Legacies of the CCS

How clergy led the outpatient revolution

Have you ever had a breast biopsy? Endoscopy? Arthroscopic knee surgery? Gall bladder removal? D&C? Vasectomy? Chances are, if you’ve had any of those surgical procedures in the United States in the last 20 years or so, you didn’t stay overnight in the hospital. You walked in and walked—or at least wheeled—out again the same day.

It wasn’t always so. In the 1960s, knee surgery, vasectomy, even D&Cs and legal abortions (usually approved by a committee of doctors only in cases of serious threat to the woman’s life) involved a hospital stay of one or more nights. It was accepted medical practice.

But from 1967 to 1970, many thousands of women were obtaining safe abortions—usually illegally—on an outpatient basis, referred to licensed physicians by the Clergy Consultation Service on Abortion (CCS). The ministers and rabbis of the CCS gave women information on how to contact doctors who performed abortions safely in their offices or in hotel rooms, houses, or apartments. Women walked in, had the procedure, and walked out an hour or two later, usually with no ill effects. They could be back at work in just a couple of days.

In 1970, New York State legalized abortion. By that time the CCS had referred thousands of women for abortion, nearly all as outpatients, without a single death. They invited a doctor to whom they had referred many women, and who had been praised as competent and caring by his patients, to help open an outpatient abortion clinic in New York City on the day abortion became legal.

The clinic, known as Women’s Services, set a standard for compassionate care. Women counselors accompanied patients through the entire procedure; the offices were decorated with colorful posters to offer a welcoming environment; snacks were available during recovery, since patients had not eaten for hours before the procedure. Women flocked to the clinic from across the country, often flying in and home again the same day.

The high volume of patients offered an unprecedented study opportunity. In 1972, the then director of the clinic, Dr. Bernard N. Nathanson (later an anti-abortion activist), published in the New England Journal of Medicine a study of the 26,000 patients served in the first year of the clinic’s operation. There had been no known deaths and a very low rate of complication for first-trimester abortions at the clinic, proof that a procedure that traditionally required a hospital stay could be done safely and much less expensively on an outpatient basis.

Women’s Services later helped to pioneer outpatient breast biopsies—another procedure that had previously required a hospital admission. And there was discussion of creating an outpatient birthing center (though that plan never came to fruition). Outpatient surgery and procedures grew in scope through the 1980s up to the present day. Now dozens of kinds of routine surgical procedures are offered on an outpatient basis. Patients avoid a hospital stay, save money, and often recover more quickly. And the pioneers of this revolution were those ministers and rabbis of the CCS, who just wanted to offer women compassion.

Photo: (c) Can Stock Photo / EyeMark

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