Thursday, December 29, 2005

Moments in the ER

In her book, Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood, Naomi Wolf writes with naïve surprise about being “infantilized” by the medical community. She is highly critical: “The medical establishment too often produces a birth experience that is unnecessarily physically and psychologically harmful to the women involved, even according to its own standards of measurement,” (Wolf, p. 6). She found her obstetricians condescending and reluctant or unable to give specific answers to questions about such matters as episiotomy and epidural rates. Being Naomi, she attributes this condescension, disrespect, and disregard for the patient to the condition she was in at the time (pregnancy). I would be surprised to find Naomi had much experience in the medical system prior to this, her first, pregnancy. If so, she might have been more inclined to use her journalistic skills to find another cause than her pregnant condition. In this quiet interim between Christmas and the New Year, I’m going to go off the topic of abortion for a moment to tell you a story – a few of my own, Naomi-like observations.

Late one evening several years ago, I was ordered to the emergency room by the neurologist who was treating me at the time. I was told he would call ahead and make the arrangements for me to be admitted, as it was time for a course of tests to determine the exact nature of my malady. The first lesson I learned that night was not to listen to one’s physician if he or she is dispensing advice with the clinking of bar glassware in the background. The second is that sending one’s patient to the emergency room after hours is a favorite tool of doctors. I would guess there are two reasons for this: first, there’s no money in an after-hours phone call to dispense advice to the patient, and only the patient’s impressions to go by to evaluate urgency. Second, there’s too much potential liability in not doing something, and malpractice premiums are an issue.

I did not want to take up emergency room space; but apparently, this is the only way one can be admitted to a hospital. I suspect there are far more insurance rules than health objectives that mandate this, but that’s par for the course. There I was on a busy night in the emergency room, with no emergent condition to speak of, surrounded by at least seventy-five other people in various states of emergency and non-emergency, and Dr. Flintstone, my possibly-tipsy neurologist, had not called ahead. We waited in chairs; well, I sat in chairs while my husband stood. Naomi complains that pregnant women get uncomfortable in hard, plastic waiting room chairs. Naomi, those chairs don’t do much for anyone waiting in an emergency room.

In the row perpendicular to ours sat a middle-aged man holding his sloppily-bandaged left hand. He had had an accident in his workshop, and had a pretty bad gash. Nurses kept coming out from behind the treatment area, hidden by thick walls cut with round submarine windows, but nirvana for those of us waiting in chairs, to check on his wound and apologize for the long wait. He had already been there for four hours when we arrived, but there was no one to stitch him up. He was in the best of spirits, smiling with understanding, and with a kind nature shrugging away any offers of sympathy for his condition. He had been bleeding, so we could all see his pain, and how it warranted attention.

I had been told to expect to stay, so I had packed a small “hospital” knapsack. It contained my toothbrush, my own toothpaste so I wouldn’t have to pay $15 for a hospital tube, my cosmetics, of course, and pajamas, and whatever else I may have grabbed in my numb state. I did not want to think about a hospital stay of my own, but I remembered my mother’s frequent visits and the things she needed then, so I relied on that rote memory to pack. A heavy-set young woman in the row of chairs in front of me had also come prepared with a small bag of her own. A nurse came out to finish her triage session, and asked her what her problem was, in earshot of at least ten people, including curious me. The young woman told the nurse in a bored voice and memorized words that she was bleeding down there, from her “vagina and urethra.” She was asked if she needed assistance with her bleeding, and said no. So, the nurse, who was carrying the patient’s very thick file, made a note on her admittance form, told her she’d be seen “as-soon-as-we-can-but-we’re-backed-up” and returned to nirvana. The young woman, oblivious to me and anyone else who was watching, reached into her bag and pulled out some provisions: a bag of raw vegetables and a novel. She started munching her veggies and seemed to settle in for a long read.

There was a slight commotion from behind us, and then a very thin young man dashed in between our rows. The veggie-lady looked irritated as she jerked up from her novel, jaws still moving, tucking her short legs under her plastic seat, squeezing as far back as she could. He stood looking back and forth at the floors and the walls, then ran toward the corner to my right, speaking breathlessly in Spanish I didn’t understand, until finally I could make out in my high-school Spanish, “Aqui, aqui!” His wife, a tiny woman, was scurrying directly behind him carrying a machine that looked bigger than she. Then I noticed for the first time that the man was cradling a small child. It was a boy of about three; he was wheezing. His mother bent over the electrical outlet that his father had located, and plugged the breathing machine in. The ER was under renovation; they had been unable to find any electrical outlet for the boy’s asthma treatment machine from where they had been standing, near the outside doors. Between the two of them, the young parents had the machine hooked to all of its complex hoses and outlets and to the child in seconds, and his medicinal breathing treatment began. “Holy cow, asthma,” I thought with alarm, and I looked around for the rush of ER personnel, a gurney, Dr. Welby, or anyone who would immediately rush this child into nirvana immediately. But all was still behind the submarine windows, and the doors didn't stir. Those seated near the outlet were kind enough to surrender their seats to the young mother, who sat rocking the child. As quiet waiting returned, he settled into sleep, the machine hissing gently. His father paced in silence, stopping often to peer into his son’s face.

