At the Saletan Clinic

Dear Will,

After I sent off my entry yesterday afternoon I asked myself: What exactly are Will and I arguing about? We both agree, after all, that it’s better not to have an unwanted pregnancy in the first place than to have an abortion, we both agree that America needs lots more birth control and lots more realistic sex education. We both want emergency contraception to be widely available over the counter. We both want men to take more responsibility—to use condoms, for example. If you and I were actually designing policy, I’m guessing we’d see the practical piece much the same way: Ramp up that funding! Build those clinics! Make health insurance companies pay for birth control like they pay for Viagra. We’d ask stern questions about how that male pill is coming along and about when we might see some new options for women. We’d look at the experience of countries with lower rates of unwanted pregnancy, teen births, and abortion (every other Western industrialized nation); we’d interview experts and study the literature, we’d set up a bunch of pilot programs to see what worked best with what sub-populations.

And then would come the ad campaign. Mine would have pictures of cheerful girls and women: “At my local Saletan clinic, the doctors are great and birth control is free! They really took time with me and answered all my questions. Best of all, I can call anytime and talk to a nurse in total privacy. Thanks to Saletan, I’ll have a baby when I’m ready—but not till then.” Yours would show a spiky-haired, pierced, and tattooed girl looking sullen and miserable: “I stayed out all night and forgot to take my Pill. Now I’m having an abortion and it’s totally my fault. Go on, hate me, I deserve it! If only I’d listened to the doctors at Saletan.” Or maybe you could have a picture of a stern-looking nun standing in front of an abortion clinic: “Birth Control: Because Purgatory’s better than Hell.”

When you, Will, think about preventing unwanted pregnancy, you think about how to sell contraception to a polling demographic that already supports it but for some reason I still don’t get, need the extra oomph of being able to make rather harsh judgments about women who have unwanted pregnancies and abortions. When I think about unwanted pregnancy I think about it as an issue in women’s lives. I think about what women need to control their fertility, to have the kids they want and not have the kids they don’t want. On that, there isn’t going to be one simple answer. Obviously, there’s the medical piece: For millions of women, affordable, easily accessible reproductive health care does not exist; they don’t get the individualized, consistent care those fortunate enough to have a personal gynecologist or the use of an excellent college health service take for granted. But there’s a social and economic piece, too: poverty, sexual violence, and coercion, family dysfunction, not thinking you have much of a future anyway, sexual Puritanism. Ideally, unmarried women are not supposed to have sex: Sex is bad. Teenage sex is doubly bad (but only for girls). That is why so many women who themselves had kids too soon and mourn their lost opportunities don’t talk to their daughters about sex except to say don’t have any; they may preach and plead and warn, but they don’t get them birth control, they don’t help them be both sexual and safe. Nor, since we need to keep men in the picture here, do they, or the men in their lives, talk to their sons about condoms. At the family level, there is just huge denial. I’ve met plenty of mothers in my own educated, urban, secular social class who will say things like, “I don’t think my kid is having sex,” or, “I think my kid may have started having sex,” and they kind of lower their voice, as if they’re afraid someone might overhear them. And the mothers are, in my experience, much more clued in than the dads, who hand off the whole area of sexuality to their wives.

I don’t think the issue of unwanted pregnancy can be solved by crafting a message from polls. I don’t think there is a clever trope that can mobilize the nation. Quite a few people following this discussion have e-mailed me with their pregnancy and abortion stories: A man talked about abortions of wanted pregnancies because of birth defects and how pro-lifers who have such abortions tend to make the kind of good/bad distinctions you are encouraging (my abortion is justified; yours is wrong). Abortions for fetal defect, by the way, are one reason “zero abortions” is not a sensible slogan, even as pointing to a distant ideal. A woman wrote a long, fascinating letter about her struggles to find and keep a method of birth control that worked for her—she felt you did not really understand what women go through in this department and that men in general have failed to do their part. Another reader brought up “Swamp Nurse,” Katherine Boo’s revelatory article in the current New Yorker, about a nurse who visits new mothers in the backwoods of Louisiana’s Cajun country and tries to help them learn how to care for their babies. It’s quite a picture—rackety families barely surviving, sexual and domestic violence, incest, mental illness, addiction, hopelessness, girls and women without much sexual agency, or any other kind of agency, who see their lives as pretty much over—at 17. The social institutions that might help them and their babies—schools, clinics, day care, social services—are threadbare. This is the reality of unplanned pregnancy in our country. Except for the program Boo writes about—which serves 20,000 babies out of the nation’s 2.5 million infants born into poverty each year—our society has pretty much written these young women off. They are already stigmatized. I don’t believe you think a national campaign of moral tsk-tsking is what they need.

You ask what my own view of abortion is. I think the meaning of abortion is what the woman says it is: For a woman who wants a child but can’t have this one it can be sad; for a woman who doesn’t want a baby, it can feel like a huge relief, like having your whole life given back to you. Negative feelings—the sense of the road not taken, that maybe you would have wanted to take had life been different, the feeling that you chose yourself instead of the baby-to-be and maybe that means you are not a good woman, the feeling that you messed up somehow—are often confused with morality, but they are not the same. Morality has to do with rights and duties and obligations between people. So, no: I do not think terminating a pregnancy is wrong. A potential person is not a person, any more than an acorn is an oak tree. I don’t think women should have to give birth just because a sperm met an egg. I think women have the right to consult their own wishes, needs, and capacities and produce only loved, wanted children they can care for—or even no children at all. I think we would all be better off as a society if we respected women’s ability to make these decisions for themselves and concentrated on caring well for the born. There is certainly enough work there to keep us all very busy.