I’ve been working in abortion care in one way or another since I got out of college, mostly for the same clinic, Aurora Medical Services, in Seattle. I worked at the abortion clinic through my own planned and wanted pregnancy. I work there now as a mom. I work there as an apprentice midwife, and I’m about to be done working there as a distance-learning student.
I have some very deeply-held beliefs which inform my work in abortion care. My religious faith has taught me that we are all manifestations of the Divine, and as such I seek in all things to act out of love for my fellow beings. I have strong moral convictions which honor the divinity of life.
As part of this, I believe in the rights to self-determination, autonomy, and bodily integrity. I have no right to exert my will over the will of another with regard to what happens with their own being. This is why I believe that informed consent in health care and public health education are so important — we need to be informed health-care consumers who take up our own power over our bodies, rather than abdicating our power to a health care provider who tells us what to do. This is why I am working toward midwifery — birthing women and their babies need care that honors their unique humanity and wisdom instead of honoring routines, protocols and institutional guidelines. And this is why I believe that women choosing abortion deserve to be able to make that choice without danger, fear, or shame.
When I was pregnant and our midwives asked me about my work plans, I said that I wanted to keep working up until I really couldn’t any more. “I love the idea of being hugely pregnant and still wholeheartedly supporting women in their choice to end an unwanted pregnancy. These are both life-affirming choices, my choice to have a child, and their choice to end a pregnancy, doing what’s best for them, their families and any potential child who could come out of the situation.” The conversations I had with patients about my pregnancy didn’t necessarily give me room to articulate that point. People would ask, “Are you pregnant?” or, “When are you due?” and I’d say, “Yes, we’re due in March, it’s our first, we planned, saved a bunch of money, and got pregnant just when we wanted to. We’re excited, but we also know we have no idea what we’re getting ourselves into.” This exchange came most easily with the women who were already moms (the majority of our patients), and who were totally comfortable their choice to end their own pregnancy. We would talk about where they had their kids and what the experience was like for them. We would compare notes on pregnancy symptoms. They asked if I was having a boy or a girl, and most were shocked to learn that we had chosen not to find out. These women seemed to understand implicitly the truth that I was living as a happily pregnant clinic worker: that we are all just women, playing out the cycles of our reproductive lives, me starting my journey to motherhood, they ensuring the best for their already-born children by choosing not to have any more right then.
I wish, though, that the people who were uncomfortable with encountering pregnant me at the abortion clinic had said something about it, explicitly, to me. I wanted to engage with them on this, to be given the opportunity to say that we are both affirming life in our different ways. But the people who were uncomfortable were generally too polite to say anything, or perhaps just didn’t want to talk about it. The truth, so hidden in our culture, is that pregnancy has different meanings in different contexts to different people. My mother, a veteran of four pregnancies including a miscarriage, two abortions, and me, was not able to relate to my excitement at the positive test before I’d even missed a period. “I can’t get invested in this until the second trimester,” she told me. When I told her how unsupportive that sounded, she said, “Remember, I’ve never experienced trying to get pregnant.” She had a hard time getting past what pregnancy had meant in her life, to be able to get excited about what it meant in mine. For the women at the clinic that were truly uncomfortable with me caring for them when I was obviously pregnant, it’s the same thing; the meaning of pregnancy for them in that moment was far from joyful, and the fact that that could be totally valid alongside my happily round belly did not compute. We like our truths in black and white in this culture, no room for nuance or a plurality of meanings. But that’s just how it is. The same me that assists at births as an apprentice midwife assists at abortion procedures as a health care assistant. The same me that planned my own wanted pregnancy was there to help a woman cut through the guilt and the rhetoric that did not really belong to her, to help her see the truth, that she was making a good choice, based on her circumstances. Her pregnancy meant something different than mine, and I could recognize that and support her in her circumstances, even if they were different from mine.
Whether or not we beleive abortion is right, whether or not it is legal, women will still have abortions. Look around the world, where a significant percentage of maternal mortality is caused by illegal abortion. Living children will lose their mothers. Making abortion illegal again will not end abortion. Though you may be uncomfortable with the concept of abortion, please recognize that making abortion illegal does not end abortion. It only leads to criminalization of women and death.
No one would undertake such a dangerous choice as illegal abortion lightly, and yet it is undertaken because women know when they cannot mother one child more. In our country, where abortion is legal, opponents seek to create a similar climate of fear, shame and silence as though abortion were a crime; they call it “murder,” which is a crime. I suppose that I am grateful that women only have to contend with shame when they choose abortion in the US, rather than shame and death. Abortion care workers, it seems, are the ones who have to worry about dying as a result of legal abortion. I wish that women and care providers could both approach abortion without shame or fear of death.
George Tiller said, “Trust women.” Yes. Trust women to make the best choices for their own families Trust women to make their own private moral decisions. Trust that another individual might know their own life better than a stranger. Trust that your fellow humans make choices that seem just as absolutely right to them as your truths do to you — and entertain the possibility that the values of another hold more truth in their own life than your values. In our own lives we live by our own truths. I would never try to force another person to have an abortion, just as I would never force another person to have an unwanted child. It is a dishonor to the humanity (and to the divinity) of another to enforce that your will be done in their life. Each of us deserves the dignity of self-determination, if we are choosing to continue a pregnancy and give birth, or if we are choosing to end an unwanted, unwelcome and/or unhealthy pregnancy.
I am Dr. Tiller.