Abortion Gang

A co-worker once told me that in her 10+ years of working in the reproductive health field, her peers in other movements validated time and again that our movement is the most fucked up. Not fucked up because we don’t have our hearts in the right place (we do) or because we don’t have science on our side (we do), but because of the way we treat each other, and the way our intra-movement politics operate.

Every so often several friends and I debate the merits of “outing” certain organizations for their legendary bullshit. Everyone knows that organization A has an executive director who’s a megalomanic. Everyone knows that two particular organizations bully other smaller organizations. Everyone knows that organization B likes to fire (almost) everyone every couple of years. Everyone knows that certain national organizations have less than cordial relationships with their local affiliates. Is there merit in pinning a name to these claims? What would happen to the person who decided to to do so? Would she be ex-communicated from the movement? Lose the ability to work or volunteer in the movement ever again?

Maybe my friends and I are just bitter (former) employees. But we also believe that our movement can and should be better than this. Is this bait for antis? Everything is bait for antis. I’m willing to bet that they have similar problems in their own organizations. In a time of unprecedented legislative attacks on reproductive health, it feels impossible to find a second to catch our breath and evaluate how we’re doing. I have to believe that making sure our organizations are functioning productively and treating their employees humanely is as important as the work we’re doing.

In an effort to be less vague, let me make it painfully obvious. Here are a few clues that the reproductive health, rights, or justice organization you work at may be a toxic work environment:

• You’re expected to treat your members/patients/donors better than the way your boss/upper management treats you.
• You’re afraid to confront your co-worker/your boss about something racist/classist/transphobic/etc she said for fear of losing your job.
• You don’t get insurance coverage. The insurance coverage you get doesn’t cover pre-natal care, contraception, or abortion. You don’t get decent maternity or paternity leave. Yet these are all values your organization supposedly champions.
• There is frequent turn over and burn-out because of low pay and high stress.
• Your volunteers, interns, or anyone with “assistant” in their title are treated as a commodity.
• Young people, people of color, and/or queer folks are not valued, are not expected to be leaders, and are tokenized.
• When you give thoughtful feedback about your job or about the organization in general, no one takes you seriously.
• Your organization primarily works with or on behalf of low-income communities, communities of color, and/or young people, yet those folks are not represented on the staff or on the board. And there are no conversations about class, race, or privilege among staff. Ever.
• You see young people being encouraged to take on responsibilities for which they are not being paid, for the good of the organization and therefore the movement.
• You find yourself having to mask your work conditions, including poor communication, bad management, and unclear organizational goals, while selling your organization to donors and supporters.
• You are underpaid and are made to feel uncomfortable for any mention of that, or for requesting to be paid fairly, because times are tough/the economy is bad/you should be putting the organization’s needs before your own.
• Your organization only cares about marginalized people in a marginalized place (hello, low-income Texan women!) when your org stands to make a buck off of promoting their rough situation.

I want to be clear that these problems don’t exist in a vacuum (certainly stigma and a small professional world both play a part), and that they don’t exist only in the reproductive health, rights, and justice world.  I think the above grievances feel particularly shitty because we expect better. We expect organizations that are fighting for basic human rights to treat their employees and volunteers like, well, human beings. No organization or movement is perfect. I certainly hope that my former co-worker is wrong and that we’re not the most fucked up. But in listening to dozens of folks who’ve done this work at the highest and lowest levels, I suspect that it’s more than just the non-profit industrial complex.

I originally ended this post with some tips for upper management folks on how to begin to correct the above issues, but let’s be real. They’re not reading this blog. Should we “out” the organizations that perpetuate these problems? Frankly, I don’t have the answer to that. So to those suffering any or all of the above conditions: You’re not alone. You’re not making it up. You deserve better. And if you need a space to vent or process any of your experiences: write about it, anonymously or with your name attached (e-mail us and we’ll even publish it here!). Find your compatriots who are going through the same thing, whether in this movement or others. Let’s figure out how to make our movement sustainable for everyone in it.

Thanks to those who helped me come up with the bulleted list. I won’t name you, in case your organizations might penalize you. You know who you are. Thank you.

I have never taken as many pregnancy tests as I did when I worked at an abortion clinic. I peed on a stick after not having sex for weeks, or when I’d had sex that day, even though I knew the results wouldn’t be accurate. Pregnancy felt contagious—in the air in the clinic waiting room, on the seats in my counseling office. When you hear a dozen stories a day about birth control failure, about women getting pregnant even when they have an IUD and their husband has a vasectomy, you worry.

