What 1,000 Abortions Have Taught
My first anniversary as a health
worker here at Cedar River Clinic, one of the Feminist
Womens Health Centers in Washington, has just passed and the event has me
thinking about the rewards and challenges of the past year. I have learned much.
In that busy year, I figure I have born witness to about a thousand abortions,
and learned much from the women we serve...
...For many women, the circumstances
surrounding an unintended pregnancy make deciding whether to have an abortion a difficult task. For these women, the decision usually entails weighing out more
than simply the options of parenthood, abortion or adoption. They struggle with
the other parameters of their lives: jobs, money, living situation, and relationship
status, among others. For some women, an abortion is the lesser of two evils,
the choice they can live with most easily when confronted with the difficult dilemma
of an unintended pregnancy. The anti-choice folks seem to think legalized abortion
invites women to terminate, as if women would line up around the block to end
their pregnancies just for the fun of it. They don't realize that many women,
if it were possible to change some other life circumstances to make having a baby
a realistic option, would choose to carry to term. Nor do they see the genuine
regret these women feel because having a baby is not possible.
women, the choice to have an abortion is more clear. Some simply do not want to
be pregnant or have a(nother) baby. Others find those other circumstances of their
lives, such as career and finances, much less easily changed than being pregnant
and so, for these women, the decision can be very straightforward. I suspect some
of these women would not choose abortion, if they were able change any of these
other life parameters. The women who make the decision with clarity are not heartless,
selfish, inhumane, un-womanly, devoid of "maternal instincts" or anything
else. They are women who are clear about their options and the choice they make.
More often than not, these women have a strong support network behind them and
they appear to me to have a good sense of their own capabilities and limitations.
I support their clarity as I do the ambivalence of other women.
biggest problem facing women wanting or needing abortion services is accessibility.
Before I started working here, I could have told you that over 87% of all U.S.
counties do not have a known abortion provider, but I didn't know what that statistic
looks like. Now I know it looks like exhausted women who travel from Idaho, Alaska,
Montana, Colorado, Oregon, even Canada, in search of services. It looks like desperate
women who must sell precious and needed belongings, borrow and beg from friends
and family to finance their journeys and procedure costs. It looks like frightened
women who must travel alone to have their abortions among strangers and away from
loved ones who support and nurture them. It also looks like the invisible faces
of the women who couldn't borrow, beg or sell enough to travel here and won't
be able to have an abortion.
...Women choosing abortions later in pregnancy
are just like women who choose abortion earlier. They are no more irresponsible,
selfish, victimized or immature than any other women, pregnant or not.
abortion debate is framed here in the U.S. in black and white, either/or terms
which rarely speak to the reality of the abortion experience. Some pro-choice
people have reservations about abortion in some circumstances and most anti-abortion
people do allow for abortion in some situations. Intuitively, I think most of
us realize that matters of sex, consent, age, family, death and money are never
easy and abortion is or can be about all of these. I think because the debate
is framed as it is (indeed, a "debate"!) people are discouraged from
discussing their feelings about abortion. Some pro-choice people are hesitant
to discuss their reservations and I believe most anti-choice people are afraid
to voice any pro-choice tendencies they may have. Both sides, then, perpetuate
the either/or view of abortion. In the end, it means most of us try not to think
about abortion, except perhaps, in abstract terms, until we become involved--we
ourselves become pregnant, or a lover or friend or sister or daughter or mother
becomes pregnant. I have counseled women who hadn't thought much about abortion
except that, "I'd never have one," until the day they discovered they
were pregnant, and now learn their partners are on opposite sides of the debate.
This reluctance to explore the gray areas of abortion can heighten the crisis
an unintended pregnancy can create.
At this point, there are no absolute answers
- science and law cannot tell us when life begins. It is up to each woman to decide
for herself what she believes in, how she will live out those beliefs, and who
she will involve in her decision. To discuss it with significant others seems
...Work in the abortion field is often misunderstood, maligned,
even attacked. Not only are doctors being shot and workers harassed, there are
more subtle ways even self-described pro-choice people show their lack of support.