Off and on, my husband had been calling Dr. Flintstone, who wasn’t getting any further from the clinking glasses. Eventually, we were allowed into nirvana, even though we protested that it seemed so unnecessary; wasn’t there a place just to be admitted? There was a man out there bleeding, and a child who couldn’t breathe. But no, I was to be taken to that special place where, even though I would still wait, at least I could do so under the watchful eye of medical workers. At many times while we waited, I battled the temptation to leave; but the longer we waited, the more time we had invested, and Dr. Flintstone had given us reason to be concerned.

I was placed on a gurney in the hall, because there were no available rooms. I didn’t mind, because I hoped I wouldn’t be taking up space for very long and I had no intention of needing privacy in the ER. My husband stood next to the gurney, and we people-watched for the next couple of hours. To my immediate left was another gurney set-up, but this one had a mobile privacy curtain. Across from me was an empty room that awaited a patient coming in from an auto accident, according to the chatter of staff, who always speak as if the patients can’t hear. Down the hall to my right, there were various rooms, and they all seemed full. There were a few more gurney set-ups like mine at that end of the hall, too. The staff was oddly slow. From our vantage point, we could see what I would call the nurses’ station. It was always surrounded by people in scrubs who sat, stood and talked, with occasional break-aways who would disappear into various rooms, then return to sit, stand and talk again. They seemed uncomfortable; but not occupied.

From behind the curtain to my left I heard a plaintive female voice call, “Nurse?” It was tentative and soft, at first, as if the responder was expected to be near. A few moments passed, and then more loudly, “Nurse? Nurse?” A maintenance man with mop and bucket was passing. He stopped on his floor-cleaning journey, and said to the Curtain, “I’m the janitor, but I’ll tell ‘em you need ‘em, Miss.” Moments later, we saw him stop down the hall at the nurses’ station, talking and pointing back toward the Curtain. Then he continued with his mopping rounds until he disappeared from sight. In the moments that followed, scrub-adorned staff members walked back and forth, up and down the hallway in front of us. Sometimes, the Curtain’s hoarse, “Nurse?” would be timed just as one went by; other times, she called to an empty hall, and us. We waited for the janitor’s message to get a response from the nurses’ station. A few more minutes passed, then my husband made the walk down the hall. He told a group of people standing at the nurses' station that the woman near us was calling for help. He returned to my side, and within a minute a male nurse came to attend to the Curtain. They spoke unintelligibly for a few minutes, and then he left her again, with some kind of return promise of something she needed, it seemed. The Curtain became quiet for awhile.

From the big double doors at the left end of the hall came a commotion; a gurney with many people around it. This was the motor vehicle patient. From what we would soon overhear, we learned she had been to imaging, and serious injuries had been ruled out. However, she was not exhibiting full consciousness, so she needed observation. Several staff members wheeled her gurney past us, into the room opposite. As they did, it was clear her hospital gown and blankets were seriously askew, and gave her no privacy. No one noticed or corrected the indignity as she was maneuvered into the doorway, first in, then out because they didn’t have the angle, then in and out of the doorway again. Finally, her bed was properly aligned, and she was out of sight. We looked at each other in relief, and then heard from our left a plaintive, “Nurse?”

The crowd that had installed the woman opposite us disbursed, leaving three men standing in the doorway. One seemed to be a nurse; the other was obviously an emergency responder, relieving himself of the responsibility of the patient; the third was Tom Bergeron.

“She’s a head case,” was the first thing the fireman said, consulting his clip board. “The cop says she drove off the road on purpose. Seems she’d left a suicide note for her family. Social worker called ‘em, and they say she’s going through a messy divorce. They can’t find anything wrong with her upstairs; but they sent for a neurology consult. She won’t wake up, but they think she might be faking that.” The male nurse nodded all the while. Tom Bergeron smirked. We watched and listened, openly. No one seemed to care or notice. The Curtain called, “Nurse? Nurse?”

