The Things We Cannot Say: Witnessing the Trauma-tization of Abortion in the United States

What would happen if one woman told the truth about her life? The world would split open.

—Muriel Rukeyser, “Käthe Kollwitz”

“Can you tell me what really happens at an abortion clinic?” My interviewer shifts forward, careful not to jar the camera she has leveled at me. It’s a question I’ve been asked many times. I began working part time at an abortion clinic in 1996. In 2000, I began speaking to small groups—classes, student organizations, feminist organizations—about clinic work, and in 2003 I began researching U.S. abortion politics. Yes, I probably could tell her what really happens at a clinic, but I don’t. Although a part of me wants to tell her that the patients at the clinic are women like her, like her mother, like me, that they come to us for help with mundane situations more often than with horror stories, I don’t, because I am being recorded, and I am afraid. Instead, I ask her to be more specific. “Tell me about the really tough cases,” she urges. She’s already confessed that someone she is close to was conceived during rape, so I suspect that she wants to hear about women who live with violence and undergo abortion. This is a politically necessary narrative about abortion in the United States; often, pro-choice activists argue correctly that laws that limit (or ban) abortion revictimize women impregnated during rape, incest, and domestic violence. Careful not to violate patient confidentiality, I tell her about my relatively infrequent experiences with rape victims at the clinic.

Why am I reluctant to talk about the majority of my clinic experiences? It would be disingenuous to deny that I fear that the common stories would disappoint my interlocutor. Each week I do intake medical history screenings and peer counseling sessions for two to four patients at the clinic. For approximately twelve to forty patients a week, I act as surgical advocate, standing next to the women as they have their abortions, coaching them through the procedure (“Now you may feel another dilation cramp; take a deep breath and blow it out”) or distracting them with small talk if they prefer, proffering cool washcloths for their foreheads, basins in which to vomit, or my hand to be squeezed. Each of these women has shared a decision-making narrative during our screening process, and many retell those narratives to me while waiting to see the doctor or during their surgeries. Most of these narratives center around women’s struggles with the ordinary—and, simultaneously, monumental—details of life: managing family economics, negotiating work and child care, setting priorities, and planning for the future. Not long ago, a coworker estimated that I have acted as a surgical advocate in more than seven hundred abortions. Usually the patients and their narratives stay with me for a few weeks at most and then begin to blend into a kind of abortion chorus in my memory. Often a patient will say to me, “You were here for my last abortion, too,” and I smile, nod, and say, “I hope I was helpful to you,” because I don’t remember her abortion.

The patient narratives that stay with me longer are the rarer or more traumatic situations. The stories of aborting fetuses conceived during rape or because of fetal anomaly and the narratives of forty-two-year-old cancer sufferers and frightened thirteen-year-olds do not merge into that chorus in the same way. These stories are easier to remember, and auditors tend to respond to them with sympathy and support, another reason for my reluctance to share the more common situations. From my experiences talking about my clinic work, I have determined that there is a hierarchy of abortion narratives from a pro-choice political perspective. There are abortion narratives that are considered politically necessary to tell (rape/incest/domestic violence victims’ difficulty in obtaining abortion services, clinic personnel’s struggles with antiabortion protesters, the risks of illegal abortion to women’s health and welfare). These narratives...