Abstract
Remnants of the drama of abortion have trickled over from the 20th into the 21st century. Little of the moral panic and urgency of the issues remain, but legislative bones are embedded in ancient codes that provide provocation and occasional bouts of apoplexy. In Victoria in August 2007 a move was made to bring legislation into line with common practice and community values [1]. The private member's bill, moved by MP Candy Broad, was withdrawn when the Premier of Victoria referred the matter to the Victorian Law Reform Commission with a request that they report by March 2008. The private member's bill was intended to put to rest the irritant of laws from two centuries ago that made abortion illegal [2]. Those laws were passed in England in 1861 and had the purpose of protecting women from the dangers of intervention during pregnancy in an era that was pre-antibiotic, pre-electricity, pre-anaesthetic, and plain dangerous [3]. Fetal life was not a consideration. In the intervening years moral crusades against abortion were used as a talisman to demonize women's sexuality, and punish women for their inability to control men's sexual drive.
Attacks on women were led initially by the Roman Catholic Church. In the latter stages of the 20th century fundamentalist Christian and other monotheistic religions joined in the assault [4]. The purpose was to constrain the lives of women to service to the patriarchy [5]. In day-to-day terms that meant that women were to carry the load of unpaid work, family work, charity and volunteer work that kept patriarchal, hierarchical capitalist societies functioning. (A patriarchal society is one that preferences the experience of men and masculinity in the public arena, and conscripts women's work to serve the lives of men.) Women were required to reproduce, to maintain the family, to keep men focused on the tasks of work, and to do the unpaid caring work of society. In service to this ideal, women's sexual desire was subordinated, corrupted and demonized [6]. Part of the process of keeping women absent from their own desire, and compliant in service, was symbolized by making abortion dangerous, illegal, morally dubious and corrupting [7].
The medical facts of abortion are that it is simple, easily done, can be done by women themselves or others trained in the task. It requires neither doctors nor hospitals, and certainly not priests or judges [8].
With the burden of humanity upon the planet Earth exceeding 6 bn people, random decisions to have children will soon be seen as a freedom of the past. The notion that women should give birth to all the children they conceive will be seen as primitive superstition, wrong-headed and blindly ignorant. Already in China the human rights struggle is to prevent forced abortion rather than access to safe, legal abortion, and couples must apply to the State for permission to have their one child. The Chinese have recognized that the survival of their civilization rests on constraining population growth [9].
What it means to women
The decision to have an abortion is a private one that women make as part of their reproductive lives. It is one among the many reproductive decisions, including when and with whom to have a sexual relationship, whether and what sort of contraception to use, whether and with whom and when to become mothers. It is part of a woman's reproductive life that starts with menarche and monthly menstrual cycles, and may include birthing, miscarriage, infertility, assisted reproduction, contraception, endometriosis, polycystic ovarian syndrome, hysterectomy, ovarian or uterine cancer, multiple births, adoption, donor insemination, malignant hypertension, hyper-emesis or premature birth. In the broad context of a woman's reproductive life abortion is sometimes necessary, occasionally difficult, and rarely one of the more challenging reproductive events [10].
Women have abortions because they cannot or will not mother at this time, with this man. The decision to terminate reflects the seriousness with which women make the decision to mother [11]. To become a mother is the most life-changing event in a woman's life. In the 21st century in developed countries it is a decision likely to be made once or twice, rarely more, and one-third of women will not give birth at all. Women have a reproductive life of approximately 30 years and assuming they are heterosexual and sexually active for most of that time, there are many opportunities for conception to occur.
Many women can identify that their libido is strongest at ovulation. As a culture Australia is still emerging from a time when women were required to constrain, indeed ignore or disguise, their sexual desire [12]. Women are now asserting moral agency in their sex lives, and are thus able to monitor and report on libido with the concomitant belief that their sexual appetite will influence the likelihood of a sexual encounter. (Dr Helen O'Connell, from Melbourne, described the first accurate anatomy of the pathway of women's sexual desire in 1998 in the Journal of Urology [13].) If it does, the chances of conception will increase faster than improvements in contraception.
Men have a role in this that has hardly changed over the millennia apart from the disappearance of the shotgun wedding and chivalry. For the most part men continue to behave as though conception has nothing to do with them, and assume women will ‘take precautions’ if they want to avoid pregnancy [9].
