ethics

Last year, I read about a case of a nurse who alleged being sexually harassed by a doctor during her job interview, and a couple of months later I was struck by a report from the Netherlands about the high rate of sexual harassment experienced by female nursing and healthcare workers. Although cases like these make it seem like doctors and managers are the primary perpetrators of sexual harassment, reports show that it is patients who sexually harass nurses most often.

With a recent study suggesting that nurses simply distance themselves from patients who are sexually inappropriate, how do nurses maintain quality health care of these patients? A new book, Catheters, Slurs, and Pick-up Lines: Professional Intimacy in Hospital Nursing (Temple University Press) sheds light on female nurses’ experiences of being sexually harassed by patients.  For this month’s column, I had the chance to ask the author, sociologist Lisa Ruchti, Ph.D. of West Chester University, about nurses experiences of “intimate conflicts” with patients.

Adina Nack: Why did you decide to study the dynamics of patient-nurse interactions?

Lisa Ruchti: I initially thought that nurses’ experiences of sexual harassment by patients would be similar to waitresses’ experiences of sexual harassment by customers because they are each one type of women’s work. Instead, I found that nurses did not refer to their encounters as ‘sexual harassment’ because work culture affects definitions of sexual harassment (other sociologists have found this too; for example, Christine Williams and Kirstin Dellinger).  In nursing, it was the fact that nurses provided both professional and intimate care that contributed to differences in how and when nurses said they were sexually harassed. I became intrigued with the function of intimacy in professional care work and wanted to learn more.

AN: I’m intrigued by the concept of “professional intimacy” – how is this experienced by nurses?

LR: In my work, I found that nurses negotiated a cycle of what I call “professional intimacy” with patients. I also found that negotiating intimate conflict with patients is inextricably a part of how nurses gain their trust. Nurses start with gaining the intimate trust of their patients. This trust sometimes escalates to patients having feelings of familiarity for their nurses, which leads to conflict for the nurse. These conflicts include patients feeling entitled to service beyond the scope of care in nursing, angry verbal interactions, and/or sexualized entitlement. This conflict can also be unavoidable such as the ways that nurses negotiated the sexual encounters between patients and their visitors. Nurses negotiate care through this conflict to renew trust to ensure that quality health care is administered.

AN: How do nurses experience conflict when providing care to patients?

LR: The majority of the 45 nurses I interviewed avoided describing patient care as involving conflict. They used words like nurture, kindness, and compassion to make it seem like nurses “being caring” was a natural personality characteristic characterized by goodness. Feminist philosopher Eva Kittay discusses this in her work: patients are not usually described as anything other than “needy,” and we don’t tend to think of needy people as causing conflicts for those who provide their care. My focus on identifying conflict is as much about seeing patients clearly as it is about seeing the work of nurses clearly.

AN: You make a key point about not only a nurse’s sex but also her race/ethnicity shaping her experiences of patients’ harassment – can you give a couple of examples of how nurses described these interactions?

LR: It is one thing for nurses to manage sexually explicit language or touches; it is quite another when those are combined with racial slurs and epithets.  Imagine that a nurse not only walks in to check on a patient and sees himmasturbating, but she is also called a “dirty foreigner.” Or, a nurses isgiving a patient a bath, and the patient says you remind him of his mammy. It was incredibly important for me to look at the function of multiple identities since I was looking at intimate care as something that is constructed in interaction between patients and nurses and informed by social ideologies. Intersectionality is an incredibly useful tool when explaining complex social experiences.

AN: As a medical sociologist, I was instantly hooked by your book’s title, but I can also see why many of us — not just nurses — should read your book. 

LR: Thanks, I wrote it not just to give voice to nurses but also because almost all of us have all been patients or visited loved ones in hospitals. Many of us have or will have long medical journeys at some point in our lives, and this book can help us understand a vital part of that journey. If we can better understand the lives of those who are taking care of us, then we can help ensure that quality care occurs when we need it.  Other studies have documented how much nurses care about patients, and it’s time for us to listen to their stories – we need to understand their experiences of caring for us.

