Speaking Abortion: Understanding Stigma, Support Networks, and Faith Within the Lives of Abortion Care Providers Kaziah White Senior Thesis 2016 Anthropology Department, Haverford College Acknowledgments There are so many individuals who have helped me in the course of this thesis. My thesis advisors, Chris Roebuck and Anne Balay, have acted as valuable sounding boards for ideas and have given insightful and generative critiques of my work. Molly Farneth, Assistant Professor of Religion at Haverford College, has also helped think through and edit the section of this thesis that discusses faith’s role in abortion care providers’ lives. I would like to thank the scholars who have devoted their careers to women’s health and abortion care. Although I have not met most of them, the ideas and work of Carole Joffe, Lori Freedman, David Cohen and Krysten Connon, and others have shaped my own understanding of abortion in the United States, and I am deeply grateful to them. I especially want to offer thanks to David Cohen, who took time to meet with me and discuss the potential of this thesis in the beginning stages of my writing. His advice steered this paper in a more effective and focused direction, and I truly appreciate that. Friends and family have all helped me think through the issues surrounding abortion that I address in the paper. Kat Poje, especially, has spent hours speaking to me about abortion, editing my work, and cheering me on. My sister, brother and parents have all been incredibly supportive of my thesis as well. I have truly appreciated their encouragement. Above all, I want to give thanks to the participants in this thesis. They have welcomed me, spoken with me about their experiences and taught me how absolutely necessary abortion care is. I cannot thank them enough. These providers have shaped both this thesis and my future path, and I feel blessed to have met them. Dedicated to the providers who ensure continuing abortion access in the United States despite the many challenges that they face, and to my mother, Rebecca, for her unflagging support, wisdom around the importance of abortion in women’s lives, and willingness to share with me our own family history of abortion. There’s story after story, and it’s not really the stories themselves, except for the continued affirmation of real life people living real lives, and exercising what control they have in order to be the people that they believe they are, and want to be. --Charles, clergy member, chaplain in abortion clinic, and participant in this thesis The purpose of the method of selecting interviewees was to discover the elements of the universe, not simulate it. --Rob Rosenthal Table of Contents Abstract......................................................................................................................................... 1 Introduction.................................................................................................................................. 2 Methods of Research.................................................................................................................... 7 An Abbreviated History of Abortion Care in the United States............................................ 11 Lived Impacts of Abortion Stigma on Providers..................................................................... 13 Support Networks, Self-Disclosure and Movement Building................................................. 24 “We’re all connected to the same mission and striving for the same thing”: Professional Support Networks for Providers................................................................................................................. 26 The Role of Personal Support Networks in Providers’ Lives....................................................... 29 “God Showed Up”: Faith’s Positioning within Providers’ Lives........................................... 33 The Shape of My Research........................................................................................................ 42 Conclusion................................................................................................................................... 44 White 1 Abstract Abortion has been a constant of human reproductive life throughout recorded history. Its more recent history in the United States, however, has been extremely contentious. Abortion has turned into a polarizing issue for many in the United States, and this polarization and politicization have had significant impacts on the lives of those who provide abortion care. In this thesis, I use oral histories of abortion care providers in a city on the East Coast in order to explore how stigma, support networks, and faith all play a role in their communities and their work in abortion care. I take an activist scholar approach to this work, in the hopes that sharing the stories and lives of providers will increase public understanding of the importance of their roles in reproductive healthcare and the need to support their work. White 2 Introduction On March 2nd of this year, I found myself at a rally calling for continued abortion access outside the United States Supreme Court in Washington, D.C., on the first day of the oral arguments for Whole Woman’s Health v. Hellerstedt. I was one of a crowd of three thousand people who had come from all over the United States in order to demand protection of abortion access. Despite the chilly weather, the rally lasted for the length of the morning’s oral arguments, with speakers such as Willie Parker, an abortion provider in Mississippi and Alabama, and Cecile Richards, President of Planned Parenthood Federation of America, addressing the crowd. The event brought together providers, people who had had abortions, and allies to stand in solidarity for the right to the healthcare that we find necessary. The crowd stayed enthusiastic throughout the rally, alternately cheering, chanting, and lifting cleverly worded signs high above the crowd. Casual conversations between individuals in the crowd about where we had come from and why we were there started and stopped, and then started again. The rally was a high point for me in this year of studying abortion providers, as I joined the thousands of people willing to publicly defend and celebrate the right to abortion, and witnessed once again the strength of these people and the abortion access movement. In Whole Woman’s Health v. Hellerstedt, a Texas-based abortion clinic is contesting the constitutionality of restrictive legislation designed to shut down abortion clinics in Texas.i People are already facing the consequences of this legislation. A study done in 2015 estimated that between 100,000 and 240,000 women of reproductive age have attempted to end their pregnancies without professional medical help in Texas (Grossman et al., 2015, 2). This research followed the passage of Texan state law HB2 in 2013 (part of which Whole Woman’s Health is challenging), which closed over half of the abortion clinics in Texas, dropping the number of White 3 clinics in the state to only 18 (Grossman et al., 2015, 4). If Whole Woman’s Health loses the Supreme Court Case, only 10 clinics in the state will be able to continue offering services (Grossman et al., 2015, 4). I am one of many who feel a personal connection to this court case. In 1939 my great- grandmother, Kahma T Long, lived in Texas. She was in the process of divorcing her alcoholic husband when she found out she was pregnant. Divorce was already scandalous at that time, and Kahma T had both a young daughter (my grandmother) and her mother to financially support. She couldn’t afford to have another