The fireman left, and the other two men went into the Head Case’s room. I saw that it wasn’t really Tom Bergeron, cheesy host of both Hollywood Squares and the latest version of American’s Funniest Home Videos. He looked like him, and wore a similar almost-a-leisure-suit suit. He carried his own air as if he was important, and I soon figured out from their conversation that he was the emergency room doctor. The only one, it seemed, so that did make him important. From our position, we could see Dr. Bergeron bent at the waist over the Head Case’s bed, but we could not see the patient. He cupped his mouth and pseudo-yelled into her ear, “Yoo hoo! Are you in there? Hell-ooooo?????” We heard a soft murmur, much like a reluctant sleepy child would make on an early school morning. Dr. B. and the nurse chuckled at each other, shaking their heads in private understanding as they left the room. They walked over toward the crowd at the nurse’s station, as the Curtain pleaded weakly from the opposite direction, “Nurse? Nurse?”

The neurology consult finally arrived, and I wasn’t at all surprised to see he looked exactly like Howie Mandel. In appropriate triage, Dr. Howie went to see the injured woman in the room across from me first. Shortly thereafter, Dr. Bergeron came scooting down the hallway, sliding around the doorway on his shiny shoes to join Howie at her bedside. Dr. Bergeron told Dr. Howie about the patient’s history, including his opinion that she was faking it to get attention. Dr. Howie called to her, more gently than Dr. B. had. He asked her various questions; but the Head Case would not, or could not, speak. Dr. Howie took more than a few minutes to review her file. Apparently, there was nothing in her tests to explain this and she had a psych history, Dr. Bergeron pointed out over his shoulder. Her family could be called and asked to pick her up. Dr. Howie headed off to the nurse’s station to contact the social worker.

In the meantime, Dr. Bergeron paced the hallway in front of the Head Case’s room, and in front of my husband and me. He whistled casually. As he walked by the Curtain, she called with more hope than I’d heard in a while, “Nurse?” “No, Doctor,” he sang in response to the Curtain, smirking and snorting, then looking at us to share the chuckle. We stared back at him. He looked into my husband’s face, and he suddenly had something to check on at the nurse’s station. He scurried off in a rush. I thought I heard a very soft, stifled sob from the Curtain.

Then Dr. Howie Mandel was standing in front of me. We went through what was by now a litany of why we were there, and how we got there at the advice of Dr. Flintstone. We explained that I had no emergent problem, but a need for a complete neurological evaluation under hospital conditions. This is what we had been told by Dr. Flintstone, anyway. But now there was some conflict between what we had heard and what Dr. Flintstone had told Dr. Mandel, who had called him at our insistence. Unfortunately, it was now getting close to last call in Dr. Flintstone’s world. This was appropriately enough the final straw in this farce, and more than I could take since now I was convinced that Dr. Howie would whip off his thick glasses and expose the Candid Camera-style trick at any moment.

We simply walked out of the emergency room shortly after my conversation with Dr. Howie, and we got more attention in that thirty seconds than any patient received in the hours we had been there. Scrubbed personnel waving paperwork suddenly knew who we were. But we had had enough, and under no circumstances would I check in there. Apparently, I survived. And it will be the last time I ever go into an emergency room unless a.) I’m bleeding beyond the control of Band-Aids or b.) I’m unconscious and can’t say wait, let me see if duct tape will work instead. But I present this story to you not so you will feel sorry for me. I am the least of the characters in it. I still wonder what became of the Head Case, and if she ever found some reason to want to speak again. I can still hear the particular timbre of the voice from behind the Curtain whose condition I never knew. I was able to see the asthmatic little boy and his parents be admitted to care in nirvana right behind me, and saw a nurse go into their room to stay. That was a relief. But when Naomi complained about the medical community’s response to its pregnant patients, I was reminded of this night at the ER.

Friday, December 23, 2005

Fountain of Sorrow

Fountain of sorrow, fountain of light
You’ve known the hollow sound of your own steps in flight.
You’ve had to hide sometimes,
But now you're all right.

~ Jackson Browne, “Fountain of Sorrow”

But finally Roger had had enough. He looked at her and calmly, coldly, said, “Have you ever had to kill anyone?”

~ Unidentified Vietnam Veteran

The blogger whose text I quoted in my last post has more grace than I; she had already reconsidered the choice of words that led to my angry and defensive tirade. In her defense and mine, “Faithful Blogger” is not a real person, although I used someone’s real words. “Faithful Blogger” is a composite of many voices. I came upon one sentence that summed up the attitude that was bothering me, so I pounced on the words of that individual in order to attack a mindset. It reverberated like a personal attack, though, which is where my defensiveness shows most clearly. I even considered deleting that post, but decided against it for several reasons. First, my book report on Naomi Wolf’s Misconceptions stands as is. Second, my last post is a perfect illustration of what is essentially a two-word answer to the question, “How does one speak to the post-abortive?” Answer: very carefully. And I’m letting it stand because it says at least as much about my own weaknesses as it does anyone else’s. There they are, and the young blogger who took it on the chin has my gratitude. If she can hold up under my ranting, then she is probably ready to talk to the post-abortive.

