During her abortion procedure, the patient turned to Claudia (names of clinic personnel are pseudonyms), a 50-year-old Latina licensed vocational nurse who sat beside her, holding her hand, and whispered, “Can you lean this way?” Claudia perched forward on her stool to get closer to the patient and suddenly the patient grasped the crucifix that dangled from Claudia’s necklace. The patient implored her not to move. Claudia recalled her surprise: “I had everything done to me, but I never had this.” The patient was very focused on the crucifix and seemed to stop paying attention to what was going on in the room. Claudia asked the head nurse to take the patient’s vital signs; the patient was medically high-risk and Claudia couldn’t take vitals from her position. Claudia stayed fixed in place, back aching slightly, throughout the rest of the 15-minute procedure while the patient held the crucifix close to her own heart. At the end, Claudia recalled, “I said to her, ‘Mi hija, it’s over.’ And she said, ‘It is?’” And then the patient took Claudia’s hand, kissed it, and said, “You’re an Angel.” Claudia was shocked and moved by the gesture. No patient had said that to her before. When she went to check on the patient later in the recovery room, the patient thanked her repeatedly. With visible emotion, Claudia finished the story: “I almost keeled over when she told me this—she goes, ‘Now I know I’ve been forgiven.’ And that was it. I think I’ve had that in my head—you know how you think about stuff like that—that thing lasted me for the whole month.”
Claudia told me this story 13 years ago, while I was conducting ethnographic research as a participant-observer in a hospital-based abortion service. I spent considerable time there helping, observing, and intermittently conducting as many interviews as I could with counselors, doctors, and nurses, in order to gain a rich view of abortion clinic life. This study became my master’s thesis, but nothing else. I feared publication might amount to a gratuitous exposé of people I respected dearly. I couldn’t think of any policy or academic imperative that necessitated revealing the intimate dynamics of this particular social world—certainly nothing that could make the potential feelings of betrayal worthwhile. Ultimately, I just tucked it away.
"Many women have felt shame and stigma forced on them by their religious groups, their families, and the society. We want to provide women with the spiritual comfort of knowing that God is with them through all things."
But recently, I heard the Reverend Rebecca Turner speak about how some abortion patients have unmet spiritual needs, and my ethnographic memories came flooding back. Her organization, Faith Aloud, like another organization called the Clergy for Choice Network, connects pro-choice clergy with religiously diverse women to help address their spiritual concerns about their abortions in ways that counselors, nurses, and doctors often cannot. The Faith Aloud website tells potential clergy volunteers: “Many women have felt shame and stigma forced on them by their religious groups, their families, and the society. We want to provide women with the spiritual comfort of knowing that God is with them through all things.”
Listening to Rebecca Turner talk about the work clergy members do to spiritually meet women where they are, I remembered how surprised I had been during my ethnographic work to find that the counselors, nurses, and physicians often informally addressed women’s spiritual needs. They ministered, in a sense, to their patients, some from a spiritual place of their own, and some from a gut feeling about what women needed to hear.
The counseling and nursing staff in the abortion clinic where Claudia worked were mostly middle-aged and vocationally trained. They were predominately Latina, like their patients, but some were Filipina, African-American, or white non-Hispanic. One particularly intriguing aspect of this abortion service was how these staff members were largely recruited from other parts of the hospital rather than from the ranks of the college feminists who staff many outpatient abortion clinics. In many ways the hospital clinic felt and looked much like any other ward, but for the simultaneously unsettling and reassuring lack of clinic-naming signage and the visible emotionality of some patients.
Clinic workers told me that they addressed patients’ emotions as they arose in all their forms, including sadness, fear, relief, guilt, and shame. Notably, some patients expressed this shame in religious terms and were not easily consoled by responses based on concepts of reproductive freedom and rights. Beatriz, a Latina recovery room nurse, herself very religious, shared how she approached patients who were experiencing spiritual angst.
