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  • Title: Medically indigent women seeking abortion prior to legalization: New York City, 1969-1970.
    Author: Belsky JE.
    Journal: Fam Plann Perspect; 1992; 24(3):129-34. PubMed ID: 1628716.
    Abstract:
    If the efforts now underway to limit access to abortion services in the United States are successful, their greatest impact will be on women who lack the funds to obtain abortions elsewhere. There is little published information, however, about the experience of medically indigent women who sought abortions under the old, restrictive state laws. This article details the psychiatric evaluation of 199 women requesting a therapeutic abortion at a large municipal hospital in New York City under a restrictive abortion law. Thirty-nine percent had tried to abort the pregnancy. Fifty-seven percent had concrete evidence of serious psychiatric disorder. Forty-eight percent had been traumatized by severe family disruption, gross emotional deprivation or abuse during childhood. Seventy-nine percent lacked emotional support from the man responsible for the pregnancy, and the majority were experiencing overwhelming stress from the interplay of multiple problems exacerbated by their unwanted pregnancy. A series of 199 medically indigent women who applied for therapeutic abortion at Bellview Hospital in New York City from December 1968-April 1970 is discussed by a psychiatric staff member who evaluated the patients as part of their application. At that time, abortion candidates were required to have 2 psychiatrists state that pregnancy was a risk to their life. They ranged from 14-41 years old; 30% were Black, 23% Hispanic; 62% were never-married, 20% were married. 56% had been pregnant before, 8% had prior induced abortions. 15% had infants or twins 1 year old. 22% were on public assistant, 42% had low-paying jobs, 20% were students. 75% successfully obtained hospital abortions. Of the remaining 49, 6 had spontaneous or clandestine abortions, 6 obtained induced abortion illegally, 9 decided to carry their pregnancy to term included 4 who attempted self abortion and 4 who attempted suicide during the pregnancy. 57% showed objective evidence of serious psychiatric disturbance, not including depression, anxiety, or threatened suicide. The 10 who were not recommended for abortion for lack of psychiatric grounds included a mother of a mentally retarded and a brain-damaged child and 5 other children, and a retarded woman abandoned by her husband. The 5 minors who were not approved for lack of parental consent included an 18-year old whose father had attempted to strangle her and whose mother abused her. 3 of these minors obtained abortions illegally. During the application process, which normally took 2 weeks, or after approval, 23 were lost to follow-up. Those lost during the process included 4 with severe psychiatric diagnoses, and 4 who attempted self-abortion. In the group there were 33% who had attempted abortion, 5% whose pregnancy was a result of rape, 11 who abused their children, 7 who did not have custody of their children, and 79 whose relationship with the father was marked by lack of support, abuse, marital conflict, or the partner was dead, ill, or dying. The prevalence of poverty, family pathology, severe stress, and psychopathology was presented in detail. It is likely that the ability to care for children of the index pregnancy in the women for whom abortion was refused was impaired. The author believes that the psychosocial pathology in this population has increased, and that newly enacted restrictions on abortion would be even more stressful for today's indigent women.
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