The result will continue to be pregnancies that are not wanted, and for a majority of those, that means abortion. So despite advances in contraception and women's personal agency, thousands of women each year will require access to safe and legal abortion, even in the 21st century [7].
Drawing on data from Australia's first abortion clinic, the Fertility Control Clinic in East Melbourne, Victoria, the present study explores what having an abortion meant for women as they made the decision to end a pregnancy, and how they integrated this decision with their sense of themselves as good women. The study utilizes data collected in the early 1970s, shortly after the Clinic had opened, and following a revealing public inquiry into the relationship between police corruption and illegal abortion, the so-called Kaye Inquiry, which brought the practice of abortion into the open for the first time [14].
Making the decision
In the 1970s women experienced their need for abortion as deviant behaviour [15]. This was only5 years after abortion had become apparently legal, and safe pathways to a high standard of medical care were still being established. Women carried with them the weight of the history of abortion; illegal, condemned by the churches, reserved for bad women; dangerous, difficult to access, expensive, painful and risky [16]. Women were injured and died having illegal abortions. There was a 30-bed ward set aside at the Royal Women's Hospital for women injured by abortion and the corridors stank with the smell of sepsis [12], [15]. There was no clear pathway to an abortion and boyfriends and husbands asked their mates, work colleagues, taxi drivers and drinking companions. They found the money. And then for the most part women were on their own.
Fear of abortion lodges deep within a woman's psyche, embedded there by centuries of careless brutality leading to pain, humiliation, injury and sometimes death. These realities are not easily expunged from inter-generational memories, and even today abortion carries a stigma and smell of fear that is disproportionate to its actual medical risk. In 1996 a security guard at the Fertility Control Clinic was murdered protecting women's access to safe abortion [17].
Objective
Abortion has iconic status as a measure of authoritarian or humanistic values. This was heightened at a time when the legal status of abortion was not clear and society had little experience of lawful abortion. Unlawful abortion cast a long and deep shadow [15].
Up until the judicial decision by Mr Justice Menhennitt in 1969 that declared abortion legal in Victoria if the doctor believed, on reasonable grounds, that the abortion was necessary to protect a woman's mental or physical health, abortion had been presumed to be unlawful in Victoria, as it was in all other States in Australia and in New Zealand [18]. This did not stop women having abortions but the journey through illegality to the backyard or self-induced abortion frightened women to such an extent that it has taken generations for women to feel more at ease with their decision to end a pregnancy [8].
The trauma of unlawful abortion had resulted in women and their partners being effectively silenced, unable to talk about their experience to anyone, and struggling to integrate this deviant act into their definition of themselves as daughters, wives and mothers [11]. Doctors, too, were traumatized by the challenge of helping their patients manage unwanted pregnancies [19–21].
In this, the first study of its kind in Australia, women were interviewed to determine how they integrated therapeutic abortion with their sense of themselves as good women. The present study uses interviews carried out in the 1970s in Victoria, when society, and women themselves, were still learning how to speak about lawful abortion. The study was undertaken using social science labelling theory current at the time [22], [23].
Method
Australia's first legal abortion clinic was established in 1972 in Melbourne. Data from patient records in this clinic provided the first reliable evidence about who had abortions and why [24]. Clinical records were accessed for all women who had a termination at the clinic between June 1973 and January 1974 (n = 1736). A second sample consisted of the clinical records of all the women who attended the clinic for abortion between July and September 1974 (n = 359). The third sample was drawn from the clinic histories and an additional questionnaire completed by women between September and October 1974 (n = 438). The questionnaire included questions about the woman's attitude toward abortion, and how she thought others felt about it, and sought consent to be contacted for an interview 1 year after her abortion. Eighty-three per cent agreed to be interviewed and came from Victoria, and were included in the sample. The women who refused further contact were more likely to be young and unmarried than women who agreed to follow up.
A random sample of 34 was drawn from the 1974 questionnaire respondents. The sample was stratified for marital status and social class. These variables were reduced to binary categories of married/not married and working class/middle class. The single women were younger than the married women, and the effect of age has not been controlled for, because the sample was too small to control for more than two variables. The women had consented to be contacted at the time of their abortion. They were contacted by mail or phone and 32 (94%) agreed to be interviewed. They were interviewed at a place of their choosing, most often this was in their home. Nearly half the interview sample had not had children (46%) and 87% had not had a previous abortion. This was consistent with findings from the 1973 and 1974 samples.
