In 1982 most abortions were performed by suction D&C and by saline.

The chances of an unborn child being born alive dwindled from an almost perfect

99.7 per cent to 45.2 per cent in 1982.

Thirty years ago, in 1954, a total of 11 therapeutic abortions were performed at Toronto General Hospital.  By 1982 that 11 had mushroomed into an incredible 2484 “therapeutic” abortions.  During the same28 years the number of deliveries in the hospital declined from 3,724 in 1954 to 2.048 in 1982 – a decline of 43.3 per cent.  Despite all the advances in medical science, and in maternal and child health care, over more than a quarter of a century, the chances of an unborn child being born alive dwindled from an almost perfect 99.7 per cent in 1954 to 45.2 percent in 1982.  Indeed, in 1982, one of the most dangerous places for an unborn baby to be was at the entrance of Toronto General Hospital, for the shocking fact is that his/her chances of emerging alive were only 45.2 per cent.  Over half the unborn babies (54.8 per cent) were aborted.

Recently we came across an interesting paper that was presented at the Annual Meeting of the Society of Obstetricians and Gynecologists in Jasper, Alberta in June 1966.  The paper, Therapeutic Abortion – a 12 year review at the Toronto General Hospital 1954-1965, was given by Manuel M. Spivak, M.D., F.R.C.S.(C) from the Department of Obstetrics and Gynecology, University of Toronto, Toronto General Hospital.  A comparison of the abortion report given by Dr. Spivak for the years 1954-1965 with the tragic abortion record of today shows how far we have traveled sown “the slippery slope” since the Criminal Code was amended in 1969.

Table 1

Therapeutic abortions and deliveries,

Toronto General Hospital

Year

Total Therapeutic Abortions

Total Deliveries

Therapeutic Abortions per 1000 deliveries

1954

11

3724

2.95

1955

16

3676

4.35

1956

28

3566

7.85

1957

11

3597

3.06

1958

25

3715

6.73

1959

12

3952

3.04

1960

14

3908

3.58

1961

25

3800

6.58

1962

25

3791

6.59

1963

22

3769

5.84

1964

43

3960

10.86

1965

30

3727

8.05

Totals

1954-65

262

45185

69.48

1982

2484

2048

1212.89

Table 1 shows that during a 12-year period (1954-65), there was a total of 262 abortions at Toronto General Hospital.  The lowest recorded in any one year was 11 abortions, and the highest was 43 in 1964 when there was an outbreak of rubella.  The annual average of abortions over the 12 years was 21.83

By comparison with these 262 abortions (between 1954 and 1965), in 1982 alone the hospital had a total of 2,484 abortions.

There were 5.8 abortions per 1,000 deliveries in 1954-65; by 1982 the number had gone had gone from 5.8 to 1212.89. Thus, for every 10 babies who were permitted to be born, over 12 babies were aborted.

Figure 1 shows graphically the changes from 1954 and 1962 (before the changes in the Criminal Code) to 1982.

Fig. 1

Exactly half of the 262 abortions during this 12 year period were performed either for psychiatric reasons, or because they had contracted rubella (German measles) in early pregnancy.  Amongst the remaining 50 per cent, the largest group was where the mother had cardiovascular disease, mainly chronic rheumatic or congenital heart disease.  Other causes that were listed in the sub groups were epilepsy, multiple sclerosis, diabetes, cancer of the cervix, toxemia and severe asthma.

Table II

Indications and Numbers of Therapeutic Abortions

At Toronto General Hospital (1954-65)

Indications Number of cases Approximate %
Psychiatric

90

34.4

Rubella

41

15.6

Cardiovascular disease

28

10.7

Renal disease

20

7.6

Diseases of the Nervous System

16

6.2

Malignancies

11

4.2

Hypertension with previous or severe toxemia

9

3.4

Pregnancy complications

7

2.7

Others

40

15.3

Total

262

100.1

Dr. Spivak noted, however, that over the 12-year period a number of trends could be shown.

  • There was a definite increase in the number of abortions. In the first four years (1954-7), a total of 66 abortions were performed. By the third four-year period (1962-5), the number was almost double – 120 cases.
  • The percentage of abortions for psychiatric reasons increased from 15 per cent to 46 per cent.
  • In the last two years of the study (1964 and 1965), psychiatric, rubella and cardiovascular conditions accounted for 75 per cent of all abortions.
  • The percentage of abortions from all causes (other than the first three shown in Table II) dropped from 53 per cent to 27 per cent.

