I’m a little slow on catching up to current events, I realize, but in a late-November article in the L. A. Times, Stephanie Simon gives an incredibly revealing and insightful article on an abortion clinic in Arkansas: Offering Abortion, Rebirth (link requires free subscription). (See also Simon’s commentary giving a behind the scenes account of the article here.)
After a brief biographical introduction to the abortionist (his own term for himself), Dr. Harrison, Ms. Simon gives an account of the days activities, the patients, and the views of the doctor and one of his nurses.
It is a few minutes before 11 a.m. when Harrison raps on the door of his operating room and walks in.
His Fayetteville Women’s Clinic occupies a once-elegant home dating to the 1940s; the first-floor surgery looks like it was a parlor. Thick blue curtains block the windows and paintings of butterflies and flowers hang on the walls. The radio is tuned to an easy-listening station.
An 18-year-old with braces on her teeth is on the operating table, her head on a plaid pillow, her feet up in stirrups, her arms strapped down at her sides. A pink blanket is draped over her stomach. She’s 13 weeks pregnant, at the very end of the first trimester. She hasn’t told her parents.
A nurse has already given her a local anesthetic, Valium and a drug to dilate her cervix; Harrison prepares to inject Versed, a sedative, in her intravenous line. The drug will wipe out her memory of everything that happens during the 20 minutes she’s in the operating room. It’s so effective that patients who return for a follow-up exam often don’t recognize Harrison.
I find it telling that Versed is administered and that patients rarely have substantive recollections of the abortion. I’m not implying that their decisions to have abortions are not free and informed. I just find it telling that it is apparently necessary to wipe out the patient’s memory of the abortion.
The account Simon gives of the abortion is disturbing by very virtue of its stark and unadorned telling.
Harrison glances at an ultrasound screen frozen with an image of the fetus taken moments before. Against the fuzzy black-and-white screen, he sees the curve of a head, the bend of an elbow, the ball of a fist.
“You may feel some cramping while we suction everything out,” Harrison tells the patient.
A moment later, he says: “You’re going to hear a sucking sound.”
The abortion takes two minutes. The patient lies still and quiet, her eyes closed, a few tears rolling down her cheeks. The friend who has accompanied her stands at her side, mutely stroking her arm.
When he’s done, Harrison performs another ultrasound. The screen this time is blank but for the contours of the uterus. “We’ve gotten everything out of there,” he says.
As the nurse drops the instruments in the sink with a clatter, the teenager looks around, woozy.
Next Simon begins to give a recounting of the reasons and motivations of some of the patients for their decisions to abort their unborn children.
“It was a lot easier than I thought it would be,” she says. “I thought it would be horrible, but it wasn’t. The procedure, that is.”
She is not yet sure, she says, how she is doing emotionally. She feels guilty, sad and relieved, all in a jumble.
“There’s things wrong with abortion,” she says. “But I want to have a good life. And provide a good life for my child.” To keep this baby now, she says, when she’s single, broke and about to start college, “would be unfair.”
The reasons and motivations, however, are not merely economic ones.
A high school volleyball player says she doesn’t want to give up her body for nine months. “I realize just from the first three months how it changes everything,” she says.
Kim, a single mother of three, says she couldn’t bear to give away a child and have to wonder every day if he were loved. Ending the pregnancy seemed easier, she says — as long as she doesn’t let herself think about “what could have been.”
By law, Harrison’s staff must offer patients two pamphlets from the state. One lists adoption services and groups that provide free diapers, day-care subsidies and other aid. The second contains photos of the fetus at various stages of development.
Patients don’t have to accept either pamphlet. Most wave them away, their minds made up.
For the few women who arrive ambivalent or beset by guilt, Harrison’s nurse has posted statistics on the exam-room mirror: One out of every four pregnant women in the U.S. chooses abortion. A third of all women in this country will have at least one abortion by the time they’re 45.
“You think there’s room in hell for all those women?” the nurse will ask.
Aside from the screwed up soteriology and metaphysics, it’s clear that the nurse is not offering an unbiased and objective look at the facts and information. The nurse is clearly trying to override the patient’s initial moral hesitations.
If the woman remains troubled, the nurse tells her to go home and think it over.
In other words: If the nurse’s advocacy for abortion doesn’t overcome the patient’s moral hesitations, then they relent.
“If they truly feel they’re killing a baby, we’re not going to do an abortion for them,” says the nurse, who asked not to be identified for fear protesters would target her.
Darn rigid moralists!
But notice the confused and casuistric rationale for when a baby becomes, well, a baby.
The 17-year-old in for a consultation this morning assures the nurse that she does not consider the embryo inside her a baby.
“Not until it’s developed,” she says. “That would be about three months?”
“It’s completely formed about nine weeks,” the nurse tells her. “Yours is more like a chicken yolk.”
The girl, who is five weeks pregnant, looks relieved. “Then no,” she says, “it’s not a baby.” Her mother sits in the corner wiping her tears.
I suspect the mother’s moral compass has not been distorted and it is revealing itself to Simon.
Harrison draws his own moral line at the end of the second trimester, or 26 weeks since the first day of the woman’s last menstrual period. Until that point, he will abort for any reason.
“It’s not a baby to me until the mother tells me it’s a baby,” he says.
But Harrison refuses to end third-trimester pregnancies, even if the fetus is severely disabled. Some premature infants born at that stage, or even a few weeks earlier, can survive. Harrison believes they may be developed enough to feel pain in utero. Just a handful of doctors around the nation will abort a fetus at this stage.
“I just don’t think it should be done,” says Harrison, who calls the practice infanticide.
At least Dr. Harrison does agree that the sensation of pain equals sentience. But his anthropology is still severely confused.
There is another picture of moral rationalizing by one of the patients.
Amanda, a 20-year-old administrative assistant, says it’s not the obstacles that surprise her — it’s how normal and unashamed she feels as she prepares to end her first pregnancy.
“It’s an everyday occurrence,” she says as she waits for her 2:30 p.m. abortion. “It’s not like this is a rare thing.”
Amanda hasn’t told her ex-boyfriend that she’s 15 weeks pregnant with his child. She hasn’t told her parents, either, though she lives with them.
“I figured it was my responsibility,” she says.
She regrets having to pay $750 for the abortion, but Amanda says she does not doubt her decision. “It’s not like it’s illegal. It’s not like I’m doing anything wrong,” she says.
“I’ve been praying a lot and that’s been a real source of strength for me. I really believe God has a plan for us all. I have a choice, and that’s part of my plan.”
God’s plan is for her to kill her unborn baby.
But it gets worse.
His first patient of the day, Sarah, 23, says it never occurred to her to use birth control, though she has been sexually active for six years. When she became pregnant this fall, Sarah, who works in real estate, was in the midst of planning her wedding. “I don’t think my dress would have fit with a baby in there,” she says.
The last patient of the day, a 32-year-old college student named Stephanie, has had four abortions in the last 12 years. She keeps forgetting to take her birth control pills. Abortion “is a bummer,” she says, “but no big stress.”