Intimate Wars (10 page)

I initially called
Roe v. Wade
the medical Equal Rights Amendment. The law had undeified physicians and required the informed consent of the patient for surgical procedures, making Patient Power real. But as I would come to learn, implementing
Roe v. Wade
did not prevent abortion from being seen as a second-class medical service, or clinics and the doctors who worked in them from becoming pariahs in American society. It would be many years before I would come to see
Roe
as a compromise—before I would see that women still had a long way to go to truly gain control over their reproductive health.

 

I STILL REMEMBER when the words “patient power” first came to me. For once,
I
was the one on the exam table. I was having a routine gynecological exam, but I was feeling vulnerable and uncomfortable, my legs spread, the paper gown just barely covering my breasts as I breathed deeply in and out. “Just relax and be patient,” the doctor said while his gloved finger searched and poked inside me. “Be patient.”

What an unbearable request, I thought. I never had much patience as a child, woman, or patient; I never wanted to wait for anything. The word “patient” originally referred to a “sufferer or victim,” an older definition that shares meaning with the modern usage of “patience”: to “suffer and endure, bearing trials calmly without complaint,” to manifest forbearance under provocation. I was beginning to understand that women have always been the ultimate patients in this sense of the word, bearing centuries of injustice as we've waited for equal rights, economic parity, suffrage, freedom from violence, legal abortion. There has always been something else, one more thing to be accomplished, a war to end, an election to win, before the legal, political, and social gaze can be turned toward women.

Battles have been won only when women have refused to keep waiting to be given our turn. Was it patience that gave us the vote, rights of inheritance? If women's freedom is like the phoenix rising from the ashes, always in the process of becoming, it is fueled by a collective and individual impatience that is expressed through righteous anger and political action.

Lying on that table in the doctor's office, where I was expected to be physically and psychologically submissive, I realized that the definition of patient had to change. If I wanted to have mastery over my medical decisions and my reproductive health, and bestow that power to other women too, I would have to reject the notion of patient as victim. I would have to struggle against society's attempts to keep me in my place, dependent on others to decide what was best for me and my body. It became clear to me that it might in fact be possible to have power and be a patient at the same time. Collectively and as individuals, we could attain Patient Power.

No, I was not patient, as a woman or as a patient. And after three years as director of Flushing Women's, I didn't believe any woman should have to be.

 

BY THEN my days at the clinic had begun to feel a little more routine. We were seeing fifty women a week, and at that time I was still counseling most of them.

I can't remember how many hands I held, how many heads I caressed, how many times I whispered, “It will be all right, just breathe slowly.” I saw so much vulnerability: legs spread wide apart; the physician crouched between white, black, thin, heavy, but always trembling, thighs; the tube sucking the fetal life from their bodies. “It'll be over soon, just take one more deep breath”—the last thrust and pull of the catheter—then the gurgle that signaled the end of the abortion. Gynecologists called it the “uterine cry.”

Over and over again I witnessed women's invariable relief after their abortion that they were not dead, that god did not strike them down by lightning, that they could walk out of this place not pregnant any more, that their lives had been given back to them. It was the kind of born-again experience that often resulted in promises: I will never do this again. I will always make him wear condoms. I will be more careful next time.

It was the very young girls that moved me most. I felt so much rage against the males who impregnated each child
—
was it her father, her brother, some young boy with no thought for the consequences? The girls, the women, were duly punished for their part of the sex act. But for the boy or man there was no censure, never was.

At times I was filled with a kind of bitter resignation. I knew that I might see each patient again soon. So many of them were barely more than babies themselves when pregnancy came, unplanned and unwanted. They were innocent and often ignorant, didn't believe they were pregnant until it was too late to deny it, too afraid to ask for help at first. “Maybe it'll go away,” they reasoned.

I spent hours counseling husbands, lovers, sisters, and mothers whose fury at their daughters' betrayal needed a kind of salve I couldn't give. “Let her get local anesthesia,” they said. “Let her really feel the pain so she knows never to do it again.” The daughters' heads lay on my shoulder as I sat on their beds, wiping tears of relief or regret or both, whispering comfort, giving absolution, channeling rage, sharing life.

“I would want to keep this pregnancy, if only . . .” I learned that it is in the “if only” that the reality of abortion resides. It's there in the vast expanse of a lived life—the sum of experience, the pull of attachment, the pain of ambivalence. “If only” is a theme with thousands of variations.

I bore witness to each woman's knowledge of holding the power to decide whether or not to allow the life within her to come to term
.

The act of abortion positions women at their most powerful, and that is why it is so strongly opposed by many in society. Historically viewed as and conditioned to be passive, dependent creatures, victims of biological circumstance, women often find it difficult to embrace this power over life and death. They fall prey to the assumption, the myth, that they cannot be trusted with it.

Many women came into the counseling room and said, “I'm not like all those other girls in the waiting room; they don't seem upset about it at all; I don't take it as lightly as they do.” Or, “I never thought it would happen to me, I never really believed in abortion.” They felt guilty about not wanting to be mothers yet, about getting pregnant even when their birth control was what failed them, guilty about not insisting that their men put on condoms—or that they neglected to put in their diaphragms. And sometimes they felt guilty about not feeling guilty. Theirs was a pervasive sense of sin, if not in
the biblical sense, then in the personal one of not living up to their own self-image
.
They felt they should have known better.