"All you do at your clinic is abortions?" I am asked. Does anyone ever
ask the dermatologist, "What, you only do skin?" I am proud of the work
that I do. I am grateful to every vocal pro-choice person I know, but women need
to receive services, not just talk about them. (By the way, we offer a range of
other gynecological services at our clinics.)
...Women frequently ask questions
like, "Can you tell what sex it is?" "How big is it?" "Does
the doctor cut the cord?" "What happens to the fetus once the abortion
is finished?" These questions are normal. Most women have a mental image
of the fetus; they want to compare their image to reality. In a few cases, women
have asked to see the tissue. My experience with this has been very positive --
the women's mental image is almost always scarier and more disturbing than reality.
For some women, the motivation is curiosity; for others, I believe it is a way
to say good-bye to this pregnancy. Women often ask these more graphic questions
in an apologetic tone, afraid their questions are morbid or strange. I see these
questions as part of the process and hope all providers meet these questions with
respect and an affirming attitude.
...Pregnancy is not a punishment, nor
a failure. Many women feel stupid, guilty or angry at themselves for not using
birth control consistently, for not obtaining an abortion sooner, or for having
sex in the first place. We all take risks in our lives, everyday. Only a very
small percentage of people use birth control every time they have sex. It is in
our natures to take chances. That doesn't make us stupid, selfish, irresponsible
or hedonistic. That makes us human.
...At the same time, the options available
for birth control are highly inadequate. With options that can cause uncomfortable
side effects, can be unsafe, are expensive or difficult to obtain, have to be
hidden from parents or partners, are difficult to use or ineffective...well, no
wonder we take chances!
...Most women voice their fear of pain as their
greatest anxiety around the abortion experience. For years, the anti-choice folks
have tried to scare women out of having abortions by portraying it as violent,
bloody and oh, so painful (as if childbirth isn't any of those!) In fact, most
women comment that it was far less painful than they feared and was finished much
sooner that they expected. My dentist recently had to fill a cavity in my molar.
I was crying from fear and pain as she injected the anesthetic. She commented
that she could imagine a lot of things a lot worse, including "what you do
at your job." My announcement that I would rather have an abortion than a
cavity filled shocked her into silence.
...Some women experience abortion
as painful. How much so depends on factors such as gestational age of the pregnancy,
type of procedure (suction or extraction), sedation used during surgery, available
support, and mental preparedness. As a health worker I try to help clients become
as calm as possible in order to diminish the fear which I believe increases physical
pain. But the fact that abortion is sometimes painful is not reason enough to
say a woman shouldn't have one. Undoubtedly, giving birth hurts more.
lots of women involve loved ones in their decision and some even bring partners,
parents or friends to the clinic, lots of women don't. For most of these women,
I think its about self-preservation. They dont tell because they expect
their parents or partner to be unsupportive, perhaps even try to prevent them
from having an abortion. I think the majority probably tell them later, when the
fear that the unsupportive loved one can block their choice is gone. These women
sometimes express guilt for not telling, but it strikes me as smart. It makes
sense to call only on people one can expect support from. It only makes me mad
that some women can't rely on their closest family and friends to support them,
no matter what.
I work with a group of courageous and special people. From
their experience and sharing, I have learned much. I'm grateful for the new skills
they have helped me develop and the lessons they've taught me. I'm looking forward
to many more.
At the end of her first
year of working at
Cedar River Clinics in Renton, Lynne V. wrote this article in 1993. At the time Lynne had Bachelor Degrees in Human Sexuality
Education and Counseling and Womens Studies from the University of Massachusetts
at Amherst. Lynne worked at Cedar River Clinics for four years, then went to Medical School and is now a doctor.
have to change the culture of America from a place where women's judgment is not
trusted and valued to a place where it is trusted.
Feminist Women's Health Center