Abortion rights activists have long preferred to hold themselves at some remove from the practice they promote; rather than naming it, they speak of “choice” and “reproductive freedom.” But those who perform abortions have no such luxury. Instead, advances in ultrasound imaging and abortion procedures have forced providers ever closer to the nub of their work. Especially in abortions performed far enough along in gestation that the fetus is recognizably a tiny baby, this intimacy exacts an emotional toll, stirring sentiments for which doctors, nurses, and aides are sometimes unprepared. Most apparently have managed to reconcile their belief in the right to abortion with their revulsion at dying and dead fetuses, but a noteworthy number have found the conflict unbearable and have defected to the pro-life cause.
In the aftermath of Roe v. Wade, second-trimester abortions were usually performed by saline injection. The doctor simply replaced the amniotic fluid in the patient’s uterus with a saline solution and induced labor, leaving it to nurses to dispose of the expelled fetus. That changed in the late 1970s, when “dilation and evacuation” (D&E) emerged as a safer method. Today D&E is the most common second-trimester procedure. It has been performed millions of times in the United States.
But although D&E is better for the patient, it brings emotional distress for the abortionist, who, after inserting laminaria that cause the cervix to dilate, must dismember and remove the fetus with forceps. One early study, by abortionists Warren Hern and Billie Corrigan, found that although all of their staff members “approved of second trimester abortion in principle,” there “were few positive comments about D&E itself.” Reactions included “shock, dismay, amazement, disgust, fear, and sadness.” A more ambitious study published the following year, in the September 1979 issue of the American Journal of Obstetrics and Gynecology, confirmed Hern and Corrigan’s findings. It found “strong emotional reactions during or following the procedures and occasional disquieting dreams.”
Another study, published in the October 1989 issue of Social Science and Medicine noted that abortion providers were pained by encounters with the fetus regardless of how committed they were to abortion rights. It seems that no amount of ideological conviction can inoculate providers against negative emotional reactions to abortion.
Such studies are few. In general, abortion providers have censored their own emotional trauma out of concern to protect abortion rights. In 2008, however, abortionist Lisa Harris endeavored to begin “breaking the silence” in the pages of the journal Reproductive Health Matters. When she herself was 18 weeks pregnant, Dr. Harris performed a D&E abortion on an 18-week-old fetus. Harris felt her own child kick precisely at the moment that she ripped a fetal leg off with her forceps:
Instantly, tears were streaming from my eyes—without me—meaning my conscious brain—even being aware of what was going on. I felt as if my response had come entirely from my body, bypassing my usual cognitive processing completely. A message seemed to travel from my hand and my uterus to my tear ducts. It was an overwhelming feeling—a brutally visceral response—heartfelt and unmediated by my training or my feminist pro-choice politics. It was one of the more raw moments in my life.
Harris concluded her piece by lamenting that the pro-choice movement has left providers to suffer in silence because it has “not owned up to the reality of the fetus, or the reality of fetal parts.” Indeed, it often insists that images used by the pro-life movement are faked.
(Pro-choice advocates also falsely insist that second-trimester abortions are confined almost exclusively to tragic “hard” cases such as fetal malformation. Yet a review of the literature in the April 2009 issue of the American Journal of Obstetrics and Gynecology found that most abortions performed after the first trimester are sought for the same reasons as first-trimester abortions, they’re just delayed. This reality only intensifies the guilt pangs of abortion providers.)
Hern and Harris chose to stay in the abortion business; one of the first doctors to change his allegiance was Paul Jarrett, who quit after only 23 abortions. His turning point came in 1974, when he performed an abortion on a fetus at 14 weeks’ gestation: “As I brought out the rib cage, I looked and saw a tiny, beating heart,” he would recall. “And when I found the head of the baby, I looked squarely in the face of another human being—a human being that I just killed.”