOR: I'm sorry. I can't. There's a law--
MOTHER: But we're getting along as it is. Please . . . it was a mistake. We folks make mistakes. It just happens . . . mistakes
ELDER DOCTOR: But you're in your fourth month. If it were earlier . . . and if there were complications
YOUNGER DOCTOR: Poor people usually don't come to the clinics until the fourth month, you know that. If you can afford a private doctor, you come earlier.
ELDER DOCTOR: A therapeutic abortion can only be done for reasons of health.
YOUNGER DOCTOR: How vague can you get? A hospital board can interpret that any way it likes. The law says . . - "to preserve the life of the mother.
" You can listen to her heart . . . and you can also listen to how she feels and behaves. But don't forget that wire coathanger.
ELDER DOCTOR: A therapeutic abortion can only...
YOUNGER DOCTOR: Be done for reasons of health. That's all rot. Let's get down to cases. We've already established that private patients come in much earlier. If there's to be depression in pregnancy . . . that's when it hits.
In the first eleven weeks. And the private patients get that "advantage" . . . if you can call it that. You've seen doctors on the staff here abort a private patient for psychiatric reasons but a ward patient . . . that's strictly heart, lung, and kidney.
That makes for twenty private patients aborted to one in a municipal hospital.
MOTHER: We're poor, Doctor. My husband is out of a job.
ELDER DOCTOR: I'm sorry. But the law won't allow it.
YOUNGER DOCTOR: Also tell her it's a crime. But then tell her it's the only medical procedure that's been put under the criminal code.
MOTHER: We're too many as it is. We'll go on welfare.
YOUNGER DOCTOR: And also tell her there hasn't been a prosecution yet in the United States for a hospital approved therapeutic abortion. The spirit of the law is being followed .. . not the letter.
ELDER DOCTOR: Then it's the law that needs changing. Why should a doctor live at the whim of a district attorney?
MOTHER: They talk about too many people already in the world. And too many Negroes being born and going on welfare.
But they don't do anything to stop you from having more. What if I was white - - - and I had the money. Then you think I could find a doctor?
YOUNGER DOCTOR: She's got you there. Could she find a doctor? Huh! You know ninety-three percent of New York's therapeutic abortions are on white patients able to afford a private room.
MOTHER: I heard about a Puerto Rican woman out on Railroad Street who'd do it for five dollars.
YOUNGER DOCTOR: Why don't you tell her that forty-two percent of deaths related to pregnancies in New York come from illegal abortions. And that ninety-four percent of those are Negro and Puerto Rican.
ELDER DOCTOR: If this child is taken from you, what's going to happen to you? I mean, your feelings . . . about your other children. Won't you have taken a life?
MOTHER: I'll just love those I got, Doctor. Maybe even more. If I don't want it--why do I have to have it?
ELDER DOCTOR: Maybe for the, same reason doctors take an oath to preserve human life . . . not destroy it.
MOTHER: But that's for a person . - . someone alive. Not a...a nothing.
ELDER DOCTOR: And who's to say what you're carrying is a nothing?
When I was younger, I would have listened to you at once. Tried to help you. But taking a child . . . it's something that stays with you the rest of your life.
A hundred questions about a life to which you'll never know the answers. What you need now is advice . . . and help. So you can carry full term . . . and not hurt yourself.
MOTHER: I'm tired, Doctor. Tired and worn. I don't have the strength.
YOUNGER DOCTOR: Answer, Doctor. The patient waits to be healed. And she is sorely afflicted.
ELDER DOCTOR: I have no answers. Except for people to talk about it. To teach and to inform about their bodies and needs. To make a just law . . . and an honest one. So that each new child will be welcomed-not feared. Will be an act of joy . . . not an act of murder.
1. Is abortion considered by some as a means of population control? Race control? Poverty control?

2. Is abortion a substitute for an adequate welfare program?

3. Is the physician giving up his dedication to preserve life?

4. Is family planning a better solution?

Union Theological Seminary /
"There is a very broad suspicion on the part of many Negroes that what appears to be a sudden concern with contraception and with abortion is thought by many to be a part of a very heinous plot to eliminate, or further control, not only the black minority in this country, but dark minorities everywhere.
"There is a story told about a pair of rabbits being chased into a log by a pack of hounds. The female rabbit said to the male, 'Now what are we going to do?' The male replied, 'Well, we are going to stay right here until we outnumber them.' "I don't believe in this kind of rabbit philosophy. I believe, on the other hand, there are other less ambitious but more plausible solutions to the minority problem in this country."

School of Law, Boston College /
"This drama poses the question: Shall we institutionalize abortion as the contraception of the poor? What would this say to the poor, who have inadequate family planning? It seems to me that the sins of society where this can happen and does happen should remind us that we owe something to those people who are to be born into this society, and before we say that our solution is not to have them born, we should say that this child might be another Beethoven or another Einstein or another Martin Luther King, to help his people. If abortion were given on request, would this not in effect lead to the proposition that the poor can have the number of their children limited by the wishes of a white suburban affluent society?
"Before we come to this bankrupt non-solution, we should increase public support for family planning, for responsible parenthood, for giving that man who is unemployed a job. We have a lot of options to explore and before we snuff out the life of that fetus, whose mother lives in a white America, because his life would be miserable, we should say we owe reparation, restitution and identification to him. Perhaps if we tried hard enough, his life in this America could be better than his mother's life. "As it has been said so well, 'Evil grows because good men do nothing.' This dramatic episode shows us we are not doing enough at all."