I wasn’t the only one who was constantly on the alert, but as a newer employee, I was the most obvious. One of my co-workers, a perceptive lady, noticed my jitters and told me not to worry, that as an employee, if I wanted one, I could have an abortion covered completely by our insurance, I could have my partner with me, the whole staff would support me, and on and on. I appreciated this compassion, but she assumed one crucial thing: that I would have an abortion at all. She didn’t push it on me by any means, but assumed, as I had before thinking I was constantly pregnant, that abortion would be my automatic and obvious decision.

Part of my new employee training to work at this clinic was shadowing a patient all day through her abortion experience. I went with her to get her labs checked, her ultrasound, her counseling session. I was with her during her procedure, where I held her hand and we talked the whole time. She told me about her kids, about how she was going to hug them extra hard when she got home, how having this abortion made her value her kids all the more, how she wanted to give them so much and couldn’t afford to sacrifice that for another child. It made me feel vindicated in my work, being present for this woman’s abortion experience.

With the patient’s permission, I went into the lab room for the next part of the training, examining the aborted fetus to make sure the procedure was complete. I didn’t know exactly what I was going to see, but was very curious. Would it really look like the gory posters that the anti-abortion protestors had outside? Would it just look like a period? I had seen abortions through the first trimester. This particular patient’s pregnancy was almost 15 weeks, the last point at which my clinic offered the option of local anesthesia instead of mild sedation.

As usual, I also thought I was pregnant at the time. I was constantly nauseous, had a heightened sense of smell, and my breasts were tender. The pregnancy tests I took were all conveniently too blurry to come out one way or the other.

The lab tech showed me the fetus. I was surprised to see that I recognized some of the parts—not fully developed by any means, certainly not what I would call a baby, but recognizable nonetheless. What I saw didn’t match the anti-abortion posters outside, far from it. But it also didn’t fit my preconceived notions that a 14-to-15 week fetus would look like a few blood clots. It looked more or less like an alien with see-through skin and insect-like eyes. Not a baby, but not nothing.

When I got home that night, I told my partner about my day, something we did every evening. I confessed to him that I thought I might be pregnant, and I didn’t know how pregnant, and I was crying and also happy but mostly epically confused. I knew we weren’t ready to be parents (most of the time I didn’t even want to be a parent, ever). We used reliable birth control.  Did I want to be pregnant? What would it mean for us?  I remembered an incident earlier in our relationship when 24 hours after a condom broke, I took emergency contraception, and I was sad about taking it, but I also knew it wasn’t the right time to take that risk. This felt like that all over again, except the stakes were higher. It felt like my body, my brain, and my heart were all turning on me, but in separate directions.

I thought about my potential pregnancy, about the possibility of our freaky alien floating comfortably in my belly, how it would look in the lab tech’s office, if I even wanted that, or if that would break my heart. And then another thought occurred to me: was I a bad feminist for feeling so conflicted? Was I going to be kicked out of the pro-choice movement for not knowing absolutely one way or the other if I wanted a baby?

Luckily for me, I hadn’t caught pregnancy from my patients. I got my period a few days later, and was both relieved and disappointed.  In the research world and the pro-choice advocacy world, we talk a lot about unintended versus wanted pregnancies. As it turns out, about a quarter of US women identify as ambivalent about pregnancy, that is, neither trying to become pregnant nor trying to avoid it. How can we create a movement that enables us to talk about our deepest emotional concerns and desires related to pregnancy without shaming or pressuring each other? Is it possible for us to encourage each other to use birth control and have open and honest conversations with our partners, while also acknowledging that sometimes these issues go beyond the logical?

We’re taking this week off for some much needed rest and relaxation. Check back the week of March 18 when we’ll resume our regular schedule of reproductive justice badassery.

Love,

The Abortion Gang

Everyone from our celebrated allies to mainstream anti-abortion commentators have recently lauded the mantra that abortion should be safe, legal and rare. I’ve tweeted at these older (white) gentlemen in an attempt to explain why the “rare” framing is so problematic, but sometimes 140 characters just isn’t enough. Thankfully, I’m not the first to explore this subject, so instead of reinventing the wheel, I’m going to summarize one of my favorite articles on this: Tracey Weitz’s Rethinking the Mantra that Abortion Should be “Safe, Legal, and Rare.” 

So what bothers me so much when even President Obama says he wants abortion safe, legal, and rare? Well, the safe and legal part I’m behind 100%. The “rare” aspect? Not so much. Here’s why.

