Abortion is Already a Whisper-Network Procedure All Over America
During Her Unplanned Pregnancy, Christa Parravani Considers the Ripple Effects of Barriers to Abortion
Tony arrived home a few hours after I made my last pleading Pittsburgh doctor call. It was late afternoon, well after I’d returned from the visit with the young Cheat Lake physician. Tony found me sitting at the dining room table, head in hand. He stood behind me and encircled his arms around my shoulders. He rested his chin on top of my head. I told him what I’d learned of my options. He didn’t believe me. I wouldn’t have believed either, the day before. But there we were.
He was hopeful about another baby. We’d be an animated, loving, rough-and-tumble bunch. A five-pack. “But the money,” I said. “I can’t bring another child into a house with such tenuous finances.” There we were, falling and falling in a fearless fight again, like superheroes wrestling through the sky in a comic book.
A few hours later the phone rang. It was Dr. X. Maude had called them on my behalf. Tony and I sat at opposite ends of the table. I set my phone on speaker. Tony listened in. I needed a witness, not for proof, but to understand. The doctor said they could end my pregnancy by prescribing RU486. I shouldn’t tell a single nurse—or anyone on staff—why I sought care. Not too long before, they’d helped a teenager have a surgical abortion. A nurse had seen it on the girl’s chart. The discovery caused upheaval; staff and nurses filed a formal complaint against the doctor. Dr. X feared for their job and probably for their life. This, though abortion is legal. If I had complications, I’d be better off calling Dr. X on their cell phone. Abortion has turned into a whisper-network procedure all over the country, a thing for people in the know. Dr. X provides abortion quietly and bravely, as many other physicians in the United States do, just not out in the open.
The doctor was required to provide mandatory counseling advising me against the procedure. They were willing to do so over the phone. Dr. X went into their office. They said they needed to close their door. They recited in a hushed voice a list of all the bad things that could happen to my body should I terminate, the least of which was regret.
It all made me uneasy. A medical procedure shouldn’t be a hidden thing. There are always risks. I worried the nosy nurse would see my name. Would I be outed and derided in such a small town? I worried I might suffer infection.
I worried for the emotional aftermath too, for the sadness and the indignity. These barriers to abortion left me feeling I’d done wrong. I had the sense of myself as a person who wished to commit unspeakable acts, who deserved every hard thing to come my way. I don’t know if the feeling passes. I’m still in the room with that ghost.These barriers to abortion left me feeling I’d done wrong.
The night I talked to Dr. X, I scanned the internet for herbal and prescription home methods: pennyroyal, savin, tansy, rue. I sleuthed websites claiming to mail mifepristone. They asked for money wires to China and India. I imagined ingesting mystery pills before bed, then never getting up again. The decision of whether to keep or terminate a pregnancy brings us to the brink of life and death, and to our limits and desires. I couldn’t travel to Charleston. I couldn’t order medication and doctor myself. I couldn’t accept Dr. X’s help. What if something happened to me? I have children who need their mother. I needed the safety of my own bed, and to watch over my daughters asleep in their dim rooms. I needed an abortion to preserve what we had.
A year later, I talked to a local activist, told her about Dr. X. I waited for her to tell me that I’d been dramatic, ridiculous; the imagined qualities I lambasted myself with. But she didn’t. Women suffering botched home abortions have been turned from Morgantown emergency rooms, she said. Second thoughts were wise.
Most women seeking abortion care are already mothers. The 2015 Turnaway Study, housed at the University of California San Francisco, followed the impact of curtailed reproductive choice on children: existing children, children born from an unwanted pregnancy, and future children. Turnaway compared one thousand women who received abortion care with an equal number of women who were denied a wanted abortion. Children with mothers denied abortion were significantly more likely to be homeless, go hungry, and fail to meet developmental milestones. They lived below the federal poverty level, at four times the average. They more often dropped out of high school, suffered mental health problems, and engaged in criminal or delinquent behavior as teens and adults.
Mothers in the Turnaway Study felt seized and cloistered, and pined for the “old days.” They had harder times bonding with their babies.
They worried about means of support. For good reason. Turnaway found “being denied a wanted abortion results in a reduction in full-time employment that lasts about four years; an increase in public assistance that persists until women are timed out of these programs . . . an increased likelihood that women don’t have enough money to pay for food, housing, and transportation; and, finally, an increased chance that women are raising children alone.”
Women denied reproductive health care more often experience serious complications: eclampsia, depression and anxiety, hip and joint trouble, PTSD, suicidal ideation, and even death. They remain leashed to abusive partners. They are twice as likely to suffer domestic violence. The Brookings Institution found women carrying unintended pregnancies experience the highest rates of domestic violence, during and after pregnancy. Judgment has nothing to do with it. Anyone can fall prey to coercive partnership. Abortion makes it easier for women to escape. Custody laws, increased financial dependence, the awareness that children need their fathers, even fathers hurting mothers. Leaving can feel hopeless.