But in order to talk to and about the woman who aborts, we have to understand the nature of abortion. We cannot say in one breath that abortion is both a traumatic experience and an act of selfishness; not in such general terms. The issue is complex. Yes, especially from the theological perspective, it is selfishness to deny God His will in determining who lives and dies. But in human terms, we have to remember that by definition, that which is traumatic is also threatening; many women who abort do so in response to a threat in their own lives. Is it always selfish to act in self-defense when one is threatened?

What can we know about the pregnant woman who is feeling threatened, which is echoed in the defensiveness of the post-abortive woman even decades later? We’ve discussed the fight/flight/freeze response to threat before. In his book, On Killing, Lt. Col. Dave Grossman tells us that “when we examine the responses of creatures confronted with aggression from their own species, the set of options [fight/flight] expands to include posturing and submission,” (Grossman, p. 5). The tiger on the jungle path cannot be reasoned with by his human prey because we don’t speak Tiger. Human beings, however, can communicate and negotiate, even when no words are used:

There, not more than 15 feet away, sat a Viet Cong eating a handful of rice from a pouch on his lap. We looked at each other for what seemed to be an eternity, but in fact was probably only a few seconds…After a moment, he put his pouch of rice on the floor of the tunnel beside him, turned his back to me and slowly started crawling away. I, in turn, switched off my flashlight, before slipping back into the lower tunnel and making my way back to the entrance,” (Grossman, p. 2).

Posturing is the display of our capabilities. Peacocks are posturing when they show their plumage. The "rebel yell" of the Confederacy was posturing, a non-violent act intended to convey a threat. King Kong beats his chest, saying clearly enough “Leave me alone. I'm more powerful than you.” Among creatures with a social order, in particular, submission is used to end a conflict without violence. One creature gives in and acknowledges the authority of another. Sometimes we social humans submit in response to a threat of violence from another:

I was always told I would never have children due to severe endometriosis; imagine my surprise when I discovered I was pregnant. I was so excited and couldn't wait to tell him about it. I was about 6 or 7 weeks along. I told him and he seemed very upset. He told me there was no way he was going to have a child. Being totally against abortion, I told him no way. We seemed to get into more arguments, and the abuse seemed to get worse. I was determined to have this baby. I was about 12 weeks or so when the worst came. He told me if I didn't go get an abortion he would kill me. He actually held a gun to my head. We drove to some place in New Jersey.

Sometimes we submit to the will of others, and may not know why or even how:

I can recall being awestruck as the lady told me that I was going to be a mother. I wept and I shook all at the same time. The joy was more than I can detail in mere words. When I told Edward he was pleased and we were both anxious to share our good news with his family. His family reacted with concern yet with love over our blessed news. Later that day Edward and I spoke of marriage. We spoke about our futures together. All seemed well.

It was time to tell my family, the family that had raised me in a supposed Christian environment. I was scared. I was afraid to do what had to be done. I knew in my heart that I had to tell the truth. I had to tell them. So I did. I confronted the issue alone. I attempted to explain as I sat there and heard something that I will never forget. The decision was that I was to abort my baby. I was told that this is what was best for all concerned. I didn’t know what to say. Thoughts raced through my head of Sunday sermons denouncing such a procedure. My mind raced as my mother explained to me that I had to use my own money. I was told to take the money out of my savings and to have Edward drive me to the city. I had done the damage. I had to fix it. I feared abandonment, having no home or support. I was told that I would be thrown out into the streets. So, I did what my mother demanded.

In my case, the positive pregnancy test hit me like a sledge hammer in the chest. I sank to the floor of the bathroom (where else does one do these tests?), and struggled to cry. It seemed too big to cry about. Then I started to laugh at my own stupidity, and when I did, I also wept. I thought, “Hello, Baby,” and “I don’t know if (how) I can keep us alive.” I started to lose my mind just about then. I understand in a very personal way that an unplanned pregnancy can, in and of itself, be traumatizing. I do not, however, understand abortion as the remedy.

