Three Views: The Battle Over a Woman's Right to Choose

Dangertalk: Voices of Abortion Providers

Jane Hassinger provides a close look at the emotional toll on abortion providers of their work in a profession that finds itself in the center of an emotional and political firestorm.

By Jane Hassinger, LCSW

In a seminar that I have taught for the last many years on Feminist Practices, Lisa Harris, an OB/GYN and the Medical Director at our local Planned Parenthood who was just finishing her PhD in American Culture, raised an interesting dilemma: Abortion providers work in highly stressful circumstances. Their lives are disrupted and threatened daily, based on the very service they deliver. They face stigma attached to abortion, the pain in the lives of the girls and women for whom they care, and the often disturbing physicality of abortion.

Yet compared to other medical professionals, they are a group about which we know virtually nothing. Almost no research has been done on the experiences of abortion providers. Very few narratives exist, with the exception of one recent remarkable memoir by Susan Wicklund (2007). For one thing, abortion providers fear that if they reflect openly on their experiences, they risk being perceived as disloyal to the feminist movement and pro-choice politics. Talking about abortion is ‘dangertalk’—carrying the potential for igniting conflict with the feminist political movement with which many identify, risking rupture with family and friends, and increasing attacks from the pro-life movement.

Lisa’s dilemma was this: feminists ask and expect abortion providers to carry these burdens and this knowledge in silence, and she worried about the resulting psychological suffering of her colleagues and staff. I worried about my own complicity with this silence, sensing this silence as symptomatic of a disastrous rupturing in our society and in our collective capacities for holding the hurt, rage, sorrow, and anxiety associated with fighting for women’s human rights without resorting to paranoid polarization and splitting.

Case in point: Emily Bazelon, author of “The New Abortion Providers” (NY Times Sunday Magazine, July 10, 2010) was begged not to mention names or to identify the major funder for abortion training programs. Providers’ silence can be understood as a habitual, adaptive response to overt and subtle threat, as well as to the daily experience of performing one version of society’s dirty work. Abortion workers are not seen and not heard.

Out of her worry about her staff and the traumatic effects of their work and its burden of silence, Lisa asked me to facilitate a group workshop. I agreed, and we embarked on the “Providers’ Share” Project. We have now completed two three-session groups in the Midwest and Mid-Atlantic, one modified project in Ghana, and are rolling out three more in large metropolitan areas on the east and west coasts and one in the south.

Our pilot project produced remarkable narratives from providers who spoke about their experiences with abortion for the first time. They spoke of their fears—of violence, of rejection by family members and in social relationships, of the potential harm to their children via actual attacks or shunning, of medical marginalization and devaluation. They spoke about their resentments—that they are viewed as monstrous, as evil; that their caring and devotion is erased; that their identities are overwhelmed by their work and other’s constructions of their work. They lamented the state of the movement—one from which they feel disconnected, both because the demands of their work make politics impossible and because they don’t find their experience reflected in the dominant discourse. They believe that life is sacred. They describe rituals of reverence for the fetuses. Providers’ responses are frequently far more nuanced and morally complex than the rhetoric would have it. They struggle daily with basic human responses to intimidation, disgust, the suffering of others, violence, neglect and abuse of women and children, and the moral quandary that arises with inflicting pain on another and the stopping of a beating heart. They struggle to retain a sense of moral agency and leadership. And they fear for the lives of their patients and their own.

Perhaps not surprisingly, the silence that providers keep in their lives extends to their workplaces. Many of these stories were narrated for the first time, even though the experiences occurred in the teams. Silence is not as selective as we might imagine; compartmentalized experience is to a large degree dissociated and dispersed among members of the group. They didn’t talk with one another either. We witnessed how participants held different parts of stories that only become coherent when discussed out-loud in the group. Although members reported feeling better, more hopeful, and engaged as a consequence of the group experience, perhaps the most remarkable development occurred in and to the groups themselves. The groups became sites of healing—where traumatic memory is metabolized, affects are managed, and knowledge is generated. Participants pointed to greater connection, a sense of family and esprit de corps, as well as re-engagement with abortion politics on the local and national levels. (These effects appeared to be robust after a year and a half.)

I had an abortion, just two months after the 1973 Roe v Wade decision. My daughter was born 11 years later, when I was prepared to be a parent. My college years were defined by three passions—rhythm and blues, fighting for the end of the war in Vietnam, and campaigning for safe and accessible abortion on demand. In 1973, when Lisa (the OB/GYN) was just 12 years old, most of us were elated. Carol Joffe, author of Dispatches from the Abortion Wars, observed then, the majority of Americans regarded abortion as a positive, moral advance in our society. Now women are succumbing to “obligatory guilt” and shame, and providers struggle to validate and de-stigmatize their clients’ choices.

My esteemed colleague at the University of Michigan, the historian Carroll Smith-Rosenberg has noted: “At times the issue of abortion lies quiescent…but at other times, forces within a society catapult (it) …to a position of political and moral centrality, transferring the acts of the bedroom and the doctor’s office to the most public arena. At such times decisions surrounding abortion become the central drama of culture, a play dealing with basic fissures in the social structure, one that raises fundamental issues concerning the distribution of power and the nature of the social order.”

Abortion providers work inside those fissures.

- Jane Hassinger


Susan Wicklund (with Alan Kesselheim): The Common Secret: My Journey as an Abortion Doctor, Public Affairs, Perseus Group Books, 2007