Making Choices

I was in my third year of medical school working on the abortion service.

In those days, women were admitted to the hospital the night before their abortions in order for laminaria to be inserted. Overnight, these dried seaweed rods would moisten and swell, slowly stretching the cervical opening so that the procedure could be performed the next day without the need for dilating the cervix manually, thus decreasing the risks of tearing and bleeding.

It was a busy service, with upwards of twenty procedures a day, two days a week. We med students were assigned to do the admission histories.

I remember sitting with woman after woman while they told me their stories. A young teenager who had fallen for an older man, a man who had loved her, left her pregnant and was now nowhere to be found. Another, a haggard, tearful woman in her thirties, was adamant that her husband would never know that she had gotten pregnant the night that he came home drunk, beat and then raped her.

There was the newly recovered drug addict just getting her life together, still hoping to get her three children back from foster care. And the mother who had five children at home and was waiting to hear whether her sister would be able to stay with them tonight. Still another teenager, this one accompanied by her mother, who said nothing but never left her side.

Each decision to abort these pregnancies appeared to have been painfully made, and none was casual. Every one of these women had mixed emotions about what she was doing, and yet every one had a conviction that this was her only choice at this point in her life. The teenager seemed a bit less sure of herself, but she reiterated to me that this had been her own choice, and Mom was still hoping she would change her mind. It was her second abortion, and she would not tell me the circumstances of her becoming pregnant.

At one point, all the women were told to undress, put on their hospital gowns and meet in the patient lounge to hear about their procedure from the chief resident, who would then examine them one by one in the small exam room next door and insert their laminaria.

“Tell them to leave their underwear in their hospital rooms”, he told me.

“What?” I cried. “You mean they are all going to sit there completely naked under their gowns while you stand there in your white doctor’s coat and tell them as a group what to expect tomorrow? Can’t they at least wear their underwear?”

“I don’t have time to wait for them to take them off”, was his answer.

“But it demeans them…” I started.

In a tone of voice that told me I had already gone too far, he said simply “Just do it.”

So I did. I was, after all, just a medical student. And he was my chief.

But at that moment, I made my choice as to what I would do when I graduated. If this was how the men who worked in this field treated women, well, then we women needed to become gynecologists and start treating women as something other than cattle.

I also decided that day that I was pro choice. I wasn’t sure if I would do abortions, but I knew that if this was the world that women were living in, then this option had to be available to them until we had something better.

Later on, I would come to realize that the something better is safe and effective contraception, sex education, childcare, family-friendly work environments, healthy male-female relationships, child support and education. Of these, the one that I believe is most within our reach today is safe and effective contraception, and that is where I have concentrated my efforts. I subscribe to the belief that abortion should be safe and available, but rare. Unfortunately, those who most vehemently oppose abortion also oppose contraception, and seem to want to assure that abortion remains anything but rare.

In my career, as it turned out, I would butt heads more than once with the men who supervised me. But I would never again encounter such a blatant misogynistic attitude among any of the ob-gyn’s I was to meet. Sure, there were a few jerks, but also some not-so-nice women. And I will go on record as saying that many of the very best gynecologists I know are men, including those to whom I refer my friends and family.

I don’t know that we women gynecologists have changed this field as much as I thought we would. I think we are too busy just getting the work done. The field has changed most, I believe, in response to our patients and their advocates, who persistently raise the bar for all of us docs, men and women alike. And continue to demand reproductive choice.

So keep up the pressure, Ladies… We need your voice.