Untold Stories

Mahood, Sally

            Every other week I leave my family practice of thirty years - multigenerational families, babies I delivered, expectant mothers, chronic disease patients - to provide abortions to women I have never met before, and likely won’t again.  That day they share their life stories as they grapple with their unplanned and  unwanted pregnancy. They range in age from twelve to fifty years, from every community in my province and every walk of life.  Each day I listen to an amazing array of stories of unwanted pregnancy and each evening I record them.  Sometimes they are stories I could never have imagined: incredible stories of loneliness, migration, poverty, secrecy, love, violence, desperation and determination.  Often they are very ordinary narratives, but speak the emotional truth of women’s lives.  The stories shock, educate, touch, and anger,  but never leave me. 

            N worked for Walmart for $8/hour on a foreign worker permit, until it ran out, health coverage with it.  Pregnant and “illegal” she sought abortion.   The hospital demanded up front cash payment for lab and ultrasound services.  I will  never forget her counting out hundreds of dollars in $10 bills from an envelope in her locker.  “I could try to contact the health department to have the fees waived, ” I said.   She quickly declined.  Her precious nest egg from months of minimum wage drudgery was less important to her than secrecy and fear of deportation: a sad beautiful face with such desperation in her eyes.

            A cheerful mother of three,  K discovered she was pregnant after arriving with her husband from Kosovo.   A refugee agency pointed her in our direction, with a woman of similar age and background to accompany her and translate – an accidental meeting and clearly the beginning of a lasting friendship.   The abortion decision was matter of fact.   When it came to future birth control her eyes widened in genuine amazement at my description of an IUD that could prevent a similar crisis in the future with  99% efficacy.  Though middle aged mothers, survivors of civil war and ethnic cleansing, witnesses to untold insecurity and fear, these women knew no method of birth control except withdrawal, and giggled with delight at a the prospect of a  five year reprieve from pregnancy fears.  My attempts to draw an IUD inside a Kosovan uterus prompted much hilarity, uncovering great gaps in their knowledge of female anatomy.  But they got the gist.  The  translater smiled shyly and asked  “Could I have one too?”  This was not my first or last ‘two for one’ sale.

            These two women stand in joyful contrast to a sad woman from Eastern Europe who had come to Canada ten years before with her little boy. She had left her husband back home, worked single mindedly, parenting her boy and saving money for an eventual family reunification in Canada.  She had just returned from her first visit to her homeland, the first real reunion of son and father, to discover she was pregnant.  “You have to come to Canada now,” she told him, only to discover he had developed another relationship at home.   The abortion “is the least of my concerns” she said, “I have lost my dream”.

            C was 24 years old and had arrived in Canada one year ago.  She was pregnant by a new partner, and not ready to have a baby yet.  Her grief was focussed on the baby she had given birth to in a refugee camp in Africa, who had died of starvation at nine months of age.  “I feel nothing for this pregnancy,” she told me. 

            Most stories are “homegrown”,  the stuff of “everyday life”,  though no less memorable.  Secrecy is a common theme: a mother and daughter having abortions at the same time,  neither having told the other for fear of condemnation or disappointment;  a forty year old widowed immigrant running a small town restaurant describing  her sixteen year love affair with a local widowed farmer.  “People would never approve”.  They carried on a long secret intimacy with one birth control failure, and an abortion. 

            “Nobody I know has ever had an abortion,”  I hear.  Most women never divulge abortions to their doctors, and doctors are reluctant to ask, perpetuating abortion’s invisibility.  More common than heart attacks or breast cancer, almost one in three women in Canada has an abortion in her lifetime.

            Moral judgments about abortion are both secular and religious. “I almost died with my last baby, and now have chronic kidney disease” says S, a 35 year old mother of three.  “My husband doesn’t understand.   He thinks abortion is a terrible sin.  I can’t even risk telling him I’m pregnant.  My closest girlfriend’s here to support me”.  Often secrecy reflects the shame and ghettoization of abortion, but often isolation is by choice.

