Last summer Attorney General Patrick Morrisey invited public comment on how his office might help to assure that women were fully protected when they sought certain reproductive health services. This is a shortened version of the comment I made.
Dear Attorney General Morrisey:
I appreciate the opportunity to advise you in your initiative to protect the health of West Virginia women. I think I can share a valuable perspective. I was born in 1948 and grew up in rural Appalachia. As a child, my cousins and I sneaked to overhear the "adult" conversations of the older women in our family. We overheard these women talk about the ingestion of substances used to end a pregnancy. These genuinely virtuous women were talking about abortion inducing agents. The need for women to control reproduction is not a recent phenomenon.
It was apparent that the women of my family had learned self-help medicine from their foremothers. Though strictly religious, they did not consider the use of these measures as a sin and certainly did not think of women who used them as committing a crime. I doubt these women were aware of the potential dangers of using roots, barks and minerals in this way. I do know they were aware of the dangers of repeated frequent pregnancy and childbirth.
The graveyards we regularly visited were an inescapable reminder that death was often a consequence of pregnancy. The tombstones of relatives and neighbors -- who had died during pregnancy, giving birth, or its aftermath -- told the story. Fortunately, both my grandmothers had many successful pregnancies. My paternal grandmother bore her last child in her 41st year, after birthing twins just two years earlier.
I was married at age 18 and pregnant within a few months. I had my first miscarriage in September 1966 with a hospitalization for a D&C procedure. As the birth control pill had recently become available (and legal), I went back to college with a prescription. I was able to complete my degree, fortunate to be in the first generation of young women for whom safe, reliable pregnancy prevention was an option.
By the time I graduated, most of my classmates in a religiously affiliated school believed that abortion should be a legally available medical procedure. The subject was not abstract for young people of my generation as they too had visited graveyards and heard the same stories as I. It became even less abstract when a classmate was raped on a first date and a pregnancy resulted.
In 1969, abortion was illegal virtually everywhere in the United States (unless one was rich and well-connected and the doctor called the procedure by another name). From eastern Kentucky, locating a provider for an illegal abortion felt as complicated as mounting an espionage operation. Eventually with information from fourth-hand sources and lots of cash, my friend went to New York City with an address and a code word to participate in a criminal enterprise -- ending a pregnancy. (Early term abortion became legal in New York the following year.)
I had multiple unsuccessful pregnancies. Among them are a ruptured tubal pregnancy that necessitated surgery and four pints of blood; a five-month pregnancy where I developed a septic infection that required massive doses of antibiotics to save my life; another miscarriage that resulted in hospitalization; and several other spontaneous abortions in the first few weeks of pregnancy. Three decades later, legislation in many states would require my doctor to notify law enforcement that I had sought medical treatment for these conditions. Multiple spontaneous abortions would definitely be suspect. Under such laws, I could expect a police investigation that would seek to determine whether my failed pregnancies were the result of intentional actions on my part for which I should be charged criminally.
My 29-year old niece, a health professional herself, was recently seven months pregnant -- her first. She was experiencing two major complications of pregnancy -- preeclampsia, a condition potentially fatal to both the woman and fetus, and cholestasis which can be fatal to the fetus after the 37th week. When the preeclampsia became more severe, my niece in consultation with her doctor, decided to have labor induced more than a month early.
My niece's decision balanced preserving her own life and health with the need to maximize fetal development before her body became toxic to the child she was carrying. Fortunately, she lived in a state where her informed decision did not have to be reviewed, second-guessed and ratified by outside parties as "acceptable" under the law. This story has a happy ending. My prematurely born great niece has thrived since her birth on Aug. 20. My niece's recovery required more than two months but was fully successful. Two generations ago when medicine was less sophisticated, it is possible that both would have died.
Recently, many state legislatures have decided to establish an independent "state" interest that displaces the judgment of the patient and her doctor in deciding how reproductive health care is delivered. These laws intrude both when the decision is whether to terminate a pregnancy and when the decision is when and how to complete a pregnancy to birth. I have shared this personal history to emphasize that women in consultation with their families and doctors can be fully trusted to make these life-altering medical decisions. The "law" does not need to be any more involved in women's reproductive health decisions than it does in decisions that patients make about any other type of medical services.
If the Attorney General's staff needs a deeper understanding in order to conclude and advise the Legislature that West Virginia does not need further laws that would substitute the decision of bureaucrats and prosecutors for those of a pregnant woman and her doctors, I suggest you visit some family cemeteries. Listen carefully. The tombstones of young women tell a powerful story.Justice lives in Charleston.