The purpose of the interview was to develop an understanding of how women who are essentially law-abiding break normative values against having an abortion. The interview explored how the women explained their action to themselves and others, and how they perceived others as reacting to them. Post-abortion changes to their lives and self-concept were identified to test for (i) the impact of labels applied by others, and (ii) the efficacy of the techniques the women used for neutralizing guilt. Guilt in this context is a sociological term that refers to a failure of duty, rather than a sin.
Self-concept was assessed using the 20 statements test. This is an easily administered test that reflects symbolic interactionist theory [25]. The women were invited to write up to 20 answers to the question ‘who am I?’ at the end of the interview and all but one did so.
The interview was structured to enquire about self-concept and changes to self-concept, how the women made decisions usually and how they made the decision to have an abortion, relationships with others, including sexual activity, and their experience of having the abortion [26]. It ended with queries about changes in relationships, and changes in self-concept. The women were interviewed 12–14 months after their abortion. Interviews lasted an average of 1½ h, and were tape-recorded and transcribed. The clinical histories of the women were also drawn on for the study.
Results
Self-concept
Responses to the 20 questions test fell into several categories. These were consensual/subconsensual, moral worth, self-determination and inter-personal style. Consensual statements are those that require no explanation in order to be understood by anyone from the same culture, and anchor the person firmly and unambiguously in their culture. Examples are ‘a mother’, ‘housewife’ or ‘a woman’. Subconsensual statements require interpretation, are individualizing and carry private prescriptions for behaviour [26]. Examples from the study are ‘I am reliable to close friends’ and ‘I am understanding of others’. These statements separate rather than link the women to those around her. Married women made more consensual statements (54 married vs 15 single women) and single women made more subconsensual statements (132 single vs 75 married women). Single women did not appear to be interested in kinship roles, while married women had these as central to their self-concept. The single women did not seem able to name their roles or position in the community, while the married women could name little else.
Moral worth was interpreted as reflecting the individual's interpretation of how she stands in relation to moral norms or values. Single (and therefore younger) women demonstrated much more concern with moral worth than married women did. Only two married women mentioned it with phrases such as ‘I have become a fairly respected person’. Single women made both positive and negative statements about their moral worth. They used terms such as ‘reliable’, ‘understanding’ and ‘helpful’ as well as ‘lazy’, ‘nasty’ and ‘gullible’. The only statement made that referred to the abortion was made by a single woman who described herself as ‘more mature’ and ‘happier’ after the abortion.
Self-determination is a category designed to incorporate statements people make about goal attainment at a personal level. The single women were very concerned with self-determination. Sixty-one per cent made at least one statement such as ‘I am striving to get the best out of my life’ or ‘I am working hard to save for my future’. Only 18% of married women made statements in this category, and those were generally defeatist, such as ‘I give up very easily’ and ‘people say “you have made your bed, now lie in it”, so I just go on’. The difference may represent the optimism of youth compared with the realities of a defined role of women in service to their families. For single women the abortion seemed to be a self-determining act, while for married women it was more to ward off disaster.
Stereotypes
Stereotypes that the women believed were held about people who had abortions were hypothesized to impact on their experience of themselves as morally good. A stereotype is formed when a set of characteristics is believed to belong together, such that if a person is found to have one of the characteristics, she may be presumed to have the others. This can lead to problems of identity management [27]. Stereotypes are readily applied to people with visible stigmata. In the 1970s being pregnant without wearing a wedding ring was still considered deviant by many, although that moral code was beginning to fracture. Women who were sexually active and avoided visible pregnancy, either by contraception or abortion, were better able to manage their identity as a good person than a single woman with a visible pregnancy, and so abortion can become a tool of identity management.
