• Jena Martin MD


I started writing this essay in 2018 after overhearing two 'prochoice' guys making phone calls for a congressional campaign. We were packed together in a conference room reserved for one of those now-famous red-to-blue districts, full of volunteers who’d come in to make calls for the candidate. It was early fall, and I was full of dread about our future. I eavesdropped on this conversation I am about to recount and said nothing.

It's painful to call strangers about politics; even with the ones who end up nice, you’re bracing yourself for hostility. The two guys were talking about their recent calls in a spirit of camaraderie. “She said she was pro life”, said one of them. “Ah”, replied the other with a smirk, “I’ve got a comeback for that. Ask her ‘why don't you just adopt all of them then?’"

I cringed. Condescending and challenging; no way to convince anyone of your position. Also, I’m an adoptive mom, and nothing makes me angrier than people who talk about ‘just adoption’.

But even more important than their entitled and privileged tone, which I don’t think I have the power to change, is how this demonstrated a false way to think about both abortion and adoption. These topics, abortion and adoption, have similarities, but not in the way you might think.

There’s a reason I haven’t written this down in nearly two years. It can be dangerous, even deadly, to discuss abortion. At the very least, it can be uncomfortable. There are a lot of uncomfortable things that the right to a safe and legal abortion brings up, and this listing is not comprehensive: men and women have sex; sex is not always consensual; if a pregnancy results and it is unwanted, it is the woman who must deal with most of the consequences (yes, not all); human biology results in non viable pregnancies.

And then there’s that issue of the word choice. As a pathologist, I recoil at the word ‘choice’ when it comes to our bodies. Health and disease are about more than our individual choices or personal responsibilities. After all, how much of what we experience is a choice? Is it a choice to get melanoma, lung cancer, herpes? The problem with this way of thinking is that some people might say you did have a choice, you recklessly exposed yourself to sun, smoked, or had sex with someone with a genital infection. Choice requires agency, and yes we do have a lot of agency over our bodies. But our choices are constrained first by genetics, then by our society. Social determinants of health set our stage.

I had trouble even articulating my discomfort with pro choice language until I realized that this is precisely because the language has been stripped from us. This article, 'The case for a positive abortion law' , a blast from a previous feminist awakening, opened my eyes.

As quoted in this article, from Marion Banzhaf in the July-Aug.1980 issue of the Abortion Rights Movement Newsletter:

Being pro-abortion means that the woman is more important than the potential life -- the fetus. It is really quite simple. The pro-abortion movement puts the woman first. The anti-abortion forces put the fetus first. The pro-choice groups put the ability to choose first.

In my adult life, there has been no pro-abortion movement. The conversation has shifted entirely to the pro-choice vs the anti-abortion. I think this absence is a loss, because no matter what you think about this controversy, an overtly pro-abortion position would recenter women.

At the heart of controversies around pregnancy are disenfranchised women.

When women don’t have agency over their own bodies and have no say in important reproductive events, their choices are invalidated. Women, especially those without financial security, often have no choices. They are not valued as the most important person in any story.

Historically, most adoptions have violated the rights of the mother. (No matter what the current acceptable name is, be it the real, natural, or birth mother, this is an artificial terminology created by the adoption system. I use birth mother as it is the current iteration.) The birth mother tends to be powerless; for a variety of reasons, what she wants is discounted and negated. Her financial troubles might be the reason for relinquishing her baby.

Adoptive mothers, of which I am one, tend to be the one in the relationship who is powerful. Her choice is celebrated. If she has financial troubles proceeding with adoption, she is rewarded with fundraisers.

Wouldn’t a fundraiser have helped the birth mother?

In fact, abortion and adoption fundamentally involve women having agency over their own bodies; both are inherently feminist issues. That’s what ties abortion and adoption together. Neither is a solution for the other - it is the woman who is the solution. The ‘solution’ for abortion is not adoption, and those who were adopted were not ‘saved’ from an abortion. A woman’s choice is what connects these two issues. They are not connected by the outcome.

Listening to those guys, I felt full of despair. If these are the advocates for a pro choice argument, I thought, we’ve long lost the fight. In many ways, it has already been lost, along with murdered doctors and closed clinics; losing the existence of safe and legal abortion procedures in the United States seems imminent. But this missive is based on the idea that all change and new action starts with words, words to share and words to convince. Words can firm up support, and words can gain new converts. We need all of that, right now.

I’m a doctor who witnessed abortions in medical school and as a pathologist I think about the body in health and disease every day. For me, it is a relatively straightforward issue: Abortion is a medical procedure; it will either be legal and mostly safe, or illegal and mostly unsafe (even deadly). My response to that caller might have been: “Regardless of your personal morals, abortions will happen even if they are illegal. If you want to save life, let’s please keep abortion legal and women empowered.” And I’d tell those guys to rethink their scorn and condescension.

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