Roe v. Wade
With Jane Hodgson, MD
Clinical Associate Professor in Obstetrics and Gynecology at the University of Minnesota at St. Paul Ramsey Medical Center, Center for Reproductive Choice and Health
Tuesday, Jan. 21, 2003; 2 p.m. ET

Jan. 22 marks the 30th anniversary of the landmark Supreme Court decision in Roe v. Wade, which legalized abortion in the United States. Yet the debate over its right to legality is still in question. How have attitudes towards abortion changed in the U.S. in the past 30 years? And what were the options for women seeking abortions before 1973?

Dr. Jane Hodgson, arrested before Roe v. Wade for performing an illegal abortion, was online Tuesday, Jan. 21 at 2 p.m. ET, to discuss the 30th anniversary of Roe v. Wade and her involvement in the issue of reproductive rights.

Dr. Hodgson, 87, clinical associate professor in Obstetrics and Gynecology at the University of Minnesota at St. Paul Ramsey Medical Center, was the lead plaintiff in Hodgson v. Minnesota, a Supreme Court abortion case. This case was nullified when Roe v. Wade was decided in 1973. She is a member of the Board of Directors of the Center for Reproductive Rights and a member of the Board of Directors and staff of Women's Health Center in Duluth, Minnesota, which she helped found in 1981. A founding fellow of the American College of Obstetrics and Gynecology, Dr. Hodgson has authored numerous articles on reproductive health. She was the recipient of the National Reproductive Health award of the American Medical Women's Association in 1994.

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Washington, D.C.: Dear Dr. Hodgson,
Thank you for the work you did pre-Roe. You were performing a public service to many desparate women who needed help.

Dr. Jane Hodgson: Of course, 33 years ago this spring in 1970 I performed an abortion publicly with the hope that I would be indighted on a woman that had contracted rubella in the first month of her pregnancy. I was denied permission in court to do that. In that period, you were able to perform abortions in cases that had strong medical indications. I knew that this wasn't open to a poor woman or a woman who wanted an abortion for personal reasons. So I did this to educate the public. I selected a housewife with three children.

Once it was publicized, the pro-life movement rose and went right after me and I was indicted. That was three years prior to Roe v. Wade. My conviction was not reversed until the Roe v. Wade decision was handed down.

New York, N.Y.: What are your views on abstinence-only sex education?

Dr. Jane Hodgson: I understand it never works very well.

Oakland, Calif.: What is the current terrorist threat against abortion providers?
Comment: My wife had her reproductive viability saved in a complicated fibroid surgery by a talented and courageous doctor in Champaign, Ill., who also provides abortion services. For myself, and on behalf of my wife and daughter, thanks so much for your courage and public service.

Dr. Jane Hodgson: It has existed and we've been submitted to acts of terrorism all along. That has been tolerated by our police, and in many parts of the country has developed into murder. I think it's wrong that we haven't been given adequate protection against terrorism. I feel like we know all about it. We've been experiencing it for 20 years. In view of our laws, we deserve to be protected and we never have and it's up to the medical profession to speak up about it.

I had a big argument with the Lancet Journal in 1992. I was writing for them about terrorism in the U.S. and their comments were that they didn't want me to use the world "terrorism."

Washington, D.C.: How do you reconcile your oath as a physician to "first, do no harm" with your killing of umborn children by performing abortions?

Dr. Jane Hodgson: We have to make those decisions every day. We have to choose the one that will involve the least risk to the patient. The adult woman standing before me alive is more important than a few fetal cells that may be viable. Their right to survive has no comparison, so I never had any problem with that.

Waipahu, Hawaii: What was the abortion rate before 1973?

Dr. Jane Hodgson: That's very difficult to determine because they were illegal and not reported. I really don't know what was agreed upon. They were certainly common. I ran into women all the time who were damaged. That was the reason that prompted me in my case before the court. I saw the terrible treatment the women were getting when seeking illegal abortions. Knowing that they'd do it against our advice. So this happened so many times because women physicians were relatively few back in 1940 when I started practicing. So I got more than my share of these patients. You see all of the unwanted pregnancies in a community. Then they'd come back and I'd have regrets that I hadn't taken care of these women that were so badly damaged. I decided that safe care was the best thing these women could have access to.

