‘About Abortion’ Unpacks Shame Narrative to End Silence, Stigma

In About Abortion, Carol Sanger examines post-Roe laws and court cases that have had implications for abortion restrictions directly or indirectly to make her case that normalizing abortion could end this compulsory silence.

In addition to the book’s focus on the ways in which judicial bypass laws and forced ultrasounds have contributed to an environment of abortion silence, Sanger muses on the different ways current campaigns elicit hope for future generations. Harvard University Press

Author and law professor Carol Sanger’s latest is the abortion book I didn’t realize I was waiting for.

At first glance, anyone interested in a book about abortion would assume they know what abortion is about—me included. But in About Abortion: Terminating Pregnancy in the 21st Century, published last month by Harvard University Press, Sanger (no relation to Margaret Sanger) digs into the roots of privacy around this personal decision and how it became more of a forced secrecy for so many.

“This silence around abortion has implications not only for how individual women fare, but for the rest of us who seek to live in a decent society,” she writes. I couldn’t agree more.

Over the course of 238 academically structured, yet completely accessible pages, Sanger lays out the self-feeding loop of abortion silence—a fear of others finding out rather than a choice not to disclose. She examines post-Roe laws and court cases that have had direct or indirect implications for abortion restrictions to make her case that normalizing abortion could end this compulsory silence. The good news? It’s in our very capable hands.

The first order of business in About Abortion is to identify where we are and how we got here.

Sanger walks a very important line detailing the way our current landscape of abortion care creates shame, stigma, and silence without blaming those who, understandably, take measures not to be found out as someone who has had—or thought about having—an abortion. She roots some of this silent shame in the days well before Roe when there were “hidden births, hidden children, hidden abortions.” And then she takes us through the legislative and court actions that have created “a network of rules whose purpose is to persuade pregnant women that what they are doing is wrong,” reinforcing the shame narrative.

For their part, the courts “accept without the need for proof that an allegation of abortion is defamatory,” Sanger writes. So, while the practice of allowing those in civil proceedings concerning abortion to use pseudonyms (typically “Doe”) is done for the safety and privacy of the plaintiff, it remains one of the many reminders that abortion isn’t something we should be talking about. This is particularly problematic with pregnant minors.

Sanger spends 30 heartbreaking-at-times pages on the chapter “Sending Pregnant Teenagers to Court.” She opens with a question that forecasts the complications and complete lack of equity in the answer: “What does it take for an unmarried girl under age eighteen to get an abortion in the United States today?”

Unfortunately, all too often what it takes is spilling their most private thoughts and actions in front of a judge who must determine they are sufficiently mature as to have a minor medical procedure or take a pair of pills to end a pregnancy. These judicial bypasses were seen as a middle ground by legislators and passive supporters of choice; they supposedly balanced the right to make decisions for minors, upheld by the Supreme Court, while also holding true to Roe that these young pregnant people had their right to privacy. If you can’t talk to your parents, just go to a judge! No big deal, right?

The degree of hypocrisy and inconsistency exhibited by this legal process—which the teen must typically learn about and navigate on their own—is greater or lesser depending on their ZIP code. Currently, 37 states have parental involvement (either consent or notification) laws.

Sanger pauses to highlight the “set of harm inflicted on young women whose petitions are approved and who by that measure might be considered bypass success stories.” They still had to risk being seen at the courthouse, tell a judge about the night they conceived—no matter those circumstances—discuss their home life for the record, and know the whole time they might not get the decision they need.

Pregnant teens are taught through the judicial bypass process that their activities are being judged literally; their very maturity is called into question in a way that imposes blame, even if they are allowed to resolve the situation as they see fit. In order to usher plaintiffs through the process as smoothly as possible, advocates will tell the teen to seem contrite. They are also typically advised that going to get the ultrasound and agreeing to view it can prove (unnecessarily) that they are both educated on the situation and have been thoughtful about their decision.

All of this takes time, effort, and money. And the clock may be ticking on how long until they cannot get a legal abortion in their state whether or not a judge deems them sufficiently mature.

