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xvii Second Preface As a student and then as a young physician at a university hospital in Chile from the late 1940s to the 1960s, I witnessed the growing epidemic and national tragedy of women who suffered the complications of unsafe abortions, and I was emotionally marked by the experience forever. Although at that time my field of work was internal medicine and I did not have the obstetrical experience of my coauthor, I cared for many women whose late complications following a botched abortion commonly resulted in death. Like most of my colleagues, I was also appalled at the number of women who came to our hospitals to give birth, only to be hurried home within twenty-four hours of delivery after being forced to share a hospital bed with another woman, in order to free beds for the increasing number of women who suffered abortion complications. At the time, Chile was in the process of becoming industrialized, and low-income women had finally begun to gain access to work in the factories , allowing them to contribute to family income and help increase family status. This new status for women demanded a smaller-family norm, which was facilitated by a progressive drop in child mortality. Women no longer needed to have many children in order to have a few that would survive. In the absence of effective modern contraceptives, the number of abortions increased dramatically, despite the fact that they were legally restricted. The outrage of the Chilean medical profession brought about a government response, which made modern contraceptives freely and widely available through the nation’s National Health Service. Aware that they had been risking their lives, women who had resorted to abortion began using contraceptives as soon as they became available. The results were spectacular. The number of women hospitalized for complications from unsafe abortions, which had been growing xviii The Human Drama of Abortion steadily over the previous twenty years, decreased by 50 percent within five years and continued to decrease in subsequent years, as deaths from abortion dropped to one-sixth of their previous level. Within a few short years, the dramatic fall in the number of beds occupied by women with abortion complications meant that the days of two women sharing one maternity ward bed were over. Chilean society at large and the majority of the country’s health professionals were satisfied with the good, albeit partial, results brought about by the accessibility of modern contraceptives, and they pursued the problem of unsafe abortion no further. Abortion was still considered immoral, a sin; legal restriction therefore continued. The tragic consequences for low-income women were ignored. Consequently, unnecessary suffering and death resulting from illegal abortion, although decreased in magnitude, remain a significant social and public health problem to this day. Since the mid-1960s, my international professional experience has taught me the following: (1) abortion is a global problem, (2) despite characteristics peculiar to different societies, some basic issues are shared, and (3) the number of abortions can be reduced everywhere if we can clarify misunderstandings and thus convert current conflicts into a practical political consensus that will allow the implementation of effective policies. It is the intention of this book to offer, in a single volume for nonspecialists , the lessons of our experience, both national and international, including all important factors that we have learned about abortion. Our aim is to provide information for public and political discussion, in an effort to enlighten a public debate that has been characterized by extremism and impassioned argument. Both intellectual integrity and mutual respect are needed to fuel a constructive debate. —José Barzelatto ...

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