Administrator, Human Resources Administration /
"When the mother says in this case 'I am poor,' she is coming pretty dose to it. In my welfare department and all of the others, because we reflect community attitudes, we would be unhappy with this lady and we would give her a hard time.
"All of us know, even though we don't talk about it, that there is a double standard. If you are in the higher income bracket and you are white, things can be taken care of. But if you are poor and Negro or Puerto Rican, then they are not going to be taken care of."

School of Law, University of California at Berkeley /
"If there is a double standard, the same objection can be made to every criminal law in the United States. Every criminal law bears unfairly on the poor. It is misleading to single out the single case and make it responsible for what is a general defect of American criminal justice, the fact of the discrimination against the poor in the minority groups.
"All of these cases put forward the most persuasive arguments that can be made for abortion, because we have in all humanity the problems of living individuals; whom we can see. I think, however, that we need to make an act of imagination and intellect that goes beyond those persons we can see, to understand what is the basis for our society, and for our shared concern for other persons in that society.
"It seems to me that today in the United States we cannot talk of a theological consensus, but we can talk of a humanistic consensus, a concern for man. The question must always be: What is man? We have to face that question.
"If we do not face it, we can contrive easy solutions, by suppressing one part of the problem. We suppress the question as to whether the being in the uterus is a participant in humanity.
"As far as the geneticists have been able to fell us, this being in the uterus shares in the same essential characteristics that make us able to reason.
"It is only different from you and me in that it has not realized a nurnber of its potentialities.
"If that being shares of our humanity, we destroy our humanity, we destroy the basis for our rational concern for others in our society when we say we can kill this being in order to solve some other pressing problem that is less than the demand for someone else's life."

Member of Parliament /
"You don't solve the problem of poverty by authorizing widespread abortion. You solve the problem of poverty by quite another means. It is a great slur upon those who happen to be poor to have others think that to be poor or not--or, at any rate, to be affluent--is necessarily to be unhappy. You can have large families of poor parents who are very happy indeed and you can have small families of rich parents who are extremely unhappy.
"One point this sketch is making seems to be that it is essential, if a child is born, that it should be wanted. Well of course, it is desirable to be wanted but can one arrange it? One can't arrange an ideal family for oneself unless there were the faculty for choosing one's parents, and that is something which up to now we have been unable to do. I would say it is better to be born even though one is born into a difficult situation and may not be entirely wanted~than not to be born at all."

Department of Psychiatry, University of Birmingham, England /
"I should like to identify in this particular case with the doctor. I saw his dilemma. He was in the dilemma because he knows that if he allows his ethics to be eroded on this particular issue, just because the girl is in trouble, he becomes less useful to society as a doctor. He has regard for life. He has regard for fetal life. Society is now telling him that this ii is expendable. He knows if he falls in with that request, he will not be much use to you as a doctor. He can be easily tricked into other decisions, which perhaps are easier for him to make than to perform an abortion. I prostituted my ethics in the past to say people were mad just to save them from the gallows. I told that white lie to keep a fellow from hanging, but I am not going to do it and kill an innocent child.
"Society in general has to take some action. It could train a crew of abortionists with no medical ethics, supervise their work, license them, train them, give them penicillin, and so on, so the job is done clean and quickly and that would be society's solution to the problem. But don't dress it up. Don't be sanctimonious about it."

Department of Obstetrics and Gynecology, Harvard University
"I suggest that any new abortion laws contain the provision that in determining whether or not there is such risk of injury to health, account may be taken of the patient's total environment, actual or reasonably foreseeable.
"If we had this in our law and every social worker and every physician knew that this was the law of the land, I dare say that this lady "would never have had four pregnancies, to say nothing about eight. With this provision in our law, the medical profession could no longer disregard its duty in counseling. We have a rule in our hospital, on the house service, that the question will be asked to anyone who has three children: 'How large is your family going to be?'
"I dare say if this lady came into our hospital for help, we would sit down with her and give her certain options. The options would be: What is society going to do for you? What are we going to do for you ultimately? We can sterilize women after a fourth pregnancy. It is a simple procedure. But before we do this we make a great study of the case. Every case is settled in a very personal way. I think if we have this in the law, then all of us will make an attempt to solve patients' problems and the patient will have her day in court."

"No woman whose family is on relief should be discharged from the hospital after having had a baby without the physician and social worker knowing her family situation sufficiently to know whether she needs birth control information, whether she knows how to get it, and insuring that it is made available to her if she wants it. There is a serious lack of education of both physicians and social workers regarding their responsibilities in this area of health and welfare care.
"There should be centers in hospitals or in other places in a community where any woman who wants an abortion should have an Opportunity to go for immediate consultation as early in pregnancy as possible. These consultation centers should be known to all the social welfare agencies who care for women like those presented in this skit. If it is wise for her to continue with her pregnancy, in many instances she could be helped to accept, and eventually even welcome the child. Especially if she were given the needed emotional and economic support, and with the promise that she would be given the advice on how to prevent future unwanted pregnancies. If this woman had had sufficient help during her previous pregnancy, she would not be in her present situation of coming here with an eighth pregnancy which is so unwanted. Many medical centers have a policy that if a couple have five living children and if they request it the woman can have her tubes tied when her sixth is delivered. For older women, this policy is followed if they have four or three living children. Therefore, better education of physicians and social workers would prevent illegal abortions in this group."

5th Case