1. By saying that you want abortion to be “rare,” you’re passing a negative judgement on the people who perform abortions and the women who have them. This judgement is harmful to women and clinicians. Dr. Weitz explains why:

“Rare” suggests that abortion is happening more than it should, and  that there are some conditions for which abortions should and should not occur. It separates good abortions from bad abortions. It creates an understanding that women’s individual decision making is somehow responsible for the violent disruptive social conflict over abortion in the United States.

Do we really want to suggest that women who have abortions and clinicians who provide these health services are the reason that abortion is such a lightening rod social issue in the US? To do so is not only simplistic, but absolutely wrong.

2. Saying that you want abortion to be rare implies that there is something wrong with abortion, that abortion is somehow different from other parts of health care.  Specifically, marginalizing abortion care

has contributed to the significant decline in the number of locations where abortions are performed in the United States…Increased access to care is not  part of the “rare” message and efforts to expand services could be construed as working against the goal of making it less frequently used.

There should be as many abortions as there need to be. Instead of saying abortion should be rare, we should be working on expanding access to safe, affordable abortion services.

3. Wanting abortion to be rare suggests that training clinicians to provide abortions is unnecessary. In reality, we need more abortion providers to increase access to safe abortion care. In fact, as Dr. Weitz states,

The uniform acceptance that fewer abortions is good creates the inability to recognize the consequences of reduced access or to accept credit for efforts that actual increase the number of abortions.

What happens when abortion is not accessible to every person who needs it? According to Guttmacher, every year 47,000 women die as a result of unsafe abortion. What would that statistic look like if we trained every doctor worldwide to provide safe abortion care?

4. Another consequence of the “rare” framework is that it legitimizes the need for abortion restrictions, and these anti-abortion laws have the most dire consequences for women with the least resources. In addition to abortion restrictions being medically unnecessary and insulting to women and clinicians, there’s absolutely no proof that they actually reduce abortion rates. They just make it harder for women to access the care they need.

5. The “rare” framing sets up the unrealistic expectation that there’s a magic number of abortions that are acceptable, and once we reach that number, abortion will cease to be a divisive issue in American culture. Dr. Weitz uses the example of Dr. Tiller to elucidate this issue:

Unfortunately, numbers have little to do with ongoing opposition to abortion and the rarity of some abortions seem to be their reason for aversion. Take for example the situation of George Tiller, MD, the physician recently killed in Wichita, KS. In addition to having a robust practice of first trimester and early second-trimester procedures, Dr. Tiller also provided medically indicated abortions in the third trimester. While these abortions were “rare” in numerical sense, occurring only 2,400 times a year in the entire country, they were the abortions for which he was most reviled. The rarity of these procedures did not provide any protection for Dr. Tiller. Instead the specialness of those abortions provided evidence that such abortions were abnormal.

Bottom line? As Dr. Weitz puts it, saying that we want abortion to be rare “does not achieve the underlying goal of reducing  the social conflict over abortion and has real consequences for women’s health and well-being, including reducing access to care, increasing stigma,  justifying restrictions, and establishing unattainable goals.”

Where do we go from here? Thankfully, Dr. Weitz has four suggestions:

1. Accept that abortion is a polarizing issue in the U.S.;
2. Acknowledge that abortion has and will always be part of the human condition;
3. Validate the rights of women to equal participation in society and control over their  reproductive lives; and
4. Engage in the hard conversations about abortion regarding the moral status of life, the extent of the rights and autonomy of women, the limits of the state to intervening in personal decisions, and
   the role of religion in public life.

Instead of stigmatizing abortion by pushing for it to be rare, let’s work on achieving those goals instead.

I quoted extensively from Tracy Weitz’s article. Please go read it if you have the chance!

How do you write about a topic that is both the third rail of US politics and also one of the most common medical procedures in America? There are many things to be mindful of when writing about abortion. This is the first installment of what I hope will be an ongoing conversation about writing about abortion with integrity. Let’s dive right in.

Language matters.
Are you using the words “pro-choice” and “pro-life”? Typically, the pro-choice movement prefers “anti-choice” to “pro-life,” since the latter implies that the pro-choice movement is “anti-life,” which is preposterous (not to mention false).  Another alternative to “pro-life” is “anti-abortion rights.” And what about using terms like reproductive justice and pro-voice? If you’re writing about women’s personal abortion stories, you may want to investigate exactly what pro-voice means, and if you’re looking at abortion from an intersectional lens, reproductive justice is your best bet.

