Sex Selection

Are there ever times you feel a little – uncomfortable – with a woman’s reason for having an abortion? We’re not all Saints of Non-judgment, though some of us may strive to be. (Err…maybe some of us don’t…)

Last week, a recent immigrant from an Asian country (I won’t say which) came to our clinic for an abortion. I was the abortion counselor that day. She was in her second trimester and wanted to know if we could figure out the sex of the fetus. This isn’t a completely strange question, but I don’t get asked that often.

Because she was less than 18 weeks and because we don’t perform diagnostic ultrasounds, I explained we wouldn’t be able to identify the sex. I let her know that usually diagnostic ultrasounds to determine the sex are done between 18-22 weeks and that if she had a physician/midwife, she could schedule an ultrasound with them at that time (as it is standard practice).

She wasn’t willing to wait at least another month to have an abortion. You know the drill: she’d have to travel out of state; the cost would be much higher; she’d have to spend time away from home; someone would have to watch her small daughter while she left the area (and explain why she needed a babysitter); and her husband would have to get a lot of time off work.

We don’t ask patients why they want to have an abortion. Really, it’s none of our business. Still, lots of women offer their reasons when we ask if they’re sure of their decision, if they have support, etc.

The woman from last week calmly offered she didn’t want to have a girl.

Look, I’m about as pro-choice as they come. As long as it is a patient’s own decision to have an abortion, I’m cool with it regardless of the circumstances or gestation. I’ll admit though, it took me a slight second to register what the patient was telling me. My brain hitched.

I nodded at her and she explained herself, though she didn’t owe me any explanation at all.

In her country (like in many), girls do not have as many opportunities as boys and are considered a burden. She and her family plan to go back to their country soon and they wouldn’t be able to afford another girl (it costs a lot of money to have girls marry/dowries).

There’s been some national controversy about this (like, in May); even the pro-choicers didn’t want to really talk about sex selection abortion occurring. The reality is, though: it does. It’s not very common in our country, and I’ve never heard anyone – except someone who is from an Asian country – even mention it, at work. And I’ve been doing abortion work a long time.

The concept seems very foreign to us; but, is it really? Globally, there is underlying sexism that drives the devaluation of women. It happens here, too. Please, how many people have raised their hands saying women in this country don’t deserve to be paid equally to men? (Rolling eyes.)

It was a good reminder for me that we’re here to support women, in whatever it is they want, and trust that they know what they need for themselves, even if we may not understand it. We don’t need to understand. We just need to be there.

The story of the time I was a dick

Why does she keep shouting ABORTION at me? 

Yesterday our guest blogger Amy mentioned that phone calls about abortion care often sound like this:

"Um...I wanted to know how much it costs?" and "Hi...I'm looking for some information about...abortion?" (spoken as a question, with the word "abortion" issued in a whisper)

And that her responses sometimes sounded like this:

"I would be happy to answer any questions you have about ABORTION! What type of ABORTION do you think you might be interested in having?"

I can totally relate. Who hasn't had this kind of call? It was one of the first patterns I noticed about callers when I started working on the phone lines.

Maybe Amy was more mature or less self-centered than me when she started her clinic work. But for my part, there was a real evolution in how I understood such callers. Initially, I felt frustrated to pick up the phone at my work and hear that the person on the other end of the line couldn't bring themselves to speak about my work. I experienced it as stigmatizing of ME, like they were attempting to distance themselves from my work even as they were asking me to tell them about it.

Sometimes they would ask with words like "terminations" or "D&C" instead of "abortion" -- maybe those words sounded more genteel or more like medicalese.

I'm ashamed to say that, early on, if someone called and said, "Hi, I need to know how much it costs," I would reply, "For what kind of services?" Even though it soon became clear that, if someone was calling about, say, a Pap smear, they simply said "Hi, I need to know how much a Pap smear costs." For a brief period of time, I believed that it was more important for the caller to say the word abortion than to feel comfortable asking about it.

At least that phase ended rather quickly. When a woman called and I heard echoes as she asked me questions, I mentioned her voice was sounding funny, as though she was in a bathroom or something -- and she said yes, she was at work and this was the only private place she could duck into. Duh, me.

Whether because they're not sure they've called the right place, they can't believe they're in this situation, or they can't risk being overheard by a coworker or family member, callers can't always discuss abortion openly and explicitly over the phone.

There will be time for that at their appointment, if they make one, when they meet with the counselor or health educator to express any questions or concerns about their health, the procedure itself, their experiences leading up to the appointment and how they will fare afterward. Usually patients can bring a loved one or support person into the counseling/education session, but a portion is also dedicated to one-on-one time with the staff person, in case the patient has something that might not be easy or safe to express in front of their companion. These sessions can be conducted as part of an abortion appointment, or prior to deciding whether or not to have an abortion. It's dramatically different from a phone call that might by necessity be taking place in public.

So now I know better. I learned to respond to "I need to know how much you charge" with something like, "Sure, I can talk to you about our different fees, but we provide many kinds of care here. Were you asking about a Pap smear, or...an abortion, or...?" If they are asking about an abortion, they normally stop me there and say "Yes, that's it." Easy peasy. It's okay for me to do the talking, if that's what the caller is looking for.

Not that every caller is in this situation! It runs the gamut: on one end is this (or even, as Amy writes, the ones who never call), and on the other end is someone calling to set up their appointment while also ordering dinner for five from the drive-through. But that's a story for another post.

Appointment Reminders and the Abortion Playlist

I hear a lot of ring back tones when I call people to remind them of their appointments. I’m convinced that the women out there are sending messages – via the type of songs their phones play – to the guys in their lives. Thing is, I don’t think a lot of guys would actually “get it” that this is what’s going on…that the girls are giving THEM a message, telling them how it is. The reason I’m convinced this is happening is because I hear the same songs over and over. Maybe those songs are just super popular. Or maybe there are a lot of girls super pissed off at the guys they’re having an abortion with. In my experience, the top songs I hear on the abortion client playlist are:

• Love the Way You Lie – Rhianna
• Hate That I Love You – Rhianna (or basically, anything Rhianna)
• Free Fall – Kelly Rowland
• Tell Me a Lie – Kelly Clarkson
• So What – Pink
• Through With You – Maroon 5

Songs I hope I hear one day:

• Not a Pretty Girl – Ani DiFranco
• Pretty Girls – Neko Case
• I Will Survive – Gloria Gaynor
• King of Anything – Sara Bareilles
• Single – Natasha Beddingfield
• RESPECT – Aretha Franklin
• Miss Independent – Kelly Clarkson
• Beautiful – Christina Aguilera
• You Don’t Own Me – Lesley Gore
• I Am Woman – Helen Reddy
• A Woman’s Worth – Alicia Keys
• Video – India Arie
• Karma – Alicia Keys
• Single Ladies – Beyonce
• Firework – Katy Perry
• Goodbye Earl – Dixie Chicks
• Just Fine- Mary J Blige
• Superwoman – Alicia Keys
• Stronger – Brittany Spears