The following has proved to be one of the most popular articles I've ever written. Although I wrote it in 2000, it could have been written yesterday. This phenonemon continues unabated at abortion clinics throughout the nation.
When the Anti-Choice Choose
Abortion is a highly personal decision that many women are sure they'll never have to think about until they're suddenly faced with an unexpected pregnancy. But this can happen to anyone, including women who are strongly anti-choice. So what does an anti-choice woman do when she experiences an unwanted pregnancy herself? Often, she will grin and bear it, so to speak, but frequently, she opts for the solution she would deny to other women - abortion.
In the spring of 2000, I collected the following anecdotes directly from abortion doctors and other clinic staff in North America, Australia, and Europe. The stories are presented in the providers' own words, with minor editing for grammar, clarity, and brevity. Names have been omitted to protect privacy.
"I have done several abortions on women who have regularly picketed my clinics, including a 16 year old schoolgirl who came back to picket the day after her abortion, about three years ago. During her whole stay at the clinic, we felt that she was not quite right, but there were no real warning bells. She insisted that the abortion was her idea and assured us that all was OK. She went through the procedure very smoothly and was discharged with no problems. A quite routine operation. Next morning she was with her mother and several school mates in front of the clinic with the usual anti posters and chants. It appears that she got the abortion she needed and still displayed the appropriate anti views expected of her by her parents, teachers, and peers." (Physician, Australia)
"I've had several cases over the years in which the anti-abortion patient had rationalized in one way or another that her case was the only exception, but the one that really made an impression was the college senior who was the president of her campus Right-to-Life organization, meaning that she had worked very hard in that organization for several years. As I was completing her procedure, I asked what she planned to do about her high office in the RTL organization. Her response was a wide-eyed, 'You're not going to tell them, are you!?' When assured that I was not, she breathed a sigh of relief, explaining how important that position was to her and how she wouldn't want this to interfere with it." (Physician, Texas)
"In 1990, in the Boston area, Operation Rescue and other groups were regularly blockading the clinics, and many of us went every Saturday morning for months to help women and staff get in. As a result, we knew many of the 'antis' by face. One morning, a woman who had been a regular 'sidewalk counselor' went into the clinic with a young woman who looked like she was 16-17, and obviously her daughter. When the mother came out about an hour later, I had to go up and ask her if her daughter's situation had caused her to change her mind. 'I don't expect you to understand my daughter's situation!' she angrily replied. The following Saturday, she was back, pleading with women entering the clinic not to 'murder their babies.'" (Clinic escort, Massachusetts)
"We too have seen our share of anti-choice women, ones the counselors usually grit their teeth over. Just last week a woman announced loudly enough for all to hear in the recovery room, that she thought abortion should be illegal. Amazingly, this was her second abortion within the last few months, having gotten pregnant again within a month of the first abortion. The nurse handled it by talking about all the carnage that went on before abortion was legalized and how fortunate she was to be receiving safe, professional care. However, this young woman continued to insist it was wrong and should be made illegal. Finally the nurse said, 'Well, I guess we won't be seeing you here again, not that you're not welcome.' Later on, another patient who had overheard this exchange thanked the nurse for her remarks." (Clinic Administrator, Alberta)
"We saw a woman recently who after four attempts and many hours of counseling both at the hospital and our clinic, finally, calmly and uneventfully, had her abortion. Four months later, she called me on Christmas Eve to tell me that she was not and never was pro-choice and that we failed to recognize that she was clinically depressed at the time of her abortion. The purpose of her call was to chastise me for not sending her off to the psych unit instead of the procedure room." (Clinic Administrator, Alberta)
"Recently, we had a patient who had given a history of being a 'pro-life' activist, but who had decided to have an abortion. She was pleasant to me and our initial discussion was mutually respectful. Later, she told someone on my staff that she thought abortion is murder, that she is a murderer, and that she is murdering her baby. So before doing her procedure, I asked her if she thought abortion is murder - the answer was yes. I asked her if she thought I am a murderer, and if she thought I would be murdering her baby, and she said yes. But murder is a crime, and murderers are executed. Is this a crime? Well, it should be, she said. At that point, she became angry and hostile, and the summary of the conversation was that she regarded me as an abortion-dispensing machine, and how dare I ask her what she thinks. After explaining to her that I do not perform abortions for people who think I am a murderer or people who are angry at me, I declined to provide her with medical care. I do not know whether she found someone else to do her abortion." (Physician, Colorado)
