Docsplainin' -- it's what I do

Docsplainin'--it's what I do.
After all, I'm a doc, aren't I?



Showing posts with label Abortion. Show all posts
Showing posts with label Abortion. Show all posts

Friday, January 22, 2010

Trust Means Letting Go of Control Over the Outcome

An attendee at a candlelight vigil in Boston, ...Vigil for Dr. Tiller       Image via Wikipedia
What is Blog for Choice Day?

Each year, NARAL Pro-Choice America poses a question to pro-choice bloggers before the anniversary of Roe v. Wade, and then asks them to blog their answer on January 22.

In honor of Dr. George Tiller, who often wore a button that simply read, "Trust Women," this year's Blog for Choice question is:

What does "Trust Women" mean to you?

Ironically, I was inspired to this post by another disabled feminist blogger's expressed opinion that abortion is just another way for upper-class Caucasians to get rid of  "bad babies", which is to say, fetuses who might already be defective in some way or who have the genetics for a future disability. 

The blogger is right when she points out that we have such a prejudice against the disabled in this country that we often disapprove of either disabled women having children, or women in general having disabled children. For example, she points out that we even frown on older women conceiving because of the mere risk of problems. The gist of her post is that no, she does not trust women: She thinks we are all out to kill her and her kind.

She notes that people who think that raising a disabled child is a terrible burden are making a basic logical mistake: It's not the child's disability that is the biggest problem. It's the lack of affordable health care, accessible child care, and so forth. In other words, that baby is facing all the societal prejudices against disability from day one. And by extension, the miserable lives that the able-bodied envision for those of us with disabilities is premised on the same logical error: It is often not our disabilities that are our biggest problem, but the attitudes of others (including the unwillingness to hire us at comparable pay), the lack of accessibility everywhere we wish we could go but can't get in, the lack of decent health care in this country, and the ignorance of our health care providers about our specific needs.

About all this my sister blogger and I are completely in agreement. But also, and unfortunately, there is little social support in the United States for any woman to raise any child. If she is a single, young, unemployed woman of color? Fuggedaboudit. No support. Indeed, she is likely to be punished in any number of ways, large and small but equally cruel, every day for the entire dependency of that child. And this, my dear readers, is why most women seek an abortion. Not because the child is going to be disabled but because the woman in question simply cannot have and raise a child. Any child. Maybe especially not a disabled child, and maybe especially not if the woman herself is disabled, but the bottom line is that any woman may find herself unable or unwilling to carry a fetus to term.

Find me one case of one of these mythical Caucasian upper-class women with, say, a hereditary crippling disease, selectively aborting pregnancies until she gets a "good" one, and I'll buy you dinner. I can safely make that bet because the fact is that "abnormalities in the fetus" is the least-frequent reason cited, world-wide, for seeking an abortion. 

The able-bodied aren't the only ones making logical errors here. Sometimes disability advocates and pro-lifers do, too:  pro-choice is not synonymous with pro-abortion, but some people have an annoying habit of conflating the two. I am not personally acquainted with any pro-choice folk who think that there is any circumstance in which a woman should have an abortion. What we want is for women to never again be forced to carry every pregnancy to term, irregardless of her personal circumstances.

Which brings us to what "Trust Women" means to me. The dictionary definition of trust is, "reliance on the integrity, strength, ability, surety, etc., of a person or thing; confidence." You will note that there's nothing in this definition about outcomes, only about process. We, as women, if we trust each other, must rely upon each other to make our own best, ethical decisions about our own bodies. Pro-lifers do not trust us: They have one specific outcome in mind and that's what they want come hail or high water, whereas people who are pro-choice by definition express confidence in each woman's strength and integrity, in her ability to make the right decision. Pro-life is a paternalistic approach that treats women as children; pro-choice respects us as the adults that we are.

To me, "Trust Women" means just that. Trust us. Trust each other.




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Thursday, December 24, 2009

Abortion

This month's American Psychologist came in the mail yesterday, and it includes an article surveying research on the supposed causal links between abortion and subsequent mental health problems.
Major, B., Appelbaum, M., Beckman, L., Dutton, M.A., Russo, N. F., & West, C. (2009). Abortion and mental health: Evaluating the evidence. American Psychologist, 9, 863-890.
What they found was this:
"The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. . . Most adult women who terminate a pregnancy do not experience mental health problems." (p. 863)
Some history:
  • 1989. After two years' study, then-Surgeon General C. Everett Koop informed then-President Ronald Reagan that there was no data to support the idea that abortion either was or was not psychologically harmful to women. That same year he testified to Congress that all available data indicated that abortion was physically no more dangerous than carrying a fetus to full term.
  • 1990. An American Psychological Assocation (APA) panel of experts concluded after a thorough review of the literature that women cope with abortion just about the way they cope with any other life stress.
  • 2008. An APA task force reported that the relative
    risks are no greater than the risks of delivering an unplanned
    pregnancy.
Are you beginning to see a trend, here?

The authors of the current article reviewed a whopping 58 papers from five countries published over the course of the last two decades and concluded that
  1. as stated above, the risk of carrying an unwanted pregnancy to term and the risk of a legal abortion are about the same
  2. termination of a wanted pregnancy because of either the mother's or the fetus's health poses no more risk than if that pregnancy were to end in stillbirth, miscarriage, or neonatal death
  3. any mental health problems that do occur in individual women following an abortion are not caused by the abortion itself. Rather, both abortions and unwanted pregnancies co-occur with pre-existing social, financial, personality, and behavioral problems (e.g., addiction) that can result in mental health issues "irrespective of how a pregnancy is resolved" (p. 885)
  4. most women do not regret the decision to terminate.

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