• abortion
• epidemiology
• health economics
• historical
• reproductive health politics

This is a book by the well-known obstetrician/gynaecologist and epidemiologist David Grimes, aimed at the general public. Readers will need to be numerate to appreciate it fully. It is packed with solid evidence (985 references) and numerous graphs to back up his remarks. To counterbalance the data the book is illustrated with case histories from his extensive experience. As Grimes says, he can remember back to the days before Roe v Wade. Although the emphasis is on USA society, evidence is presented from other countries too. In an appendix are some cases of women with life-threatening medical conditions where an abortion was needed and some cases where the abortion was particularly challenging. Grimes includes the tragic story of Savita Halappanavar here.

Grimes describes the ‘sandwich’ years of the late 1960s and early 1970s when abortion was largely available on the East and West coasts (California and New York) but not in the rather large space in between. Tens of thousands of women travelled great distances in order to obtain an abortion. For example, during a 3-year-period, 20 000 women travelled 33 million miles between Illinois and New York. Grimes details the advantages of receiving abortion care closer to home.

Grimes demonstrates how safe, legal abortion is a landmark public health achievement of the 20th century. He quantifies how safe abortion is compared to the alternatives. He warns of the danger to women of going back to the “bad old days”.

Grimes points out in no uncertain terms the widespread dissemination of false information on abortion, largely on the internet. Some of this is unintentionally incorrect based on ignorance (misinformation), probably more is intentionally misleading (disinformation) and some a mixture of the two. He illustrates this with detailed chapters on breast cancer, mental health, preterm delivery and fetal sentience. He roundly condemns state-sponsored disinformation, which has become enshrined in some USA laws. He emphasises how unethical it is to mislead consumers.

This book is a mine of information, carefully and clearly presented, which can be used by lay and professional people alike to properly educate themselves about abortion. They will then be suitably furnished with accurate and up-to-date information to participate in the ongoing debate on abortion, which appears to continue to be most vitriolic in the USA.