Abortion and the Actualized Self

The Choices We Made (Angela Bonavoglia, 1990) is the latest collection of sympathetic abortion narratives, a genre Gloria Steinem refers to as “populist truth-telling,” “the heart and soul of movements and revolutions all over the world.” As may be expected from a book excerpted in Ms, many of the narrators are notables—Grace Paley, Elizabeth Janeway, Polly Bergen, Whoopi Goldberg—and few believe that their decisions to abort were wrong.

Witnessing about abortion is designed not only to serve the immediate political purpose of galvanizing prochoicers but also to elicit compassion for the women who abort, as well as to seek tacit endorsement of their decision. Steinem sees the abortion fight in the U.S. as part of a worldwide movement to give individuals the right to reproductive freedom, “adding the female half of humanity to the goal of global democracy. And the point of democracy is not: What gets decided? The point is: Who decides?” Portraying the individual choice to abort in this way, as a step toward freedom for the entire human race, invites women to see the sorrow they feel about their own abortions as part of a false consciousness instilled by a society determined to repress female sexuality.

Choices, like the half-dozen other books detailing the abortion experience, contains few narratives involving predicaments as terrible as that faced by women whose lives are endangered by pregnancy; much of the sorrow expressed seems as confused as the relationships that produced the unwanted pregnancies. An underlying message in many abortion narratives is that these poor women have already suffered enough; questioning their judgment will only make them feel worse.

Women’s experiences with abortion are unpleasant, to say the least, but because court decisions have privatized abortion, it is difficult to gather reliable data about the immediate and long-term effects of abortion. Former Surgeon General C. Everett Koop concluded in 1989 that studies of post-abortion effects were all methodologically flawed. James L. Rogers’ review of research on the psychological consequences of abortion found that only one out of 300 studies could be considered valid (in James K. Hoffmeier, Abortion: A Christian Understanding and Response, 1987). Most studies displayed faults ranging from lack of control groups to use of biased and unreliable measuring instruments to the use of subjects who were either self-selected or selected by abortion clinic personnel. Koop recommended that a long-term study of large numbers of women be conducted to examine the effects of pregnancy, childbirth, and abortion. His conclusions have been interpreted by the popular press as support for liberal abortion policies.

“Is There Angst After Abortion?” queried the July 1989 issue of Mademoiselle. The article pooh-poohs “post-abortion syndrome,” declaring it to have been “soundly debunked” by Koop and the American Psychological Association. It heralds a study of sixty-three women confirming “dozens of others concluding that the most common post-abortion reactions are positive ones—relief, happiness, a sense of renewed control.” The “vast majority” of those sixty-three women also felt that they’d made a “wise decision.”

Similar evidence that abortion is helpful rather than hurtful is presented by the Alan Guttmacher Institute in a study that reveals that fully three-quarters of 19,000 women surveyed who had had an abortion “reported that having a baby would have seriously interfered with work, school, or other major responsibilities.” (This should come as no surprise to anyone who has ever cared for a child, an aged parent, or a sick friend.) “And even if some women weather post-abortion bouts of depression or guilt,” continues the article, “studies show that these periods are usually short-lived.” The researcher quoted here, Jeanne Parr Lemkau, concludes that “Ambivalence about abortion is normal—it doesn’t mean you have psychological problems.” Nor does it mean you have made the wrong decision, the author of the article adds, again quoting Lemkau, “only an emotionally significant one.”

The article reflects the currently common belief that ambivalence is normal, guilt is not. Whatever decision a woman makes, simply because she makes it, is right—even if she feels bad about it. The author also solicitously warns against post-abortion “support groups” run by “phony counseling clinics,” where prolifers “typically feature a repent-your-sins format and a heavy dose of anti-choice education.”

Narratives about the abortion experience show that there is plenty of pain to go around, even for prochoice women. There are fewer accounts of how women heal after abortion. Obviously, the process differs from woman to woman, but even recognizing the need to heal is impeded by lack of knowledge about negative reactions to abortion. A support group called Women Exploited by Abortion (WEBA) has produced a pamphlet called “Surviving Abortion,” in which it is noted that “many women are surprised to find themselves grieving an aborted child because the abortion was—more or less—a voluntary act; but that is all the more a reason to grieve—the added dimension of responsibility—or guilt—intensifies the grief.”

