Abortion and the Illusion of Choice

When I was going through medical school many years ago, I became passionate about reproductive justice: a woman's right to control her own body, to make her own reproductive choices, and ultimately to have an abortion if and when she wanted to without any interference from others.  I felt a strong sense of justice because women throughout history have borne the consequences of society making choices about their bodies: when they could have sex and with whom, when and who they would marry, how many children they could have, or not have.  A woman's control of her reproductive choices is about taking back control of her life.

I still believe in these same fundamental principles, but having worked at an abortion clinic for several years now I realize that the idea of "choice" is far more complex than it seems at first.  No woman chooses to come to our clinic to have an abortion in the real sense of the word.  Who wouldn't rather be somewhere else?  Working?  Shopping?  At the dentist even?!  While many women are eager and even happy to be able to come to our clinic, I wouldn't necessarily call it a "choice".  

Most women come to our clinic because they find themselves in a situation not of their choosing. The reasons that women end up unintentionally pregnant, or pregnant at the wrong time, or unable to bear a child are myriad, and I don't need to go into them here.  The key point is that for many women having an abortion or a D&C isn't a real choice, it is their best response to an unhappy, or nerve-wracking, or even devastating situation.  

However the idea of choice is not unimportant.  Having an abortion may be the most viable option under difficult circumstances for many women, but at least in Canada abortion is legal, and it is safe.  In many other countries abortion may also be the only choice a woman has, but there she must put her own health and safety, and even her own life at risk to get the service she needs.  Where there is often little space for real choice for women, it is society that dictates how dangerous her journey will be.