What is happening hormonally, on a neuropsychological level, when a pregnant woman is threatened? To learn that, I started trying to find information about how hormones affect behavior in pregnant women. I didn’t find nearly as much as I hoped, so I’m going to wing it. I found quite a few sweeping and generalized statements that women who are pregnant are under the influence of hormones, but not a lot of information as to how this influence is manifested. Naomi Wolf writes that obstetric psychology as a field of study is widely known in Europe and Australia, but virtually unheard of in the United States.

So for now I’ll try to reason it through in a simplistic, but perhaps revealing, way. The goal of the species is twofold: the survival of the individual and the survival of the species. In mammals, and only in mammals, these goals become intertwined in a remarkable way when the female is pregnant with the next generation. They cannot be separated. When the survival of one threatens the survival of the other, then this is a sign that something is wrong.

It also makes sense for the pregnant mammal to be more alert while she is pregnant, because of this twofold goal to secure survival. From a neuropsychological standpoint, this is a unique time. The pregnant woman’s brain is being bathed by hormones, mainly estrogen and progesterone. According to the British Society for Neuroendocrinology, oxytocin, which will play a major role in labor, birth, and maternal bonding, is being stored up during the first and second trimesters for that purpose:

The adaptations in neural circuitry in the mother's brain are prepared by actions of pregnancy hormones. While the neural circuits for birth, maternal behaviour and lactation are ready for sudden action at term, they must be restrained until birth. So the circuits have powerful inhibitory as well as excitatory controls.

Oxytocin builds up in the posterior pituitary during pregnancy because less is released and more is produced. Oestrogen stimulates the oxytocin gene when progesterone secretion falls, though we do not yet know how the oestrogen receptor expressed in oxytocin neurones regulates this gene. Oxytocin neurones are strongly inhibited by three mechanisms which prevent them from releasing the stored oxytocin prematurely.

First, progesterone, acting through an intermediary, intensifies actions of the inhibitory neurotransmitter GABA on oxytocin neurones….brakes on. Second, stimulated oxytocin neurones produce nitric oxide, which diffuses from the cells and their terminals, restraining oxytocin cell activation and secretion….more braking. During pregnancy, oestrogen and progesterone increase neuronal nitric oxide synthase (nNOS) activity and also activate the third mechanism, which uses brain peptides with opiate-like activity. These opioid peptides restrain oxytocin secretion first via receptors in the posterior pituitary and later at the nerve cell bodies….safety stop?

The brakes come off….when progesterone secretion collapses near term: GABA is less effective and the nNOS gene is turned down. However, the opioid restraint remains, stopping the oxytocin neurones from running out of control, as excitation now predominates. A boost is given by oxytocin itself, breaking out from the nerve cell dendrites and driving the oxytocin neurones to operate near full power. Finally, oxytocin released in the brain acts on the circuitry for maternal behaviour, sensitised through induction of oxytocin receptors by oestrogen.

Oxytocin is being built up in storage, in the posterior pituitary of the brain of the pregnant woman. During times of stress, we know this about oxytocin: “In rats, the presence of adrenal steroids, released in response to fear and anxiety, increases the ability of oxytocin to bind with its receptors (or be put to use), but mainly in the amygdala." The amygdala will facilitate the state of hyper arousal.

What happens to the built-up oxytocin in a pregnant woman in response to the fear and anxiety associated with someone rejecting her and/or her child? Since we have reasoned that nature would benefit most from a pregnant woman who is more alert to danger than not, what can be known about the state of arousal as it is affected by the pregnant condition? Is the pregnant woman in a hypervigilant state of arousal? The estrogens and other hormones are already affecting her behaviorally:

“..only recently has it become apparent that estrogens exert many actions outside of the reproductive function, including actions on brain areas that are important for learning and memory, emotions and affective state, as well as motor coordination and pain sensitivity.”

The anterior cingulate of the brain, which is that area engaged in social bonding behaviors, will gate or inhibit the actions of the amygdala, which is stimulated in the brain under times of stress, and is facilitating the stress response. It makes sense then, that the pregnant woman would try to calm her aroused state by seeking the society of other human beings. Indeed, this may be Nature’s goal in creating the hyper aroused state to begin with: pregnant human women need assistance during labor and birth. The aroused state is created so the woman will seek that help. Finding no one willing, as is the case in more than two-thirds of all abortions, her stress will increase. She may dissociate from her emotional responses, including and especially the maternal bond, which is closely associated with the threat. In that state, she will acquiesce to the demands of others more easily; and in that state, the maternal bond can be more easily ignored, or denied, at least for as long as it can take to have an abortion.