WEBA members refuse to let others trivialize their pain and encourage women who have aborted to acknowledge the sorrow they feel.

You may be led to believe, by doctors, abortion facility counselors, or other “family planning” personnel, by other women who have had abortions, psychiatrists, parents, husband, or boyfriend that your grief is illegitimate. This frequently leads women to feel foolish, selfish or guilty about their grief and that just makes their already confused state more stressful . . . . There is a paternalistic attitude in the abortion field that seems to promote an opinion that an uninformed decision is a less painful one. We know that the opposite is true.

For some, healing begins the old-fashioned way: by acknowledging abortion to be a sin and repenting. These women testify that they are healed by Christ. For others, those convinced that morality is private, and that only they themselves can judge the rightness of their own actions, healing means accepting ambivalence, and perhaps offering comfort to others through public confession. That “ambivalence”—which is often a euphemism for equating good and evil—is apparently shared by those assisting in the abortions: their task is not to help women make the right decision, but to help women make it through the abortions they’ve already decided to have.

Sallie Tisdale, a nurse from an abortion clinic reveals in an article in the October 1987 Harper’s Magazine (“We Do Abortions Here: A Nurse’s Story”): “There are weary, grim moments when I think I cannot bear another basin of bloody remains, utter another kind phrase of reassurance.” But she recognizes, she says, that “in abortion the absolute must always be tempered by the contextual, because both are real, both valid, both hard. How can we do this? How can we refuse?”

Those in Nurse Tisdale’s line of work must be brave enough to acknowledge, if not to administer, “necessary” medicine. She apportions counseling according to her judgment of the particular woman: “Some are stoic, some hysterical, a few giggle uncontrollably, many cry.” As they walk down the hall together, Nurse Tisdale tries to “gauge” the woman, tries “to get a sense of the words and the tone” she should use. “With some I joke, with others I chat, sometimes I fall into a brisk, business-like patter.” She asks every woman, “Are you sure you want an abortion?” Most, she says, nod with “knowing smiles.” Some seek her “forgiveness,” or offer excuses. Occasionally a woman will flinch at the sound of the A-word, and ask her not to use it.

And she is careful with her language, describing the procedure without saying “pain” or “baby.” But some women will interrupt her factual discussion of “the tissue” and “the contents” to ask how big “the baby is.”

These words suggest a quiet need for a definition of the boundaries being drawn. It isn’t so odd, after all, that she feels relief when I describe the growing bud’s bulbous shape, its miniature nature. Again I gauge, and sometime lie a little, weaseling around its infantile features until its clinging power slackens.

Nurse Tisdale seems unaware that her “weaseling around” might be interpreted as preventing informed consent; her intent is to help. This is a fearless woman acting out of a higher morality: she can see abortion for the “dirty work” that it is and still be willing to assist with “stark and loving dispassion” in the “sweet brutality” of abortion, which she calls a “merciful violence, like putting a suffering animal to death.”

She and the other clinic workers hide their own dubiety from their clients because abortion is a “matter of choice, privacy, control.” The clinic staff keep their ambivalence to themselves: “We are too busy to chew over ethics.” She in any case is convinced that she participates in a necessary evil, the necessity justifying her “complicity”:

At the end of the day I clean out the suction jars, pouring blood into the sink, splashing the sides with flecks of tissue. From the sink rises a rich and humid smell, hot, earthy, and moldering; it is the smell of something recently alive beginning to decay. I take care of the plastic tub on the floor, filled with pieces too big to be trusted to the trash. . . . Abortion requires of me an entirely new set of assumptions. It requires a willingness to live with conflict, fearlessness, and grief. As I close the freezer door, I imagine a world where this won’t be necessary, and then return to the world where it is.

If there is any solidarity between feminist healthcare workers and clients, one would be hard put to find it in Tisdale’s condescending compassion. A similar separation between professional and client is seen in psychiatrist B. R. Arnowitz’s essay called “The Psychodynamics of Abortion” (included in a volume titled Critical Psychophysical Passages in the Life of A Woman, edited by Joan Offerman-Zuckerberg). “Anesthesia pops the lid off the id,” clinic workers tell Arnowitz. Under anesthesia, women vocalize their conflicted states: “I had to do this. I didn’t want to kill this baby. My husband didn’t want it. My poor baby. I hate him.” Religious and superstitious women appear to have the worst experiences, “apparently due to their guilt and consequent conflict.”