Is the legality of abortion in the U.S. a moot point if too few ob-gyns are willing to perform the medical procedures?  A recent post on FREAKONOMICS inspired me to find out more about a new article in the journal Obstetrics & Gynecology titled “Abortion Provision Among Practicing Obstetrician-Gynecologists.”

This group of researchers mailed surveys to practicing ob-gyns and reported on the data from 1,800 who responded. The article’s main findings are as follows: “Among practicing ob-gyns, 97% encountered patients seeking abortions, whereas 14% performed them.” Their analysis of the data revealed that male physicians were less likely to provide abortions than female physicians. Age was also a factor, with younger physicians being more likely to provide abortions.

The new article’s abstract states, “…physicians with high religious motivation were less likely to provide abortions.” I wonder if the large numbers of ob-gyns who do not provide abortions speaks to moral judgments that this medical procedure is a sin. So, the legality of abortion may be rendered pointless by physicians who may be making decisions based on religious doctrine? Access to abortion remains limited by the willingness of physicians to provide abortion services, particularly in rural communities and in the South and Midwest.” Does a woman’s geographic location doom her to restrictions on her ability to obtain a medical procedure that is protected by law?

During my study of women and men living with genital herpes and HPV/genital warts infections, I coined the term moral surveillance practitioner to describe the doctor-patient interaction style of health care providers who conveyed a sense of disapproval, judgment, condemnation, and even disgust to their patients who had sought their sexual health services.  In the case of STDs, these practitioners tended to blame their patients for having contracted a medically incurable infection because of their own “bad” and sinful sexual behaviors.

It would be interesting to see if a companion study to the newly published one, perhaps a qualitative interview study, would reveal a more nuanced understanding of the attitudes and values that ob-gyns hold about their female patients who seek abortion services.  With women’s physical and/or mental health often hanging in the balance of the ability to receive a legal abortion, we deserve to know more about the large number of ob-gyns whose moral opinion may be taking precedence over their ethical obligation to, in the words of the Hippocratic Oath, “First, do no harm”…in this case, to do no harm to their female patients who may be harmed by not having a medically safe, legal abortion.

__________

Note: If you’re curious about physicians’ insights and experiences in providing (or not providing) abortion care, then check out two recent books: Carole Joffe’s Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us and Lori Freedman’s Willing and Unable: Doctors Constraints in Abortion Care. And, for more of the latest research on reproductive health care and policy, explore the work of UC San Francisco’s reproductive health think tank ANSIRH.

*Spoiler Alert: in order to critique this show, I need to reveal some plot points.

Zombies do not discriminate on the basis of sex, race, ethnicity, socioeconomic status, or ability…people do. This sad truth played out in the short but compelling 6-episode first season of AMC’s new show The Walking Dead. Zombies eat any living thing they come across – scary but not evil creatures because they don’t have a functioning brain which would allow them to be human, to distinguish right from wrong.

 Admittedly, I haven’t read the graphic novels of Robert Kirkman, on which this series is based. So, I’m not 100% sure who to credit for the plot twists that portrayed the violent racism of a white supremacist, the vulnerability of daughter and wife to a physically-abusive man, and the terror of a woman fighting off a former lover who is trying to rape her. When the hospital is invaded by “walkers” (a.k.a. zombies), the living soldiers choose to execute ill and disabled patients rather than try to rescue them. [Mind you, the zombies do not seem to move fast enough to cause problems for someone armed with a semiautomatic weapon, but the choice is still made to sacrifice these lower status people.]

 If a common enemy should unite, then social scripts of bigotry and bias should disappear. As one character notes in the season finale, human beings may have reached their point of extinction. The question is whether the zombies or our own human failings are to blame.