Now, what happens to the built-up oxytocin when the pregnancy is terminated by abortion? We remember that oxytocin has opiate-like qualities:

After the abortion, I felt nothing but relief, mentally! My body went into grieving mode due to hormone realignment. That lasted a couple of weeks. I understood what it was and did not make it a obsession. It confirmed the opinions of the doctors that Post Partum Psychosis would have been the outcome had I carried to term. When that was done, my relief was TOTAL. Ever since, I have been nothing but relieved.

Sharon’s testimony is notable because she had a history of post-partum depression. It seems our best guess at this point as to the cause of this disorder is the termination of hormones once the pregnant state ends in birth. First, the answer, when we find it, will have to be much more complex than this. The cessation of high hormone levels is the natural consequence of birth; it is abnormal for it to cause illness, so there is a mechanism involved in post-partum depression that we are missing. Secondly, I note this because it is illogical to assume this same mechanism cannot cause depression if the pregnancy is terminated surgically or chemically, by abortion, instead of by natural cessation, or birth. Yet, some experts will still deny that abortion can induce clinical depression. I, at least, am going to try to develop an understanding of obstetric psychology. I don’t see how any discussion of abortion could proceed without it.

Tuesday, December 20, 2005


“For someone who is pro-life, the news of an abortion by a friend or relative brings a mixed bag of emotions. Anger, rage, regret and sorrow are some of these emotions. She did commit a selfish act by aborting her child, however no woman who truly understands what abortion is seeks an abortion.”

~ a Faithful Pro-Life Blogger

In an article telling pro-lifers how to talk to the post-abortive, a young blogger begins with the above paragraph. My comment in response did not make it through her screening process to publication, which disappointed me. I had politely cautioned the blogger against beginning her conversations with the post-abortive with statements such as the one she made above.

I didn’t retain my exact text, but can remember it pretty closely: “While it is true that abortion is an intrinsically selfish act, it is not appropriate to say that the woman who submits to an abortion is always acting selfishly. There may be mitigating factors, such as coercion...Secondly, there are plenty of women who understand exactly what they are doing when they abort. But again, the state of mind of the sinner is the Lord’s domain.”

That’s pretty close. I don’t see anything objectionable about it myself, but it’s been twenty-four hours and I’m not published, so I will assume my commentary has been rejected. It’s a good thing I don’t mind giving unsolicited advice; rejection doesn’t bother me. It’s also a good thing I have my own blog, because my response will be published. I want to protect the blogger’s identity, as this doesn’t merit any undue attention. She meant no harm. The content that followed her introductory paragraph was good, with references to organizations such as Rachel’s Vineyard and the Silent No More Awareness campaign.

This serves as an example, though, of what’s wrong with some of the thinking in the pro-life movement, particularly among those whose hands are squeaky clean and who wear their religion on their sleeves. Let’s start with the title of the article in question – it runs along the lines of, “How to talk to the post-abortive.” Why, thank you. I appreciate your interest in speaking to me. But no, wait. She didn’t publish my comment, so that was not her goal. She only wants to tell others how to do it; I’m not ascribing motives to her, because she presents her article as a template to be handed out. But since I’m taking up valuable internet space with this topic, let me add to the remark I made above, because the spread of this kind of misinformation shouldn’t be encouraged. Step one, Faithful Blogger: if you want to learn to talk to the post-abortive, you’re going to have to come down here to our level. The first thing you do is stop referring to us as if we were a unique type of freak who requires special handling. We are just sinners, after all. Abortion is a particularly heinous kind of sin because the unborn is always an innocent victim; but it isn’t the only heinous crime against the innocent that people commit. And in the final analysis, particularly if one professes the Catholic faith, we don’t get to judge which sinner is the worst kind. So try to think of yourself as one of us, for just a moment: a sinner. St. Paul does this when he acknowledges, “there but for the grace of God, go I.” Come on down here where the sinners live and get to know us, even though you aren’t one of us, and when you do, remember to thank God for your clean hands.

The second step you will want to take in order to effectively communicate with the post-abortive is to stop thinking we are all ignorant of what we are doing. Not only are we apparently unique in the world of sinners, but we are also stupid, because “…no woman who truly understands what abortion is seeks an abortion.” Faithful Blogger wants to believe that we are only aborting because we don’t know better. This kind of thinking is only going to lead her and others who feel the same way into deep disappointment and disenchantment with the world. It exposes her inexperience and ignorance of the often sordid reality of reproductive “choice.” FB, go read some abortion testimony, and some statistics – 43% of today’s abortions are repeat procedures. Ignorance isn’t likely. A lot of us knew what we were doing; unfortunately, that knowledge didn’t suffice to change the outcome. Something else was needed to prevent the abortion. Again, if you are interested in speaking to the post-abortive, listen first – find out why we abort. It will make you more helpful in the long run.