In contrast to the religious/superstitious women are women who have a strong sense of self. They awaken from anesthesia “almost immediately, [and] handle postoperative cramping with only minor distress.” For these women, even the first abortion is quite bearable. Dr. Arnowitz believes that “women with a history of self-soothing and self-tolerance or general ego strength in response to psychophysical events had the best preoperative and postoperative adjustment.” These women tended to have “realistic expectations” about abortion, and “conveyed a healthy and trusting attitude about their sexuality, and most importantly, have incorporated the nurturant qualities of their own primary caretakers into their self-structure.” The self-nurturant woman may even view the procedure “as a growth-promoting experience”; and “the circumstances surrounding the abortion may even be a self-enhancing occasion for the woman.” Says Arnowitz:

One may expect that with evolving societal norms regarding women’s roles and those specifically relating to sexual behavior and thus encompassing abortion, obtaining an abortion will decreasingly be viewed as deviant activity. Instead of being interpreted as a woman’s feminine immaturity or incomplete socialization, abortion will be viewed as a viable and respectable option. In turn, shame and guilt over denial of maternal instinct, feeling of moral transgression, and maladaptive reactions based upon these constructs may likewise subside.

This feminist psychiatrist predicts “extremely negative psychological sequelae” should the “fundamental right to abortion as a legitimate option in attaining control over one’s own bodily self be suddenly renounced.” The right to abortion is thus necessary for the “psychological integrity” of women.

Rosalind Petchesky, in Abortion and Woman’s Choice, pushes the argument further. She acknowledges the tension between individual choice and collective purpose, declaring that there will always be a need for abortion. “Rather than apologize for abortion, feminists must proclaim loudly—as they did in the late 1960s and the early 1970s—that access to safe, funded abortion is a positive social need of all women of childbearing age.” So “self-actualized” women ought to accept abortion as a necessary part of the healthy expression of their own sexuality.

But some women with strong selves have extremely negative experiences. They, too, feel pain. Sue Nathanson is a prochoice psychotherapist whose own abortion precipitated what she refers to as a “soul crisis,” her name for an experience deeper than an intense emotional reaction to loss or trauma (Soul Crisis: One Woman’s Journey Through Abortion to Renewal). “It involves the shattering of one’s beliefs about oneself and one’s life into fragments that cannot be put back together again in exactly the same way,” forcing, she believes, “an assessment of one’s basic mode of being in the world,” and requiring the loss “of innocence and a simple worldview.”

As with Tisdale, Arnowitz, and others, Nathanson sees her recovery as a personal act requiring a shift from innocence to ambivalence; she finds that she must learn to appreciate the darker powers of the self. “The work of restoration was essentially mine,” she notes; “completing it successfully took years of psychological effort on my part, combined with the active support and assistance of others . . . and the help of myth and ritual. The shattered self must be reconstituted in a new way.” In a sense, her reconstituted woman is the image of a New Age goddess, a creator and a destroyer whose actions are good even when destructive. As Maggi Cage explains it in Woman of Power, “The sacred act of creating has to do not only with creating, but with destroying as well.” She commends cultures in which “abortion is viewed as one way of completing the sacred cycle that begins with sexuality,” condemning the squeamish “white Western culture” in which we “don’t want to accept responsibility for our destructive acts or our negative side, so we deny their existence.” She warns that fear of our own “negative side” turns into shame and guilt. Unless “we embrace the totality of life by accepting both creation and destruction as natural parts of the flow of life, we will continue to turn away from our power and be at the mercy of those who will use shame and guilt to control us.”

Nathanson, the archetypal new woman, is also fearless, or at least able to live with fear. She takes responsibility for her actions, but seems to think that taking responsibility necessarily makes the action right. She didn’t want the abortion—she got it only because “the choice of an abortion was essential for the well-being of everyone” in her family, though she still wishes she “could have chosen otherwise.”

She likes motherhood and says she “would have given anything to be able to climb one last time to the unparalleled peak of the mountain. But I made the best choice I could make with my rational mind, if did not anticipate how profoundly I would suffer emotionally, or how long my suffering would endure.”

