Those of us who have worked in the field of abortion and contraception for many decades are frequently confronted and frustrated by the deep, persistent and destructive divide between contraception and abortion. It was uplifting to see an entire issue of Conscience (Vol. XXXV, No. 3) devoted to such a thoughtful review of the manifestations and consequences of this divide. It has created a world of two silos: penetrating policies concerning medical practice, and then funding, which in turn has a profound impact on the focus of both governmental and nongovernmental agencies.

As a result, as Dr. Winikoff points out, health policies and services continue to perpetuate the stigma of abortion. The birth control movement rose out of the demand for women’s rights and autonomy, but it failed to include safe abortion. To this day, the movement struggles to embrace abortion as its rightful partner. Questions, such as when life begins, obfuscate the fundamental issues of liberty, autonomy and public health. Perhaps the focused effort in our programs to connect contraception and abortion as a continuum of care and medical practice will help transcend the division created by policymakers and funders. When physicians learn in medical schools and teaching hospitals that contraception and abortion are part of the reproductive continuum, we can begin to deconstruct the silos. Medical science allows even more effective means to prevent and create pregnancy and to interrupt it, blurring the lines of what constitutes contraception and abortion.

Even physicians who opt out of doing abortions, as they are entitled to, learn about the necessity of abortion under a variety of medical and social circumstances. Perhaps a new generation of physicians will one day demand their right to practice medicine responsibly and sensibly, without being forced to perpetuate the stigmatizing separation between contraception and abortion.

UTA LANDY, PHD
National Director, Ryan Residency Training Program and Fellowship in Family Planning
San Francisco, Calif