With record ratings, the Wall Street Journal and other sources report that this Sunday night’s finale attracted 6 million viewers.  I may not be the typical fan of this show, so I wonder: will most viewers remain focused on the horror of a gruesome, fictitious zombie epidemic? Or, are there others like me, who despite flinching every time a zombie lunged for a bite of human flesh, left the season finale feeling acutely aware of the very real pandemic that plagues almost all societies: that potent combination of bigotry and selfishness which manifests as one of the many ‘isms. I’ve yet to see a ‘walker’ lurching down a street, but I have encountered far too many living human beings who lack empathy, respect, and compassion for each other and for the diversity of life on this planet.

This month’s guest column* by Christine H. Morton, PhD, a research sociologist at the California Maternal Quality Care Collaborative, draws on her research and publications on women’s reproductive experiences and maternity care advocacy roles, including the doula and childbirth educator. She is the founder of ReproNetwork.org, an online listserv for social scientists studying reproduction.

The ever-evolving history of the childbirth reform movement has new developments, which need to be incorporated into the older story which documents the shift from home to hospital birth; and the paradigm clash of midwifery and medical models of birth reflecting holistic and technocratic values, respectively. We need to incorporate the story of the doula, which I argue, is one of many efforts to bridge the divide – to provide, as Robbie Davis-Floyd has called it, humanistic care in birth, which is what most women desire.

History is happening now. In addition to the emergence of the doula in the past thirty years, more recently, we see efforts underway in maternal health policy (Childbirth Connections’ Transforming Maternity Care), among physician and nursing professionals (most especially around maternal quality measures, and maternity quality improvement) and resurgence among, for lack of a better word, ‘consumers’ or childbearing women, who seek greater access to vaginal birth after cesarean (VBAC). What are the goals of each stakeholder; how do they intersect and overlap, and come into conflict with one another? This is a big story, and we need to tell it!

I take a small slice of this larger historical backdrop to consider the interconnected history of childbirth educators and doulas, which will be the subject of my research presentation at the Lamaze-ICEA Mega Conference in Milwaukee.

To back up a bit, when I embarked on my sociological investigation of the doula role, I was interested in many aspects of this innovative approach to childbirth advocacy and support. What strategies and mechanisms enabled women with no medical training to insert themselves at the site where medical care is delivered to a patient in a hospital, and enact their self-defined role? Why did women become doulas and what did the work mean for those who were able to sustain a regular practice over time? How were doulas utilizing and leveraging the corpus of evidence based research which suggested their impact was as great, if not greater, than that of the physician, the culture of the obstetric unit, or the labor and delivery nurse? Where did doulas come from? What, in the history of childbirth reform, or childbirth education, or labor/delivery nursing, could help me understand how doulas emerged at this point in time in U.S. history?

Later, after learning that there were limited histories of childbirth education (by non-childbirth educators), and little research on the history of obstetric nursing, I had to take a step back and consider these factors as well. Why was the work and perspectives of women who support other women during childbirth an overlooked piece of historical research? Why did histories of women’s health reform efforts largely exclude childbirth reform? Why had there been no history of the women who were involved in childbirth education; in labor and delivery nursing; in the mainstream arena of birth care in the US? So as not to be accused of ignoring the scholarship that does exist in this area, I acknowledge my debt to Margot Edwards and Mary Waldorf; to Judith Walzer Leavitt, to Barbara Katz Rothman, Robbie Davis-Floyd, Margarete Sandelowski, Deborah Sullivan and Rose Weitz, Judith Rooks and Richard and Dorothy Wertz (I can make my full bibliography available to those interested). I have been inspired by these histories, but they focused less on the women (childbirth educators) who were making history and more on the larger cultural shifts in beliefs about medicine, technology, women’s bodies and reproduction.

When childbirth education per se was a topic of inquiry, the research focus tended to be on the primary sources of the male physician champions – Grantly Dick-Read, whose work informed the natural birth movement, and Ferdinand Lamaze (and his US counterparts – Thank you Dr. Lamaze author Marjorie Karmel and Elisabeth Bing) who formulated a method for accomplishing unmedicated, awake and aware childbirth. However, most of this scholarship makes unsubstantiated generalizations about what particular childbirth educators (of various philosophies /organizations) believed, and how they taught. There is surprisingly little in the way of empirical research – few scholars interviewed childbirth educators or conducted systematic observation of their classes over time.

