Jay has an excellent post up about the complexities of abortion, and how anti-choice politics and ideologies compromise women’s basic medical care. A taste:
“Any other pregnancies?”
Such a simple question. She was cuddling her five-week-old, happily describing how much help she had from her ten-year-old daughter. I could tell as soon as I asked that the answer wasn’t so simple. I could tell from the look on her face, from the hesitation as she answered me. I have learned to identify the body language of loss. I made sure I wasn’t clicking my pen, or tapping my foot, or in any other way expressing impatience. I waited quietly, openly, and after a minute she said “Well, I had an abortion a few years ago. And I pray every day to God to forgive me”.
I’m used to that, to women who believe the messages that they have failed themselves and their God by making this most difficult of choices. I’m used to hearing about the grief and guilt and the tears that show up every year on the day the baby would have been born. And no, this doesn’t happen to every woman who has an abortion and no, it’s not “post-abortion syndrome”. It’s the logical result of a traumatic experience brought on, at its root, a cult of motherhood and femininity that serves the patriarchy by demonizing women. I hate it – I am sickened by it – but I’m used to it. It was her next comment that stopped me cold:
“My last doctor told me I shouldn’t tell anyone that, even a doctor. He said I should say I had a miscarriage. But I didn’t, and I figured you need to know the difference. And you’re a doctor. Doctors aren’t supposed to judge people”.
No, they aren’t. Read Jay’s whole post. Doctors who tell women to lie about their past abortions threaten our physical and psychological health — they handicap future health care providers, and they reinforce the idea that abortion is the worst, most shameful thing you can do. Anti-choice doctors, pharmacists, nurses and other health care providers don’t just do harm when they refuse to provide basic reproductive health services; they do harm when they project their ideologies into the care they provide. As Jay says, doctors “can wound with our words as surely as with a scalpel.”
She follows up with another post about the Google searches that have lead people to her blog.
The search string was “can a doctor tell if you had an abortion”. The simple answer is “no”. A doctor doing a pelvic exam can tell if you’ve delivered a full-term baby vaginally, but a first- or second-trimester abortion doesn’t alter the cervix in the same way.
But that’s just the simple answer. Reading the question makes me sad and a little sick inside. I can feel her fear. Maybe she had an abortion in the past and is afraid that someone will find out. Will the doctor condemn her? Will the doctor tell her partner? Her parents? Her employer? Like my own patient, she may already be judging herself, may have been shamed by her culture or by a previous encounter with one of my colleagues. Not all women feel guilty after an abortion; many feel relieved, and many are ambivalent. But women who don’t feel guilty or ashamed don’t want to hide their history from their doctors.
I’d add that this extends to sex and reproduction in general. Women who don’t feel guilty or ashamed about the number of sexual partners they’ve had don’t hide their history from their doctors; women who don’t feel guilty or ashamed of having a sexually transmitted infection don’t hide their history from their doctors; women who don’t feel guilty or ashamed for having given birth and then given that child up for adoption don’t hide their history from their doctors; women who don’t feel guilty or ashamed of being sexually assaulted don’t hide that history from their doctors. Women who don’t feel guilty or ashamed of their sexual histories are able to provide their doctors with a more complete history, and get more narrowly-tailored, effective care.
Imagine what reproductive health care would look like if sexuality was viewed as both a pleasure and a responsibility, without guilt and without shame. Imagine if women weren’t inundated with images of themselves as sexual objects, if we looked outward instead of watching ourselves be watched. If women’s bodies weren’t visual representations of sex itself. If packaged-and-sold sex was trumped by the real thing — and if narrow moralizing and misogynist ideals weren’t hung on the real thing. If women weren’t trapped between Good Girls Don’t and Girls Gone Wild.
Unfortunately, that is not the world we live in. Jay has more on that end. In the meantime, I’m heartened to see responsible physicians like her offering thorough and compassionate care. (And I’ll just throw it out there that holy shit is Two Women Blogging an awesome site).