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This Common Secret: My Journey as an Abortion Doctor

January 2nd, 2009 No comments
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Title:
Wicklund, Susan, and Alan Kesselheim. 2007. This Common Secret: My Journey as an Abortion Doctor. PublicAffairs.

Rating:
8/10

Review:
In the fight over abortion in the U.S., two voices are not regularly heard: (1) The voices of the hundreds of women who died from botched illegal abortions prior to 1973. (2) The voices of the women whose lives were saved as a result of not having to have an illegal abortion since the procedure was legalized in 1973. And (3) the voices of the doctors who perform these abortions and save so many lives. This Common Secret, by Susan Wicklund, brings to the debate two of these voices. Dr. Wicklund is a doctor who has performed abortions for women for over 20 years. In this book she tells her story, but also tells the stories of many of the women whose lives she saved.

But she starts the book talking about a life lost in what is probably the most compelling story of the book. In the 1990s, Dr. Wicklund appeared on 60 Minutes to talk about how she was being persecuted by anti-choice/anti-abortion activists. Before her interview aired, she decided she had to tell her grandmother what it was she did for a living. As she was explaining her job, her grandmother stopped her and told her a story. When her grandmother was sixteen, her best friend got pregnant, possibly incestuously from her father. Not knowing what to do, she turned to Dr. Wicklund’s grandmother for help. They had heard that if you stick something sharp in a pregnant woman’s vagina it can abort the fetus. Dr. Wicklund’s grandmother, with the help of her sister, tried to help, “We closed ourselves, the three of us, in one of the bedrooms late one morning. We didn’t talk much, and she didn’t ever cry out in pain. It took a few tries to make the blood come. None of us spoke. We didn’t know what to expect next, or what to do when the blood kept coming. It was all over the sheets. All over us. So bright red. It was awful. It just wouldn’t stop… We stayed there together, unable to move, even after she was dead. Her father found us, all three of us, in the bed. He stood in the doorway, staring. No words for a long time. When he did speak, he told my sister and me to leave and that we were never, ever to speak of this. We were not to tell anyone, ever. Ever” (pp. 7-8). Dr. Wicklund’s grandmother had played a direct role in the death of her best friend at 16. Now imagine this scenario playing out about 7,200 times a year in the U.S. alone. That’s about how many women would die every year in the U.S. from botched illegal abortions if abortion were illegal.

The book talks about Dr. Wicklund’s journey from young, single mother (who underwent a very cold abortion herself (p. 15), motivating her to improve abortion provision) to medical student to abortion provider. Along the way she tells many stories. There are too many to recount here, but a few should illustrate the power of these stories. Dr. Wicklund helped a father and daughter overcome the emotional distance that had built up between them as a result of the daughter being raped while walking home from a night out with friends. She became pregnant as a result, but didn’t feel like she could tell her parents. Her father felt like he had failed his daughter because she couldn’t tell him about the rape and he couldn’t protect her. Dr. Wicklund’s extensive counseling prior to the abortion helped them overcome the barrier and reconcile. There’s also the anti-choice protester who just weeks before had chained herself together with other protesters outside Dr. Wicklund’s clinic who was now in the clinic hoping to get an abortion herself (pp. 178-179). Turns out she had come to the clinic once before but the protesters prevailed, promising they would help her with her child the first time she got pregnant. She had the child, but all they gave her was some diapers and a layette set. She was pregnant again, but now she had a 5-month old and needed help. The protesters were nowhere to be found. Dr. Wicklund performed the abortion, educating the woman about the procedure in the process and helping another person see the importance of legal abortions in the U.S.

A major contribution to the abortion debate is the factual information the book includes. First, Dr. Wicklund is not pro-abortion (no one is). She decided early on that she would not perform abortions after 14 weeks as it was just too hard for her to do (pp. 28-29). She recognizes the importance of such abortions, but she chooses not to perform them. She also regularly dissuaded women from having abortions when they were pressured into it for the wrong reasons. The goal of all abortion doctors isn’t to abort children; it’s to save the lives of women and children and give women some control over their lives. Safe, legal abortions do that. Deciding to have an abortion is not a small decision, “Never once did these decisions seem easy or casual. Every one was the product of tremendous personal struggle. Anyone who claims otherwise is either very ignorant or unkind or both. Anyone who says that women use abortion as a method of birth control or as a simple matter of convenience should spend a day in a clinic where abortions are performed. No honest person would ever make that statement again” (pp. 28-29).