So after completing my dissertation on the emergence of the doula role, I had the great opportunity to continue with my research interest through a research grant from Lamaze International to conduct an ethnographic investigation of childbirth education, with my colleague, medical anthropologist Clarissa Hsu. We talked to educators, observed their classes and analyzed our data.

We found that educators who were actively practicing doulas drew heavily on their direct labor support experiences as authoritative resources for stories and examples that supplemented the material they taught. Actively practicing doulas also included more curricular content on early labor than educators without such experience. Having real births to draw upon provided doula-educators a different type of credibility and authority than educators without such current labor support experience. These educators relied on other mechanisms to establish their authority, such as knowledge of the latest research on birth and use of more authoritarian teaching styles.

We found that the intersection of doula practice and childbirth education has significantly affected how childbirth preparation classes are taught, and this new infusion of practice and ideology is worth exploring. I encourage you to explore this with us, and welcome your thoughts.

*Note: this column was originally posted on the Science & Sensibility blog.

Health posts are my thing, and today I cannot stop thinking about the health of the Gulf Coast…which clearly impacts the health of more living creatures than we can fathom.  News coverage may talk about bodies of water like they are distinct things, but ‘the Gulf’ is merely a cartographer’s distinction.  It’s hard to watch the live feed of the endless spray of oil shooting into the ocean.  It feels like watching a massacre, like a spray of machine-gun bullets ending life after life.  Calling this catastrophe a “spill” is like calling an amputation a “boo-boo.”    And, frankly, I can think of nothing more important to write about for this month’s column. 

So, allow me to compare our planet to a patient, a very ill patient who has suffered a severe injury and is receiving really crappy medical care.  Or, let’s take it to a more intimate-level: we can anthropomorphize one affected area, the Mississippi Spillway, as the vulva of the U.S.  One of my favorite sociologist bloggers, Mimi Schippers, Ph.D. (a.k.a. Marx in Drag), did just that in a post where she calls British Petroleum (BP) a pimp — and not the MTV/”pimp my ride”/bling-bling/Snoop Dogg kind of pimp.  No, we’re talking a stone cold, cruel, exploitative, abusive, criminal.  In the words of Dr. Schippers:

 BP and the rest of the oil industry are the johns and the federal government is the pimp.  Federal, state, and local politicians pimp us out to put money and power in their own pockets while, by paying the right price, Big Oil gets to take what it wants and needs.  And they-the pimp and the johns, do so with absolutely no regard for the needs or well-being of the body they use.  The body—the living environment, including the people—is, however, a breathing entity.  And though it appears as if it is just an object to be used, the people know what they are doing.  They strike a bargain that, for the moment, benefits themselves but sacrifices the rest.  You give me jobs, and I’ll give you whatever you want.  Invoking the vulva as metaphor suggests there is something feminine or female about this place and that masculine or male power is the problem.  But don’t let that confuse the issue.  This is about class and economics. 

Whether you prefer to see the U.S. government as an incompetent physician (allowing a patient to inch towards death) or as a corrupt police officer (being too kind to a felon), we have got to ramp up our demands for swift, safe, effective action.  And, perhaps, we need to think seriously about how to safely shut-down all of the deep-water drilling before the next tragedy.  All the money in the world cannot buy a healthy ocean.  Even if this torrent of BP oil is the last one we ever have to deal with, don’t think that we’re close to knowing how bad things really are..in the words of that 70’s BTO classic:

Here’s somethin’ that you’re never gonna forget. B-, b-, b-, baby, you just ain’t seen na, na, nothin’ yet!

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.