"In 1973, after Roe v. Wade, abortion became legal but had to be performed in a hospital. That of course was changed later. For the first 'legal abortion day' I had scheduled five procedures. While scrubbing between cases, I was accosted by the Chief of the OB/Gyn service. He asked me, 'How many children are you going to kill today?' My response, out of anger, was a familiar vulgar retort. About three months later, this born-again Christian called me to explain that he was against abortion but his daughter was only a junior in high school and was too young to have a baby and he was also afraid that if she did have a baby she would not want to put it up for adoption. I told him he did not need to explain the situation to me. 'All I need to know', I said, 'is that SHE wants an abortion.' Two years later I performed a second abortion on her during her college break. She thanked me and pleaded, 'Please don't tell my dad, he is still anti-abortion.'" (Physician, Washington State)
"The sister of a Dutch bishop in Limburg once visited the abortion clinic in Beek where I used to work in the seventies. After entering the full waiting room she said to me, 'My dear Lord, what are all those young girls doing here?' 'Same as you', I replied. 'Dirty little dames,' she said." (Physician, The Netherlands)
"I had a patient about ten years ago who traveled up to New York City from South Carolina for an abortion. I asked her why she went such a long way to get the procedure. Her answer was that she was a member of a church group that didn't believe in abortion and she didn't want anyone to know she was having one. She planned to return to the group when she went back to South Carolina." (Physician, New York)
"I once had a German client who greatly thanked me at the door, leaving after a difficult 22-week abortion. With a gleaming smile, she added: 'Und doch sind Sie ein Mörderer.' ('And you're still a murderer.')" (Physician, The Netherlands)
"My first encounter with this phenomenon came when I was doing a 2-week follow-up at a family planning clinic. The woman's anti-choice values spoke indirectly through her expression and body language. She told me that she had been offended by the other women in the abortion clinic waiting room because they were using abortion as a form of birth control, but her condom had broken so she had no choice! I had real difficulty not pointing out that she did have a choice, and she had made it! Just like the other women in the waiting room." (Physician, Ontario)
"A 21 year old woman and her mother drove three hours to come to their appointment for an abortion. They were surprised to find the clinic a 'nice' place with friendly, personable staff. While going over contraceptive options, they shared that they were Pro-Life and disagreed with abortion, but that the patient could not afford to raise a child right now. Also, she wouldn't need contraception since she wasn't going to have sex until she got married, because of her religious beliefs. Rather than argue with them, I saw this as an opportunity for dialogue, and in the end, my hope was that I had planted a 'healing seed' to help resolve the conflict between their beliefs and their realities." (Physician, Washington State)
"I had a 37 year old woman just yesterday who was 13 weeks. She said she and her husband had been discussing this pregnancy for 2-3 months. She was strongly opposed to abortion, 'but my husband is forcing me to do it.' Naturally, I told her that no one could force her into an abortion, and that she had to choose whether the pregnancy or her husband were more important. I told her I only wanted what was best for her, and I would not do the abortion unless she agreed that it was in her best interest. Once she was faced with actually having to voice her own choice, she said 'Well, I made the appointment and I came here, so go ahead and do it. It's what's best.' At last I think she came to grips with the fact that it really was her decision after all." (Physician, Nevada)
"We have anti-choice women in for abortions all the time. Many of them are just naive and ignorant until they find themselves with an unwanted pregnancy. Many of them are not malicious. They just haven't given it the proper amount of thought until it completely affects them. They can be judgmental about their friends, family, and other women. Then suddenly they become pregnant. Suddenly they see the truth. That it should only be their own choice. Unfortunately, many also think that somehow they are different than everyone else and they deserve to have an abortion, while no one else does." (Physician, Washington State)
Although few studies have been made of this phenomenon, a 1981 study (Henshaw, S.K. and G. Martire. Abortion and the Public Opinion Polls: 1. Morality and Legality. Family Planning Perspectives. 14:2, pp 53-60, March/April 1982) found that 24% of women who had abortions considered the procedure morally wrong, and 7% of women who'd had abortions disagreed with the statement, "Any woman who wants an abortion should be permitted to obtain it legally." A 1994/95 survey of nearly 10,000 abortion patients showed 18% of women having abortions are born-again or Evangelical Christians. Many of these women oppose abortion, as research shows Catholic women have an abortion rate 29% higher than Protestant women, and one in five women having abortions are born-again or Evangelical Christians.
