Sunday, January 22, 2006

Happy Birthday Roe, and Thank You.

6 weeks after my brother was born, my mom went back to the Army doctor who delivered him to get an IUD. My father was about to finish his time in the Army and start his medical residency in the States. My mother's doctor explained all about IUDs and why they were preferable to European women than traditional birth control. She agreed to get one implanted.

Unfortunately, the IUD didn't work. My mom found herself pregnant shortly after the IUD procedure. It turns out that the physician who implanted the device had done so too quickly and it became lodged in the uterine wall. My mom remembered a friend of hers who was in similar predicament and knew that the risks of the pregnancy to her health, the developing fetus, and her ability to have more children were not good. My mom was also a nurse, and trained to think through risks and outcomes.

After much deliberation, my mom decided to schedule both an abortion and the removal of the IUD device from her uterine wall. Abortion was not yet legal all over the country, but there were places you could get one in California.

Just recently my mom and I were talking over her views of abortion and in the course of the conversation, it became abundantly clear that my mother's ability to get a safe and legal abortion lead her on a significant odyssey and transformation in thinking about what it means to have the right to get an abortion.

Before my mother found herself in a position to get an abortion, she was certain that she found it utterly repulsive for anyone to get one. Her views had been informed by a previous boyfriend, who, in the light of day, was a principled conservative who disapproved of premarital sex, birth control or abortion, but by night, after a few drinks, confessed to her that he had to scrape together money to get his college girlfriend abortion. He wanted to "fix" the situation. This drunken confession deeply disturbed my mother, who would routinely say during my early childhood that getting an abortion as a form of birth control was totally wrong. Her anger was directed mostly at the cavalier way in which the man had just walked away from a responsibility.

She would say this even after her own abortion.

"How did you feel about your abortion," I asked my mom. "Did you ever feel regret, or disappointment, or depression." My mom paused for awhile and then said "You know, I have never felt any regret. I saw my decision as the best medical and moral decision I could make as a young mother with two infants." The fact is that if my mom had continued the pregnancy, she faced the following bad outcomes: (a) rupture of her uterine wall, which would mean she could never get pregnant again, (b) a very premature baby, who may go on to have a host of horrific health consequences including lung disease/respiratory problems, digestive failures, etc., and (c) excessive hemorraghing, which threatened her own life. If she were to avoid the worst outcomes to her own health by continuing the pregnancy, but still had a premature baby, she was looking at both an emotional and economic drain, which would compromise the quality of life for her existing young children.

Examining these risks, my mother and father decided it was the best decision to both remove the IUD and get a dilation and curettage. She registered at a hospital in a rather conservative area, who agreed to do both procedures and sent my brother and I to our grandparents house. When the operation was over, the physician returned to tell her that he had successfully removed the IUD and "the other thing went well too." That was the last, and only conversation, that my mother had about the termination of the pregnancy.

Trained as a nurse, my mother immediately noticed how coolly and indifferent her post-operative nursing care was. It was clear that they did not approve of what she did, even though she was a married woman facing a risking pregnancy. But, the nurses didn't even know that much, because they simply ignored her.

This response to my mother was totally disturbing. Since this experience, my mother has dedicated her life to advocating for the importance of nurses in helping patients recover quickly from illness. Nurses, in her view, are charged with the responsibility of attending carefully to both the emotional and physical needs of patients after and during illness. If my mom was recovering from any other operation, she was certain they would do this. What made her operation so different?

This question took her over 25 years to understand. After my brother and I entered school, my mom finished her Masters and specialized in child development. Her first job was to monitor families who had premature babies, to see how the child was developing and what resources the state could give them to help them cope. After years of making home visits in impoverished areas and trying to help struggling, working class families cope with their premies, she started to get a glimpse into the profound obstacles and problems as many of these families faced. She started to reflect on the sort of harsh judgment she heaped upon "those people who get abortions as birth control," realizing that her quick judgment of others was probably the same sort of emotional trigger that lead the nurses to ignore her while recovering from her abdominal surgery and abortion.

The last job my mom held, before becoming a union activist (I told you this is an odyssey, she started out a committed anti-abortionist Republican), was the Office of Family Planning. My mother started to implement a program in her state that encouraged doctors and clinics to routinely ask if their patients had experienced physical or mental abuse in their homes. On one visit to a family planning clinic, a nurse blurted out to my mom how disheartening it was to see this one Latina woman come back time and again for an abortion. The nurse wanted to vent that this was such irresponsible behavior, which was sentiment that 20 years earlier my mom might have shared.

My mom then asked the nurse if she had ever talked to her about why she kept finding herself pregnant after her abortions. She encouraged her to be non-judgmental in her approach and try to start a dialogue with her about how birth control worked for her, her attitudes toward pregnancy etc. My mom left the clinic.

Several months later, when my mom returned to check up on this site, the nurse flagged her down to tell her about her experience talking with the patient who kept getting multiple abortions. It turns out that each time she would leave the clinic with birth control, her husband would find it, beat her, and then try to impregnate her. When she would show up to the clinic, and someone would tell her that she was pregnant, they would then tell her, by state law, all of her options: adoption, abortion, continue the pregnancy. With little sense of any control over her body, her home, or her well-being, she would choose to terminate the pregnany before her abusive husband would find out. During the pregnancies she had carried to term, his beatings only intensified.

After having this conversation with the patient, the nurse, who formely had assumed that she was facing a irresponsible woman, was now telling my mom how she had creatively brainstormed with her colleagues to find a form of birth control that would be effective and that she could hide from her husband. They gave her depo shots and then referred her to a battered women's clinic.

The last time my mom and I discussed abortion, when she shared that story with me, she pointed out how popular IUDs are among Mexicans. She said, "its a largely Catholic population, where men are also very controlling of women's bodies." She paused and then said: "No one should be forced to get a form of birth control that is easy to hide from their spouses or male partners. They should be free to make any and all decisions about their sexuality."

My mother's commitment to women's health and her compassion for all women's stories has inspired me to write this blog entry on the 33rd anniversary of Roe v. Wade. I am thankful that my mom was given a safe and legal abortion so that she could be the inspring mother towards my brother and I that she was. I am also grateful that she dedicated her life to understand and care, as a nurse should, about all women and their health risks--emotional and physical--and strive to help others become more compassionate as well.