Risking women's health
THIRTY-TWO years ago a Suffolk County jury in Massachusetts found me guilty of manslaughter in the death of a fetus during the performance of a legal second-trimester abortion.
In that particular case, the abortion was carried out by hysterotomy, a major surgical procedure often described as a mini-caesarean section, after multiple attempts at saline infusion had failed. Both hysterotomy and saline infusion are techniques which are effective in terminating pregnancies, but both of them carry substantial risks for the pregnant woman. The best, safest procedure for my patient would have been one called dilation and evacuation, or D & E. Yet neither I nor anyone on the staff of Boston City Hospital at the time had the skill or experience to perform this procedure in the second trimester. So to carry out my patient's wishes, I had to expose her to increased risks to her health and life.
Last week, the US Supreme Court removed intact D & E -- a variant procedure now called "partial-birth abortion" by its opponents -- from the list of options that women and their doctors have to terminate a pregnancy after the first trimester. By upholding a federal ban on the procedure, the court has increased the risks to women who want to exercise their constitutionally guaranteed right to privacy to terminate a pregnancy.
There are numerous medical conditions which can complicate a pregnancy, jeopardizing a woman's health and life, and sometimes require a second trimester abortion. Many such conditions were enumerated in the New England Journal of Medicine in 2004, in an eloquent article written by Dr. Michael Greene and Dr. Jeffrey Ecker after President Bush signed the Partial-Birth Abortion Ban Act of 2003.
If the Bush administration and a conservative Supreme Court can ban one procedure, then it can ban other abortion procedures, thereby restricting women's access to safe and legal abortions. In the many difficult cases which require pregnancy termination, who is best equipped to make these choices? Who knows the woman's circumstances better than she does?
In its decision overturning the guilty verdict in my case, the Supreme Judicial Court of Massachusetts said, "We deal here with the professional judgments of a qualified physician acting under stress at the operating table. The Supreme Court has cautioned in the abortion cases against the undue trammeling of judgments of the individual attending physician." In last week's decision, the Supreme Court has limited the judgment of physicians to act in the best interests of their patients.
During the last two presidential campaigns the abortion-rights movement warned that a Bush administration would appoint Supreme Court justices who would try to overturn Roe v. Wade. The court has now taken a step in that direction. Banning legal abortions would force desperate women to seek illegal abortions, to submit to dangerous procedures, often at great expense, and result in the deaths of many of them. This burden would fall disproportionately, as it did before Roe, on the poor women of our country. We must never return to those days of horror.
Dr. Kenneth C. Edelin is emeritus professor of obstetrics and gynecology at Boston University and the author of the forthcoming book "Broken Justice: A True Story of Race, Sex, and Revenge in a Boston Courtroom." 