Science matters.
Who can you trust to tell you if a certain piece of legislation is based in medical evidence or ideological bullshit? Physicians for Reproductive Choice and Health, for one (full disclosure: I used to work there and can say with confidence that the doctors affiliated with PRCH are fantastic). Other potential sources of medical information include the clinician/s or medical director at your local clinic and the National Abortion Federation. The best reason to ask clinicians if a piece of legislation is medically necessary or makes scientific sense? Most legislators aren’t doctors.

Planned Parenthood is not the only abortion provider in the United States.
While they’re certainly the most high profile abortion provider, they are far from the only ones. In fact, there are entire organizations composed of independent abortion providers, such as the Abortion Care Network and the Feminist Abortion Network. In covering only Planned Parenthood, you’re getting a small piece of America’s abortion story. Most abortions are done at free-standing (non-Planned Parenthood) clinics. Independent providers have a long and proud history of providing women with compassionate care–why not call them in addition to your local Planned Parenthood?

Be wary of abortion stigma
No one could argue that there isn’t a stigma associated with abortion, whether it’s with the women who have them, the clinicians who perform them, or anyone remotely associated with the topic. The last thing you want to do is perpetuate the notion that abortion is a gruesome procedure performed by badly trained doctors that only slutty, selfish women have (see what I mean by stigma?). Many people perpetuate stigma without even realizing it. How?

• “Only 3% of our services are abortion!” Planned Parenthood pulls out this statistic every time they get attacked by a politician. They do so to try and emphasize the fact that they are primarily family planning providers, not abortion providers. By doing this, however, they distance themselves from abortion, as if abortion is shameful, as if abortion is something that should only be 3% of their services. Are they proud to provide abortion services? Of course. But you wouldn’t know it with this talking point.
• Talking about rape, incest, and life threat situations as acceptable instances of when a woman can have an abortion. What woman deserves to have access to abortion care? A woman who was raped? A woman with a fetal anomaly? A woman who can’t afford to have another child? A woman who didn’t use birth control? A woman who’s had an abortion already? Every woman, no matter her circumstance, deserves to have access to abortion care. We stigmatize abortion when deem certain abortions as moral or some women as deserving to have abortions, while others are “bad” or unworthy of legal medical care.
• Later abortions: Define your terms. When you say “later abortion,” what do you mean? In research land, it usually means abortion after 24 weeks. Some people use the medically innocuous “late term abortion” to signify anything from an abortion in the second trimester to an abortion into the third trimester. Make sure you know which one you’re talking about. Read the literature on second trimester and later abortions. Accept the fact that there is nothing inherently, morally wrong with later abortions. Learn about why women need them, that there’s no medical consensus on viability, and no agreement on “fetal pain.” Check your language–are you somehow implying that later abortions are morally wrong, or that a woman should’ve just hurried up and made a decision earlier? That’s stigma in action.
• For more on abortion stigma, see ANSIRH’s research.

One woman’s abortion story isn’t every woman’s abortion story.
One in three US women will have an abortion by the age of 45. It follows, then, that one in three US women will not have the the same reasons for having an abortion, or the same reaction afterwards. Who has an abortion? Every type of woman, it turns out: women of every class, race, ethnicity, and education level.  We also know that women seek abortion care for every possible reason: they can’t afford another child, a birth control mess up, a health condition, or simply not wanting to be a mother (whether for the first or sixth time) at that point in her life. Whatever the woman’s reason for an abortion, it’s a valid one, and not your job to make a judgment call on it. Similarly, many women feel relieved after their abortions, some women feel regret or sadness, others feel a mix or something completely different. If you’re writing about women’s reactions to having abortions, make sure you talk to a variety of people who can give you multiple perspective on the experience. If you need to talk about abortion stories in broader strokes, talk to organizations like Exhale and Backline that support women before and after their abortions.

There’s a lot to think about when covering abortion. As much as we want it to be, abortion isn’t just a medical procedure; it’s tied up in political and cultural battlegrounds that demand thorough exploration. You need to make deliberate decisions to seek out medically and scientifically accurate information if you want your article to reflect the reality of abortion in the US.