In the discussion, which followed Dr. Spivak’s presentation, Dr. Vant of Edmonton, Alberta said, “As I open the discussion of this paper I can’t help but feel that the absolute indications for therapeutic abortions are decreasing each year.”  This was said in 1966.  By the 1980s, according to experts such as Dr. Harley Smyth, Dr. Heather Morris and Dr. Bernard Nathanson amongst many others, the absolute indications for therapeutic abortions had decreased to “a theoretical possibility.”

Rubella was never a threat to the mother’s life or health; the endangered one was the baby.  Today, by what Sir William Liley called “fetal preventative medicine before the baby is actually conceived,” future mothers can be immunized before they become pregnant.  This public-health measure is a common procedure in many countries: rubella is never an excuse for aborting a baby in any country with good medical standards.

Medical experts without number – cardiologists, neurologists, urologists, internists, etc. – have testified that, in this day and age, any woman whether or not she be epileptic, diabetic, suffering from toxemia, cardiac disease or any other of a multitude of ailments, can readily and safely carry a pregnancy to term if her condition is treated by the appropriate specialist, and an obstetrician supervises the pregnancy.

The incidence of abortion is 1212.89 per 1000 births.

In 1966, Dr. Vant said of the Toronto General Hospital report that “the incidence of 5.8 therapeutic abortions for each 1000 deliveries seems reasonable and reflects that Toronto General Hospital acts as a centre.”  Today the incidence of “therapeutic abortions” in the same hospital is 1212.89 per 1000 births.   There is here a bitter paradox.  On the one hand there is a whole new arsenal of weapons against disease: better nutrition, new drugs and antibiotics, new diagnostic and surgical techniques, and presumably – as the Hospital is one of the main teaching hospitals in Canada – a host of medical practitioners at the top of their profession.  On the other hand the health of Canadian women seems to have deteriorated catastrophically.  In 1954 only 11 women were found in need of a “therapeutic” abortion; by 1982 there were 2,484 such women.

The statistics for the incidence of abortion at Toronto General Hospital in 1982 are not available to us, and we can only speculate that they resemble other hospitals in Toronto.  Evidence was given at the Borowski trial in Regina in May 1983, that few – if any – abortions are refused by the Therapeutic Abortion Committees at seven teaching hospitals in Toronto; that in one hospital most abortions are done for socio-economic reasons; and that others are camouflaged by terms like “reactive depression of pregnancy” (wrongly used) or “psychiatric condition.”  Dr. Heather Morris testified in Regina that she had worked for one month on the Therapeutic Abortion Committee at Women’s College Hospital in Toronto.  During that time every application for an abortion was allowed by a vote of 2 to 1 (Dr. Morris being in the minority).  In evidence she stated, “In fact in the time I was on the committee there was no instance in which a serious physical threat to the health of the patient with a diagnosis of psychological or emotional illness being sick enough to even have been referred to a psychiatrist.”

Great increase in psychiatric indications

In the light of that statement by Dr. Morris it is of interest to note what Dr. Vant said in 1966 in discussing Dr. Spivak’s paper.

Dr. Spivak has noted the great increase in psychiatric indications during the last four-year period, and others have noted this fact.  Indeed, I think these have to be considered very carefully as in many cases the observation period is short, the work-up is scanty and inadequate, and the decision to advise therapeutic abortion is not sufficiently positive to warrant consideration.

Dr. Vant sounded a warning bell in 1966.  Regrettably it was not heeded, and today it seems that the observation periods and work-up are not merely short and inadequate, but completely non-existent.

New “reasons” for abortion have developed since the mid-1960s following the medical and technological break-through of amniocentesis and ultra-sound.  Both of these procedures were developed to save the lives or improve the health of pre-born babies, but the bitter truth is that both procedures are now also used for the diametrically-opposite purpose, to “search and destroy” any pre-born children who might be less than perfect.  Despite the fact that many such babies can be treated, even surgically, whilst still in the womb (and have even been removed from the womb, operated on, and replaced) any pre-born child who is likely to be handicapped is at risk of being eliminated by abortion.

Other changes since 1954-65

There has been a remarkable change in the age-pattern of the mothers.  Between 1954 and 1965 at Toronto General, the youngest mother was 15, the oldest was 46.  Most women – 61 per cent – were over 30 years of age; 33 per cent were in the 20-30 year bracket and 6 per cent were under 20 years.

We have no access to the 1982 data on age groups at the hospital.  However, we do have the statistics for all Ontario residents and, as the hospital performed 7.9 per cent of the provincial total, it seems reasonable that the percentage-age distribution according to age group in Toronto General Hospital will be very close to that of the Province.  See Table III below.