The same thing in working overseas. I spent four years working in countries overseas and the contrast was so remarkable in countries where abortion was legalized -- Eastern Europe, Britain in 1957 I think. So these were examlpes of where they were doing it successfully and not having any picketing or terrorism, and yet, it blended into the society with ease.

Whereas when we legalized abortion we developed problems of the pro-life forces and we're the only country I know of that has such strong opposition. It's a puzzle to me. Even catholic countries like France or Italy are much more lenient.

Washington, D.C.: What's the status of RU-486? Is it legal? If so, is widely available and inexpensive? If not, when will it be?

Dr. Jane Hodgson: Of course it is legal and available to any physician that wants to apply for it. It is too expensive. Some clinics have to charge up to $100 a tablet which is ridiculous because it is cheap to make.

New York, N.Y.: Since Roe was handed down, what has most dramatically changed, and what has stayed same as far as women's access to abortion?

Dr. Jane Hodgson: Well, of course women didn't have any legal access to abortion before. Though the well-to-do and doctor's families had them, so there was a double-standard there. You could always get consultations from some doctors and with a couple of consults on a patient's chart, wich any medical complaint it could be done. But physicians didn't take advantage of that in our community.

Even though you were a specialist in the field you'd fight with everyone on the staff as to what were real indications for medical abortion. But they were done. There was a survey in the Twin Cities, there were recorded about 200 a year. That is not nearly what was being done. Probably the same thing with D&Cs. They were really performing abortions and covering it up. This was not available to the average woman.

We're still having problems with our figures because there are four states that aren't reporting their abortions to the CDC, so it looks like there's been a great drop.

We still have the double standard. Young women are the victims. One issue now is parental consent and typically now 43 states have laws and that's really tough on kids -- especially ones in isolated rural areas that need to find a clinic. That was true in Minnesota -- there were youngsters that were just helpless. In addition, to have to notify their parents -- Minn. had the most harsh law in the country -- to notify both parents, whether living together or not. That is almost impossible to comply with. That is why we thought in 1981 that for 10 years we got it revoked for a while, but eventually the Supreme Court upheld Minn's law and declared in constitutional.

So, discriminating against the young and the poor. Because prices and cuts on federal payment for abortions have been so harsh. There are a number of states that refuse to take federal money. The Center for Reproductive Law and Policy has challenged the law in several states and has been successful in forcing them to pay Medicaid payments.

So, that's far from solved and means that poor women simply can't have abortions. Cost of health care is going up so bad that they can't even afford the medical solution. So, the sum total cost when the abortion is medical is the same as the surgery.

Washington, D.C.: In your opinion, are abortion rights at risk under the Bush administration?

Dr. Jane Hodgson: Oh yes. They're very highly at risk. I've been increasingly pessimistic as time goes on, since he was elected. On a daily basis, there's something that affects women's rights.

Dr. Jane Hodgson: Along with that, Frist worries me because he's a medical man and considered an expert. But he doesn't understand the situation. That's the problem with medicine right now. So many doctors have specialized that they never see the problems of unplanned pregnancies and don't know the situations they're in. They minimize the importance of it. They don't feel like they're required to get out on a soapbox.

The only spokesman we have going for us right now is Dr. Frist and he's definitely pro-life. We need someone with a strong voice who can speak out for women -- even for the right to decent healthcare. And reproductive care is one of the most important things in a woman's life.

Long Beach, Calif.: I find it offensive for President Bush to make the anniversary date of Roe Wade to be "Sanctity of Life Day." What's your opinion?

Dr. Jane Hodgson: Well, absolutely. And he made the statement today -- Ari Fleisher did -- talking about working to reverse Roe v. Wade. He said the President is actively supporting a program to make this a society that is more concerned about preserving life. He put it in different words. It's intolerable because it takes away a woman's right to pursue medical care. We will lose lives if this is reversed. Now, teenagers that are denied abortions are inducing labor, delivering in secret and some are sterilized for life.

