Dr. Carolyn Westhoff: So I give the abortion movement full credit for creating free-standing clinics, not just for abortion, but as a model for all sorts of other care. You know the whole ambulatory surgery didn’t exist. I think abortion invented ambulatory surgery for lots of good reasons but generally to improve access, reduce cost, increase convenience, improve access. Which then led to all these problems where abortions were performed here and doctors were trained there. I mean, that’s a whole level. So yes, in those early years, hospitals didn’t really want to. It was like, “We don’t do that here, we don’t want to, it’s legal but it’s yucky and we don’t want any part of it.” I would say that was very widespread. It’s probably still widespread. And so the creation lies of ambulatory abortion clinics is what I think what mostly created access to care in the country. Is that fair?
Dr. Phil Darney: Yeah, and those clinics grew quickly, particularly in New York, because referrals were coming from everywhere.
WESTHOFF: And those abortions were legal three years before Roe.
DARNEY: And those clinics were really efficient compared with the inefficiencies of inpatient care, had the things that Carolyn was describing. It’s really minor surgery, so they were much cheaper, too. So it gave hospitals the excuse to say “Well, we don’t need to get involved in this business because these clinics are good at it. We’ll just send people who need an abortion there.” Although many of the private practitioners – and I saw this as a medical student, from ‘64 to ‘68 in San Francisco, a liberal city like New York – that when they were admitted and I would hear from the nurses that really they were having an abortion. Incomplete, private practitioners would do abortions but they’d do it in the hospital and they had to call it something else until California changed the law, and even then, they were cautious for the reasons Carolyn described, not to be identified as abortionists. But a couple of events made a big difference in that, and one of them was the Rubella epidemic in which physicians felt compelled to do something about terminating pregnancies among patients who were pretty likely to have badly deformed fetuses.