Table III

Therapeutic abortions

Percentage distribution according to age groups

Toronto General Hospital 1954-65

Under 20 years

6%

20-30 years

33%

30-40 years

44%

40 years plus

17%

Ontario 1982

Under 20 years

27.7%

20-30 years

51.6%

30-40 years

18.6%

40 years plus

By 1982, the percentage of women under 30 years having abortions had more than doubled – from 39 per cent to 79.3 per cent.  Thus, most abortions are now being performed on the youngest, and what one might reasonably expect to be the healthiest, segment of the childbearing group.  Significantly, too, the percentage rise in the under 20-year group rose from 6 per cent to 27.7 per cent.

However, one interesting fact emerges.  If the age-pattern for Ontario holds true for Toronto General, then the actual number of abortions in the oldest, over 40 years group, remains virtually unchanged.  This serious blight on the health of Ontario women seems confined to the younger age group.

The methods of terminating pregnancy are almost completely different today.  In earlier years, 84.7 per cent of abortions were by three main methods: dilation and curettage – 37.4 per cent; abdominal hysterectomy – 25.2 per cent; and abdominal hysterectomy – 22.1 per cent.  In 1982 none of these methods is mentioned for Toronto General, and most abortions were performed by sectional D&C and by saline.

Greater number of abortions at earlier stage.

A greater proportion of abortions are being performed at an earlier stage of pregnancy and, one would expect, with fewer major complications to the mother.  In the earlier period there were 23 major complications (9 per cent), one of which resulted in death.  No wonder Dr. Spivak concluded his paper with the words: “Therapeutic abortion at any stage of gestation is still a somewhat hazardous procedure and should be recognized as such.”  One must presume that he was only talking about one of his patients.  An obstetrician has two patients and for the second one, the little person who is also concerned, the procedure is not merely hazardous, it is downright lethal.

Comparison of Toronto General Hospital with other areas in 1966

Dr. Vant in the discussion that followed Dr. Spivak’s address made some interesting comparisons with other areas, and with his own hospital in Edmonton.

Table IV shows the number of abortions to every 1,000 deliveries.  New York’s Mount Sinai Hospital closely resembles the picture at Toronto General.  The Los Angeles County Hospital story is quite different.  Over a ten-year period, a total of 16 abortions was performed at the L.A. County Hospital (which reported more than double delivered as did Toronto General).  In comparison, Toronto General reported 262 abortions over a period of 12 years.

Table IV

Comparison of abortion rates in various studies

Hospital

Period of study

Abortions:Deliveries

No of deliveries

Toronto General

12 years

1 :   172

45,185

New York: Mt. Sinai

5 years

1 :   160

N/A

Salt Lake City

10 years

1 : 2,482

N/A

Los Angeles County

10 years

1 : 6,416

102,654

Dr. Vant also reported on the statistics for Edmonton’s University Hospital in the years 1955-65.  “Our figures …. Reveal an incidence of 1.02 therapeutic abortions to each 1,000 deliveries (33 in 22,292 deliveries)” [sic.]  The figures quoted cannot be accurate.  The reasons for the 33 abortions are clearly stated and so it would appear that there is a misprint in the total deliveries.  The correct figure for deliveries is 32,292.  Of the 33 abortions, 13 were for psychiatric reasons, 17 for various medical conditions, and 3 for rubella.

Therapeutic abortion committees

The general tenor of Dr. Spivak’s paper seemed to support establishing Therapeutic Abortion Committees and liberalizing abortion laws.  Indeed he stated “…the only way to eliminate criminal abortion is to permit unrestricted legal abortion at the demand of any pregnant woman … such a goal would be most desirable.”  On the other hand, he described the setting up of the Therapeutic Abortion Committee in 1964 with the aims “not only to prevent indiscriminate use of this procedure, but also to provide for abortions which were legally and medicinally advisable.”  Two points emerge: abortion on demand and prevention of indiscriminate use are mutually exclusive; obviously in 1964 doctors did believe that certain types of abortion were within the law.

The handwriting was on the wall

Dr. Spivak also showed concern for a proper study before an abortion was performed.  His plea for Therapeutic Abortion Committees was expressed in these words, “Merely having one or two physicians validate a request for a therapeutic abortion is a loose, unreliable method.  There is no physician who could not convince one or two of his colleagues of the urgency of any particular situation.”

Dr. Spivak was not to know that within a few years the Therapeutic Abortion Committees he so strongly endorsed would validate requests for abortion in the same “loose, unreliable method.”  However, even at that time, the handwriting was on the wall, and the pity of it is that even when driven to the wall some doctors and politicians could not (and, even now, cannot) read the writing.