If the aborted child seems forgotten in Nathanson’s focus on her own suffering, that is only a temporary lapse; the child is, after all, another means to self-actualization: motherhood envisioned as an “unparalleled peak of the mountain” of personal experience. The self unavoidably comes first, for only a well-cared-for self can serve the needs of others. Nathanson had to act against her own better instincts for the sake of herself and her family, her husband in particular.

This new ethic—that abortion is more moral than interrupting schooling or employment—is held not only by writers for New York fashion magazines and Californians infused with New Age spiritualism, but also by an aging feminist movement. Eleanor Smeal’s Fund for the Feminist Majority produced a video entitled “Abortion: for Survival,” which promotes the view that women cannot morally refuse—much less be denied—abortion in some instances. This argument is arrived at by equating the plight of starving African peoples with that of a young white woman in the U.S. having an abortion because she already has two children and feels she couldn’t possibly care adequately for a third. Emotions are further aroused by the sight of family members recalling the deaths of mothers and sisters from illegal abortions. This video and “No Going Back,” from the Federation of Feminist Women’s Health Centers in Los Angeles, discuss low-tech methods for menstrual extraction or early self-abortion.

The new feminist view, as advanced by Drucilla Cornell in the Yale Journal of Law & the Humanities, as well as by others, recognizes that justifying abortion under the right to privacy has become problematical. Cornell embeds “the call of justice [for women]” into a discussion of “bodily integrity.” She acknowledges that in Roe v. Wade Justice Blackmun attempted to “heed the call to justice” by making abortion readily available to women. The “woman’s call to justice” that Cornell defends is warranted by women’s suffering “under the conditions women would again face if the Roe framework was dismantled,” that is, the requirement that a woman carry an unwanted pregnancy to term, travel to a state or country where abortion was legal, or seek an illegal abortion. While demanding respect for women who decide what is just for themselves, she views questions about the right to abortion (e.g., by Justices O’Connor and Rehnquist) as irresponsible acts of judging.

Placing the abortion discussion within the larger context of bodily rights legitimizes abortion under any circumstance. The term “bodily integrity” covers a variety of issues related to “invasions” of the body—coerced abortion, mass testing for AIDS, forced sterilizations, or the use of mind-altering drugs on prisoners, children, or the aged. By locating abortion among the parade of horribles worldwide, it ends up not only tolerated but protected as a cherished right.

Do not mistake this right or duty to protect the self from unwanted pregnancy for anything so crass as a “me for me” mentality: nothing is more important to those around her than what Maggi Cage calls the “absolutely crucial” task of each woman to make a place where “she can be herself, recognize herself, and come face to face with herself” so that she may “regenerate” herself and her sacred power of creation.

While it is tempting to dismiss Cage as extreme, and to caricature the Nathansons as a yuppie couple, each with their respective therapists and programs of exercise and diet, dismissals and caricatures will probably not invite them to see things differently. Certainly it is hard to see how an individual can save her own self from the pain of her self-chosen course. This for Nathanson is a psychological task that at first seemed “overwhelming” and ultimately required “every iota” of knowledge she had gained through her study and practice of psychology—particularly the art of not sacrificing too much for her children: “Central to the mothering instinct within me is a predisposition to recognize and meet the needs of my children, voluntarily sacrificing my own at times when there is a conflict.”

She actually considers the possibility of giving birth to a fourth child, but her husband sees the needs of the family more objectively, reminding her that he doesn’t want another child and has his high blood pressure and high cholesterol “to deal with.” He feels that caring for another child will “kill” him.

The word kill chills her, bringing home to her “the extent of Michael’s worry about himself.” She responds with surprising empathy for her husband, who is “probably for the first time in his life beginning to pay attention to his own needs” and must now face the problem of having fathered a fourth child. “My heart aches for him, and for myself, but we are not talking about the choice of whether to conceive a child; this child is a reality, taking shape already deep within my body.”

But maybe for some reason we’re supposed to have this baby, she suggests. Her husband reminds her of their current responsibilities, suggesting instead that it is as easy to argue that it is their “fate” to have to make “an incredibly difficult decision.” “We’re only limited human beings,” he argues. “Can’t you see that we’re being very responsible to ourselves and to our living children by making the difficult choice not to have a child?”

“Awash in love for him,” Nathanson does what any well-educated woman with a strong self-structure would do: she makes his decision her own. “I will take responsibility for the decision that must be made. . . . I will have an abortion. . . . I do not want to enter into a life-and-death battle with this man whom I love and who shares my life.”