I recently blogged about hooking up at the newly launched Ms. Magazine Blog. I end the piece by saying that when it comes to sex:

Reducing sexual harms like assault, coercion, and slut shaming means maximizing sexual pleasure. Let’s kick forced power disparities and nonconsensual objectification out of our everyday lives in the bed and beyond. That’s when the girls will really go wild. On our own terms.

Writer-artist Karen Henninger wrote me to say she’d love to share some insights, experiences, and history about hooking up. It seems Karen and I don’t quite see eye to eye on the issue of casual sex among consenting adults. So, in keeping with the theme, I thought it would be cool to — yes — hook-up across blogs to keep the conversation lively. With that, I introduce our Girl W/Pen guest blogger who writes the following:

Are you aware that the Women’s Movement at the turn of the 20th century started with the idea of Free Love?

Free Love goes beyond “sex without commitment.” In the late-1800s the issue included marriage, women’s lives, and freedom from government control. Since the 1950s, especially, there has been success moving toward free love rather than forced love. But we won’t even know what is possible until we are given political freedom to live as we choose when it comes to sexuality and love.

I am for Free Love and Free Sexuality but this requires treating people without harm. I watch others go down the same old patriarchal road in their relationships over and over while I scratch my head thinking, Wow, there’s another way that is so much better for everyone.

No only is love free, but it is abundant. Love can’t really exist if it isn’t free. What makes hooking up harmful is the way it is done. The same goes for marriage and everything in between. Harm comes from the abuse of power and control. Love is simply freedom from harm. Yet harm is so entrenched in our everyday lives that we see it as normal. And then activism becomes necessary to experience something different.

Karen Henninger is a visionary visual artist, writer, and independent scholar. She holds a degree in Letters, Arts and Sciences from Penn State University and a Related Arts degree with concentrations in English and Women’s Studies from Kutztown University.

With Tiger Woods in the news for this latest round of Very-Public-Infidelity, guest blogger Ebony A. Utley weighs in with her expertise on the issue. A research expert on marital infidelity, Utley confronts common stereotypes and raises questions about cheating, talking, silence, and power.

The proverbial cats are out of the bag as the tabloid media collect stories from Tiger Woods’ alleged mistresses. The mistresses are increasingly chatty — talking about “I was with Tiger here” and “he left me a voicemail there.” Woods is busy denying what he can and apologizing for what he can’t while Mrs. Woods remains silent.

None of this is unusual. With a slew of high-profile unfaithful men in the news lately, it’s hard not to notice a pattern. These men haven’t come out in public to say, “I had inappropriate sexual relations outside my relationship” without first facing an impeachment trial, sexual-assault accusations, blackmail threats, texts, sexts, voicemails … you get the picture.  Rarely have these men come clean without some sort of provocation.  Often, famous unfaithful men confess to their infidelity because the other woman beat him to it.

Mistresses are notorious for telling their side of the story because the world wants to hear it. The sex secrets of sexy women are titillating. Be honest with yourself. You wanted to know whether Tiger’s mistresses were prettier than his wife. Some of you readers out there also wanted to know whether she looked like she was better at sex than the wife. Admit it. Those are our society’s infidelity stereotypes. The other woman had to be offering something that the wife did not.

The wife wasn’t giving it up. Or if she was, her sex was boring.
The wife let herself go.
The wife was too invested in the kids.
The wife didn’t (emotionally) support her man.
The wife was emasculating.
The wife was never around.

Mistresses are quick to perpetuate these stereotypes, but the husbands are quick to offer their wives $4 million diamond rings and $80 million prenup revisions.  If the wives were such horrible people, why dish out all the cash to keep them? Since the husband can no longer keep the mistress quiet, is he buying his wife’s silence? I don’t think so. Men who cheat on their wives rarely want to leave them; usually they’re genuinely sorry. The silence on the wives part is not about his money. It’s about power.

A mistress has power because she is the secret. She is the one tasked with being discreet. Once the secret is out, the mistress loses her power. She scrambles to get it back with revealing details, but the more she talks, the more her power diminishes. People know who she is, where she was, what she did, how she did it, and who else she did it with. Once the prurient details are all out there, people are free to pass judgment on the mistress and she rapidly moves from sexy story to object of public scrutiny to obscurity.

