Thursday, December 10, 2009


Last week, after talking with a patient about coping and depression, I implored her, "Please call me at the clinic if you need to. I'm happy to listen if you need someone." She hesitated and responded, "REALLY?  I won't bother you?"  "I promise, you will not bother me," I assured her.  This week, after receiving the confirmation of her unplanned pregnancy, I asked a patient, "What's going through your head right now?  What do you need?"  She sighed and said, "I need to go to McDonald's.  That's what I need.   I'll think about the rest later.  Where's the closest McDonald's?"

Women are, either by nature or by nurture (or both), self-sacrificing people.  Like the patient I had last week, we don't want to inconvenience anyone.  We've all seen the Weight Watchers ads that tell us to "do something for [our]selves," because we're so busy caring for others, we never do that.  And Weight Watchers suggests that we remedy that by making sure we take up no extra space, thus inconveniencing no one.  (And there's my plug for Fat Acceptance.)  It's completely against nature, not to mention against Weight Watchers to just want to go and eat a cheeseburger in an effort to be--GASP--selfish.

My McDonald's aficionado of a patient was an anomaly because I've gotten so accustomed to hearing women saying, "I can't have another child right now, and I don't really want one, either. But my daughter would just love a sibling, so I feel like I'm being really selfish."  I hear, "I guess I could ask the sperm donor [that's what they call 'em, and it's brilliant] for some cash to help pay, but I don't want to inconvenience him," never mind the fact that he has inconvenienced her with an unintended pregnancy that he won't deal with either way.  Women fret, "I talk to my mom about everything, but I can't tell her about this.  She already has too much to worry about," not thinking that a daughter in crisis might be the most important thing to worry about.  I've seen women who say, "I'm going to have local anesthesia only because my best friend has to go to work and I'd feel bad asking her to drive me to my abortion," even though a best friend probably wouldn't think twice.  Even when the patient is feeling so alone and helpless, the first concern is that she will make someone else uncomfortable or obligated or even responsible.

Maybe a lot of those responses stem from what women hear from anti-choicers: That women who have abortions are selfish monsters.  They internalize it and they will do anything they can to prove that they are the furthest thing from selfish and needy.  When I counsel them, I suggest that everything they've told me about why they can't be pregnant right now indicates that they're anything but selfish.  They are so selfless that they will work through whatever feelings might surround an abortion to ensure that they will not bring someone into the world under the wrong circumstances.  And sometimes, I just want to tell them that if this is selfishness, then be selfish.  I'm pro-choice, pro-abortion, and pro-'selfishness'.


  1. you know, i feel like a lot of people who have experienced trauma feel this way. i have done a bit of work with sexual assault and rape survivors and whenever the subject of talking about it with a trusted friend comes up it's always "i dont want to bother him / her." "i'd feel bad making him/her listen to me." rape/sexual assault/abortion are all kind of taboo topics involving women in our society though... maybe it has something to do with that too.

  2. mr. bg -- I think that's a really good comparison. Also, with pregnancy decisions, it seems like EVERY decision is tinged with "what do other people need?", you know? Sometimes it's having an abortion that feels "selfish," and other times it's bearing a child (I can't burden the guy, etc). Most women are surrounded by people, both loved ones and voices on the radio, making THEIR needs heard without a problem, and indirectly making claims about what women need to do for others in order to be decent people...which is almost always way more than "normal people" (read: men!) are expected to do for others.

  3. I like to tell women that there is value in being selfish. It's a word surrounded by negative connotations and is never used in a positive manner, so when we hear it, we automatically put whatever we hear in a negative context.
    What's the adage- if you can't care for yourself, you can't care for others, either ... ?
    Philosopher Ayn Rand wrote "The Virtue of Selfishness". I haven't read the whole thing, but agree. Ethical egoism is the belief that one ought to do what is in their self-interest.
    Nothing wrong with being selfish. at. all.

  4. thefemaleeunuch -- that's interesting, I've always hated 95% of what Ayn Rand has to say. Her philosophy was pretty simplistic, her "fiction" was terribly written (because it was more like a straight documentation of what she believed), and she's always used by douchey young libertarians to justify no-holds-barred capitalist exploitation.

    ...On the other hand, when I try to put myself in her context, I do see how being persecuted by an autocrat in the name of Communism, plus being a woman in a time when women (at least in the US) couldn't have their own property or bank account or identity really, could make you care so strongly about individuals' *economic* rights in particular that the value of inter-dependence and inter-responsibility (is that a word?) might completely take a back seat.

    I can see the logic of a pro-choice stance based in Rand-type ideas, but my own pro-choice stance DOES value inter-dependence and non-infringement, which is still logically consistent since (a) I don't think fetuses are persons and (b) I don't believe in burdening an oppressed class with unjust demands and then rationalizing them with the word "responsibility".

    Err... would love to have more conversation sometime about stuff like this sometime.


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