Competing Emotions

I've covered abortion for NEWSWEEK for two years. The issue has put me in touch with a young activist in rural Colorado, an embattled clinic just outside St. Louis, and chanting crowds in Washington, D.C. Whether I'm covering abortion's staunchest guardians or its most adamant opponents, there's always the same passion: both sides feel abortion is an issue worth waging war over. (Story continued below...)

Writing these stories, I'd become well-versed in abortion policy, the pro-choice and pro-life arguments, the latest legislation. But I'd never actually seen an abortion; I'd never watched the procedure that activists vehemently defend or deplore. And, when I flew to Omaha to spend four days at LeRoy Carhart's abortion clinic for a profile in this week's magazine, I wasn't sure I would. I confess I was hesitant to step into Carhart's operating room. I knew that I'd most likely be watching a first-trimester procedure; while Carhart does offer late-term abortions, the majority of his patients, and the majority of abortion patients nationwide, are early in pregnancy. I learned how long the procedure would take (10 to 15 minutes), what equipment would be used (a long plastic tube connected to a suction device), and what the patients would feel (slight pressure and possibly cramping). Yet I still felt uneasy.

Why was I reluctant to watch? To be fair, I'd never observed a surgery and knew myself to frequently flinch at Grey's Anatomy. But abortion isn't like the complex, bloody operations you see on television: medically speaking, it's a simple and common procedure. About 1.2 million were performed in 2005, the same, numberwise, as outpatient cancer surgeries. I was nervous, I think, to watch something so controversial; no one protests outside cancer clinics. I didn't know how I'd react. Would I find the surgery repulsive? Encounter women whose choices troubled me? Whom I disagreed with? I was uneasy about coming in such close contact with such substantial decisions.

I was still unsure when I entered Carhart's clinic, so I began my day by interviewing patients. I learned their names, why they'd come to Carhart's clinic and how they felt about it. I went with them through the pre-op routine. There was an ultrasound to confirm the pregnancy, blood work and pre-op medications, a patient advocacy session. We sat together in the waiting room, killing time until a nurse called them in to surgery. When their names were called, and I'd spent all morning with these women, it felt unnatural to stop short of the operating room (one woman, who'd come alone, even asked me to accompany her). So I entered a small room that joins Carhart's two operating rooms, where I could see patients on both sides.

A first-trimester abortion, from my vantage point behind the glass window, looked like an extended, more invasive version of a standard ob-gyn exam. A woman with her heels in stirrups, clothes traded in for a hospital gown, a speculum holding the cervix open. Carhart used a suction tube to empty the contents of the uterus; it took no longer than three minutes. The suction machine made a slight rumbling sound, a pinkish fluid flowed through the tube, and, faster than I'd expected, it was over. Women spent less than a half hour in the operating room. I'd anticipated some kind of difficulty watching an abortion; it wasn't there.

At least not physically. But there was a discomfort I hadn't expected, my emotional reaction to watching abortions. It happened when I watched a married couple, in their mid-30s, the husband squeezing his wife's hand, stroking her forehead. Another woman, a single mom with a 10-year-old daughter, started crying when we talked about abortion. "I think it's OK," she told me, "but it's hard to see everyone doing it, there's so many. I'm not mad at them at all. It's just like, wow, there are so many people. There are seven or eight babies out there [in the waiting room]." There was the 23-year-old from Iowa who was 16 weeks along—she'd known about the pregnancy for two months but needed time to scrape together the money. By the time she arrived at Carhart's, she was visibly showing under her striped pink tank top. To be sure, each and every patient had come to the conclusion, on their own, that this was where they needed to be. And I met a few patients who saw nothing complicated about that decision, who never second-guessed their choice. But they were not the majority. In Carhart's clinic, most women were doing their best to balance competing emotions about their abortions, simultaneously sad and relieved, conflicted but confident. No one expected to spend a Sunday morning in Carhart's clinic—but all were absolutely grateful to be there.

When I returned from Omaha, friends and colleagues wanted to know if I had "done it." When I said I had, their reactions surprised me. Friends who supported legal abortion bristled slightly when I told them where I'd been and what I'd watched. Acquaintances at a party looked a bit regretful to have asked about my most recent assignment. The majority of Americans support Roe v. Wade's protection of abortion, about 68 percent as of May. But my experience (among an admittedly small, largely pro-choice sample set) found a general discomfort when confronted with abortion as a physical reality, not a political idea. Americans may support abortion rights, but even 40 years after Roe, we don't talk about it like other medical procedures.

And maybe that's appropriate. Abortion may be a simple procedure medically, but it is not cancer surgery. It's an elective procedure that no one—neither its defenders nor its detractors—expects to elect for themselves. I had (and still have) difficulty understanding my own reaction, both relieved to have watched a minimally invasive surgery and distressed by the emotionality of the process. Abortion involves weighty choices that, depending on how you view it, involve a life, or the potential for life. And my reaction, complicated and conflicted as it was, may have been a reflection of our national ambivalence about a private medical procedure at the center of a very public debate.

© 2009