But the wife who refuses to talk gains power. Now she is the one deciding to be discreet.  No one knows what she’s thinking and everyone wants to. Did she know?  Did she have a revenge affair? Why didn’t she leave him? Does she love him that much? How is she going to spend those millions? The quieter she remains, the more dignity that wife regains.  Long after we’ve forgotten the mistress’ name and the seedy motels and the racy voicemails, the silent wife is still standing in the spotlight with an air of mystery about her. We might not understand her, but her secrets are the ones that garner respect. The most understated gift a chatty mistress gives to the wife is power.

Ebony A. Utley, Ph.D. is an expert in infidelity. She is currently writing about her interviews with wives who have experienced infidelity during their marriages. See more of her research at http://www.theutleyexperience.com/

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.

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, Robin Abcarian observes that:

“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.

Naked women. What’s not to love, right?
Well…Let’s talk about Frank Cordelle.

Cordelle is a photographer with a long-running exhibit he calls The Century Project. It’s a collection of pics — nude girls and women ages birth through 100. (Get it? One hundred years of naked women = The Century Project.) The line-up for 2009 includes shows at the University of North Carolina, Wilmington, Rhodes College in Memphis, and the College of William and Mary in Williamsburg, VA.

The pics are supposedly a celebration of the naked female body in a variety of shapes, sizes, races, and ages. Each photo comes with a little story about the featured female. Many of these “moving personal statements,” as Cordelle calls them, are first-person blurbs about overcoming abuse, eating disorders, etc.

Cordelle’s Mission Statement describes his exhibit as a project that “aims more generally to stimulate thought and discussion about subjects that are often taboo in our culture, or otherwise too personal, too painful.” An 8-year-old girl certainly has lots to tell us. But why does she have to do it in the nude?

Visual artist Karen Henninger comments, “if men REALLY got the issues, they would refrain — as in take a break — from female nudity. There is NO need for men to do female nudity — unless it SERVES them. It’s pretty much a mainstream art thing. Female nudity is acceptable and will get you attention. So much for art being a place of ‘creativity,’” Henninger says. Check out the Met. Or any other museum. As the Guerrilla Girls have noted for years, themes of female nudity melded with rape or sexual assault — regardless of how the art is intended — have been a constant theme in art history. Think Rubens’ Rape of Europa or Hayez’s Susannah at her Bath. Depicting women naked, vulnerable, or linked in some way to abuse has been “a constant way for women to be portrayed” in the art world Henninger comments.

But back to Cordelle.

The problem is not female nudity or female sexuality. The problem is that The Century Project uses naked female bodies, eating disorders, and abuse in ways that promote voyeuristic interest. While childhood nudity should be free and joyful, in our culture that’s a big challenge because girls are already hypersexualized at younger and younger ages. As a result we — as a culture — often don’t know how to see a naked female body (regardless of age) other than in sexualized terms. Is she available? Arousing? Sexually interesting? Or not?

I am anti-censorship. I’m a huge fan of feel-good sexual exploration and the freedom to accept our own bodies on our own terms.

The Century Project is not it.

It’s the same old-same old: girls’ and women’s naked bodies on display. I saw the exhibit and talked to the photographer. For the most part, the “moving personal statements” moved me to want to vomit. The exhibit visually exploited women and put their stories on display for no apparent productive end.

Check the photographer’s website and see what he has to say under the FAQ “Why Women?” I remain unconvinced that he gets the issues. Cordelle’s explanation for exhibiting naked female bodies reinforces assumptions about women as different and needing special attention or unique protection. There’s something really off about it. He puts girls and women on display while claiming concern for our well being. Really, Frank: Don’t.

And P.S., Therese Shechter (Trixie Films) has continued this convo over at the blog American Virgin. Drop by and take a look!