This was another interesting section in Bazelon’ s article that I discussed in my last post:
SINCE BEFORE THE days of Roe v. Wade, a small number of doctors have quietly provided abortions in their offices (often only for patients with health insurance or who pay out of pocket). Their numbers have dwindled: in 2005, the Guttmacher Institute counted 367 abortion providers in doctors’ offices nationwide, down from more than 700 in 1982. Doctors’ offices now account for only 2 percent of the total number of procedures; hospitals account for barely 5 percent.
This highlights the challenge of making abortion truly mainstream — of moving beyond residency training and outside the haven of medical-school faculties, so that more doctors offer abortions when they join a regular OB-GYN or primary-care practice. As yet, all the success in training new doctors hasn’t translated into an increase in access. Abortion remains the most common surgical procedure for American women; one-third of them will have one by the age of 45. The number performed annually in the U.S. has largely held steady: 1.3 million in 1977 and 1.2 million three decades later. In metropolitan areas, women who want to go to their own doctor for an abortion can ask whether a practice offers abortion when they choose an OB-GYN or family physician. But in 87 percent of the counties in the U.S., where a third of women live, there is no known abortion provider.
That evidence reveals abortion as astonishingly common (1/3 of women by age 45!) but also quite geographically limited. The push to mainstream abortion by offering it at more doctor’s offices is partly intended to break out of these limits:
Family physicians deliver babies, set broken arms, remove precancerous moles. Because they’re more likely than specialists to work in rural areas, they are for abortion-rights advocates the best hope of bringing more providers to the parts of the country where hundreds of miles roll by without one.
It’s hard and horrible to read that there can be a “best hope” to widen access to abortion. Hope and abortion seem that they should be incompatible.