Clayton H. McCracken, Jr., MD, MPH

Improving the System

Dr. Clayton McCracken first saw the need for safe abortion as a student at Duke University Medical School in the late 1950s. “I still remember a teenage girl from a tobacco farm who had turpentine instilled into her uterus to induce an abortion,” he says. “Life support systems such as renal dialysis were just being developed. The girl died.”

His medical and educational journey between 1958 and 1981—a rotating internship in Louisville, Kentucky; the Alaska Native Health Service; a pediatric residency in Cleveland; the Indian Health Service in South Dakota; a masters in public health at the University of North Carolina; and the Indian Health Service in Billings, Montana—confirmed the overwhelming need for contraception and abortion and the tremendous silence surrounding the issue. “As an intern I was not permitted to take part in the care of the sickest patients, those on the septic abortion ward. Although maternal and infant mortality rates among the Eskimo (Inuit) in Alaska were quite high, it was against federal policy to provide contraceptives. As a pediatrician on the Pine Ridge Reservation, it became my routine to advise mothers about birth control methods. It now seems odd that when earning my masters in maternal and child health in 1967, abortion was not discussed.”

“It was a logical switch from maternal and child health to providing contraceptive and abortion services,” says Dr. McCracken, who is now medical director of Inter Mountain Planned Parenthood, which provides these services to women throughout Montana and regions of Wyoming, North Dakota and South Dakota. “By providing abortion services, we also improve maternal and child health and community health in general.”

Improving the range of contraceptive choices and access to those methods is a critical element of Dr. McCracken’s work. “Most of the patients come to our abortion clinic as a result of failure of a birth control method, or a failure of our system to provide birth control. Our present system for providing birth control does not assure that contraception is available, affordable or acceptable. As abortion providers, we must be advocates for better contraceptives and a system that truly makes contraceptives universally available.”

Provision of contraception, abortion and sterilization services is a global issue for Dr. McCracken. “As the ever-increasing human population is destroying the very environment that supports that population, there is nothing more important than reducing the sheer number of human beings. The only humane way to do that is to make contraception, abortion and sterilization universally available.”

“I’m now 68 and I’ve had the privilege of providing contraceptive and abortion services for more than 20 years. At Inter Mountain Planned Parenthood, we help women terminate unwanted pregnancies,” he says. “But we are only one part of that process. We have three goals for each patient: that we safely and completely empty the pregnant uterus; that the patient has a birth control plan that will work for her; and that she leaves the clinic feeling good about herself.”

The Planned Parenthood clinics in Montana have suffered from harassment. The clinic in Helena has been barricaded, invaded, stink-bombed and finally burnt down. “I am impressed with the staff,” says Dr. McCracken. “They step right up and handle problems as they occur.” Dr. McCracken and his wife (the executive director of Inter Mountain Planned Parenthood) have both been personally targeted. “We try to sidestep it if we possibly can,” says Dr. McCracken. “Otherwise, we look as it as part of doing business. I’d rather see those who are opposed to abortion out in front of our clinics rather than in our state legislatures. That’s where they do the most damage.” Organizations like the National Abortion Federation, PRCH and the Association of Reproductive Health Professionals help Dr. McCracken to fight the isolation that faces many abortion providers. “They have been essential to my learning. They are my medical community,” he says. “Doctors who are involved with abortion services must be politically active. If we ourselves can’t be the activists—and oftentimes people are just not suited for that role—we have to support those who are.”