Last week I had the privilege of participating in a panel called Demystifying Abortion, an event that aimed to shift the conversation away from the politics of abortion into the day to day reality of reproductive health care provision here in NYC. I was on the panel representing NYAAF, the abortion fund here, and joining me was an abortion provider, an abortion doula, a woman who’d had an abortion, a representative from Exhale, and a clinic escort. While the panel did a lot to shed light on the who, what, when, where, and why of abortion, it also did something I didn’t expect: it revealed just how much the pro-choice movement itself stigmatizes abortion.

Stigma manifested itself in a number of ways. For one, the abortion doula decided to use this quote to describe why women have abortions: “A woman wants an abortion as an animal caught in a trap wants to gnaw off its own leg.” Unbeknownst to the doula, this quote is from the anti-choice group Feminists for Life, and is meant to describe a desperation that is destructive, a desperation that leaves a woman alive but (literally) hurt by the experience. Did the doula know the context of this quote? No, and I’m sure she thought she was somehow making women who have abortions sympathetic to the audience. Regardless of the quote’s origins, do we really want to discuss abortion in the context of self-mutilation? To do so is misleading, manipulative, and harmful.

The doula wasn’t the only person to perpetuate abortion stigma. During the Q&A after the panel, several women shared their abortion stories. One woman in particular mentioned that after listening to the representative from Exhale, she felt guilty for not feeling regret after her abortion. I have no doubt that Exhale provides support to women regardless of how they feel after their abortions, but there is something not quite right with your messaging if you’re making women question the validity of their emotional responses, positive or negative.

What surprised me most about the event (though it really shouldn’t have surprised me) was how much both the provider and the doula emphasized that most abortions are not later abortions, and that later abortions are particularly icky. The provider casually mentioned that some people pass out when they see later abortions (giving absolutely no context as to why, leaving the audience to assume the worst), the doula emphasized that all women who have later abortions cry their eyes out before and afterwards. Is it true that some people pass out and some women cry? Of course. But to lay out these statements as universal truths is misinformation, and stigmatizes later abortions (what could be so bad that people pass out??) and the women who have them (what could be so bad that they cry all the time?). What could’ve been useful: some science on later abortions and the women who have them. The truth? Most people don’t pass out. Some women cry, some women don’t. Making later abortions sound like gruesome tragedies stigmatizes the women who need them and the clinicians who perform them.

I understand why we emphasize that the majority of abortions are first trimester abortions from a PR standpoint–most people are grossed out by the idea of later abortions, I get it. And the reality is that most abortions happen in the first trimester. But does emphasizing this over and over do anything besides stigmatize later abortions? Shouldn’t we have empathy, respect, and compassion for all women who need abortions no matter when they have them? We do our movement, and the women we serve, a disservice when we say that an early abortion is ideal and a later abortion is tragic or bad. In doing so, we lose the nuance of why women have abortions, of their personal stories, and instead focus on what makes us comfortable or uncomfortable. It’s not about us. It’s about the women who have abortions.

I don’t want to give the impression that this event was a disaster. In fact, it was the exact opposite. What could be better than an enthusiastic and eager audience listening to experts talk about the ins and outs of getting an abortion? With that said, I do not think the pro-choice movement is absolved from thinking about how we perpetuate certain myths and stigma surrounding abortion. It’s not just the anti-choice folks who succeed in this role. We clearly have some work to do on our own.

Note: To clarify, this post is not meant as a criticism of the work of any of the organizations represented by individuals on this panel. Rather, this post is a critique of abortion stigma, and is meant to cast a light on how pervasive this stigma is, as even members of the pro-choice movement ourselves perpetuate it. 

 Happy holidays from all of us at the Abortion Gang. We’re taking a short blogging vacation and will be back in January with the same sassy and sharp reproductive justice commentary that you love. If you miss us too much, find us on twitter and facebook.

Trigger warning for anti-abortion violence, violence against women, gruesome imagery, threats, etc.

Sophia wrote a post a day or two ago about being a Tebow fan and being pro-choice. To reconcile the fact that she loves watching the football player and that he’s anti-choice, she talked about how she’s going to donate to a pro-choice organization every time he scores a touchdown. Who knew that what riles up anti-abortion folks is not the potential to help women and their (already existing) children, but defending a football star and insulting bloggers they’ve never met?

Instead of publishing the dozens of insulting, hateful, and blatantly violent comments and emails we’ve gotten over the last 48 hours, below are some highlights (lowlights, really), in case you had any doubts about what the anti-choice movement is really about: shaming, disrespecting, and hating women.

Some people thought they’d be really smart and donate to their local anti-abortion organization instead. Imitation is the sincerest form of flattery!

