I returned to our room in the cheap hotel in Paris to find a bloody mess. My roommate, John, left a note that he had gone to the hospital with his girlfriend.

We were in college and were spending the summer studying the French language. John had met Ruth in London, our first stop. She was already pregnant and had decided, although it wasn’t legal, to abort the pregnancy. She arrived in Paris several days later and thought that everything had gone well. Immediately after she got to our room she started to hemorrhage. John called an ambulance, she was hospitalized, transfused and had a D&C. She recovered eventually.

That was my first introduction, as an innocent 20 year old, to the subject of abortion, and my first brush with gynecology. It made a lasting impression.

Two years later my fiancée (and later, wife) was in graduate school and I in medical school in a different city. One of Gail’s roommates had been out of town, then spent a night in the hospital. After she returned to the apartment, the police came for an official and frightening visit. The hospital reported that Jane had had an abortion, and the visit was to find the identity of the doctor who had performed it. The officials interrogated her at length but left without that information.

Fast forward to when I was in general practice in New Mexico. The records of a new patient showed that she had had a hysterectomy – not unusual for a middle-aged woman. But what was surprising was the pathology report. In addition to the expected uterus, it showed a 6-inch long splinter of wood! I asked the woman how the splinter got there. She replied that she didn’t know, that she was as mystified as me. We both knew what the real story was.

During my residency I was called to the emergency room one evening to see a woman who was pregnant and bleeding. This was her fourth pregnancy and she had three young children at home. I thought she could be having a miscarriage. Spotting could also be an indication that the woman was trying to cause an abortion by introducing something into her uterus. Abortion was already legal in all states in the United States, although the Supreme Court decision was less than a year old.

Back then, I used to warn all women with a threatened miscarriage that it was important to tell me if they had done anything to abort the pregnancy. This was because nonmedical abortions were still common, and because of the risk of a serious infection. This woman responded “no”, she would never do that – she was a member of a religion that didn’t believe in abortion.

I was surprised a few hours later when the same woman returned to the emergency room. She told me that she returned because what I had told her worried her. She couldn’t be sick because her children needed her. She admitted that she had, indeed, tried to cause an abortion with a knitting needle.

These are cases that I can remember well of women who faced unwanted pregnancies. All of these cases are long past history, thank goodness, because now safe abortion services are available. Regrettably some people are trying to take away access to safe, empathetic and legal abortion. Worldwide, over 20 million women have unsafe abortions, resulting in 50,000 maternal deaths and many more serious injuries. “Not Yet Rain” is a video made in Ethiopia about the difficulty young women have in getting safe abortions after rape. Studies show that abortion is actually more common where it is illegal!

An unplanned, unwanted pregnancy is a difficult situation for a woman to face. Sometimes things work out well and the child is adopted. Sometimes the child is raised by the mother and loved despite an inauspicious beginning. But often things don’t work out well. Currently, women in the U.S. occasionally resort to unsafe abortions because of increased difficulty in accessing safe abortion services.

Some politicians are trying to overthrow the Supreme Court’s Roe vs. Wade ruling. They put hurdles in the way of women to decrease access to abortions. They also decrease access to contraception, the best way to decrease the need for abortion, by defunding Planned Parenthood. They advocate needless requirements for clinics that have provided safe abortion services for years without them.

For women’s sake and for the sake of our already overcrowded planet, we must maintain access to safe, legal abortion services.

Richard Grossman practiced obstetrics and gynecology in Durango. Reach him at richard@population-matters.org. © Richard Grossman MD, 2016