It's no better for adult women to have their adult lives ruined either.

Burke, Va.: How many members of the current Supreme Court are committed to reversing Roe v. Wade? If it is reversed, is it possible the Circuit Courts will have influence in shaping abortion law and could there be varying rights depending upon the Circuit?

Dr. Jane Hodgson: Everybody seems to think that's what would happen. Some states would keep their laws, others would revert. It's terrible, because what have is like a prohibition. I'm old enough to remember what bootlegging is like, but it would be the same thing. You'd travel across a state line.

The difference in the legality of the procedure -- women are so confused and feel so guilty. I was director of a pre-term clinic in D.C. in 1972 and we had women coming from all over the country and we'd do nearly 100 a day. These women were so different -- they all looked guilty even though they might have come from states that were allowing abortion under certain circumstances and they tried so hard to find a clinic and go through this procedure. I was very struck and they didn't know what to do if they went home afterwards and had complications. That was a real problem then. That's what would happen now if we had a heterogeneous system of law.

A woman would need to see a lawyer to know what to do. And there would be a lot of illegal abortions. And we'd be right back where we were and it was horrible. And nobody really remembers that now. And the young women that are 30 years old and under 35 that seek abortions need them. Most women don't realize and take it for granted that the service is available if they need it. But it's getting harder now anyway because medical education has been inadequate -- not enough are being trained -- and it should be mandatory in our medical colleges. But that isn't insisted on, that our curriculums need correcting. So we need some authoritative voice. Hopefully, physicians will organize to do this. The only one organized by physicians is PRCH. And that was founded in New York City, but it's a national organization.

We need a medical authority -- not Dr. Frist.

Northern Virginia: How quickly after the Roe v. Wade decision did abortion become accessible to the average woman? That is, a year later would it have been relitively easy to find an doctor to perform an abortion? Especially in the South?

Dr. Jane Hodgson: No. It would not have been because there were several debates about where they would be performed -- hospitals? Doctor's offices? It took a lot of discussion in medical societies and hospital staffs and they all voted on whether the hospital would provide abortions. It was the general feeling that they should be done in hospitals.

But a clinic in Washington proved that the outpatient model worked better than the hospital because they were doctors that were specialized in the procedure.

So most hospitals don't perform abortion services. Less than 10 percent are being done in hospitals. Clinics blossomed, and we developed a lot of them on each coast -- not so many in the middle of the country. And they flourished for a while, but they are having to close now for lack of providers.

We had to prove it was a safe procedure, the cost, who would perform them, that sort of thing. We tried to set up training for residents at GW Medical School, but eventually the picketing wore everybody down and the school didn't want to be bothered with it.

I have a dream -- that it would be just another procedure in a fertility clinic. That every hospital would have this clinic and a woman could go there if she couldn't get pregnant, or needed contraception, or sterilization and abortion would be just another procedure offered. And a woman could go there through her reproductive life.

Johns Hopkins had just that. I don't know if it is as active now as it was then. We had one in St. Paul, too, that is still functioning. But there aren't many of them.

The subject of infertility is very popular and very respectable. It's strange that infertility can be treated very expensively and simple abortions which cost so much less is unavailable.

Falls Church, Va.: Why is there such a difference made between training doctors for abortions and training them for other potentially controversial procedures, such as doing organ transplants or grafts from living donors? Are "conscientious objections" allowed from doctors-in-training to any procedure they find problematic?

Dr. Jane Hodgson: No. They're not. I think it's only where they think its religion that's involved. And that's the only procedure I ever heard of that a physician could get out of on the basis of his religion only. And, as far as I'm concerned, the belief that women should have that right is my religion. But we aren't trying to talk anybody into abortions. Women just need them -- they always have and always will.

Philadephia, Pa.: "We will lose lives if this is reversed." -- your comment in referring to Roe V. Wade.

Unfortunately, we are losing millions of more lives every year because it hasn't been reversed.

I am no Bible-thumper, or Pro-Life crusader, or abortion-clinic bombing terrorist.

