abortion

OctGwP
Photo Credit: Jennifer Rothchild

This month, I bring you a guest post which sheds light on current events, events that literally hit home for me when the Planned Parenthood clinic closest to my university was attacked by arsonists. I welcome back Jennifer Rothchild, Ph.D. Associate professor of Sociology and Coordinator of the Gender, Women, & Sexuality Studies (GWSS) Program at the University of Minnesota, Morris, she is one of the founders of the American Sociological Association’s section on the Sociology of Development. She currently researches gender and development, health, childhoods, and social inequalities by examining the intersections of gender, sexuality, and reproductive health in the United States and abroad.

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“Choose mercy! While there is still time!” A man shouted to me as I walked into a Planned Parenthood office. I couldn’t see him, which made the comment oddly affecting. I kept my eyes forward and pushed through the front door.

More than 20 years ago, my friend Kat had told me about her first trip to Planned Parenthood. As she left that building, a woman standing outside approached her, grabbed her shoulders, and cried, “‘DO YOU KNOW WHAT YOU HAVE JUST DONE? DO YOU KNOW WHAT YOU HAVE DONE?’”

I will turn 45 this February, and yesterday was my first visit to Planned Parenthood. Shame on me: a self-proclaimed activist, and a gender and sexuality scholar. Until now, my privilege had allowed me to get all the women’s health care I needed through medical clinics and private practice physicians. All covered by insurance. But I knew Planned Parenthood was always there, should I ever need their services.

I had a health problem, and this time I chose Planned Parenthood because that is what it is: a health clinic. The woman at Planned Parenthood who booked my appointment warned me: “You should know that this clinic will have protesters. Turn into the parking lot, and a volunteer will help you get by the protesters, and then park.”

There are many misconceptions about Planned Parenthood; here are some facts:

  • Planned Parenthood services include STD/STI (sexually transmitted disease/sexually transmitted infection) testing and treatment for both men and women, cancer screenings, contraception, abortions, and other health services.
  • Abortions make up less than 3% of the services provided by Planned Parenthood.
  • Federal funding for Planned Parenthood is only for Title X: restricted to family planning and STI testing.
  • Planned Parenthood clinics that provide abortion services do not receive any federal funding, even if those particular clinics also provide services that meet Title X criteria.

On a rainy, cold morning, I arrived at Planned Parenthood, and a volunteer waved me into the parking lot. Next to this volunteer stood a protester, holding a sign about texting a certain number before “aborting.” I wondered if these two women talked to each other as they stood together in the rain?

Once inside, I was overwhelmed by a need to express gratitude to everyone I met. I assumed that most Planned Parenthood patients felt same way, if not always vocalizing their sentiments. But I was wrong. My intake nurse told me that just that morning a patient told her, “I hate who you are. I hate what you do. I don’t want to be here, but I need birth control pills.”

Her story made me wonder about the level of denial and disconnect that must be actively maintained to keep those ideas working side by side. In 2012, Frank Bruni wrote in the New York Times about a doctor who performed abortions:

He shared a story about one of the loudest abortion foes he ever encountered, a woman who stood year in and year out on a ladder, so that her head would be above other protesters’ as she shouted ‘murderer’ at him and other doctors and ‘whore’ at every woman who walked into the clinic.

One day she was missing. ‘I thought, ‘I hope she’s O.K.,’ he recalled. He walked into an examining room to find her there. She needed an abortion and had come to him because, she explained, he was a familiar face. After the procedure, she assured him she wasn’t like all those other women: loose, unprincipled.

She told him: ‘I don’t have the money for a baby right now. And my relationship isn’t where it should be.’

‘Nothing like life,’ he responded, ‘to teach you a little more.’

A week later, she was back on her ladder.

That morning, security was at a premium at the Planned Parenthood clinic: a guard stood at the front door, and I needed to show him identification. I was given a name tag that read only “Jennifer.” A few minutes later, “Jennifer R.” was summoned from the waiting room. I wondered how much money could be saved and put to better use if Planned Parenthood didn’t feel compelled by threats and attacks to spend on security measures.

In the waiting room I saw young and old women, white and black and Latina. There were men, too. I couldn’t imagine the individual stories that brought them to Planned Parenthood. But, I might have assumed they all shared was a lack of access and means to the kind of health care that should be their right. According to a 2012 report from the Government Accountability Office, 79% of people receiving services from Planned Parenthood lived at 150% of the federal poverty level or lower (that comes out to around $18,500 per year for a single adult). These people live in vulnerable conditions, where an unplanned pregnancy could result in future burdens, unfair and disproportionate in consequence.