You know what, for every touchdown Tebow scores, I think I’ll donate money to my local pregnancy care centre. Dare to disagree with that, and you’ll expose yourself as the anti-choice people you really are…since if you’re really pro-choice, you should respect my right to donate my money to something that will really help women. GOOOOOOOOOOOO, Tebow!!

Others thought that insulting Sophia and telling us all we should die was the way to get us to change our minds (nope, still doesn’t work).

This is genuinely pathetic in every way. Sophia, you are a pretentious piece of garbage. It pains me that your mother didn’t have enough sense to abort you when she had the chance. I’m sure she’s really proud of you. Get a life, and if you love abortions so much why dont you go f-ck yourself and jam a wire hanger up your snatch.

Definition of anti-abortion respect and kindness there, am I right? Other folks decided to go straight up medical and take us to task for being sluttly abortion lovers.

Who devotes this much time and energy advocating the act of sucking out a human fetus from a woman’s uterus using a vacuum. I don’t mind if you’re pro choice, but my god this is dreadful. You guys must really have a lot going for you. You guys are like abortion addicts. I bet for every one girl participating in this blog there are 7 terminated pregnancies. Nasty ass ho’s. NASTY.

And then there’s the folks who just couldn’t resist getting all World War II on us, claiming that we’re discriminating against Tebow a la Hitler. As a Jew, I get particular joy out of this. You want to make this about the Holocaust? Try me, fools.

You are discriminating against someone who has every right to display his faith, just as you have every right to display yours without prejudice from those around you who would disagree.  The hatred oozing from you is astonishing!!  Hatred for what!??!  Someone who believes in God??  Just because you don’t believe in God doesn’t mean He doesn’t exist…and I daresay one day you will experience the consequences of your lack of faith.  I would liken you to Hitler…for your hatred.

And, my personal favorite, the over-reaching Christian who hopes that Jesus saves us all (memo: already too late).

You folks are truely deranged.  Does Jesus save?  You’ll know for certain a microsecond or so after you cross over from this life into the next.  God luck.

Oh anti-abortion folks. Sometimes I wish I could just give you a hug and tell you that it’s all going to be ok. This isn’t a war on Christians, or your beliefs, or your precious Tim Tebow. We are doing the work, God’s work, if you will, that saves women’s lives, strengthens their families, and lets women achieve their hopes and dreams, all while you’re anonymously commenting on a blog post about football. You make our job so easy! Thanks for reminding us who is really on the side of love, kindness, respect, compassion, and justice.

Cross-posted from RH Reality Check, by both Steph Herold and Susan Yanow.

Last week, a 20-year-old woman in New York City was arrested on charges of “self-induced abortion” and faces first-degree misdemeanor charges.  Initial news reports indicate that she intentionally caused the miscarriage/abortion of her 24-week fetus.  The woman disposed of the fetus in what was probably the only way she could think of: wrapped in plastic bags and placed in the trash receptacle of her apartment building.

The prosecution of this woman echoes similar cases in Idaho, Massachusetts and South Carolina.  In spite of ever-increasing restrictions, abortion is legal through the second-trimester throughout the United States, although it is inaccessible to many women.  Yet if women safely end their pregnancies without medical supervision, they face criminal penalties.

The key word here is “safely.” There are many misconceptions about what happens during a non-surgical abortion.  In fact, abortion with medications (such as misoprostol alone or in combination with mifepristone) causes a miscarriage.  The symptoms of abortion with medicines in the first trimester are exactly the same as a miscarriage, and as safe.  Rarely do women who have a miscarriage need medical attention; the same is true for women having a medication abortion.

In the second trimester, the risks of a complication after a miscarriage, whether occurring spontaneously or provoked by medicines, is somewhat higher.  However, it is notable that the woman in New York City, like the women prosecuted in three other states, was in the second trimester and did not require any kind of medical intervention after her abortion.  We have to ask then – is the outcry when women choose to self-induce truly driven by the need to protect the health and safety of the woman?  Or is this another example of over-regulation because of the politics of abortion?

The choice to self-induce an abortion in New York City raises important questions.  The most recent prosecution of a woman for making this choice was in Idaho, in the spring of this year.  Jeanne McCormack was between 20 and 24 weeks pregnant, obtained medicines over the Internet and ended her pregnancy.  She was charged under an Idaho law that forbids abortions unless performed by an Idaho physician, and the original charges carried a possible five-year prison term.  Ms. McCormack, a low-income mother of three, said she ordered the medicines because the closest abortion provider was in Utah, and she had no money for travel or for the procedure.