She attempts to consult her own physician, but he’s out of town; his associate schedules the abortion, and Nathanson prepares her emotional self, her soul, for the ordeal—being careful not to slight her responsibilities to her family and clients. But her preparation is inadequate; her controlled self is challenged by innate reluctance to have the abortion:

In minutes I am taken to an operating room, brightly lit and filled with gleaming medical instruments and neatly packaged supplies. These are the tools of modern science. Where are the tools that will help my soul?

She considers the nurses “compassionate and sensitive”; describes herself as “always controlled, cooperative, compliant, an excellent patient, automatically responsive to the needs and feeling of others,” who is “shocked” when her grief breaks through her “normally strong controls.” Naked, she sobs quietly as she climbs upon the cold and narrow table.

Her extreme sorrow after the abortion is genuine, but her only source of strength is her own empty “wounded soul,” lost, as she says, “in anguish that I never imagined I could possibly feel.” In her “soul-agony,” she wants to tear her skin, to rip out her insides and strew them across the bed she shares with her husband until there is “no life left within.”

As it turns out, the abortion was incomplete. With signs of pregnancy persisting, she fantasizes that somehow she has not lost her child, somehow the abortion failed. Her unreasonable hope is ended with a phone call telling her that the pathologist found living tissue. She is “flooded with a torrent of horror” and is swept into “a dark fog of nausea.” She vividly recalls, “Alone, I sob for myself, my child, the remains, the child smeared into bits by the vacuum aspirator, sucked from the warmth of my womb in a violent moment of death.” She sees herself as “a shriek of horror and anguish, straining with all my might somehow to reverse what cannot be reversed, what is irrevocable. I do not know, I cannot imagine, how I will be able to live with the horror of what is, the horror that I alone have caused.”

Her therapist, family, and friends try to help her by assuring her that she made the right decision; none of them understands her pain. She decides to be sterilized as she struggles to accept the abortion as “right.” She doesn’t want to end her fertility any more than she wanted the abortion, but is “terrified” not only that she will become pregnant again, but also that she will deliberately have a child in an attempt to make the loss of her fourth child tolerable. She can no longer trust what some of us might think of as her better side, explaining that if she had another child she would feel even worse because she would be admitting that the decision to have the abortion was a dreadful mistake, admitting that she and her husband “could in fact have managed to care for another life.”

Her inability to make the abortion feel right takes her toward suicide, destruction of the self:

In preventing my fourth child from having a life, I have unwittingly fractured my own; like Humpty Dumpty, my life, my self, is beyond repair. I have made a decision that I am utterly unable to integrate into my sense of who I am. The strength of my belief in the “rightness” of the choice of an abortion given the context of my life and in the necessity for women to have the legal right to make the choice that I exercised enabled me to carry out my decision; but these convictions do not protect me from suffering the consequences of my choice.

Her husband talks her out of suicide, and she is eventually “saved” by a relatively inexperienced therapist (who has also recovered from a traumatic abortion). Responding to Gestalt techniques, Nathanson becomes convinced that her child was one manifestation of Life, and that while she stopped him (she has a feeling the child was a son), she is not really capable of stopping the Great Life Force, she is merely part of it. In a way, she imagines the child’s forgiving her.

She learns to see her abortion decision as painful, difficult, but right. It is her intent to encourage the general public to understand and have compassion for women who abort. She remains distressed that the woman who aborts is “judged . . . either for the choice she makes or her reaction to the experience.” She laments that prochoice advocates see the woman who suffers “guilt and despair to be out of touch with her own needs, either deficient in feminist consciousness or victimized by Right-to-Life propaganda”; prolife advocates perceive the woman who displays no feelings as “inhuman and insensitive or as a victim of a culture that permits her to be indifferent to the value of life and provides her with no other options.”

Nathanson advocates better training for therapists, so that the psychological needs of women who abort can be addressed, allowing women “to develop themselves psychologically.” Women, in her view, need to “accept the consciousness of having the power and capacity to choose to end a life that is also part of their very own being.” She wants women who choose abortion to be protected from the judgments of others, shielded while they “confront their own inner judges.”