            I grapple with my own ambivalence about F, a tall, slender, tanned and affluent housewife from the ritzy end of town, pregnant by her much younger lover who “already ditched a previous girlfriend for having an abortion”.  “I wouldn’t be doing this under any other circumstances” but couldn’t “break up my family,” who would “kill me if they knew”.   Upon discovering  a spontaneous pregnancy loss she was ecstatic.  “So I didn’t technically have an abortion.  I’m so glad as I’m totally opposed to abortion”.

            Once decided, I am always struck by their determination.  Like my infertile patients who will risk all to achieve a pregnancy, so too will these patients to end one.  A young couple desperately searched for a babysitter for their  toddlers while they drove eight hours on winter highways for a fifteen minute abortion.  Another young woman hitchhiked hundreds of kilometers for a procedure  unavailable at home.

            The complexity of relationships that lie beneath the iceberg of unplanned pregnancy is often remarkable.  A 14 year old living with grandparents after her own mother’s suicide was seeking an abortion.  She reached out to her biological father for the first time in years.  He came on a dime, travelling from afar to reconnect and support her in the first of perhaps many challenges ahead. Both were still mourning the lovely young aboriginal woman who had succumbed to depression so many years before, but this abortion was, strangely, a new beginning for both.

            “I fought back pretty hard for the first few hours” a frightened K told me,  describing how her new partner had “gone berserk”, dragged her into his truck, duct taped her mouth, kicked her senseless in a field where police later found her.  “I don’t want anything that will tie me to this for the rest of my life,” she said.  

            Bad behaviour isn’t always limited to abusive partners.  I will never forget the patient who reported her doctor, on discovering her intention to seek abortion, removed a crucifix from around his neck and dangled it over her abdomen chanting “Mommy loves you, Mommy loves you….please don’t kill me Mommy’”  A professional body acted on the patient’s  subsequent complaint.

            Last week there were no horror stories, just two ordinary married mothers with babies under a year.  Tired and breastfeeding, they had missed a birth control pill.   Both were supported by their husbands who looked shell shocked. Next door, a married couple twenty years their senior, scrimped for years to take their adult children to Hawaii. The trip had a salutary impact on their quiescent sex life.   Despite a tubal ligation, they were embarrassed to be pregnant, twenty years after their last child was born.

            What complicated webs of love and loyalty I witness!  Y divorced and remarried, had an abortion unbeknownst to her current husband, supported by her ex-husband who is her friend but not her lover. No such support for G.  She has three children by the same partner, but parents alone.  When asked about his whereabouts she admitted she doesn’t know where he lives.  “He drops by every few months”.  That is the extent of his involvement.  She has no other expectations.  “Three children is the right family for me”.

            Next week will be the same but always different – more windows into women’s lives struggling with their complicated realities.  Their need to lead reasonable lives is often oblivious to the political debates swirling around abortion.   “How can I want one child but not another?”  “Is our house big enough?”  “Can I afford to take time off work?”  “Will this partner be there?”  “30 years is a long time to go without a slip-up”.  “One can still feel sad about something you freely choose”.

            And where did my story begin?  Why am I an abortionist?  Before 1989  Canadian law allowed abortion only after a committee of three (usually male) doctors approved.  Detailed consults from a sympathetic psychiatrist were frequently the only route.  As a child I remember my psychiatrist mother spending  Sundays dictating detailed reports for Therapeutic Abortion Committees,  who would vote yay or nay.  I remember those stories too,  and her frustration when physicians denied the procedure on their own personal ethical grounds.  Her patients’ stories are lost to history.  I suspect they are the same stories I hear today. 

            “I’d rather focus my work on saving lives or something more rewarding like delivering babies,” says a colleague.  I smile quietly knowing the relief I see in women’s faces when they tell their stories. Their gratitude at getting through a crisis and safely back to their lives gives me as much reward as anything I do.  Lives are saved. I can’t always fix what’s broken, but not having to have a baby at the wrong time in your life counts for a lot. 

Theme: Community | Communauté
Theme: Family | Famille
Theme: Health Care Delivery | Prestation des soins de santé
Theme: Patients | Patients

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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