[I] do a lot of spiritual counseling with them because of their guilt. They cry and they think that they will never have forgiveness from God. Sometimes they say, “I hope God forgives me for this,” or “my mother thinks that I’m really a sinful person,” or they cry and say, “I feel so bad about what I did and what happened to me.” So I say, “Well, many times we have to do things in this life, some kinds of decisions that are very painful, and that sometimes we have no choice or sometimes it seems like there’s no way out. But God understands and he knows what’s happening ... and you can ask forgiveness to God and he forgives you immediately. It doesn’t take years for that.”
Beatriz and Claudia starkly challenged my own unexamined assumptions that religion and abortion mixed like oil and water. I marveled at their easy confidence that they could help these women spiritually. There is no script for such moments, certainly no mainstream religious scripts that so readily grant women who get abortions forgiveness in such reassuring ways. In fact, data show that women who get abortions are likely to keep it a secret precisely because they fear they will receive harsh disapproval. They fear they will be judged and that the people that they care about will see them as less than what they were.
Ironically, for these patients, the abortion clinic may be one of the few safe spaces to seek spiritual counsel. Leticia, a Latina counselor, observed to me that patients who are socially or emotionally isolated are more likely to divulge their spiritual concerns: “They talk a little more with me when there’s not a relative that can understand the situation ... when there’s nobody, no support system, that’s when the women will approach me and tell me about their feelings at that moment.” These nurses and counselors may have had such candid conversations about forgiveness not only because patients lacked alternate sources of support, but also because the staff and patients shared ethnic and religious identities. Along these lines, a white nurse named Anne contended, “I think sometimes you can say the right thing for people who are religious, particularly if you come from the same background.”
Today, research and teaching about abortion regularly address stigma, ambivalence, regret, and complexity. We are exiting a political moment (that lasted decades) during which women’s spiritual and emotional pain around their own abortions was often poorly understood or even perceived as threatening to women’s rights by giving voice to moral questions, thereby presumably ceding ground to abortion’s opponents. Such women were often met with impassioned pleas to keep silent and with rhetoric that repeatedly asserted that most women feel relief (subtext: “So, what’s wrong with you?”). Influenced by the work of leaders and members of the Abortion Care Network to address this problem, new literature on the topic wades into nuance, acknowledging the effects religious teachings against abortion have had on the women who both share those beliefs and, because of the circumstances of their lives, decide to have an abortion.
I am taken back to these decade-old observations as I currently conduct research on the effects of religious doctrine on obstetrics and gynecology practice in Catholic hospitals. One in six patients in the United States receives care in a Catholic hospital where abortion, sterilization, birth control, and infertility services are prohibited. In my interviews with doctors who have worked in Catholic hospitals, I have learned that treatment options for women facing some of the most difficult pregnancy complications and losses, such as incomplete miscarriage in the second trimester, are restricted as well. These physicians tell me that, as they tried to offer their patients the best care they could, they felt their hands were tied by doctrine.
Stories from my earlier research of nurses and counselors ministering to the need for forgiveness in the abortion clinic provide a useful reminder of the value and importance of religious beliefs for some patients, but they also illustrate how religious practice in ob-gyn care is best directed by the patient, not the institution. I am learning in my current project that, in the context of Catholic hospitals, hospital ownership dictates the role of religion in women’s reproductive lives by using doctrine to restrict access to care in ways that neither those working there nor patients necessarily want. Whereas women like Claudia, Beatriz, and Leticia met individual women’s needs and concerns in the moment, with faith in a forgiving and understanding God, the Catholic health doctrine governing hospitals prescribes a one-size-fits-all religious approach.
As such, the individual suffering of spiritually diverse women goes unaddressed in the name of God—a problem made worse when the Catholic hospital is the only game in town. Religion and abortion can and sometimes do mix well at the individual level when patients speak their concerns and are ministered to by compassionate people, be they abortion clinic staff or supportive clergy, who meet them where they are.
This post originally appeared in the "Bad Girls" issue ofAtrium, and is reprinted with the author's permission.