The book notes that women from all social groups get abortions: rich, poor, white, black, highly religious, not religious. However, poor women are four times more likely to have unwanted pregnancies and three times more likely to have an abortion. Making abortion illegal is just one more way the wealthy disenfranchise the poor. The book also notes that nearly 40% of women will have an abortion at some point in their lifetime. The book actually follows an entire procedure from start to finish as she talked it through with a patient, illustrating exactly how the procedure is done. It’s quick and safe. If done right, more time is spent on counseling and making sure the patient is making the right decision for her then on the actual procedure. Dr. Wicklund also allows the women to see the tissue removed if they would like. One young girl, whose uncle was on his way to the clinic to stop the abortion, saw the tissue and summarized the whole debate in one sentence, “How can it be that my uncle believes I am less important than that tiny bit of tissue you just took out of me?” (p. 140). This is what it is all about: women controlling their own lives (p. 161).

Perhaps one of the greatest contributions of this book to the abortion debate is the depiction of anti-choice protesters by someone who suffered horribly at their hands for decades. Dr. Wicklund first encountered them when she went for her own abortion. She remembered them as “an annoyance, a hassle” (p. 15). But she would later come to see them quite differently. Anti-choice activists have killed 7 people, tried to kill 17 more, bombed 52 buildings, burned another 180, invaded thousands of homes and offices, kidnapped people, threatened people with death and violence, thrown acid on people, robbed clinics, and stalked hundreds of doctors (p. 44). In many locales, anti-choice activists were not punished for their crimes (p. 53) as local authorities refused to prosecute them. Dr. Wicklund was threatened with violence and death through the mail for years before federal prosecutors caught wind of what was happening and finally took action. She used disguises to travel to and from clinics to avoid the protesters (p. 59), but that was not enough: she was physically assaulted on several occasions. The protesters barricaded her in her home and harassed her, her daughter, and her husband (p. 63). They broke into her home and regularly picketed her clinics. Until they were ordered to stop by the courts, the anti-choice activists maintained a pseudo-hit list of abortion providers online, checking off those that were shot or killed (pp. 190-191). They run deceptive “Crisis Pregnancy Centers” that pretend to be staffed by doctors but are designed only to misinform women and prevent them from getting the help they need, feeding them lies about abortion (p. 130). Anti-choice protesters are misogynistic power mongers, or as Dr. Wicklund put it, “For the black-and-white protesters, women are reduced to little more than incubators. Their role is to produce babies, no matter what the circumstances” (p. 238).

There are a couple minor issues with the book. First, the writing is fine, no major grammar or spelling issues, but it’s simplistic. It’s not captivating; the descriptions throughout are a bit dry. Additionally, the way the book plays out and is organized is a bit hard to follow. Stories seem detached from when they occurred; they simply pop into the otherwise chronological narrative of Dr. Wicklund’s life whenever and wherever without a clear sense of organization. These are very minor issues, admittedly, but they do make the book a bit harder to read then it should be.

Overall, I think this book should be required reading in 8th or 9th grade. Everyone should have access to accurate information about abortion and realize that abortions are not only necessary, but that they save lives: the lives of women and children. Anti-choice activists have one major goal in mind: the subordination of women. This is fundamentally an issue of women’s rights. Read the book and see for yourself.

(UPDATE: I originally accepted the claim made in the book that there were about 5,000 deaths due to botched illegal abortions every year in the U.S. alone prior to 1973. Turns out, that claim is just wildly inaccurate. First, we don’t know how many there really were as they were not reported. Second, the CDC does have data on 1972, the year just before abortions became legal. The number: 39. That did plummet quite rapidly and is no at about a constant 0, but it wasn’t in the thousands. Sorry, this is a new criticism of the book – she uses misleading numbers. It makes me wonder about some of the other numbers.)