“Looking Back, Thinking Forward” by Jennie Bristow (Vol. XXXVI, No. 1) follows the UK’s 50-year journey away from generalized abortion stigma and towards its normalization as a health procedure. In discussing the stigmatization of abortion, I’m often surprised that people who self-identify as prochoice—whether in the UK or the US—draw a line between the woman who has one termination and the woman who has several, as Bristow discusses.
The woman who has a single abortion is seen as an innocent—pregnant due to a contraceptive failure or lack of education—and deserving of rescue from the consequences of unintended pregnancy. The woman having her third, fifth, pick-a-number abortion is seen as callous, careless, irresponsible. Unintended pregnancies are concentrated in poor women. Thus, these are invidious distinctions that target poor women, while letting more privileged women—those imagining they’ll only need a single abortion—off the hook. If your own single abortion is justified, why not that woman’s 10th?
Because our facility contains both a freestanding birth center and an abortion clinic, we see every day that the same woman can carefully prepare for a joyful birth, then decide to terminate the next pregnancy or several pregnancies—making these decisions based on what is best for herself and her family. Obstetric practice in the United States, where abortion has been largely removed from hospitals and routine practices, cares only about a woman’s current pregnancy. This has led to skyrocketing cesarean section and induction rates and an American maternal mortality rate that has doubled in the past decade. Just as women are stigmatized for wanting to terminate a pregnancy or for having “too many” abortions, so are they derided as insufficiently maternal for wanting a say in their birth experience.
All these issues are grounded in a lack of respect for women. If we are truly prochoice, if we are truly feminists, we must support the woman who refuses an induction or insists on her right to a vaginal birth and the woman who requires 10 abortions, no less than the woman who requires one.
KATHARINE MORRISON, MD, FACOG
Buffalo Women Services, LLC
The Birthing Center of Buffalo