Kisner, an African-American, was one of only four doctors performing the procedure in the city of Pittsburgh. In interviews here April 7-8, Dr. Morris Turner and health center director Claire Keyes said that in Pennsylvania only 13 percent of counties have abortion providers, the same as the average nationwide. Among rural counties across the United States, only 3 percent have facilities offering abortion. These facts show that while abortion was decriminalized in 1973 in the United States it has become increasingly difficult for women across the country—especially working-class and farm women—to gain access to abortion services, they said.

Women’s rights backers say that this reality, and new measures to further restrict abortion rights such as the misnamed Partial-Birth Abortion Act and Unborn Victims of Violence Act, is why they have been campaigning for a massive turnout for the April 25 march on Washington to defend women’s right to choose (see ad linked to home page).

Dr. Turner, who was Kisner’s medical practice partner for 31 years, told Militant reporters that Kisner was a pioneer in extending the reach of family planning options for women and better medical care for African-American and other working people. “He set up free clinics in Pittsburgh and also in the Monongahela River Valley for ex-steelworkers who found themselves in dire circumstances,” said Turner. “We trained nurse practitioners and a physician who would visit once or twice a week. These were mainly poor, white women. They were thrilled at having a caring physician.”

Kisner was also instrumental in establishing the Allegheny Reproductive Health Center, which provides abortions, and was one of the first doctors to perform the procedure in Pittsburgh following the U.S. Supreme Court’s 1973 decision to decriminalize abortion in Roe v. Wade.

“Since 1973 there have been no other abortion providers outside Pittsburgh,” Turner said. “Four clinics and our private practice service half a million women a year. Magee-Women’ s Hospital is the only hospital today in Pittsburgh where abortions are provided.”

Nationally, 95 percent of abortions today are performed in clinics or doctor’s offices. When asked if he still sees cases of self-induced or other botched abortions, Turner said, “I saw cases as a resident before 1973. Late at night, women would come in from self-induced abortions. The watershed was legality in 1973. With the clinics available, even the Pennsylvania restrictions have not caused the same tragedies as the early years.”

Restrictions passed into law in Pennsylvania in 1989 include requirements for a 24-hour waiting period after consent is given for the procedure, and parental consent for women under the age of 18. A requirement to notify the husband was struck down. “Throughout the fighting, we were hoping to make it safe for other physicians to provide abortions,” said Turner. No young doctors have come forward here to continue to provide abortions to the women in this region, he said. “None have been willing to walk the gauntlet, to undergo the death threats. Somebody needs to hear that.”

“Our clinic serves Western Pennsylvania, Eastern Ohio, Northern West Virginia, and the panhandle of Maryland,” said Claire Keyes, director of the Allegheny Reproductive Health Center, April 8. “Some patients come from 200 miles away because 87 percent of counties in Pennsylvania don’t have abortion facilities.”

“From the late ’80s to the early ’90s, Pittsburgh was a target for Operation Rescue,” Keyes said, referring to the rightist outfit that organized a violent campaign in that period to shut down abortion providers. “They made their training videos here—how to shut down a clinic, how to block doors, etc. I hope I can say that the last incidence of violence here was 1992 when our windows were shot out.”

Keyes said, however, that doctors who have referred patients from miles away “have had their tires slashed and received threats. Many have backed away from it.” She said that a group called Medical Students for Choice has begun to make inroads on the host of obstacles in the way of doctors entering practice, such as lack of training in medical schools.  
 
Limits to access nationwide
Attacks on the right to choose since the 1973 Roe v. Wade decision have fallen most heavily on working-class women in the United States.

In a nationwide survey conducted in 2000, 87 percent of counties overall, and 97 percent of non-metropolitan—that is, largely rural—counties, had no provider. One study estimates that almost one in four having the operation travels 50 miles or more for services. This means that women must bear additional costs and delays on top of the expense of the abortion itself.

The 1976 Hyde Amendment denied Medicaid funding for abortion in most cases, and today only 21 states provide funding for it. The result is that some two-thirds of women pay for the procedure. Few are reimbursed by insurance.

Since 1982, the number of abortion providers in the United States has fallen by 37 percent. Several factors contribute to this shortage. One is lack of training. Students are graduating from medical school with little or no instruction in techniques, partly because only 5 percent of abortions happen in hospitals, where most medical students and residents are trained.

The National Abortion Federation (NAF) points out the predominance of private providers represents “a significant shift away from hospital provided care, which was far more common in the early years after the laws criminalizing abortion were struck down.” A 2001 study found that barely 10 percent of hospitals provide abortions. The NAF concludes that this has a big impact on “women in rural areas where there are no abortion clinics,” and working-class women “who depend on hospital emergency services for medical care.”

More than one-half of all obstetrician/gynecologists who perform abortions are 50 or older. Many were pioneers whose commitment to safe, legal abortion was shaped by having witnessed the effects of botched illegal or self-induced abortions. Younger physicians have not been faced with the reality of unsafe abortion.

Turner said that many of the abortion providers in the first years after Roe v. Wade faced violence from anti-choice forces. “We were threatened, but instead of letting that deter Dr. Kisner, he became more determined,” he said. Many of those who provided this care “were part of the political movement. We gave speeches and testified.”

Even though the 1973 decriminalization of abortion remains the most important gain for a woman’s right to choose, much ground needs to be retaken to make abortion safe, legal, and accessible for all women. The current provider shortage threatens women’s reproductive health by leaving many women without a real choice.

La’Tasha Mayes is the local organizer for New Voices for Reproductive Justice of Pittsburgh.  
 
 
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