The moral force of a stereotype can be applied by a woman to herself, whether or not others know of her pregnancy. To require an abortion it is first necessary to conceive an unwanted pregnancy. When asked to describe someone who was pregnant without wanting to be, the interviewees had a range of ready descriptions. All but one of the 32 women were able to describe a person who was unmarried and pregnant, although three women side-stepped the issue by replying that ‘it is their own business’. The others produced two stereotypes: that such women were morally wrong (‘careless’, ‘a social reject’ ‘tarts’, ‘shameful’ and ‘dirty’), or that the pregnancy would make them vulnerable (‘insecure’, ‘a poor thing’, ‘better off not being pregnant’, ‘bad luck’ or ‘a lot of strain on them’). Half of the women who commented on the moral valency of sex outside of marriage stated that it was acceptable, and half the women had reservations. The women who had reservations were identifying one source of social disapproval of the abortion that followed. These women were reflecting the moral landscape of their era, the early 1970s, and it is unlikely that these attitudes persist today except in particular cultural groups.
The women were also asked to describe someone who had had an abortion, and they were much less able to do so. Six women had nothing to say, and 13 described such women as normal, or as one put it ‘Basically you are asking me to describe myself. … just someone who had a problem and they made a decision about it’. The two stereotypes that were produced can be summarized as normal, sensible decision makers with ‘a good mind and they have thought about it’. The second stereotype was that women who have abortions must be desperate and may be traumatized by it.
The women produced four descriptions of abortion as an event based on what they thought community beliefs would be. These were that abortion was morally wrong, that it was dangerous, that is was illegal, and that it was necessary/acceptable. Only two women believed it was against the law, and the legal status did not seem to be important to the others. Only five of the women believed that the community accepted abortion as a solution to an unwanted pregnancy, which put them at clear odds with what they believed to be the moral values of their culture.
There was a marked reluctance to stereotype women who have abortions while at the same time a ready ability to identify negative community stereotypes of abortion as morally dubious and physically dangerous. These stereotypes could be expected to apply to each of these women if their behaviour became public knowledge, and so they needed to carefully manage information about their abortion.
The expected and actual responses of others to news about the woman's pregnancy and abortion is likely to be reflected in the woman's experience of the abortion. It will contribute to possible sources of guilt, and possible changes in self-concept that may result from the abortion.
Significant others
The married women nominated their nuclear family as critical to their self-concept, and as the people most important to them. Single women nominated friends as well as family. Some of these significant others were invited into the decision-making process, and others were deliberately excluded. Most of the women told the putative fathers (four single women did not) and 26 of the men made comments that made the women feel better about themselves. One husband denied paternity. Single women avoided telling their parents when they could, although the mothers who were told (fathers were left out) responded helpfully. Some had to be coached.
Well, she was half-hearted, she just kept thinking it could be a girl… but then I convinced her that I couldn't have coped, so she realized in the end.
Single women involved their friends, selecting those they thought would be supportive of their decision or who could help. Married women relied more on their husbands and parents, most of whom provided the hoped-for support.
Doctors were consulted for confirmation of the pregnancy, and support for a termination. They had an important role and were very effective in supporting and validating the women's decision. Two of the single women and three of the married women found their doctors punitive and unhelpful and they were bitter about that.
Twenty-two of the 32 women who were interviewed expected a hostile reaction from at least some of the people who were important to them. Expectations varied with social class. Working-class single women received more messages that extra-marital sex was bad, wrong or disgusting than middle class women. The women were generally more gloomy in their expectations of others’ responses than was warranted. Only one single woman expected uniformly supportive responses yet 11 received them, and only nine married women expected uniform support, and 14 received it. Despite all the anxiety and fear of disapproval only seven women were actually exposed to negative comments.
Guilt
Guilt is used in this discussion as a sociological term, meaning feelings arising from a failure of duty, or delinquency, or an offence against accepted values, rather than a sin [27]. Guilt is part of the social glue that keeps communities functioning. It serves to prevent people from contravening social norms by making them feel uncomfortable when they do so. It is distinguished in the present study from guilt invoked by religions that threaten hell for disobedience as part of their mechanism for invoking obedience to church law. In the case of women having abortions in the early 1970s, guilt related to a sense of failure of duty or breach of community moral standards.
Four types of guilt were identified by women in the present study. They were based on feelings that (i) the pregnancy was untimely; (ii) contraception had been inadequate; (iii) abortion implied selfishness towards the fetus; and (iv) abortion involved killing a fetus, and that good women are competent, unselfish and do not kill.
Marital status had a big impact on the type of guilt experienced. Single women were more guilty about the pregnancy than the abortion because it exposed their extra-marital sexual activity and challenged their persona as ‘good’ women.
