Tuesday, June 7, 2022

What might the abortion gray market look like, post Roe?

 My favorite psychiatrist points out that, before abortions became generally legal except when the woman's life was at risk, psychiatrists were often called upon to make a decision.

The ‘Open Secret’ on Getting a Safe Abortion Before Roe v. Wade  By Sally L. Satel

"Dr. Satel is a visiting professor of psychiatry at Columbia and a senior fellow at the American Enterprise Institute."

"If the Supreme Court overturns Roe v. Wade, will psychiatrists resume their pre-Roe role as arbiters of abortion access? The law once compelled psychiatrists and pregnant women to perform dishonest rituals to get abortions. Will psychiatrists once again need to be complicit post-Roe?

"Before Roe v. Wade, a number of states allowed abortions if doctors could certify that the mother’s health, not solely her life, was at serious risk. A great number of those certifications were granted by psychiatrists, some of them by the professors who taught me as a resident in the mid-1980s in Connecticut.

"Through the 1940s and 1950s, medicine advanced to the point where health problems like heart disease and tuberculosis were generally no longer considered to be indications for therapeutic abortion. As a result, psychiatric justification became the primary rationale for therapeutic abortion before Roe.


"It was an “‘open secret,’” Dr. Richard A. Schwartz of the Cleveland Clinic observed in 1972, the year before Roe was decided, “that a woman can obtain a safe abortion in a licensed hospital if she can find a psychiatrist who will say she might commit suicide.

"To accommodate such women, psychiatrists used a combination of empathy and civil disobedience to declare them at risk unless they were allowed to terminate their pregnancies."


If the Supreme Court overturns Roe, laws about abortion will go back to the individual States. One difference from the pre-Roe environment is that there will now be probably around half of the states that will continue to allow legal (and hence safe) abortions.  So the gray market in states with abortion bans will also involve travel, for those who can afford it (and perhaps mail order pills for those well organized enough and for whom travel isn't a good option).

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