The woman is 28 years old and ten-and-a-half-weeks pregnant. She wears false eyelashes, blue eyeliner, and a striped shirt of black and gray. The condition is: I can sit in on her counseling session if I do not know her name.
“I can see that you are stressed,” starts Claire Keyes, her counselor.
“Yeah,” the woman responds. “Always look stressed.”
Keyes was particularly interested in counseling this woman because of the constellation of adjectives she’d checked off on her intake form: selfish, uncertain, guilty. If you listened only to pro-life cant, you’d think that women were unconflicted—cavalier, even—about their abortions, using them fungibly with birth control. Keyes can tell you this is seldom the case, especially in such a Catholic city as Pittsburgh, and especially among African-Americans, like this woman, who on national surveys are less inclined than whites to identify themselves as pro-choice.
“I see you’re going to school,” says Keyes. “Is it harder doing that or working?”
“Going to school.”
“Because I got to cram in homework; sometimes I don’t do it,” says the woman. “I got three kids: 13, 11, and 8. And I got to deal with them, and the household, and phone calls from school, ’cause they’re cutting out. So it’s just like … a whole lot of … everything.” She reaches for a tissue. “Basically, I go to school, and as soon as I come home, I go straight to sleep.”
Not all abortion clinics drill down and do this kind of work. But the Allegheny Reproductive Health Center in Pittsburgh, from which Keyes stepped down as director in January but still works as a counselor, has a national reputation for being psychologically oriented. If there’s any place where the complexity and ambivalence surrounding abortion plays out, it’s here.
Keyes opens the woman’s folder. “The first thing I saw in your chart,” she says, “is you’re not sure about your decision. What do you want to tell me about that?”
“I don’t know,” says the woman. “In a sense, I got too much going on, and I can’t afford to take on another child. But in a sense, I feel pressure from my boyfriend, because he don’t want the kids … so it’s like, I want to. I’m not into the whole abortion thing. I did it before”—twice, according to her chart, once last year at this very clinic—“and I really didn’t like it. I think some things happen for a reason.”
The youngest generation of voters—those most likely to need an abortion—is the most pro-life to come along since the generation born during the Great Depression.
Keyes knows that most women refer to the developing lives inside of them as “babies,” rather than fetuses, whether they’re conflicted about their abortions or not. She knows that occasionally women want to keep sonograms of the fetuses they’ve aborted and even ask to see their reassembled remains once the procedure’s through. (This is standard medical procedure, in order to make sure all the parts have been removed.) While many of her clinic patients are at peace with their decision, others are not, and she’s got piles of loose-leaf binders containing pink hearts inscribed with messages to husbands, boyfriends, parents, God (“A lot are to God”), and the never-born that express those feelings of uncertainty—like this one, written in the bubble handwriting of a teen who had accompanied her friend: To the unborn child, Know that your mom made the choice to keep you in heaven and this was not easy for us. (I was her support.) At the end of each counseling session, Keyes offers women a basket of stones from which to choose and make a wish. In early 2008, she built a small sanctuary in her clinic so that women and their partners could “say a final good-bye or a prayer, or just to sit quietly and not think anything at all.”
Keyes gestures toward the waiting room, where the patient’s boyfriend is sitting. “Is he an important part of your life?”
The woman hesitates. “I guess. For now.”
“He doesn’t have kids?”
“He’s got kids. He just don’t want any more.”
Keyes pauses. “I don’t feel you in this decision, and that makes me sad.” She thinks. “If you had to name a percentage—pick a number—what percentage of your decision to be here today is yours?”
The woman stares into space. “Basically, 99 percent of it is him.” She looks listlessly at Keyes. “So. Get it done and over with.”
Keyes gently returns her look. “We have a saying around here: We don’t do abortions for boyfriends.”
The woman is silent for several long, drawn-out seconds. Then, she offers something. “But see, that’s where it comes down to my percent. I have three kids already. So, he leaves, and now I have four children and no dads.”