O Let me tell you of foolish love
Tony and I traveled in the same circle before we met, New York creative types. He was a writer of stature. I was a graduate student. Tony was known in a way I have never been known. We met in late September 2010. Tony was immediately good to me. I couldn’t believe my luck. Tony wanted me. A family with me. He treated me to elaborate dinners out in a whiplash speed courtship.
A month after we met, Tony slipped a full-carat solitaire diamond ring over my finger. “Yes,” I said. “Yes.” I had no father. My twin sister, Cara, died when we were twenty-eight, five years before. I was desperate for family. My handsome husband-to-be offered me what I’d lost.
The day before we married, Tony confided he had no money. It was a confession delivered without hubris, but a bit of a dare.
“Not even a penny?” I’d asked, confused. Tony had had a big success with his first book. He couldn’t explain what he’d done with the proceeds. I knew nothing of that world. I took him at his word.
There was the nagging feeling of what he’d concealed. I pushed it aside. I promised Tony I’d carry us on student loans; he’d get back on his feet, it didn’t matter if he was broke. What mattered to me was that I loved him, and I did love him, better than I loved myself. I didn’t understand. Tony had blown large sums of money, was capable of blowing large sums of money. His credit was fried. But I’d never had any money. Who was I to judge? Love. I bet on love. How does the old song go . . .
It was the thirteenth week of my unplanned pregnancy. Second trimester. A week after Thanksgiving. University office hours. I sat at my campus desk, door closed, waiting for students to knock. Hunks of brown dust-like material covered the desk’s varnished wood. Fallen through holes in the drop ceiling, like flour from a sifter.
My phone rang. Dr. X’s number scrolled over the display. Another loop in the knot pulled tight. I stared at a forty-by-fifty-inch framed photograph I’d taken years ago of Cara and me. It hung beside a window on my office’s west-facing wall. We’re gripping hands in a cornfield in the picture, mud caked onto the hems of the matching white hooded cloaks we wore. It’s early blue evening in New England, our foreheads pressed together—in another time I was a photographer and a sister. I’d run between Cara and the timer mounted on my lens. Take after take, I’d tried to get the picture right. Fifteen years had passed; a stranger lived that life. The space between Cara and me in the picture is person-shaped, but small. I used to think the void meant what was missing.
Four rings and I answered the call. Dr. X had the results of a blood test calculating probability of fetal abnormality. I clenched my jaw. I stiffened my neck and shoulders. How I’d worried for this child. My age. The stress. Pregnancies one after another; the baby was at higher risk. I carried concern like a rock in my chest. “It’s okay.” Dr. X sensed my worry. “Healthy. You have a healthy baby.”
I exhaled. Relief so potent I felt lifted. We were lucky. Spared.
Dr. X asked if I wanted to know the gender? I did want to know, though it would be impossible to leave that moment free. I saw a him. Imagined his face. Attached myself. A son. My son coming. My boy.
The same beat; a son for Tony at the moment he’d lost his father. Our boy was at a door between West Virginia and the spirit world, if there is such a thing, if I chose to believe, which I didn’t.What of the psychological pain of women who must wait for a wanted abortion?
The basement door was wide open when I returned home from work. A box packed with holiday decor sat ransacked in the dining room. Jo and Iris ran around it, jingle bells tied with red ribbon around their necks. Christmas was coming. Tony pulled our giant silver tinsel tree from a spider-infested shelf under the basement stairs. “You okay?” I shouted down into the sour-smelling cavern. Branches poked through cardboard, rubbing Tony’s neck red as he shouldered the box. I’d bought our ten-foot tinsel wonder one Black Friday. Morgantown winters are rainy and gray, snow scarce. Silver is a beckoning. It promises otherworldly grace.
I unfurled the tree. Worked hours pulling it apart. It’s a bear of a thing. Hoisting it alone is nearly impossible. Back and forth, back and forth—I close-danced the tree, my face smashing its middle. My hands deep in, I grabbed the base. Metal scratched my hands and forearms. Jo leapt and twirled around the room. I swore at Christmas. I was done when Jo stopped dancing to point out the tree’s bald spots.
We baked my grandmother’s sugar cookies. The recipe is handwritten in black ink on age-browned paper. My grandmother tucked her instructions inside a small, pictureless cookbook of standard Sicilian dinners. We got three steps in. Jo left to imagine at her dollhouse. Iris clanged metal bowls against the kitchen’s stone floor. The puppy, Kingsley, stayed underfoot, snout to the ground, licking crumbs. My mother’s mother cooked by intuition. A thumb of butter. Sugar fills the bottom of the bowl. Wrist-deep flour. Her secret ingredient: rum-soaked fruit rolled in.