Faithful Blogger is an example of the pro-lifer with no personal abortion experience; clean hands, clean hearts, clean minds. Good for her. I hope she stays that way. On the flip side of the same coin, I finally finished Naomi Wolf’s book, “Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood.” If you don’t know her, and I don’t know much about her myself, Naomi Wolf is a feminist writer who now advocates legal abortions only through the first trimester. She changed her position on abortion after her first pregnancy, which resulted in a live birth. As far as I can tell, she and Faithful Blogger can sit comfortably side by side, as Naomi appears to have clean hands, too. She is a Pro-Abort with No (declared) Experience – a P.A.W.N.E., if you will. The friend who referred me to her writings insists that Naomi has had an abortion, but I can find no confirmation of that anywhere. She is said to have taken the morning after pill once, but that doesn’t count. Every woman who has ever used oral contraceptives has killed a “Maybe-Baby,” or two, or three, or ?. Possibly killing someone who may have existed is about as far as one can get from the kill emotionally; the psychological consequences of this kind of killing are not usually severe. In spite of my efforts, instead of finding any mention of personal abortion experience for Naomi, I find quotations from her along these lines:

“Naomi Wolf suggests a need to face clearly that a death occurs during an abortion, saying that pro-choice rhetoric would be more honest and therefore more effective.”Clinging to a rhetoric about abortion in which there is no life and no death, we entangle our beliefs in a series of self-delusions, fibs and evasions. And we risk becoming precisely what our critics charge us with being: callous, selfish, and casually destructive." She applies this idea to helping abortion staff. "Pro-choicers, too, scapegoat the doctors and clinic workers. By resisting a moral framework in which to view abortion we who are pro-abortion-rights leave the doctors in the frontlines, with blood on their hands, the blood of the repeat abortions -- at least 43 percent of the total; the suburban summer country-club rite-of-passage abortions; the 'I don't know what came over me, it was such good Chardonnay' abortions; as well as the blood of the desperate and the unpreventable and accidental and the medically necessary and the violently conceived abortions. This is blood that the doctors and clinic workers often see clearly, and that they heroically rinse and cause to flow and rinse again. And they take all our sins, the pro-choice as well as the pro-life among us, upon themselves.

"And we who are pro-choice compound their isolation by declaring that that blood is not there."

At least she is honest enough to call abortion what it is; but those who have only been horrified by the sight of their own blood should be careful when discussing the blood spilled by others. In “Our Bodies, Our Souls,” Naomi elaborates further about perpetuating the myth that no one dies during an abortion. The article is posted on the Priests for Life website at

On their website, Naomi is referred to as an “abortion apologetic.” I take issue with this title. Apolegetics is defined as:

1. The branch of theology that is concerned with defending or proving the truth of Christian doctrines.

2. Formal argumentation in defense of something, such as a position or system.

Naomi Wolf is not an apologetic as I would understand the term. In my limited experience, Catholic apologetics are Catholics. In my opinion, Naomi cannot be an abortion apologetic if she has never had an abortion. In fact, I'm not sure how well she defends the issue at all. In this book, Misconceptions, Naomi devotes a chapter about her third month of pregnancy to “Baby Values,” and questions whether we have the right to take the life of the unborn child. And she waffles, back and forth, about the humanity of the unborn. At one moment during her first sonogram, she sees the tiny hands and feet of her unborn child and, in her own words, “Some voice from the most primitive core of my brain - the voice of the species? - said: You must protect that little hand at all costs; no harm can come to it or its owner. That little hand, that human signature, is more important now than you are. The message was unambivalent,” (Wolf, p. 29). Later, when she sees the child’s eyes in the image, she is struck by its “alien appearance:” “This was a baby in my belly, but it was also a time glider hanging poised in inner space, ensouled already, or to become ensouled at some moment that I would be wholly unaware of...And I could swear that, when it had looked at me, it had conveyed this directly to me: Yes, I will be a human baby eventually, small, helpless, new, and wholly lovable. But not yet,” (Wolf, pp. 30-31).

I finished reading this chapter in complete disbelief that Naomi Wolf was a pro-choice advocate. I'm not sure Naomi knows what it is she advocates. This book is not a difficult read by any stretch of the imagination, but it sat unread at this point for two weeks. I didn’t want to finish the book, but I couldn’t stop thinking about it. So in the interim, I did internet research about Naomi, hoping perhaps to find some insight into what makes her so flaky. Is she pro-choice or not? There is mention that she “flipped” on her fellows in the pro-choice movement after this, her first pregnancy, and mention of an article she writes advocating limits on access to legal abortion in the first trimester only. This is a flaky cop-out as well. If abortion is a necessary, right, and healthy medical procedure at 10 weeks of gestation, it is at 13 weeks as well – or it is none of these things.