I still feel ashamed that I've had the abortion, but not actually because of the abortion itself but because of the fact that I got myself pregnant.
This young woman is reflecting an internalized cultural belief that she was entirely responsible for the pregnancy, and that being pregnant was wrong. Eleven of the 15 single women and one of the 17 married women felt some guilt about the pregnancy. The married woman had conceived as the result of an extra-marital affair. Working class women were more shamed by the pregnancy than middle class women.
Contraceptive ineffectiveness left the single women feeling ‘stupid, careless’. It led to potential loss of face in front of others who thought they were too smart to have been caught in such an obvious trap. The married women used contraception that failed. Their guilt related to the fetus, ‘not giving the baby a chance’ as one woman put it. No single women felt the abortion was selfish with regard to the fetus. The nearest they came were mild feelings of regret that they would not have a cuddly baby to play with. A theoretical link between a missed period and a baby could not compete with the strong instrumental needs of single women to not mother.
Women who have experienced childbirth, the transition from fetus to baby to child, were more likely to consider the interests of the fetus. Women who were mothers were also more likely than nulliparous women to consider that abortion was killing a fetus, albeit necessary for them to do so. Nearly all the women who felt the abortion was guilt-producing were mothers, and nearly all the women who felt the pregnancy was guilt-producing were not mothers.
Nine of the 32 women experienced no guilt and these were primarily working-class women who had completed their families and were used to managing difficult circumstances in the best way they could.
Decision-making
A decision to terminate a pregnancy may be the result of a balance of the utility and disutility of having a child. And it may also be a strategy to cover up sexual activity, to protect a persona as a person who does not make mistakes, as a person who belongs within the culture, or to assert independence from social pressures. These alternate goals were reflected in how the decision was made, and who was told or not told about the pregnancy and the abortion.
Three patterns of decision-making were identified and linked to the sources of guilt. ‘Collateral’ decision-makers were those women who avoided their usual networks and developed a new group of advisers for this decision. ‘Complementary’ decision makers added others to their usual network, and ‘congenial’ decision makers treated the abortion decision the same way they handled other difficult decisions.
The collateral decision makers were young and single and all but one told their boyfriend and all but one did not tell their parents. A 17-year-old explained:
I ask Mum's advice… (but) she doesn't really believe in abortion and all that. She would have a heart attack if I ever told her, so I didn't mention it.
Complementary decision-making hinged on ambivalence and was used by eight women who wanted to continue the pregnancy but were not able to do so, usually because the man involved ‘wouldn't have a bar of it’. They referred to their usual sources of advice and finding these insufficient, continued to discuss the pregnancy with others, including friends, workmates and relatives. The strategy was not successful in resolving their ambivalent feelings because the more options that were offered the more difficult it became to find a way through.
The congenial decision makers mostly regarded the abortion as the natural extension of a prior decision to control their fertility. They were in stable relationships and their partners mostly felt the same way they did about the pregnancy. Their relationships survived the crisis of the pregnancy.
Guilt neutralization
Guilt needs to be neutralized to allow rule-abiding people to engage in deviant behaviour [28]. Guilt neutralization techniques were a vital part of the way an abortion was experienced, and influenced the consequences of the abortion for the woman. The women in the present study were essentially normal, law-abiding people. Like most people they carried with them a history of attitudes about abortion, which they were forced to examine only when they became pregnant. Any belief these women had that abortion was a failure of duty, or delinquent behaviour, or an offence against accepted values was aggravated when they had to go to an abortion clinic. This guilt, and accompanying anxiety and fear, had to be subdued, even if only temporarily, so that these rule-abiding women could break the rules on this occasion.
Part of the process of overcoming inhibitions about norm violation begins when an actor starts to develop her reasons for the act, or her motive. Motives are strategies for action. The women were aware of disagreement within their community about the morality of abortion and they needed a vocabulary of motive to allow them to act in the face of this disagreement. Doctors were particularly effective at helping them develop this vocabulary. The women also needed to be able to control who knew, so they could presume that others did not. A young single woman describes the process of losing control of the information and becoming the subject of gossip:
Sue had been going past the control room and at the time I was walking to work. She'd been in the garage and she heard Peter say to another friend in there ‘there's the girl who had an abortion’. And then I confronted his wife and she told me that Ann had told her, because she in turn had told her husband. I felt really bad.