But they found a kind of redemption at the clinic, facilitated by counselors and staff who did not devalue, but supported them. Redemption in the form of rescue from an unwanted and unplanned pregnancy, and everything that meant. Redemption in the form of demystification, neutralization, and acceptance.

—SIMONE DE BEAUVOIR

 

 

 

 

 

I
remember the moment I became political. It was a rainy Sunday morning, 1976, and I'd allowed myself to stay in bed a little longer than usual. Monotonic radio voices intruded on my sleep . . . something about Henry Hyde and abortion. I sat up in bed, all ears. Republican Congressman Henry Hyde had succeeded in passing legislation that would effectively remove the right to abortion for women on Medicaid.

“If we can't save them all, we can at least save some,” Hyde declared, referring to the pregnancies of black, Hispanic, and all politically and socially disenfranchised women who would now be unable to afford abortions. They were Hyde's first strategic target, the opening salvo in his war against women. Because of their collective powerlessness and political vulnerability they made for an especially easy kill.

Hearing that news, my stomach clenched as I thought about the circumstances that brought many of my patients to the clinic, and the systemic inequalities that placed adequate
health care out of reach for so many. Those women from whom Henry Hyde would callously cut off abortion rights were people I worked with every day. Many were unemployed, many had several children, most were poor and had nowhere to turn for help. My growing awareness that women's reproductive freedom was precarious—that the passage of
Roe
was also the beginning of a war designed to have it reversed—was transformed into a sense of urgency and purpose that morning. I instinctively knew that my life had changed, that the five years I'd spent providing abortion services had led me to this moment. I recognized that if I wanted to truly advocate for women I'd have to reach out beyond the world of the clinic to the broader, more demanding and dangerous one of political activism.

My immediate impulse was to speak. If people would only see and understand the truth, they would do something to stop it! Ironically enough, my first action was to go through the halls of Queens College, knocking on classroom doors to ask whether I could address the class and hand out leaflets. Surprised professors invited me in and allowed me to distribute my pamphlet on the effects of the Medicaid ruling: how discriminatory it was, how it singled out poor women, minorities, and the young.

“My name is Merle Hoffman and I am here to talk to you about a crisis in reproductive care,” I told the students once their professors stepped aside to let me speak. “We must do something at once—poor women are being discriminated against, poor women will die!”

Uncomfortable silence. The students listened attentively, but there was hardly a response, much less the passionate outcry I'd hoped my news would elicit. Finally, a woman spoke up. “But we will always be able to get abortions. We can fly to London or Puerto Rico,” she said to nods all around.
Of course. I was speaking to white, middle-class college students. They had their ways of dealing with an unwanted pregnancy if it happened to them, and they didn't care to worry about those with fewer resources.
⁵

I encountered a similar attitude when I spoke to the women's group at a local Queens synagogue. They self-identified as women's libbers who had made the
choice
of getting married, giving up their careers, and staying home with their babies. They had the money to fly to those abortion havens if rights were cut off in the US. No coat hangers, bottles, or back alleys for them.

I left, discouraged by their passivity and lack of empathy. In
The Feminine Mystique
, which helped to spark second-wave feminism, Betty Friedan outlined her view that the freedom to become a fully engaged person is personal and achieving a gender-neutral society with no barriers to women's self-fulfillment is political. Her analysis did not go far enough to embrace issues of race and class. This disconnect became increasingly evident as I witnessed the demographic of my patients change after the Hyde Amendment was passed in 1976. In the beginning there had been a great deal of racial and class diversity at Flushing Women's and other abortion clinics; everyone went to them. Even the daughters and wives of public figures and politicians frequently came to clinics for abortions.

The Hyde Amendment changed all that. Because New York was one of only four states that continued to have Medicaid funding for abortion, licensed clinics in our state began to see a large portion of Medicaid patients, mostly lower-middle-class women of color.
⁶
Middle-class white women didn't want to share facilities with poor minority women, so they found other places to get abortions. Clinics were increasingly thought to be dirty, unsafe facilities, fit only for those who
could afford no other option. Gradually, the words “abortion clinic” in New York came to be synonymous with “Medicaid Mill”—a label with all the baggage of stigma, disgust, and racism that continues to this day.

This baggage was compounded by sheer ignorance on the part of middle- and upper-class women who claimed that clinic doctors were not as talented or professional as private gynecologists. As more and more women began to have abortions, there were inevitably unpleasant stories about experiences people had in clinics—long waits, scheduling mix-ups, personality conflicts. These complaints were endemic to any hospital or surgical procedure, but somehow with abortion they became writ large. The politics of abortion were beginning to poison the well of experience.

In fact, many doctors who performed abortions in their private offices were much less experienced than those who did hundreds of abortions each week in clinics. Private doctors had absolutely no regulations, many charging patients more money than the clinics for procedures they weren't experts at conducting. Some doctors victimized illegal immigrant women in particular; since they did not have Social Security numbers, they were ineligible for Medicaid, and were forced to pay exorbitant prices to private providers. And hospitals—unwieldy in terms of space and operational function, incredibly cost prohibitive, and unwilling to deal with abortion politics—were often not feasible alternatives for women of any class.