child. So, although it was illegal then, she left her small town and went to Dallas to have an abortion. Kahma T survived the experience, and shared the story with my mother. However, many other women in that time were harmed in illegal abortions. In 1930, nearly one fifth of all recorded maternal deaths in the United States were officially caused by abortion (Gold 2003, 8). In 1940, just under 1,700 women died from illegal abortions (Gold 2003, 8). The thought that others might have to resort to measures such as these again, and that some women are already attempting to self-abort in Texas, is abhorrent to me. Whole Woman’s Health v. Hellerstedt takes place in an environment of increasingly restrictive regulations of abortion clinics and violent rhetoric targeting clinics and providers. In the past four years, there have been over 200 laws across passed in states across the country that restrict abortion access (Robles 2015). These restrictions have enormous impacts for the people seeking abortions and the people providing them. In Mississippi, Missouri, South Dakota, North Dakota, and Wyoming, only one clinic in each state has been able to stay open (Deprez 2015). Legislative attempts to close abortion clinics have been augmented by anti-abortion activists’ efforts. The so-called Center for Medical Progress released a series of videos in the summer of 2015 accusing Planned Parenthood of selling fetal tissue, which had a range of harmful effects White 4 on reproductive healthcare (Fernandez 2016). The claims made by the Center for Medical Progress sparked conservative pushes in different levels of government to defund Planned Parenthood (Fernandez 2016). These videos have also dramatically increased the violence and threats of violence around abortion care—in 2015 alone, there were 3 murders, 9 attempted murders, and 94 threats of harm or death (National Abortion Foundation 2016, 2). In November of 2015, a gunman killed three individuals in a Planned Parenthood in Colorado, and cited the videos in his defense of the protection of the unborn (National Abortion Foundation 2016, 2, and Turkewitz 2016). Including these most recent deaths, 11 people have been murdered for their involvement with abortion care in the United States (National Abortion Federation 2016, 2). I focus on the narratives of individual providers in this thesis, but this background of increasing regulation and consistent harassment of providers is important to keep in mind. The aggressive targeting of clinics through both activism and legislation has affected most abortion providers through the creation of an environment of fear and heightened job insecurity for abortion providers, including those who shared their stories for this thesis. Despite these regressive cultural trends, spaces for hope continue to exist within abortion care in the United States. Abortion providers and their allies have faced these attacks together, and a diverse coalition has come together to advocate for reproductive freedom and bodily autonomy. This was visible at the rally at the Supreme Court, as speaker after speaker named their different communities. Black, Asian, Latina, and queer communities all had a presence on stage that day, as did many different geographic locations. The resilience and strength of the community is also apparent when speaking to providers, as they share the motives that drive them and their desires to continue working in the field, regardless of threats to their safety or community standing. White 5 The deeper one gets into an issue like abortion, the more sides of the issue appear. I went into this project knowing that I wanted to listen to the stories of abortion care providers, in order to better understand why there are so few abortion providers, and why abortion in the United States is so embattled. After months of talking to these extraordinary people, and listening to the stories of not only the individuals who get abortions but also those who provide them, I have realized that I cannot write here about all the facets of abortion that I think we should be discussing as a society. Therefore, I have chosen to focus on three aspects of abortion providers’ lives that I believe have a significant impact on their practice: stigma, support networks, and faith. Experience as a provider largely depends upon one’s community, and how willing it is to protect access to abortion. By studying stigma, support networks, and faith, we can better understand the ways in which abortion care providers are regularly impacted by the communities in which they live and work. This paper begins with a brief examination of the history of abortion in the United States. The background I offer focuses on the providers of abortions, and their role throughout the history of the country. The history will then situate the experience of providers currently working in the United States in a context of those who offered abortion services in the past. Following this condensed history, I will examine the stigma that the providers I spoke with experience because of their work. Most of the providers who shared their narratives for this thesis mentioned at least one type of stigma and its impact on their lives, and this section will focus on those experiences. I will next delve into the support networks that abortion care providers use, and the ways in which they manifest both personally and professionally. Support networks shape an abortion provider’s experience of her work through the actions and beliefs of colleagues, family and friends, and therefore significantly impact the providers. The next part of the paper will White 6 explore the role that faith plays in some of the participants’ understandings of their work. These beliefs can play a prominent role in providers’ lives, in how they handle stigma, the sources of motivation they have for the work, and the systems of support that they rely upon. Before I begin this paper in earnest, then, I find it important to make my own investments known to the reader. I strongly believe in reproductive justice and abortion access, and my work will demonstrate this leaning. This position comes partly from a knowledge that I would not be here today if some of the women in my family had not been able to have abortions. It also comes from my involvement with organizations working towards reproductive justice and gender equality. I want people in the United States to continue to have access to abortion services, regardless of income, race, or location. While my thesis focuses on aspects of providers’ lives, that examination is grounded in my desire to de-stigmatize abortion and understand how to make it more accessible within our society. This positionality has certainly shaped the conversations that I have had with providers and the thesis that I have written. The responses I got from participants were at least partially shaped by my openly stated belief in their work. I have also grown in my understanding of the social challenges that abortion providers face while writing. Even as a researcher, I have experienced a kind of stigma in my decision to write on abortion access and providers. Although I am very open about the focus of my thesis on abortion, I notice an internal conversation weighing the pros and cons of disclosing every time that I tell someone about the work that I am doing. If someone quickly changes the topic after I tell them my thesis topic, I wonder if they do so because they do not believe that abortion should be available. These repeated experiences have increased my sensitivity to some of the different challenges that providers face when deciding whether or not to disclose their work.