If Planned Parenthood clinics are shut down, we will see not only tremendously diminished reproductive health but also epidemic numbers of unplanned pregnancies and unsafe abortions, as well as greater needs for social services such as WIC. Concerns for women’s health aside, Planned Parenthood delivers mercy upon people who benefit from its services.

The nurse practitioner spent time talking with me, getting to know me. I told her how grateful I was for the work she did. She graciously explained, “I started working here 15 years ago to educate women about their bodies. Women don’t know their bodies.”

Driving out of the parking lot, I stopped and rolled down my window to thank the same volunteer who had stood in the rain when I arrived, waving me into the parking lot. There was now a different protester. This woman was young, white, blonde, and wearing a pink raincoat. She could have been a twenty-something version of me. In her hand, she clutched a brochure limp from the rain. Her sad gaze followed me as I drove away. I wish she saw and knew the things I understood.

I also wish everyone understood that Planned Parenthood volunteers, nurses, and doctors risk their own safety and well-being because women’s health—and women’s lives—hang in the balance. These women and men are standing up and fighting for me, fighting for you.

“Choose mercy.” Yes, we should.

With this coming Tuesday marking the 40th anniversary of Roe v. Wade, I’m inspired to post this month’s column early.

I encourage readers to check out the work of ANSIRH (Advancing New Standards in Reproductive Health), a UCSF research program “dedicated to ensuring that reproductive health care and policy are grounded in evidence.” So, rather than cover the breadth of political and social dynamics related to abortion policies, I’m focusing on one specific new study which has important implications for protecting women’s health:

A newly published landmark study by ANSIRH demonstrates that trained nurse practitioners, certified nurse midwives, and physician assistants match physicians in the safety of aspiration abortions they provide. We hope that these results will give policymakers the evidence they need to move beyond physician-only restrictions in order to enable more women to have their reproductive health care needs met in their local communities by health care providers they know and trust.

The results of this study are significant because PAs, NPs and CNMs have been shown to be important and accessible health care providers for rural and low-income women. ANSIRH’s new findings support policies which would reduce health care disparities and increase continuity of care because a larger group of health care providers would be able to offer early abortion care. For more on this topic, read the latest post by Tracy Weitz, Director of ANSIRH.  This research should inform health policy across the U.S.

For more on the realities of abortion in the U.S., watch Abortion in the United States, a short video from the Guttmacher Institute.

I dedicate this month’s column to parents who are in the midst of crises which are well-articulated on the website A Heartbreaking Choice:

Pregnancy does not end happily for everyone. Sadly, some parents receive grim prenatal news that something is seriously or fatally wrong with their loved and wanted unborn baby. They have to make a decision about continuing or ending pregnancy. We realize that all parents make a loving choice, one they feel is better for their baby. Regardless of the fetal anomaly found, the decision to end a pregnancy is always a difficult one.

Although it is estimated that between 80 and 95 percent of parents receiving a severe prenatal diagnosis choose to end the pregnancy, those who face this nightmare often feel alone. There is very little in the way of support programs for them. With this site and the dedication of courageous parents willing to reach out, we hope to create a safe haven of encouragement, validation, hope and healing.

How many of us have thought about all that is involved with therapeutic abortions?  Parents in these situations have to navigate a medical system which is under the influence of a legal system which (in my humble opinion) has succumbed to a failure of the separation between church and state. It saddens and infuriates me that these mothers — especially those in their third trimesters — may be denied access to medical options which could best protect their physical and mental health. In this day and age of U.S. abortion policies, should we be grateful that any states allow any options at all?  Gratefulness is hard to come by in the face of so much suffering.  My prayers and love go out to all parents who face these heartbreaking choices.

Impossible Motherhood is a new memoir by Irene Vilar, editor of The Americas series at Texas Tech University Press and a writer who uses the history of her life and the lives of her mother and maternal grandmother to highlight critical relationships between colonialism, sexism, reproductive rights, and motherhood. But this will not be the headline that captures the interest of the public. Vilar’s fifteen abortions in fifteen years, on the other hand, seems to be causing quite a stir of attention.

In many ways, this is a memoir about misery. Throughout the book, Vilar critiques the idea that her success on paper — early graduation from high school and a move from Puerto Rico to the U.S. at the age of fifteen, marriage to a Syracuse University professor, book publishing – has not kept her from suffering with severe issues of depression, abuse, self-mutilation, and addiction. Her marriage to a highly regarded, intellectual writer several decades her senior, who defines “independence” by keeping her forever at an emotional distance from him and insisting that the couple cannot have children together, triggers a downward spiral which culminated in twelve abortions in an eleven year relationship, followed by three others with another partner after the dissolution of her marriage. However, with intense therapy and a happy second marriage, Vilar overcomes her painful ambivalence toward biological motherhood and gives birth to two daughters.

