“Oh,” says Keyes. You can see that she is processing this, trying to figure out whether one percent truly means one percent. “Okay. So let’s just say you had the abortion done here today. What happens when you wake up tomorrow?”
“I’ll feel bad. But I wouldn’t be, like, angry. The way I see it, whatever happens, better that way, because if it don’t work out between us, at least I don’t have any strings attached.”
“So if he disappeared tomorrow, would you say”—Keyes snaps her fingers—“ ‘I should have continued that pregnancy?’ ”
Keyes reaches for a pen. “Okay. You’re going to have to tell me what to write here.”
“I’m gonna do it. Get it over and done with.”
Keyes sucks in her breath, uncertain again. “That’s not a reason.”
The woman reaches for another tissue. “It’s for the best, and best interest of me, and my life.”
A few minutes later, we leave the room. Keyes is shaking. I start to ask her a question, but she cuts me off. “Do I feel good about signing this? Shit, no.” She wipes her eyes. “And I could deny her. We do deny women abortions.”
Well, look, I say. You told her she has trouble acting for herself. That was valuable.
Keyes brushes it off. “She was here a year ago. She might have heard the same thing from the counselor then. In fact, let’s look.” She starts flipping the pages of her chart. “Oh my God.”
“I was her counselor.”
She covers the woman’s name, and together we peer at Keyes’s old notes: Certain of her decision … not prepared for a fourth child … may have a fourth later … gave her a stone.
After surveying a raft of studies dating back to 1989, the American Psychological Association concluded last year that there was no evidence to suggest that an abortion causes mental-health problems in adult women. Indeed, clinic workers will tell you that most patients experience relief when the procedure is over, believing they were doing what’s best. But that doesn’t mean women approach abortion without anxiety or conflict. And if you want to hear honest talk about the realities of abortion, go speak with those abortion counselors and providers. Even the most radically pro-choice will tell you that the political discourse they hear about the subject, with its easy dichotomies and bumper-sticker boilerplate, has little correspondence to the messy, intricate stories of her patients. They hear about peace and guilt, relief and sin. And it is they who will acknowledge, whether we like it or not, that the rhetoric and imagery of the pro-life movement can touch on some basic emotional truths. Peg Johnston, who manages Access for Women in upstate New York, remembers the first time her patients unconsciously began to co-opt the language of the protesters outside. “And it wasn’t that these protesters were brainwashing them,” she says. “It’s that they were tapping into things we all have some discomfort about.”
This is quite a brave confession for Johnston—or any pro-choice person—to make. It means making oneself vulnerable to opportunist pro-life activists, who’ll happily take those words about uncertainty or moral qualms and repurpose them for their own ends. Back in the late eighties, Charlotte Taft, who first pioneered the practice of writing notes on hearts in her Dallas clinic, mentioned to a journalist that women knew “abortion is a kind of killing,” and poor Kate Michelman, at NARAL, was forced to go on the defensive for days. Last year, Lisa Harris, a Michigan doctor, wrote an incredibly powerful essay for Reproductive Health Matters, trying to come to terms with the goriness of second-trimester abortions while simultaneously recognizing their validity: “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?” Following the publication of her essay, the pro-life movement went nuts, calling her a hypocrite, semantic gymnast, and Dr. Mengele.
But Harris raises a very real and terrible dilemma for those of us who are pro-choice: Engage these questions and you play into the hands of the pro-life movement; refuse to engage in them and you risk living in a political vacuum. Nancy Keenan, the current president of NARAL, knows this. Last year, at an event commemorating the 35th anniversary of Roe v. Wade, she told her audience: “Our reluctance to address the moral complexity of this debate is no longer serving our cause or our country well.” Michelman knew it too. Twenty years ago, on Face the Nation, she said practically the same thing.