Women in New York City have much better access to abortion care than Ms. McCormack did.  New York State allows state Medicaid funds to cover abortion services, and there are a number of clinics in New York City that provide abortion care through 24 weeks.  New York also does not have the restrictions, such as waiting periods and parental consent, that are insurmountable barriers for women in many other states.  So why would a woman in New York City decide to end her pregnancy by herself?

We don’t have details about why this particular woman chose this method.  Is it possible that the relentless headlines about new abortion restrictions across most states have confused some women, who may think that these laws are national?  Or is the (successful) effort by anti-abortion forces to stigmatize abortion effective enough that some women feel too much shame and fear to seek medical care when faced with an unwanted pregnancy? Or did this woman have no trusted health care provider who could direct her to a clinic?

Ultimately, it doesn’t matter what her reasons were for self-inducing an abortion. Not every woman wants clinicians involved in her health care, especially if she feels that she can take care of it herself. We each have different ways of dealing with our bodies, our sexuality, and our health care.

We do not have enough information to guess whether or not this woman fell through the gaps in the social support and health net, or made a conscious choice to end her pregnancy in a way that she felt most comfortable.  But why is self-treating an unwanted pregnancy a crime?

We certainly should do everything possible to provide excellent information to women about services and fight to keep abortion care widely available and accessible.  But if a woman decides that the best thing for her to do is to self-induce an abortion, she should have access to the best information available on how to do this safely (ie with medicines, NOT herbs) and know where to go in case of a complication.  Criminalizing her choices does not protect her health. If we believe that women have the right to control their fertility, then we must also trust women with the right to choose the methods that make the most sense for them.

Endnote: There are no scientific studies that identify any herbs as effective for ending a pregnancy, and some herbs are dangerous.  There are numerous studies documenting the efficacy and safety of mifepristone plus misoprostol, and misoprostol alone, for ending a pregnancy.

For more information on self-induction, see these studies:

- Self-induction of abortion among women in the United States

- How commonly do US abortion patients report attempts to self-induce?

- Re-emergence of self-induced abortions

- Misoprostol and attempted self-induction of abortion

- The knowledge, acceptability, and use of misoprostol for self-induced medical abortion in an urban US population  

I had the privilege of being asked to read and review a Life Choices: The Teachings of Abortion by abortion care pioneer Linda Weber. As someone who’s worked in abortion care myself, I was curious to hear what someone who’s worked in the field for decades had to say about the future of abortion care and how we can improve it. Instead of telling you how fantastic the book is (it is!), below is a glimpse into Weber’s beliefs and experiences first hand. In bold are the questions I asked her, followed by her thoughtful answers.

Your book revolves around your 40 years of experience as a counselor in an abortion clinic. You share the stories of many of your patients as well as your reflections on what these stories taught you. Can you share some of your self-care strategies? What kept you in abortion care work for 40 years?

I am a private psychotherapist, spiritual counselor, and women’s vision quest guide. I was in direct abortion services from 1970 to 1972 in New York City and from 1973 to 1987 in Boulder, Colorado. As you see, the forty years of counseling work has taken different forms. This keeps it interesting and stimulating to say the least. As a psychotherapist I hear all kinds of stories. Some of these are “gut-wrenching,” but mostly for the client. Part of the skill of a good counselor is to know how to receive people’s stories; in other words, how to listen correctly and reflect back to the person telling the story what it is I think I’m hearing along with insights into the importance of her story.

Care for myself is essential to be able to stay strong, centered, and receptive. In the early years of my work, I was occasionally overwhelmed by the intensity of what I was observing in my patients. As I matured and became more experienced, that kind of reaction to the work subsided. My self-care includes meditation, time in nature, journal writing, and making music, as well as regular down time. These things help me to maintain my perspective, which includes the understanding that whatever someone is going through holds the possibility for self-understanding and self-acceptance. As long as I am energized by the work I do, I will continue to do it.

You frequently discuss how “legal, freely chosen abortion” can lead to “authentic empowerment and autonomy for women.” Why do you frame abortion in this way? What role do you think women who’ve had abortions should play in the abortion rights movement? How can the abortion rights movement empower women who’ve had abortions without giving them the burden of speaking out about their experiences?