I am merely a middle-class American who is sad for the utter disregard for human life. Too many women (and I know plenty) use abortion as birth control.

There must be a better way.

Dr. Jane Hodgson: No, it isn't true. No woman would intentionally use abortion as a form of birth control. THat's just a theory that they've just pushed on us that just isn't true. The reality is that no woman seeks abortion. No one plans on getting pregnant and having an abortion. If contraceptives are available to women, they're expensive. If they were included in Medicaid care or if we had laws that required insurance coverage for them it would make a real difference.

If you think its more important to save pre-viable fetuses. Admittedly, abortions do kill living tissue. Women are producing ova that are destroyed and wasted and we don't grieve over that. The difference is that this is pre-viable tissue that is of no value at that time.

No one is advocating late-term abortions unless for very important medical reasons. And that's the way it should be. Unfortunately, some medical conditions aren't diagnosed until the 24th week. We don't have to try to save every single sperm and ova produced in this century. I don't advocate abortion rights simply because of the population issue, but I do think about it.

Vienna, Va.: I am a person who currently respects the decision of the Supreme Court in 1973 as the law of the land even though I strongly disagree with it and believe that it was (and is) morally wrong. Will you (and your like-minded colleagues) respect a future decision of the Supreme Court if it eventually overturns the Roe vs. Wade verdict at a later date? In view of what has happened with past Court decisions on slavery, segregation, and capital punishment, this is a very real possibility.

Dr. Jane Hodgson: Well, we have respected the law. Except the time of my test case, I never performed an illegal abortion. But I don't think I could practice medicine. If I were given the chance to live another life on this road, I certainly wouldn't want to be exposed to this because of the futility and frustration of not being able to help someone and you can't because of a decision with which you don't agree. I would probably move to another country.

Dr. Jane Hodgson: I'm a great believer in the law and always have been. I even avoid parking ticket.

New York, N.Y.: Many Reproductive Rights advocates argue that young women today do not perceive that their abortion rights are in danger. Do you find this to be true in your interactions with younger patients?

Dr. Jane Hodgson: Well, absolutely. If you were born in 1970 or thereafter and never lived in a society in which it was illegal, you just take it for granted. And I think that's the reason for lethargy among young women and they don't stop and think about politicians' attitudes on abortion.

I think it's terribly important that women make a real issue of this when they go to the polls. And they don't because it's not talked about until after they've been elected. I should have been out there on the stump two years ago, but I was hospitalized for a while and was helpless, so I had to just hear what was going on.

Dr. Jane Hodgson: One factor that makes me optimistic is the number of women going into medicine now. Most of them see the light and understand the emphasis on teenagers and poor women.

The men, when they're highly specialized -- eye surgery or dermatology -- they never ever have any contact. So they don't understand. And they don't that it's worth fighting about and don't know what it involves in an average woman's life until it comes to their own families. Thirty years ago there were a lot more family practitioners, but now everyone is so specialized.

Waipahu, Hawaii: Am I right that Jane Roe carried her baby to term while the case played out? And if so, what became of said person?

Dr. Jane Hodgson: That's right. And I have no idea what came of the child.

Washington, D.C.: I am in my mid-20s, and cannot afford to donate money to organizations who are trying to prevent the anti-abortion legislation from being passed in Congress, but want to get involved. What can I do to help? Who should I contact?

Dr. Jane Hodgson: I would go to Washington, D.C. to the headquarters of NARAL and they'd have all kinds of suggestions, I know. Because they desperately need help. But that is probably one of the most effective organizations. In New York, you could volunteer at PRCH.

Dr. Jane Hodgson: I guess that it's very discouraging for me because I've devoted 30 years of my life to this, but I still hope and am optimistic about the future.

I think if we do have a reversal, it won't be long before its understood that it is a bad law and will be regained. It's a shame we're having to go through all of this again.

We do have good contraception now, which we didn't have, and hopefully some states would retain their laws. I think with the high number of women in medicine, that will help most. In time, we'll be back to reality and it'll just be another medical procedure and it'll be handled just like anything else.

We need prevent picketers from their illegal obstructionism.

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