Most of the women were very conscious of the need to control the information. This was more complicated than restricting it to as few people as possible. It involved selecting carefully those people who could be expected to support her in her decision to terminate the pregnancy, and avoiding others who would be critical. Supportive others became guilt neutralizers, or ‘normal-smiths’ in Lofland's terms [22]. Doctors were powerful normal-smiths when they chose to be, capable of defining the unwanted pregnancy as a medical situation that required intervention, for which treatment was available in a medical setting. Clinical encounters where the women were believed and not judged had the effect of strengthening the women by honouring their accounts.
I sort of had it in my head that they'd sort of look down their nose and say ‘well you're not getting it, and why do you want it’ and this sort of thing. But the girl that interviewed me, she was lovely, she put me at ease straight away… I was a bit shaky going in, but I came out quite happy.
Non-professional normal-smiths varied in their effectiveness. Parents, friends, workmates, siblings and the male partner offered help in constructing an account, providing validation of the woman's ideas, and sharing the burden of knowledge, with varying success. Mothers were effective at constructing accounts of necessity for their daughters. Sharing the burden of knowledge was helpful for the young women who had little experience in making life-determining decisions.
Excuses and justifications were also used to neutralize guilt about norm violation. Excuses reduce the level of personal responsibility, and justifications assert that the act was acceptable. Excuses included instances in which others were deemed responsible, impersonal factors were held to have led to the abortion, the abortion was inevitable, or the women asserted that human acts are inherently uncertain. Justifications used included instances where women described the abortion as altruistic, where they condemned the condemners, or they denied any deviance.
Many of the younger women justified the abortion in terms of their untried capacity for mothering, maintaining that children need capable mothers, ‘if you have a child you've got to be a good mother’. Others attacked the attackers, identifying men and Roman Catholics in particular, labelling them ‘narrow minded’, ‘just goody-goody churchgoers’, ‘just a few cranks’, ‘still in the Dark Ages’ and ‘so naïve they don't know anything about it’.
The main challenge women who were mothers had to overcome was imputations about their moral worth as mothers. They dealt with this by describing the hazards they were protecting the fetus from, including that they were fully committed as mothers, and that the world was a dangerous place and the future uncertain.
Most of the women used both excuses and justifications in their search for techniques to integrate their experience of unwanted pregnancy and abortion with their sense of themselves as good women.
Conclusions
Experiencing an unplanned pregnancy and subsequent abortion had important consequences for the women in the present study. They said they felt different as a consequence of having the abortion, and for the most part this was for the better. The abortion increased the information they had about their world, including the way others viewed them, their capacity to act in a crisis, the strength of the dyad responsible for the pregnancy, and information about reproduction.
The most important change reported by the women was an increased capacity to run their own lives. As Simone de Beauvoir wrote ‘it is at her first abortion that a woman begins to “know”. For many women the world will never be the same’ [29]. The women in the present study discovered that they could make and carry out difficult decisions, that they could alter the course of events and exert their wishes over their destiny.
One-third of the women had no moral qualms about the abortion, either before or when interviewed 1 year afterwards. This research was undertaken in the 1970s, an era when sexual activity for women who were not married was deemed generally unacceptable, and it is unlikely that feelings of shame or guilt related to this aspect of abortion still apply generally. The women for whom the abortion was problematic, rather than the sexual activity that led to it, had more difficulty resolving feelings of shame or moral trespass.
The women in the present study were mainstream women, upholders of the rights of children and the importance of the family. Most of them justified their abortion in terms of the need of a child for two parents with sufficient maturity, or a secure future, or that the abortion was necessary to protect the wellbeing of their existing family.
The strength of this research stems from a linking of the clinical record and original interview at the time of the abortion, with data from an interview conducted with the women 1 year afterwards. This is a difficult-to-access group of people, and the high response rate to requests for interview contributes to the reliability of the findings. The findings would be improved by an up-to-date study to establish how community experience with safe abortion, and changed social norms about sexual activity, are reflected in the way women experience and are affected by abortion today.
Footnotes
Acknowledgements
This study was undertaken in completion of a Master of Arts. Katie Richmond was my supervisor and her academic guidance and support were crucial to the successful completion of the study. The trust and frankness of the women who shared their stories and experience with me were the greatest gift a researcher can receive. Their strength and dignity is acknowledged with gratitude.