Because patriarchal culture has little sympathy for women who abort or kill their children, Nathanson feels that there are no “existing structures” to help women “weave” the abortion experience “into the ongoing creation of their souls.” “Women in our culture who can’t suppress or repress their experience of abortion must bear the burden of their consciousness alone.” She advises that the consciousness of power and responsibility be borne with courage, grace, and dignity.

She laments that there are few therapists who can help women who refuse “to seal over the experience of abortion,” who refuse to deny its importance and meaning, and “who want to connect it with its deep roots in elemental feminine experience.” She finds it significant that patriarchal stories of fathers sacrificing their children, such as Agamemnon and Abraham, elicit empathy, while the story of Medea is viewed with abhorrence rather than compassion.

Nathanson blends the notions of sacrifice and murder into a neat package of potential power. Women who can accept themselves as both creators and destroyers are considered healthy and compassionate, able to extend nonjudgmental support toward the act of abortion as well as to the woman who aborts. Of course, making meaning of an experience requires judgment. In the end, Dr. Nathanson judges the experience of abortion as implicitly good.

Soul-crises such as mine, if experienced within an empathic and compassionate human relationship, within a culture that makes room for them without judgment and condemnation, have the possibility of becoming opportunities for personal growth and transformation rather than dreadful experiences simply to be endured and survived.

A necessary evil, through the miracle of modern psychology, is transformed into a positive good. Petchesky recalls a sense of “buoyancy” after Roe, “because abortion—easily available, cheap, administered under safe, hygienic conditions early in a pregnancy and in an ambience free of stigma and guilt—is a component (not just a condition) of women’s liberation.” She sees clearly the reason that women who abort feel bad about it.

What makes abortion “awful” is the shame and guilt caused by two heavily ideological notions that all women in the society still learn to some degree: (1) the association of fetus with “baby” and the aborting woman with “bad mother,” and (2) the assumption that sex for pleasure is “wrong” (for women) and that women who indulge in it have to pay a price.

Apart from the question of whether women have to “pay” for their sexual activity is the fact that women do pay dearly for their abortions. This undeniable pain is part of the contradictory stance of those endorsing abortion: feminists don’t want to trivialize the impact of abortion, but feel pressed to prove that abortion is medically and psychologically safe; each woman must decide for herself about abortion, but there is no common ground upon which to make the decision, and onlookers are not allowed to judge the rightness or wrongness of another person’s decision; having “options” is more valuable than the morality of exercising any one option. Those who believe most fervently in private morality are most anxious that the community as a whole not merely tolerate abortion, but respect it, provide it, and fund it. Cut off from traditional values of the church, the law, and the state, personal experience is elevated to the status once accorded those foundations for communal good.

Rosemary Radford Ruether, in Women-Church, provides the “new words, new prayers, new symbols” that will free women from patriarchy and allow them “to live the new humanity now.” Her community prayer for the rite of healing from an abortion clearly subordinates the judgment of the gods to that of the “supplicants.” What may have once been a prayer for forgiveness has become an indictment against gods sloppy enough to let unplanned pregnancies and other evils exist to plague us.

O great Mother and Father, power of all life and new life, we are sorrowful this day . . . we are also angry. . . . We are surrounded by a world in which vast numbers of people go to bed hungry and where many children come into the world unwanted and without the most minimal opportunities for love and development. We don’t want to create life that way. We want to create life that is chosen, wanted, and can be sustained and nourished. Our sister has made her hard choice. . . . We affirm and uphold her in her ongoing life, as she gathers her life together and centers her energies on how she is going to continue to sustain her own life and the lives around her which it nourishes.

Taking energy from sorrow and anger and “centering” it on the self is a common theme in abortion narratives, and in some of the rituals of recovery. The need to “speak out” suggests that the pain of abortion can be deep and long-lasting; communicating with others who have aborted establishes safety in numbers (surely millions of women can’t be wrong).

As the psychology of the self has turned the law, the church, and the academy into tools for self-actualization, our bonds to family and community have been loosened. Focusing on the self makes it impossible to see clearly beyond the self, impossible to transcend self-ish interests for the sake of one unseen, unborn. Women who elect to abort have made a bad bargain with technology. Their sad, absurd, too-common stories of human relationships awry serve to remind us that while self-deception may begin with individual choice, it is often sustained by collective collusion.

Camille S. Williams has previously published poetry in First Things .