I dreaded returning to Naomi’s writing, but finally realized the dread I felt was disproportionate to the scope of the project. I had only agreed to look into her writing at the suggestion of a friend, after all. Nothing major hinged on my finishing the book; I could walk away from it if I wanted to. Or I could just take the few hours needed to go on from her third month of pregnancy to the end of the book. One day, I threw the thing across the room, disgusted with it, and left it askew in the corner for days. I vacuumed around it. As it gathered dust, I tried to figure out what my problem really was. If you have post-traumatic stress disorder, this will sound familiar. Apparently, healthy people don’t have to go on an expedition to find out what their emotions are, from where they stem, and why. But I do, and at times, I am very dense.

I sat one morning glaring at the book, noting its drab color scheme, pus-yellow and brown; Naomi smiled at me through a fairly thick layer of cosmetics from the back cover; and as I tried to talk myself into picking it up, I thought, “But, crap, she’s going to take me through every month of her freaking pregnancy,” and it dawned on me, at last. I opened the book, barely noticing the bookmark and its “All things are possible with God” message, and finally understood my reluctance to continue. Naomi and I had left off at the beginning of her fourth month of pregnancy. This is where she and I would diverge. I had been pregnant until my fourth month. I did not want to go there again, and more than anything, I did not want to go beyond.

So I did. I finished it that day. Here’s my book report: if you are a woman who wants to have children, read the book. It will tell you everything you ever wanted to know about being pregnant, bluntly, honestly, and from a pro-woman perspective. There’s marvelous information about the natural birth process and midwifery, and Naomi’s case studies in birth trauma support my contentions on abortion and maternal bonding, found here and here. Naomi “discovered” that the medical community condescends to pregnant women, and in so doing, demonstrates one of the things I don’t like about her. Apparently, social problems don’t become social problems to Naomi until they trouble her own world. Abortion was to be advocated until she became pregnant and recognized the individuality of the child in the womb. And as she searched for a nanny, she lamented that equality between the sexes has not advanced into the area of child care, since she and her friends who were mothers were deemed responsible in the household for all things “Baby,” in spite of having husbands who had been well-trained in the finer points of feminism.

Here she disappoints again. She calls herself a journalist; yet, when she wanted to know what other women experienced in becoming mothers, she asked her friends. When she wanted to know what women of color experienced, she asked her friends’ nannies. She discovered, to her outrage, that the child care providers she and her friends employed were most often leaving their own children unattended or in substandard care in order to go to work every day. To Naomi, this best exemplifies the disrespect we show to mothers in our society; we make no provisions for them in the workplace. She ends her treatise on modern motherhood with “A Mother’s Manifesto,” otherwise known as “A List of Things Naomi Thinks Other People Should Do To Help Mothers.” Here’s one example: “We need on-site day care so that we can see our children while we are at work and on-site nurseries...” Marvelous idea. I support it all the way, along with the spirit of the rest of your manifesto. I just have one question, Naomi – when you were interviewing your friend’s nannies, one of them, a black woman, mentioned that her own youngster was a latchkey kid, left home alone while she worked. Your own nanny’s children were in another country; she was sending money home but unable to see them. Why not suggest to your friends that your nannies could raise their own children alongside yours very easily? You could have provided on-site day care instead of talking about the lack of it. You had the resources in your hands; you saw the problem; and you could have actually done something to make a difference.

And now, I really am finished with Naomi Wolf. I have a litany of complaints, and more than a few compliments. But most of what I would say would probably be tainted with sour grapes. I don’t like P.A.W.N.E.S, Naomi, especially those who go on to discover the joy and sometimes savage beauty of motherhood. I also don’t like people who have never killed who endorse killing as though they are intimately familiar with its characteristics:

“Abortion should be legal; it is sometimes even necessary. Sometimes the mother must be able to decide that the fetus in its full humanity must die. But it is never right or necessary to minimize the value of lives involved or the sacrifice incurred in letting them go. Only if we uphold abortion rights within a matrix of individual conscience, atonement, and responsibility can we both correct the logical and ethical absurdity in our position - and consolidate the support of the center.”

~ Naomi Wolf,

It is most often those who have never experienced combat who endorse it; who describe it in its most glowing terms; and who want to glorify the deeds done therein. The only woman of sound mind who can so blithely discuss wielding the power of life and death over her unborn children is one who has never actually done so.