According to an article called Abortion Clinics' Toughest Cases (Medical World News, pp 55-61, March 9, 1987):
Physicians and clinics frequently terminate pregnancies for women who believe abortion is 'murder' and 'a sin' but who are not anti-abortion activists. Demonstrators, organizers, and leaders in the [anti-abortion] movement are seen less frequently, ranging from perhaps once or twice a month to a few times in the course of a professional career.
The article contained the following anecdotes:
An administrator at a Missouri clinic recalled a woman blurting out in the recovery room, "It should be illegal." The other women's mouths fell open, said the administrator. "They couldn't believe it."
The medical director of an Indianapolis clinic recalled one prospective patient who phoned to ask whether the clinic had a back door. He said no. How, she asked, could she get inside without being seen by fellow picketers outside? Pointing out that two orthopedists practiced with him, the doctor told the woman "she could limp and say she was coming to see the orthopods."
The medical director at a Dallas abortion clinic told this story: A white woman from an affluent north Dallas neighborhood brought her black maid in for an abortion and paid for it. While the maid was in a counseling session, a commotion was heard in the waiting room outside. The maid's employer was handing out anti-abortion leaflets to other women waiting for abortions.
From a clinic director in a mid-western state: "One of the most remarkable cases was a woman who came [from another part of the state] and said she was the Right-to-Life president in her county. 'But,' she said, she 'had become pregnant and had to have an abortion.'"
From a counselor in Virginia: "[The patient] was disturbed and upset and insisted she couldn't carry the pregnancy to term. She opposed abortion -- and in fact had picketed this very clinic -- [but] felt the abortion was something she had to do."
Many anti-choice women are convinced that their need for abortion is unique - not like those "other" women - even though they have abortions for the same sorts of reasons. Anti-choice women often expect special treatment from clinic staff. Some demand an abortion immediately, wanting to skip important preliminaries such as taking a history or waiting for blood test results. Frequently, anti-abortion women will refuse counseling (such women are generally turned away or referred to an outside counselor because counseling at clinics is mandatory). Some women insist on sneaking in the back door and hiding in a room away from other patients. Others refuse to sit in the waiting room with women they call "sluts" and "trash." Or if they do, they get angry when other patients in the waiting room talk or laugh, because it proves to them that women get abortions casually, for "convenience".
A few behave in a very hostile manner, such as calling clinic staff "murderers." Years ago, a clinic counselor in British Columbia told me that one of her patients went into the procedure room apparently fine with her decision to have an abortion. During the abortion, at a stage when it was too late to stop the procedure, the woman started screaming "You murderers!" and other invectives at everyone in the room.
A few doctors actually refuse to provide abortions to anti-choice women for liability reasons. In the words of a Kansas physician:
"Early in my career, I thought I was obligated to provide an abortion for every woman who arrived at my doorstep requesting an abortion. My experience in general medicine, surgery, and abortion has led me to believe differently. Not inadvertently, women give either me or my staff an uneasy feeling about their ambivalence or their anxiety about the abortion process. Since I have never been sued for an abortion I did not perform, my policy is to acknowledge my gut feeling, which is more often right than wrong."
A clinic counselor from Georgia stated:
"I have long felt that anti-abortionism is a psychological contraindication to the abortion procedure. And that we don't have to give everyone who asks an abortion. An anti-abortion woman is likely to be uncooperative and will probably not follow post-op instructions or instructions on how to deal with complications. There is actually a case where an anti-abortion patient failed to go as directed to Emergency for an unrelated complication. She ended up dying, and her family sued the physician and badgered him publicly. Additionally, if you have a complication that day, it will be the anti-abortionist. I'm not talking about the patient who says, 'I was against abortion until it happened to me', or 'I'm really against abortion, but I have to do this'. I'm talking about the picketer, the activist, the totally anti-creature who will come back to haunt us."
