By Eleanor J. Bader
Thursday, December 7, 2006
Abortion is the most common surgical procedure in the United States, but the stigma surrounding it remains powerful, even for pro-choice advocates and abortion providers. Efforts to reduce the psychological toll are on an upswing.
(WOMENSENEWS)--Several years ago, when Annie Tummino, chair of the Women's Liberation Birth Control Project, was working at Planned Parenthood League of Massachusetts, she had a pregnancy scare.
"I worried that people would think I should have known better," she admits. "I was afraid that if I needed an abortion my co-workers would talk about me, condemn me, behind my back."
Thirty-five percent of U.S. women will have at least one abortion before their 45th birthday, making it the most common surgical procedure in the country, according to the New York-based Guttmacher Institute. But the procedure is surrounded by stigma, from fear of harsh judgments from family, friends and colleagues to the belief promulgated by vigorous abortion foes that punishment awaits those who abort.
This leaves many women carrying a huge psychological weight that activists in the past few years have been trying to help unburden. Counseling that recognizes some women's post-abortion grief and that promotes conversations to explore guilt, shame and fear are being developed throughout the country in an effort to get women to talk about their abortions and help de-fang harmful attitudes.
"The head and heart are connected," says Amy Hagstrom Miller, founder-owner of Whole Woman's Health, a four-clinic chain in Texas and Maryland. "Women who feel guilty about the abortion have more cramps and bleeding. But when we talk about the decision beforehand, they do better afterwards. Look, no one gets pregnant so they can have an abortion, but a big part of what we do is helping patients understand how universal this experience is for women."
"We need to discuss the complex feelings of women who've had abortions," says activist-writer Jennifer Baumgardner, co-producer of the 2005 documentary, "Speak Out: I Had an Abortion," in which 10 women candidly recount their abortion experiences.
"Most women have a good outcome, but others have mixed feelings," Baumgardner says. "Especially if they become mothers later, they'll have feelings about the fetus, which one came at the right time and which one didn't. It's the repressing of these emotions that's the enemy here."
Baumgardner and colleague Gillian Aldrich made the film to show the range of women who have abortions and to highlight the difference between safe and legal abortion and the dangerous surgeries performed before Roe v. Wade, the 1973 Supreme Court ruling that state laws barring all abortions violated the constitutional right to privacy.
The film has been widely screened and is just one of many attempts to chip away at the negative assumptions surrounding the procedure.
Pro-choice religious leaders are also offering moral support.
The Clergy Advisory Group of Planned Parenthood of the Texas Capital Region in Austin, for instance, issued a statement intended for duplication: "We believe, as religious persons, that abortion is a morally permissible choice for women . . . We believe in a loving and compassionate God . . . This God accepts human beings with all their strengths and weaknesses, their shortcomings, their choices, and will not punish you for choosing to have an abortion."
The Washington-based Religious Coalition for Reproductive Choice also encourages public declarations and trains clergy to conduct "options counseling" to help women during the decision-making process.
"I don't minimize the abortion decision," says Coalition President Rev. Carlton W. Veazey. "But we make a lot of decisions and not all of them leave us completely at peace. We try to counsel in a way that eliminates guilt. We remind women that having a child can be a sacred choice, but that not having one can also be sacred. We work to dispel the notion that abortion will send a woman to hell."
Virtually every clinic in the country offers pre-operative counseling, but patients often feel uncomfortable in that setting, especially if they were greeted by shrieking picketers as they entered the facility.
"Clinics aren't a place where someone can spend hours talking," says Grayson Dempsey, president of Backline, a national hotline located in Portland, Ore., that promotes conversations about pregnancy, parenting, adoption and abortion. Women, she says, often prefer the anonymity of a phone line where the counselor has nothing to gain from the outcome of the conversation.
In its two-year history, Backline has counseled people from 35 states both pre-and-post abortion. "Some say, 'I've scheduled an abortion for tomorrow and I'm scared. I need someone to talk to,'" Dempsey says. "Other callers tell us that they're not at the point of thinking about what to do, but need help telling their boyfriend that they're pregnant. Some are looking for a referral to a local clinic."
Last year, Dempsey says, 15 percent of the callers were male; 13 percent were parents or guardians.
Baumgardner and Dempsey both note that abortion providers and activists themselves are susceptible to anti-abortion messaging. In addition, they say even the most stalwart pro-choice advocates become squeamish in certain situations, such as late-term procedures, women who have had multiple abortions, or when working with adolescents.
The Abortion Conversation Project, a program of the Washington-based National Coalition of Abortion Providers, asks clinicians and pro-choice activists to air these concerns and reactions. Since 2005, it has held forums in Austin, Texas; Orlando, Fla.; and Portland, Ore. It sponsors online chats and bulletin boards that discuss everything from how to talk about working in a clinic to the best ways to promote post-abortion health. It also runs five-week-long classes for those working in the field of reproductive health.
Another national hotline, the San Francisco Bay area group, Exhale, focuses exclusively on post-abortion counseling. Its 47 multilingual volunteers and five paid staff speak to more than 2,000 people a year.
"Members of the pro-choice community often argue that women feel relief after an abortion and if they have other feelings it's because they have other things going on," says Exhale founder Aspen Baker. "The other side says that the woman killed her baby and should feel guilt or regret. These are the poles: relief and empowerment or guilt and regret. If you don't fit into either set of feelings it's as if you're outside the norm. We work on this terrain of 'unacceptable emotions.'"
Baker says callers often question whether their reactions are normal.
"A lot of it is unburdening, getting it off their chests," says Baker. "They're often not sure what their friends or family will say about the abortion so they don't want to risk sharing it and getting a bad reaction. They want to hear that it's OK to have intense feelings about ending a pregnancy; that it's possible to integrate the experience into their lives. They want someone to listen and not judge them."
Eleanor J. Bader is the co-author of "Targets of Hatred: Anti-Abortion Terrorism" and is a frequent contributor to The Brooklyn Rail, Library Journal, Lilith, the New York Law