Illegal abortion is a truly horrible thing. It is not empowering; it is dangerous and traumatizing. Legal abortion is the opposite. While it can be difficult for women, it represents an expansion of the freedom to choose the direction of our lives. Reproductive choice making recognizes the individuality of a woman and her power to bring life through her body or not. The or not is of course the issue. Legal abortion raises profound issues about the role of women in society. This role has been determined for centuries by patriarchal law, which keeps women in limited roles defined primarily by marriage and motherhood. It is not coincidental that we are seeing significant societal changes at the same time that abortion has been legalized. It seems clear that we as a species have moved into a time of history when it is no longer necessary to be focused so exclusively on reproduction. As for individual psychology, I have witnessed life-changing growth for women when they courageously confront internal pain and conflicts about abortion. I have seen them step into their essence and life purpose with increased self-awareness that came directly from their willingness to address all the issues in their lives that were raised by their experience of abortion. Some of those stories are in the book.

As for political activism, that is up to the individual. There is no should with regard to women who have had abortions. With regard to empowering women, I think the pro-choice movement does that just by its existence and commitment to staying strong in the political arena. It can do more by embracing the full range of sensibilities among women. An organization that leads the way with this is Exhale, a post-abortion hotline out of Oakland, California. They describe themselves as pro-voice. It’s a good way to think about it.

You mention that working in abortion care lead you to see the lines blur between “pro-choice” and “pro-life.” It seems like most people identify somewhere in between those labels. How can the pro-choice movement both keep this in mind and continue to fight for abortion rights? Is there a way to change our messaging to better reflect the experience of women who’ve had abortions?

Most women making a decision about pregnancy are concerned about and feel responsible for life. This is as it should be given that pregnancy by definition is the channeling of life through the body. The attacks on women by the so-called pro-life movement make some women feel that somehow they are against life by choosing to have an abortion. In fact, the opposite is true. The choice of abortion is an active exercise of women’s role throughout history of making judgments about if, when, and where to bring life through. Abortion is just as pro-life as having a baby.

The pro-choice movement has to reclaim the word life. One way to do this is to talk about real life and to orient towards a perspective that embraces the way of life on Earth, which includes death (what I call taking life back into itself) as part of the flow. I think the recent “personhood” vote in Mississippi shows that most people whether they consider themselves pro-choice or pro-life, understand how real life works and will vote accordingly. So, I am suggesting that the best way to counter narrow ideological arguments is to broaden and deepen our own thinking.

You mention a medical model of abortion care, which isn’t sensitive to the emotional or spiritual needs of women seeking abortions. What do you propose as an alternative model? Some people say that having separate clinics that only perform abortions, for example, may further stigmatize abortion instead of incorporating the procedure into general medical practice. How do you negotiate both the need for feminist women’s health centers and the fact that they may further stigmatize abortion?

Women’s health clinics arose out of the women’s health movement, which was part of the women’s liberation movement. They filled a gap in care and emphasized education and empowerment. The movement was represented by the classic book, Our Bodies, Ourselves, now celebrating its 40th anniversary, and the feminist lobbying organization, the National Women’s Health Network (since 1975). Some abortion clinics follow this feminist model. Others are more like hospitals and follow traditional western medicine. Some are creative combinations of philosophies.

The medical model organizes care around the condition or disease, instead of centered in the person needing care. It recognizes the doctor as supreme. The alternative is to create forms that address medical needs in the context of people’s lives and that respect the narrative of those lives. It incorporates psychological and spiritual needs as intrinsic parts of treatment. Professionals act as a team and the patient has a central role in what happens. This would apply to all health care, not just women’s health. It’s a very large subject that I can’t go into depth about here.

The reason for separate services for abortion is mainly political. Abortion services have been ostracized in many communities. Many medical schools don’t even train physicians to perform abortions. I’ve heard that this is getting worse with the increase in the virulence of the fundamentalist religious influence on political discourse and the election of right wing legislators. I don’t think that having separate feminist health clinics stigmatizes abortion. I think that quite the opposite is true. Abortion is stigmatized because society is not yet able to fully embrace it as a legitimate part of life and a necessary and good health service. It is still in the shadow of social consciousness. Feminist health clinics lift abortion out of the shadow and into the light of legitimate experience. Just like safehouses and rape crisis teams, we look forward to a day when all women’s health services are incorporated as part of complete care.

Linda’s book is published by Sentient Publications. This post is part of a blog tour for her book. The next post will be at Feminists for Choice and the previous post was at Women’s Glib. If you’re interested in hearing Linda speak about her book, she’s going on a book tour on the West Coast of the US in February.