This Date in UCSF History: Defending the Right to Choose

Campus

Originally published in Synapse on Nov. 21, 1996.

Before 1973, the year Roe vs. Wade guaranteed women the right to safe, therapeutic abortion in the U.S., David Grimes, MD, recalled visiting the septic unit of a Los Angeles hospital. Women seriously ill from botched illegal abortions lay in the twenty beds of the common ward.

Two private rooms allowed the dying to spend their last moments with grieving family members. The ward was always filled to capacity.

Grimes, chief of Obstetrics and Gynecology at San Francisco General Hospital and vice chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF, was one of seven abortion providers who spoke on Saturday, November 16 at the regional conference of Medical Students for Choice.

About sixty medical students from UC Davis, Stanford, the UCSF/Berkeley Joint Medical Program, and UCSF gathered in the Millberry Union Conference Center to discuss the social, medical, and ethical issues surrounding abortion care.

Their reasons for attendance varied from seeking clinical information about abortion that is not available in their medical school curricula, to sorting through personal feelings about choice or thinking about whether they would be willing to provide abortions.

Medical Students for Choice, with more chapters at more than 100 medical schools and over 3,000 members nationwide, was founded in 1993 by Jody Steinauer (now a fourth-year medical student at UCSF) over concern about the lack of abortion education in medical curricula and residencies.

This omission is especially disturbing given the estimate that almost half of women in the U.S. will have at least one abortion before the age of 45.

MSFC's goals are to increase education and training opportunities for medical students about abortion and reproductive health, and to provide a network of support and resources for students interested in issues about choice.

As Arzou Ahsan (third-year medical student at UCSF and national coordinator) summarized, "Medical Students For Choice is not about pro-choice medical students. It is about all students supporting their colleagues and patients in personal decisions regarding abortion."

Five abortion providers in the morning session gave personal accounts of their own practices and convictions.

They spoke of their commitment to their patients, and how the simple 15 minute procedures allowed women to reclaim control of their lives.

Dr. Grimes and Dr. Tracy Flanagan, assistant clinical professor of Obstetrics, Gynecology and Reproductive Sciences, and director of outpatient obstetrics and residency programs, also spoke of their experiences as targets of anti-choice protesters.

Subjected to threats, harassment, even picketing, both had to consider their careers in the context of the safety and well-being of their own families.

Dr. Grimes, although concerned by the threats, pointed out that statistically it was much more dangerous to drive to a clinic than to work at it, given the higher incidence of traffic accidents. He also reported that ER doctors were more at-risk for violence in the workplace.

Nevertheless, the threat is felt by many. A student attending the conference shared that her father, an ob/gyn in private practice, was discouraged from providing abortion services by similar scare tactics.

In the afternoon session, participants chose either a case-based discussion of ethical issues in abortion care or a demonstration of first trimester abortion techniques.

Grimes and Phillip Darney, professor of Obstetrics, Gynecology, and Reproductive Services, and director of the SFGH Family Planning Clinic, described medical abortion using methotrexate, RU4B6, and misoprostol.

Although RU4B6 is both more effective and has fewer systemic effects than methotrexate, its largescale application in the United States is likely to be delayed for a number of years. Janet Arnesty, MD, demonstrated the tools and techniques of first trimester surgical abortion.

The workshops were followed by a screening of Dorothy Fadiman's newest documentary, The Fragile Promise of Choice.

The sobering film revealed the plight of women without access to abortion and exposed the increasing barriers to abortion services in this country, especially for young or poor women.

Many states have passed laws that prohibit the use of Medicaid funds to pay for abortions except in cases of rape or incest or require parental consent for minors seeking abortions.

Lack of abortion providers also limits women's access to care. Only 17% of U.S. counties have abortion providers, and the majority of ob/gyn residencies do not even offer abortion training.