The seemingly happy ending of Vilar’s tale of thwarted motherhood will still raise ethical and moral red flags in readers, causing us to squirm uncomfortably as we embark on the author’s lifelong journey of recovery.  Vilar does not go for pat answers or self-satisfied conclusions about her decision to repeatedly abort unwanted pregnancies rather than utilize birth control (which was available during her time in the U.S.).  Instead, this a complex, emotional account of one woman’s emergence from cycles of oppression into an acceptance of her unique identity and experiences.

Cover of Impossible Motherhood: Testimony of an Abortion Addict by Irene Vilar

Vilar’s unhappy childhood – a distant philandering father and a mother who committed suicide when Vilar was only eight years old – contributes to her feelings of abandonment and a need to please authority figures, if only to ensure her survival. Vilar is not claiming to be a representative for pro-choice or pro-life arguments, though she does offer this disclaimer in the prologue:

“This testimony… does not grapple with the political issues revolving around abortion, nor does it have anything to do with illegal, unsafe abortion, a historical and important concern for generations of women.  Instead, my story is an exploration of family trauma, self-inflicted wounds, compulsive patterns, and the moral clarity and moral confusion guiding my choice.  This story won’t fit neatly into the bumper sticker slogan ‘my body, my choice.’  In order to protect reproductive freedom, many of us pro-choice women usually choose to not talk publicly about experiences such as mine because we might compromise our right to choose.  In opening up the conversation on abortion to the existential experience that it can represent to many, for the sake of greater honesty and a richer language of choice, we run risks.”

Reproductive justice movements, particularly in the U.S. and its territories, often have a tumultuous history with communities of color.  But many readers will likely approach the book with little, if any, background knowledge of reproductive justice movements in Puerto Rico. So how did colonialist policies and a U.S.-driven abortion counseling, abortion services, and abortion outreach contribute to these decisions?  In an interview with The L.A. Times, :

“Puerto Rico, at the time, was a living laboratory for American-sponsored birth control research. In 1956, the first birth control pills — 20 times stronger than they are today — were tested on mostly poor Puerto Rican women, who suffered dramatic side effects. Starting in the 1930s, the American government’s fear of overpopulation and poverty on the island led to a program of coerced sterilization. After Vilar’s mother gave birth to one of her brothers, she writes, doctors threatened to withhold care unless she consented to a tubal ligation.  These feelings of powerlessness — born of a colonial past, acted out on a grand scale or an intimate one — are the ties that bind the women of Vilar’s family.

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How did the pro-choice movement fail to help a survivor of abuse like Vilar?  Is there a theoretical and activist disconnect between three major intersections — martial strife/violence, psychological trauma, and reproductive justice?  Pro-choice communities would do well to examine books like these and form outreach for women who have experienced multiple abortions.  Vilar understands the stigma which confronts women who have had multiple abortions and does not shame these women, but tries to provide a lens of her own experiences with repeat abortions as a way to personalize this sensitive issue.  In a 2006 Salon.com Broadsheet post, Page Rockwell notes that:

Liberal message-makers would probably have an easier time if repeat abortions were rare, but the truth is, they’re not: According to a report (PDF) released last week by the Guttmacher Institute, which we found thanks to a flare from the Kaiser Foundation, about half of the women who terminated pregnancies in 2002 had previously had at least one abortion. (The report notes that because many women do not accurately report their abortion experiences, these findings are “exploratory.”) Rates of repeat abortion have been on the rise since Roe v. Wade, and ignoring that fact isn’t doing women who need multiple procedures any favors.

In the anthology Making Face, Making Soul, Gloria Anzaldúa wrote that, “[W]omen of color strip off the mascaras [masks] others have imposed on us, see through the disguises we hide behind and drop our personas so that we may become subjects in our own discourses.  We rip out the stitches, expose the multi-layered ‘inner faces,’ attempting to confront and oust the internalized oppression embedded in them, and remake anew both inner and outer faces…. We begin to acquire the agency of making our own caras [faces].”  This is one of those books that rips out the metaphoric stitches and exposes Vilar’s process of multilation and healing, addiction and recovery, for readers to examine.  This is not an easy or light book; it will trigger and it will probe and it will leave readers feeling as if they’ve been punched in the stomach, repeatedly.  But it also has the power to transform and expose previously hidden oppressions.

The outer face of Vilar is a brave one and so is the inner face.  Impossible Motherhood is a book for any pro-choice believer who wants a deeper understanding of the complex issues surrounding reproductive rights in the U.S. and its territories in the twentieth century.  This is also a book for people who believe in the power of personal redemption.  It will leave readers aching, hopeful, and perhaps a little more empathetic to Vilar’s life.