Jo taped Santa’s list to the mantel. Iris pulled all ornaments within her reach from the garish silver branches. I rearranged the glass globes higher and higher, until two feet of tree was naked, spare white lights.
Albany is nine hours by car from Morgantown. I hadn’t told anyone, but I’d called the gynecologist who gave me my college abortion. They could schedule me for a dilation and extraction abortion the Tuesday before Christmas. The cost was three thousand dollars. I didn’t have the money. I requested and was granted a credit line increase on a previously maxed-out card. I’d need to find a ride home from the surgery center. I could ask an old friend from high school who still lived in town, I thought. A brutal surprise out of nowhere, but it was what it was.
Dilation and extraction abortion, also known as D&E, is performed between fourteen and twenty-four weeks of pregnancy. The Centers for Disease Control and Prevention estimates 7.6 percent of abortions occur in the second and third trimesters, 2.1 percent of those between sixteen to eighteen weeks. Numbers decline steeply as pregnancy progresses. Osmotic dilators begin a D&E. Rods of brown seaweed thinner than twigs are inserted into the cervix. Body moisture swells the rods, slowly opening the womb; two or three days wide. Sedation, vacuum aspiration, forceps, and a curette—a long-handled, sharp-edged surgical spoon—are needed during the twenty-minute procedure.
UCSF medical sociologist Katrina Kimport studied the reasons women seek second-trimester abortions. Out of twenty study participants, six discovered severe fetal abnormality during early second-trimester tests. The remainder “wanted an early abortion and tried to get one but were unable to do so because of the substantial obstacles placed in their path.” Barrier states, like mine.
A D&E would send me home to Albany for Christmas, but without the girls. I couldn’t care for two rowdy kids while also recovering from surgery. Mom would think the situation strange, though she’d be delighted that I’d be home for Christmas. After Cara died, Mom stopped celebrating holidays, never even adorning a tree. Mom would have supported me in the hard truth, held me in that moment. But upholding Mom’s belief that I was okay, not only okay in my pregnancy, but in my life, seemed necessary. Mom had attached herself to the idea of a grandson. My ever-expanding family was a sliver of proof that living wasn’t all about dying. So I had hidden everything: the money, the fighting, the desperation, how little I felt I mattered in the place where I was raising daughters. I’d have to tell Mom I’d miscarried. But I couldn’t bloody my childhood bed in secret, Mom one room over, watching reruns of Law and Order. I’m a lousy liar.
I’d have to bleed elsewhere.
I could maybe return to Santa Monica, where I’d had Iris during summer break. The cost of the abortion was the same as in New York. A friend had offered her spare room for free. I’d have to figure out how to pay for the flight, which I couldn’t fathom affording. I could seek care with my former Los Angeles OBGYN; I called Dr. Y to ask if I could be seen in my condition. I told her of those last weeks of denial and waiting. She held her disbelief through silence for longer than felt comfortable. “Women see me and think they’re being persecuted for having to wait a few hours, and they are,” she said. “Come home. I’ll take care of you.”
My California plan went as far as imagining Tony, Jo, and Iris stringing our fake tree with popcorn and cranberries, Dr. Y putting me under on the sunnier coast. After, I’d sit in Santa Monica more alone than I’d ever been, the too-blue ocean mocking me.
Human awareness is guided by sense: sight, smell, taste, hearing, touch. The cerebral cortex forms perception, intelligence, memory, language, and what some call “consciousness.” Ten states, including West Virginia, have banned D&E abortion. Lawmakers championing those bans espoused unprovable, false pain science. Countless studies state it’s unlikely a fetus perceives pain before the third trimester because the cerebral cortex is yet to be formed.
False fetal pain theories have obscured the real pain suffered by women impeded from first-trimester abortions. And yet early abortion restrictions guarantee more second-trimester abortions, and thus more (imagined) fetal pain. What of the psychological pain of women who must wait for a wanted abortion? The pain of a distraught mother on her living children? The days of dread and confusion? The humiliation of seeking hidden options? The self-blame? The second-guessing?
In The Argonauts, Maggie Nelson writes, “Feminists may never make a bumper sticker that says IT’S A CHOICE AND A CHILD, but of course that’s what it is, and we know it. . . . We’re not idiots; we understand the stakes. Sometimes we choose death.” And sometimes we cannot. A person the size of an avocado or pear—depending on which app or book you read—sucked his thumb in me, had fingerprints and cupid-bow lips. Pain. The truest pain I’ve ever known. Pain in exact proportion to the vibrancy of the imagined body inside of mine. That’s what I felt. And I couldn’t bring myself to schedule a D&E. Could you?
From Loved and Wanted © copyright 2020 by Christa Parravani. Published by Henry Holt & Company, a division of Macmillan. Reproduced by permission.