How hospitals outsourced America's abortion controversy

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Even Regions Hospital, where Jane Elizabeth Hodgson defied Minnesota's abortion law, has stopped doing the procedure. Star Tribune/Jeffrey Thompson

Jane Elizabeth Hodgson’s career was a challenge even before it started.

In the 1920s and ’30s, educated women were supposed to work as teachers, if at all. Instead, Hodgson took after her dad, a doctor in Crookston. She graduated from the University of Minnesota Medical School in 1939, one of eight women in a class of 200.

In 1945, the day before Hodgson arrived in a small Florida town near her husband’s military base, the doctor who hired her dropped dead. Hodgson, 30, inherited his patients. The poor black ones came in clutching cash to show they could pay. Hodgson told them to put their money away.

Two years later, the couple moved to St. Paul, and she opened her own clinic. The patients she remembered were those she couldn’t help. Minnesota’s abortion law, dating to 1886, was one of the country’s strictest. Abortion was allowed only to save the mother’s life. Anything else subjected both doctor and patient to criminal charges.

If the pleading women could afford it, they’d book another doctor, secretly. If they couldn’t, they’d find another route, like going to the amateur whose day job was running a dry-cleaner. Sometimes they returned to Hodgson’s clinic bleeding and she rushed them to the hospital.

She began her career opposed to abortion. These women changed her.

By 1970, this mild-mannered woman was plotting revolution. She found just the right patient: a 23-year-old married mother of three who was beset in her fourth pregnancy by rubella, a feverish illness that causes serious birth complications. Hodgson performed the abortion at St. Paul Ramsey Medical Center. Someone tipped the police. She became the first American doctor charged for an abortion performed in a hospital.

As he handed down a conviction, Ramsey County Judge J. Jerome Plunkett recognized Hodgson’s “forthrightness and courage.”

That courage got her a 30-day suspended jail sentence, pending appeal. She never served a day, but the dragging appeals process meant Hodgson’s medical license was suspended for three years.

Reprieve came from another Minnesotan: Justice Harry Blackmun, who wrote the opinion for the 7-2 majority in Roe v. Wade.

Hodgson returned to her practice and took on a second career as an activist. From the mid-1970s until her death 30 years later, Hodgson was a lead plaintiff or expert witness in numerous court battles. She sided against laws mandating the consent of parents for minors seeking abortions—winning a partial victory in the U.S. Supreme Court—and in favor of Minnesota reinstating the use of Medicaid payments for abortion, winning that one outright.

Always perfectly coiffed and sharply dressed—news stories noted calf-high boots and a white leather jacket—Hodgson won admirers. And made enemies.

“She tried to shelter me from what was happening,” says Hodgson’s daughter, Nancy Quattlebaum Burke, a partner at the Gray Plant Mooty law firm in Minneapolis. “But there were a lot of phone calls, a lot of letters, with… unfriendly approaches.”

The battle didn’t get to Hodgson. What did bother her was the increasing feeling she and a few others were going it alone.

Hodgson noticed how women seeking abortions were increasingly forced out of full-service hospitals, and into freestanding clinics like Planned Parenthood. The trend continued after her death in 2006.

Consider Minnesota: In 2010, at least 645 abortions—about 5 percent of that year’s total—were carried out in Minnesota hospitals, down from about 1,000 a year in 2000. Last year, hospitals accounted for just 54. 

Even the site of Hodgson’s history-making procedure gave up. In 2011, Regions Hospital, formerly St. Paul-Ramsey, announced it was eliminating a “special service” clinic and ceasing elective abortions. A spokesman declined to comment if the closure had anything to do with the building’s frequent protesters, who declared victory.

By walling off abortion from childbirth and other pregnancy care, hospitals effectively outsourced the controversy. No conservative board members or donors would desert them. No Catholic doctors would quit. No client would have to endure the rage of furious protesters.

They simply cast providers and women out on an island circled by sharks.

And the sharks smell blood. This year, Minnesota’s Republicans passed a bill that would’ve blocked MinnesotaCare (our state-run Medicaid) from funding abortions. Another would’ve added stricter licensing standards through the state health department. Gov. Mark Dayton vetoed both bills, but they will be back.

Hodgson never shied from what she did, and could be unsparingly clinical, even blunt. But she wasn’t an “abortionist,” as critics said. She was a doctor. Abortion made her famous, but she also delivered 5,000-some babies. On the days she fought Minnesota’s archaic law in court, she carried a beeper in her purse in case anyone went into labor.

Both responsibilities, Hodgson figured, came with the territory. You can’t just hold Mom’s hand and smile at newborns. Those uncomfortable with this reality should “go be dermatologists or something.”

America could use a few thousand more people like Hodgson, professionals with real credentials on all facets of pregnancy, willing to stick their necks out. Without them, this fight pits a dwindling pool of ever-braver doctors against a rising tide of hardcore conservatives.

Public opinion on the procedure is largely unchanged these past few decades. Most support legal abortion, while also backing some restrictions. What changed is the anti-abortion groups got organized and went pro.

Meanwhile a generation of medical professionals who considered abortion part of a doctor’s duties, people like Jane Elizabeth Hodgson, have died off. It’s hard to see if there’s a new one coming behind them.

Summing up her mother’s feelings, Nancy Quattlebaum Burke says, “The mainstream wasn’t, sort of, carrying their share of the weight. For her it was more an issue of how difficult that made it for women who needed help. Her response was always, ‘Okay, I’ll try to help serve others more.’”

Is there a doctor in the house?

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