




Over the last hundred years, the world has increased its knowledge of medicine and surgeries. In the 1920’s, women were not conscious of the effects of alcohol use during pregnancy. Binge drinking was a large problem that women used as a stress reliever during the nine-month period. During this time, women did not have much of a say in what they wanted or stood for. Therefore, the idea of having an abortion was heavily influenced by the man. Throughout history, research has advanced in the fields of abortion and alcohol abuse during pregnancy to decrease the chances of babies being born with birth defects. In the story, “Hills Like White Elephants” by Ernest Hemingway, the couple is left with an unyielding decision of life or death of their child.

In Hemingway's short story, a pregnant girl must decide if she wants to go through with the abortion like the American man wants her to do or proceed with having the baby. They waste the days away drinking and discussing the matter, although the girl does not want to. The man spends the day trying to persuade her to follow through with the procedure telling her that “it's not an operation all” however, she does not want to talk about it. They wait for a train to Madrid where the procedure would take place, yet, the girl is still very unsure about everything in her life, especially the procedure. 

The procedure of abortion has been a huge political and social issue over the past hundred years. During the 1920’s, all surgeries were done without the aid of modern blood transfusion and antibiotics, causing them to be much riskier than any similar surgery today. In the article, “Criminal Abortion” by Russell S. Fisher, Fisher defines abortion as “the expulsion of the fetus from the uterus at any time before its term of gestation is complete”. This causes women to be on the time clock, the uterus must be emptied before the 24th week of pregnancy. Today, abortion is classified into three different categories; criminal, spontaneous, and therapeutic. During the 1920’s, abortion was an illegal act that would be classified in the criminal category. Kitchen-table surgeries were very popular during the time and were surgeries performed on the kitchen table of the patient's home. In the story, the American man tells the girl that the procedure is quick and easy, however, I believe that the man is unaware of the actual procedure and the pain the woman is endured in. These surgeries remained dangerous until in later years when surgeries were performed in hospitals. Fisher explains that during this time all surgeries were announced as criminal, although in two-thirds of abortions today they are reported as spontaneous, due to abnormal development, death or maternal disease. It is very difficult to discover the real cause of the abortion unless it is one of these reasons, therefore, the term used is “accidental traumatic abortions”. A major cause of abnormal development is alcohol abuse during the pregnancy. 

At this time, people were unaware of the effects of alcohol on pregnant women. In the story, the couple orders multiple rounds of drinks. This provides evidence of how oblivious people of those days were to the problems of alcohol abuse. In the article, “Alcohol Abuse in Pregnant Women” by Asher Ornoy, he discusses that the use of alcohol during pregnancy is affected by how much alcohol the user is consuming. “In high repetitive doses there is a 6–10% chance of the fetus developing the fetal alcoholic syndrome manifested by prenatal and postnatal growth deficiency, specific craniofacial dysmorphic features, mental retardation, behavioral changes and a variety of major anomalies”. In lower consumption doses, there are also some less severe dangers, although these are not the cases for some pregnancies, the mother is highly advised to turn to abstinence prior to and during the nine-month period. Ornoy explains that in the early 1900’s the percentage of abortions and stillbirths increased due to alcohol. The idea of what alcohol did to newborns was known during this time, however, doctors were not sure what the exact consolations would be until later in time when fetal alcohol syndrome was established. Alcohol drinking, even in moderate amounts, is also associated with an increased risk of spontaneous abortions, especially in the first trimester of pregnancy. Every pregnancy is different; therefore, it is very difficult for doctors to put an exact amount on how much is too harmful for the fetus. Peer pressure can be a major cause of why women turn to alcohol. Many women go to parties, drink a glass of wine at dinner or turn to drinking when they are stressed. These are some examples of why it is hard for women to let go of drinking for the long nine months. I believe the main cause of alcohol abuse in the story is because of the stress the couple is under.

It is my assumption that if the couple in the story was more aware of the dangers they were putting their child in, they would not question the decision of having the abortion and go through with the procedure. However, the story ends in a mystery, nobody knows what the couple concludes in. This leaves the audience in suspense and allows them to interpret it in whatever way they wish. Due to so many people being for or against abortion it is a strong decision to leave the story ending in an interpretation. The American man in the story is very much in control of the relationship. He urges the girl to have the operation, repeating again and again that he does not want her to do it if she does not want to. However, he clearly is insisting that she do so. This leaves the girl in stress and annoyment of the man because he will not let the subject go, leading her to cope by drinking more. 

Over the course of the story, the girl begins to question what is best for her life. She begins to stand up for herself towards the man and decide if going to Madrid is the right answer. Throughout the last century, knowledge of the topic of alcohol abuse has increased, causing a huge uprising in healthy babies. Women, like the girl in the short-story, have taken a stand in choosing what is best for themselves and their babies by not letting an outside opinion influence their decision about their own bodies. Although we are unaware of the girl’s final decision, we can conclude that she makes the best decision for herself and her baby.