In fact, an anti-abortion organization called Life Dynamics Inc., of Denton Texas, specializes in malpractice suits against abortion providers. They advertise for and exploit women who regret their abortion decision or who had complications, and try and persuade them to file suit against the doctor or clinic. Many of these women are vulnerable and suffer from emotional problems, but others are anti-abortion, or at least very ambivalent about their decision to have an abortion. The message that abortion is murder has had a profound influence on them, and it may leave them with a legacy of guilt and shame after their abortion, too often borne alone and in silence. When these women find themselves unable to cope with their abortions, they may look for somebody else to blame, and doctors become a convenient scapegoat.
At times, clinic staff understandably become frustrated and angry when they have to deal with abusive, hostile, or hypocritical patients. And it is rare for anti-choice women to express appreciation for the service they've received. But most clinics perform abortions on anti-abortion women because they feel it's their obligation to help all women. They provide more thorough and specialized counseling to these women to ensure they take ownership of their decision, as far as possible. Here's a couple of examples of counseling techniques:
"When a patient comes in with my 'favorite' sentiment: 'The only moral abortion is my abortion,' I try to expand her understanding that a few more of us have had and deserve a 'moral' abortion. When a woman expands her need for care beyond herself, you no longer have an 'anti'." (Clinic Administrator, Louisiana)
"Sometimes I say to patients who have that 'I have no choice, I know I'll regret it, just do me' attitude: 'You may not care, but we do. We only do abortions on women who want our services. We will not knowingly contribute to any possible trauma of any woman.' They seem surprised that we care how we do our work, but they also accept it." (Counselor, New York)
Some anti-choice women who have abortions do make peace with their decision and even become pro-choice, or at least more forgiving of other women seeking abortions. A Louisiana patient who was anti-choice before her abortion, wrote a warm and grateful thank-you letter to the clinic, admitting that she had been a hypocrite:
"I never dreamed, in my wildest nightmares, that there would ever be a situation where I personally would choose such an act. Of course, we would each like to think that our reasons for a termination are the exception to the rule. But the bottom line is that you people spend your lives, reputations, careers and energy fighting for, maintaining, and providing an option that I needed, while I spent my energy lambasting you. Yet you still allowed me to make use of your services even though I had been one of your enemies. You treated us as kindly and warmly as you did all of your patients and never once pointed an 'I told you so' finger in our direction. I got the impression that you cared equally about each woman in the facility and what each woman was going through, regardless of her reasons for choosing the procedure. I have never met a group of purely non-judgmental people like yourselves."
On occasion, an abortion turns out to be a momentous, life-affirming experience for an anti-choice woman. A doctor from a north-western state shared the following personal story with me:
"I was born into a very Catholic family, and was politically pro-life during college. After dating my first real boyfriend for three years, we broke up, and the day my boyfriend moved out, I discovered I was pregnant. It was an agonizing decision, and something I never thought I would do, but I decided an abortion was the only realistic option. Thanks to Planned Parenthood counseling, I worked through some very tough conflicts within myself. I had to learn that my decision was a loving one. That 'my god' was actually a loving and supportive god. And that men don't have to make this decision, only women do. That it is a very personal, individual decision. I had to own it. I became much more compassionate towards myself and others as a result of my experience. Two years later I began medical school. When it came time to choose a practice, an abortion clinic opportunity came up. In working there, I began to feel that this was my calling. Having been in my patients' shoes, and coming from an unforgiving background, I could honestly say to patients, 'I know how you feel.' Deciding to have an abortion was THE hardest decision I've ever made in my life. Yet it has brought me the greatest transformation, fulfillment, and now joy. I am a more loving person because of it, and a better doctor for having experienced it. I love the work that I do, and the opportunity to support women seeking to end an unwanted pregnancy. My patients and my work are life's gifts to me, and I think my compassion and support are my gifts in return."