Further, the unnecessary time-consuming hurdle of the ultrasound is a roadblock dealt with by pregnant people of all ages thanks to the deploying of fetal imagery aimed at dissuading patients from terminating. This is a newer development, because it simply wasn’t effective until technology could create a significant visual that people began incorporating those black and white pictures into our culture, endowing them with social meaning.

“Only recently, however, has the image [of an ultrasound] come to signal a child as morally significant and as scientifically real as a born child,” writes Sanger, as she recounts anecdotes about the way we engage with those pictures handed to us by excited expectant parents.

She writes, “Most of us know which response file to pull up when shown an early ultrasound scan. We do not say, ‘Hey, nice sac!’ but focus instead on the semi-discernable shape in the center. We know that we are being asked to look at something regarded less as a something than a someone.”

Eventually, fetal imagery became a weapon for legislators to further punish a person who should have made “better decisions.” Despite how rarely forced ultrasounds result in the pregnant person actually changing their mind, these laws contribute to the effect the inundation of the images and their newly ascribed meaning have on our culture.

“Unlike informal brochures on the stages of fetal development, mandatory ultrasound statutes require the woman to participate in the physical production of information that she is then urged to consider,” writes Sanger. “[T]here is something unjust in using a woman’s innards to make the state’s case about abortion.”

The visual aspect of abortion secrecy seems to be shifting, according to the author, who has noticed more informational and even helpful fetal imagery popping up recently, situating this as another battleground for reproductive rights activists to strategize over.

“Graphic design websites now offer an array of fetal logos and up-to-the-minute clip art, such as instant Zika warnings in 2016 showing a microcephalic fetus in its mother’s womb. Thus despite a general agreement that pro-life advocates have held the rhetorical advantage—unborn child, ‘partial birth abortion,’ and so on—the fetus may no longer be wholly owned and operated by those who oppose legal abortion,” Sanger writes.

In addition to the book’s focus on the ways in which judicial bypass laws and forced ultrasounds have contributed to an environment of abortion silence, Sanger muses on the different ways current campaigns elicit hope for future generations. Hope runs throughout About Abortion with stories of how we’ve changed as a culture, with nods to campaigns like #ShoutYourAbortion#IHadAnAbortion, and #1in3. Many people are finding their courage and raising their voices with the support of the storytelling community within the reproductive justice movement.

Sanger, like these campaigns, takes heart in the foundation of our right to abortion in law.

“In Roe v. Wade, the Supreme Court acknowledged that whether to terminate is up to the pregnant woman: she is best placed to know what is right for her,” writes Sanger. “The pro-choice slogan ‘Trust Texas Women’ [created to counter the Texas legislators’ and former Gov. Rick Perry’s onerous regulation of clinics] says it all.”

“We can trust Texas women (and women of the other forty-nine states) because everyone has trusted them (and with so much) up to this point.”

Sanger is convinced that more visible conversation about and with those who have had or considered abortions will necessarily influence the body politic. Legislators are people, after all, and take their cues from the same cultural tropes and stigmas as the rest of us. Storytelling initiatives and anecdotal evidence from the lives of those who have opened up to loved ones show that stigma can be reduced when anti-choice people realize they know someone who has had an abortion.

“As abortion becomes less stigmatized, as it will in time,” she writes, “it will come to be regarded like other medical decisions—thoughtfully taken and exercised without a gauntlet of picketers on the pavement or hard looks at home. For now, there doesn’t have to be a full-on revolution, just a bit more openness and generosity.”

While I am here for full-scale revolution on several fronts, I take significant comfort from Sanger’s assertion that we are already on the right track to accomplish the destigmatization of abortion care. In a political era where the reproductive rights movement seems to face setbacks daily—the confirmation of Neil Gorsuch to the Supreme Court, the reinstatement of the “global gag rule,” and 431 state-level abortion restrictions introduced this year so far, to name a few—the knowledge that history and trajectory are on our side helps me sleep at night.

I’m not content to sit back and wait for this culture change to take full effect—and Sanger certainly isn’t suggesting that we do so. She does, however, provide new tools and frameworks for forging ahead while knowing we are already on the right path.