What We Can Learn From “Pro-life” Patients


This post is by Kate Cockrill, and is part of Tsk Tsk: Stigma, Shame, and Sexuality, a series hosted by Gender Across Borders and cross-posted with RH Reality Check in partnership with Ipas.

Over the years that I have been working in abortion research and care, I have heard many compelling stories about prolife patients. Feminist blogger Joyce Arthur gave some exposure to these stories in her 2007 Daily Kos piece entitled “The Only Moral Abortion is My Abortion.” Occasionally the story of the “prolife” patient is presented as a conundrum for counselors. What do we do when a woman thinks that having an abortion is the same as killing a baby? But more often than not, the “prolife” patient story becomes another sign of prochoice losses in the culture war over abortion. The patient is painted as the abortion-version of Benedict Arnold: hypocritical, a backstabber, a turn-coat.

I offer a different perspective. To me the abortion experiences of prolife women can offer us insight into understanding internalized stigma and the relationship between an individual’s conscience and their behavior. They remind us of the empathy we must harness to improve abortion care for all women, especially those with the least access to social support.

The following is the story of one prolife woman I met in my research. Her story has helped me to better understand the social and emotional experience of abortion for prolife women. Amanda was a 25- year-old student living with her husband and four children in a two-bedroom apartment. Early on in our conversation, she told me she was opposed to abortion.

I don’t believe in killing a baby, you know. It’s living, no matter if it just, you know, just happened, or nine months from now.  You know the whole entire time it’s a living, growing thing. It’s, you know, it’s life so I don’t think that it’s, nothing like that should be taken lightly. It’s not just something you can pay money and just feel like, ‘Get rid of it.” And that’s how I feel about it.

In the past, she had protested outside of abortion clinics.

Yeah, with our church (we would) hold signs out, you know. We try to, I don’t know, to let people know that it’s okay to do other things. There’s other options then abortion, you know. Some women have more courage than others. Some women can go full term and have a baby and give it up for adoption because there are lots of women who, you know, can’t have kids and it is great to be able to give it to a family that, you know, will be able to love it and take care of it…I’m just not that strong. 

Tragically, Amanda had become pregnant with her youngest child as a result of a traumatic rape. She had considered abortion for that pregnancy but when she arrived at the clinic and saw the ultrasound she changed her mind.

I went to the abortion clinic in [small southern town] and walked in, paid the money, went and had an ultrasound, and the lady asked me if I wanted to look… I was real scared to look. And I went ahead and looked anyways and it was Jessie, and she was moving around and it freaked me out. I left and I didn’t go back. I walked out and that was it, and I had Jessie. She’s my seventeen-month-old.

When she became pregnant for the fifth time, Amanda and her husband had a difficult decision to make.

You know, sometimes we’ll eat peanut butter and jelly sandwiches for a whole week, you know, I mean, just with four kids, it’s a lot of people to take care of and feed. And it’s even harder, ‘cause when I get pregnant I’m out of work.

I asked her if there were any good reasons to have an abortion.

No, not really. I mean, my reason would be selfish. My reason for having an abortion would be selfish because it would be for myself and, you know, the rest of the kids in my house you know, to kill one life… But the more kids you have, the less attention they get, you know, the less care that you can really see yourself giving to them, or more tired. I feel like I can’t please all of them right now. I already feel like I’m going crazy, you know like, “I love you, I love you, I love you, I love you.”

Amanda expected judgment because of her decision.

I won’t tell anybody what I’m doing because I just don’t feel like I should be bashed for my decision. It’s my life and it will never happen again, so.

But she still had harsh words for other women who have abortions, especially more than one.

You know, like I say that I don’t believe in abortion, I don’t think it’s right…I don’t think that women should be able to keep coming back to an abortion clinic. I don’t think that you should be able to come back two or three times and be able to just continue to have abortions.

When we talked about abortion policy, Amanda did not think abortion should be illegal. But she was in favor of every other abortion restriction we discussed: waiting periods, age limits, mandatory counseling and prohibiting federal funding for abortion.

One of the tenets of qualitative research is to ask open-ended questions without guiding the participant toward any sort of answer.  In my interview with Amanda, we explored her beliefs but I did not ask her to confront or explain her ambivalence or conflicted feelings. This style of interaction enabled me to see Amanda in the way she saw herself: against abortion but having one anyway. From her perspective abortion is always wrong and some abortions are more wrong than others. She felt good about her commitment to her family and simultaneously selfish for extinguishing the life that was growing inside her. She did not see herself as a victim. She just hoped God would forgive her.

Although I label Amanda “prolife” I am aware that women’s negative attitudes toward abortion and even abortion policy are not static. The boundaries of prochoice and “prolife” are notoriously hard to define.  It makes sense that “prolife patients” would espouse contradictory values in light of their own abortion experience. Amanda was no different.  Though she expressed condemnation of abortion and other patients throughout the interview, she showed a change of heart when I asked if she would protest abortion in the future.

I would, I would go out there with [prolife protestors] but I would… be able to have a sign that said that I want everybody to choose, you know, what they want to do. I would never go out there and just say don’t have abortion. Not any more.

At ANSIRH we recently collected data from over 600 women who have had abortions in the US. Our preliminary analyses of the data suggest that the most common type of stigma women experience is internalized stigma (eg. guilt, self-hatred and shame). More women internalize their stigma than experience direct forms of stigma like judgment from others, the loss of a relationship, gossip or abuse. Unfortunately, women who have negative attitudes toward their own abortion are likely to come from communities with similarly harsh views and therefor may be the least likely to seek support from others.

Stories about “prolife” women who turn their backs on their abortion providers have some truth. Having worked in abortion care, I know that not all patients are grateful or well-mannered. Some women can be downright abusive. But if we expect the “other side” to move from judgment to empathy on the issue of abortion, then we should expect no less from ourselves. Focusing on the outrageous behavior of a few “prolife patients” does nothing to support the very women who may be at the most risk of stigma and isolation. At the same time it furthers a mythology that adds fuel to the culture wars that are harmful to all of us. By seeking an understanding of these women we blur the political lines and expand the potential of our movement.

When I think about “prolife” patients, I think about Amanda and how she battled her conscience to do what she believed was right for her family. I don’t expect her to join the movement for abortion rights. Though I am glad those rights were there for her when she needed them. I mostly hope she has found peace with her decision and moved forward with her life.

Kate Cockrill  is the Stigma Project Director at Advancing New Standards in Reproductive Health, at the University of California San Francisco.

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