Sunday, July 18, 2010

The New Abortion Providers

Today's New York Times Magazine features a superb article about "The New Abortion Providers." But before I write about it I have to acknowledge a conflict of interest. The author, Emily Bazelon, is my daughter in law.

Emily describes how young physician leaders, mainly women, are training residents and fellows in abortion procedures and family planning. Their aim is to offset the retirement of current abortion providers and to bring abortion services back into mainstream medicine.

I was blown away by the reflectiveness and moral courage of the physicians who were interviewed for the story. Providing abortion services requires tremendous courage. "Pro-life" terrorists have murdered 8 Americans and assaulted 153. If Al Qaeda did the same in a foreign country we would probably bomb or invade! If I were a newly trained OB/GYN physician I don't know if I would have the guts to include abortion in my practice.

Despite terrorism and the hate-laden rhetoric of the "pro-life" protesters who surround abortion clinics, the new abortion providers show respect for colleagues who oppose abortion in a civilized manner. One physician who does abortions only up to nine weeks explained “It was a way of being respectful, because I know that not everyone agrees with me and what I do.” Another handles all the arrangements and does the billing himself for the abortions he provides in his general OB/GYN practice because of the views of the beloved nurse who works with him:
When I talked to Ann [the nurse] — Ray [the physician] offered her his office chair while he saw a patient — she said that when Ray took over the practice, she and the office manager, another woman in her 60s, weren’t sure if they would stay. “We didn’t want a young doctor with attitude,” Ann said. “We’re too old for that. But we gave him a chance. And he has exceeded our expectations wildly. I thank God every day, because he’s so good with the patients. I’m just blessed. Other than the little termination thing — ” she made a small box with her fingers and then moved her hands to her left, as if to set the box aside.
The New York Times piece mentioned an extraordinary article by Dr. Lisa Harris - "Second Trimester Abortion Provision: Breaking the Silence and Changing the Discourse" - that I would never have seen otherwise. Dr. Harris describes the experience of doing an abortion for a woman who was 18 weeks pregnant when she was herself 18 weeks pregnant with her first child, and moves from her personal experience to broad moral reflection:
I went about doing the procedure as usual, removed the laminaria I had placed earlier and confirmed I had adequate dilation. I used electrical suction to remove the amniotic fluid, picked up my forceps and began to remove the fetus in parts, as I always did. I felt lucky that this one was already in the breech position – it would make grasping small parts (legs and arms) a little easier. With my first pass of the forceps, I grasped an extremity and began to pull it down. I could see a small foot hanging from the teeth of my forceps. With a quick tug, I separated the leg.

Precisely at that moment, I felt a kick – a fluttery ‘‘thump, thump’’ in my own uterus. It was one of the first times I felt fetal movement. There was a leg and foot in my forceps, and a ‘‘thump, thump’’ in my abdomen. Instantly, tears were streaming from my eyes – without me – meaning my conscious brain - even being aware of what was going on. I felt as if my response had come entirely from my body, bypassing my usual cognitive processing completely. A message seemed to travel from my hand and my uterus to my tear ducts. It was an overwhelming feeling – a brutally visceral response – heartfelt and unmediated by my training or my feminist pro-choice politics. It was one of the more raw moments in my life.

...What do we do when caught between pro-choice discourse that, while it reflects our values, does not accurately reflect the full extent of our experience of abortion and in fact contradicts an enormous part of it, and the anti-abortion discourse and imagery that may actually be more closely aligned to our experience but is based in values we do not share?...I want to make the case that honesty about abortion work can be the basis for a stronger movement – one that makes it easier for providers and the teams they work with to do all abortions, especially second trimester abortions."
Dr. Harris is spot on. Dodging the moral complexity of abortion will weaken the feminist "pro-choice" perspective. Recognizing that complexity makes for a more mature, small "c" catholic moral position.

If Ann, a "pro-life" grandmother who goes to Mass every week, and Ray, a young physician who includes abortion in his practice, can work together in mutual respect, there's hope for ameliorating our national nightmare about abortion policy!


Chris K. said...

Wonderful article! Too often is the abortion discussion turned into an argument with 2 opposing sides. A lot of this is due to politics, and it only ends up distracting us from having a respectful dialogue about the issues.

Jim Sabin said...

Hi Chris

I'm glad you liked the article.

I think there's an irreducible element of conflict with regard to abortion, since people who feel in their hearts that a first trimester fetus or even a fertilized egg has full personhood simply won't be able to accept abortion. But like you I was heartened to read about how young providers of abortion services convey a deep understanding of the moral significance of the process. That will encourage a more civilized discussion and will, I hope, marginalize the hate-laden "pro-life" extremists.